Pamela A. Lipsett

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BACKGROUND Although many catheter-related bloodstream infections (CRBSIs) are preventable, measures to reduce these infections are not uniformly implemented. OBJECTIVE To update an existing evidenced-based guideline that promotes strategies to prevent CRBSIs. DATA SOURCES The MEDLINE database, conference proceedings, and bibliographies of review(More)
OBJECTIVE To determine whether a multifaceted systems intervention would eliminate catheter-related bloodstream infections (CR-BSIs). DESIGN Prospective cohort study in a surgical intensive care unit (ICU) with a concurrent control ICU. SETTING The Johns Hopkins Hospital. PATIENTS All patients with a central venous catheter in the ICU. INTERVENTION(More)
HYPOTHESIS Catheter-related bloodstream infection (CRBSI) in critically ill surgical patients with prolonged intensive care unit (ICU) stays is associated with a significant increase in health care resource use. DESIGN Prospective cohort study. SETTING Surgical ICU at a large tertiary care center. PATIENTS Critically ill surgical patients (N = 260)(More)
OBJECTIVE To evaluate the prophylactic use of enteral fluconazole to prevent invasive candidal infections in critically ill surgical patients. SUMMARY BACKGROUND DATA Invasive fungal infections are increasingly common in the critically ill, especially in surgical patients. Although fungal prophylaxis has been proven effective in certain high-risk patients(More)
OBJECTIVE The authors document changes in the etiology, diagnosis, bacteriology, treatment, and outcome of patients with pyogenic hepatic abscesses over the past 4 decades. SUMMARY BACKGROUND DATA Pyogenic hepatic abscess is a highly lethal problem. Over the past 2 decades, new roentgenographic methods, such as ultrasound, computed tomographic scanning,(More)
Objective: To determine if having a night-time nurse-to-patient ratio (NNPR) of one nurse caring for one or two patients (>1:2) versus one nurse caring for three or more patients (<1:2) in the intensive care unit (ICU) is associated with clinical and economic outcomes following esophageal resection. Design: Statewide observational cohort study. Hospital(More)
OBJECTIVE The authors compared the presentation, treatment, and long-term outcome of children and adults with choledochal cysts. SUMMARY BACKGROUND DATA The typical patient with choledochal cyst disease has been the female infant with the triad of jaundice, an abdominal mass, and pain. However, the recent experience of the authors suggested that the(More)
BACKGROUND The successful treatment of intraabdominal infection requires a combination of anatomical source control and antibiotics. The appropriate duration of antimicrobial therapy remains unclear. METHODS We randomly assigned 518 patients with complicated intraabdominal infection and adequate source control to receive antibiotics until 2 days after the(More)
CONTEXT Morbidity and mortality rates in intensive care units (ICUs) vary widely among institutions, but whether ICU structure and care processes affect these outcomes is unknown. OBJECTIVE To determine whether organizational characteristics of ICUs are related to clinical and economic outcomes for abdominal aortic surgery patients who typically receive(More)
Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Tamar F. Barlam, Sara E. Cosgrove, Lilian M. Abbo, Conan MacDougall, Audrey N. Schuetz, Edward J. Septimus, Arjun Srinivasan, Timothy H. Dellit, Yngve T. Falck-Ytter, Neil O. Fishman, Cindy W.(More)