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Fifty-seven patients developed an episode of catheter-related infection (CRI) in the bloodstream during their stay in the intensive care unit (cases) and were prospectively observed to establish the attributable mortality, increase in length of stay, and excess costs. Costs were estimated by multiplying the number of excess days of stay by the reimbursement(More)
OBJECTIVE To compare the effectiveness for prevention of central venous and arterial catheter colonization of 3 skin antisepsis with 1 of 3 antiseptic solutions: 10% aqueous povidone iodine (aqueous PI), 2% aqueous chlorhexidine gluconate (aqueous CG), and 0.5% alcoholic chlorhexidine gluconate (alcoholic CG). DESIGN Prospective, randomized controlled(More)
STUDY OBJECTIVE To investigate the epidemiology of infection by Acinetobacter baumannii in patients with ventilator-associated pneumonia (VAP). DESIGN Prospective clinical study. SETTING Three medical-surgical ICUs in teaching hospitals. PATIENTS We followed up 707 mechanically ventilated patients and 148 episodes of VAP with etiologic diagnosis. (More)
All episodes of lower respiratory tract infection that developed among 96 patients surviving for > 24 hours after cardiac arrest were prospectively studied over an 18-month period. Pneumonia developed in 23 (24.0%) of patients after a mean of 7 days (SD, +/- 6.2 days). The development of four superinfections raised the cumulative incidence to 28.1%.(More)
The use of microbiologic investigations in routine clinical practice, their value in guiding antibiotic prescription, and their influence on outcome were prospectively studied in 113 consecutive adults who developed ventilator-associated pneumonia (VAP). Blood cultures were performed in 78.7% of cases, protected specimen brushing in 95.5%, and(More)
OBJECTIVE Pseudomonas aeruginosa is a frequent cause of ventilator-associated pneumonia. Recent evidence suggests that production of type III secretion proteins is correlated with increased pathogenicity in both cellular and animal models of infection. The objective of this study was to determine whether this system contributes to disease severity in humans(More)
BACKGROUND Catheter hub contamination is being increasingly recognized as a source of catheter-related sepsis. The authors have investigated the efficacy of a new hub design in preventing endoluminal catheter contamination and catheter-related sepsis arising at the hub. METHODS Adult surgical and intensive care patients requiring a subclavian catheter for(More)
STUDY OBJECTIVES To determine the clinical significance of Candida sp isolated from bronchoscopic samples in patients with suspected pneumonia. DESIGN A retrospective chart review was performed in all nonneutropenic adult patients with Candida sp isolates from respiratory secretions obtained by bronchoscopy over a 5-year period (1991 to 1995). Potential(More)
Hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) strains are no longer limited to acute-care hospitals but have now spread to other healthcare settings such as long-term-care facilities (LTCFs), in most of which they are endemic. In Europe, few studies have addressed the MRSA situation in LTCFs. A cross-sectional study to determine MRSA(More)
OBJECTIVE To examine the characteristics, prognostic factors, and outcome of patients with severe hospital-acquired pneumonia admitted to the ICU. DESIGN AND SETTING Prospective observational clinical study in two medical-surgical ICUs with 16 and 20 beds PATIENTS AND PARTICIPANTS During a 7-year period all hospitalized patients requiring admission to(More)