In this study, the overall incidence of surgical site infection was 8.83% (3.28% for index hospitalization events [ie, events that occurred during hospitalization for surgery] and 5.55% for postdischarge events [ie, events that occurred within 30 days after discharge]). There was a negative association between surgical volume and the incidence of surgical site infection following coronary artery bypass graft surgery. The hospital volume has a greater effect than does surgeon volume on reducing the incidence of surgical site infection.

To better determine the optimal combinations for empirical dual antimicrobial therapy of Pseudomonas aeruginosa infection, we evaluated the utility of a novel combination antibiogram. Although the combination antibiogram allowed modest fine-tuning of choices for dual antibiotic therapy, selections based on the 2 antibiograms did not differ substantively. Drug combinations with the broadest coverage were consistently composed of an aminoglycoside and a β-lactam.

The objective of the present study was to evaluate the feasibility of azithromycin prophylaxis with respect to tolerability and compliance during a pertussis outbreak among healthcare workers in a university hospital ward. Compliance with the prophylaxis regimen was 89%; compliance was 75% from intent-to-treat perspective. The rate of adverse events was 33%. Female sex was associated with reporting of adverse events. Nonstudents and healthcare workers who reported adverse events were less compliant with the prophylaxis regimen.

Gentamicin-susceptible methicillin-resistant Staphylococcus aureus (GS-MRSA) strains are replacing gentamicin-resistant MRSA (GR-MRSA) strains. We showed that exposure to other patients harboring GS-MRSA was the major risk factor for GS-MRSA acquisition, and that antimicrobial exposure, especially to β-lactams, was strongly associated with acquisition of GR-MRSA but not GS-MRSA. Gentamicin use was significantly associated with GR-MRSA acquisition in univariate analysis only.

We surveyed program coordinators at 106 hospitals and health departments that participated in the National Smallpox Vaccination Program to ascertain how program-level factors affected the rate of smallpox vaccine uptake by staff. In a fully adjusted multivariate model, health departments achieved significantly higher vaccination rates than did hospitals, as did facilities that invited fewer employees to be vaccinated.

Five strains of Enterobacter species (n = 4) and Pantoea species (n = 1) resistant to third-generation cephalosporins and isolated from clusters of 3-25 premature infants and small children and 5 strains (4 Enterobacter strains and 1 Pantoea strain) with the same resistance pattern that were isolated from 1 premature infant or small child each were inoculated on the fingertips of 10 volunteer study participants to test whether survival on fingertips is correlated with horizontal transmission. Although there was no significant difference in survival between the groups of transmitted and sporadic strains, there were significant differences in bacterial survival between the participants.

Analysis of acid-fast bacillus smear results at a hospital with a mod-erate incidence of tuberculosis confirms recent recommendations that 2 negative smear results suffice for discontinuation of respiratory isolation. Use of polymerase chain reaction analysis further increases the confidence with which the diagnosis of active tuberculosis likely to be transmitted to others can be excluded.

A comprehensive influenza vaccination campaign improved vaccination rates among healthcare workers with direct patient care responsibilities from 45% during the 2003-2004 influenza season to 80% during the 2004-2005 season. A strategy of weekly feedback to unvaccinated employees was the most important factor in enhancing the rate of vaccination acceptance and was particularly effective among the nursing staff.

In a hospital in Lima, Peru, a review of 103 Staphylococcus aureus infections was conducted during 2002. The prevalence of oxacillin-resistant S. aureus strains was 68%; 25% of strains were resistant to multiple drugs. Previous use of antibiotics and undergoing a surgical procedure during the current hospital stay were associated with the presence of an oxacillin-resistant S. aureus strain.

An intensive care nurse with eczema was repeatedly treated for methicillin-resistant Staphylococcus aureus (MRSA) carriage. Because cultures remained positive for MRSA, her house was investigated. Thirty-four percent of environmental samples yielded MRSA. Her children and cat were free of MRSA. The house was decontaminated with gaseous ozone. All subsequent cultures were negative for MRSA. This decontamination cost €2,000 (approximately $2,400).

We performed a study to measure the compliance of laboratory personnel with different components of hand hygiene. The level of compliance at the end of duty was 100%; however, 36.7% of subjects wore a ring, 46.9% wore a watch, and 6.1% wore a bracelet. Pathogenic microorganisms were exclusively found on hands of laboratory personnel who wore jewelry. After interventions, the level of compliance with the no-jewelry policy among laboratory personnel showed sustained improvement. Efforts to improve hand hygiene should be directed not only at healthcare workers but also at laboratory personnel.

The incidence and patterns of and factors associated with inappropriate antibiotic use were studied in a tertiary care center in Thailand. The incidence of inappropriate antibiotic use was 25%. Admission to the surgical department (adjusted odds ratio, 2.0; P = .02) and to the obstetrics and gynecology department (adjusted odds ratio, 2.0; P = .03) were associated with inappropriate antibiotic use, whereas consultation with an infectious diseases specialist was protective against inappropriate antibiotic use (adjusted odds ratio, 0.15; P = .01).

We report the results of a 2-year, 7-center program of surveillance of deep sternal wound infection (DSWI) after cardiac surgery. DSWI was defined as the need for reoperation. Stratification data were abstracted from computerized files. The incidence of DSWI was 2.2% (198 of 8,816 cardiac surgery procedures). The risk factors identified were obesity, age, coronary artery bypass grafting, postoperative mechanical ventilation, and early surgical reexploration. The resource efficiency of this simplified surveillance method is discussed.

We report an outbreak of Serratia marcescens bloodstream infection due to contamination of total parenteral nutrition solution by insulin or poligeline solution when single-use vials were used for multiple doses in a surgical ward. Four patients had severe sepsis, and no patient died. Multidose vials, used either correctly or incorrectly, may be associated with bloodstream infection.

In August 2003, an outbreak of scabies was detected in a Canadianlong-term care facility. The outbreak was likely associated with 2index cases, 1 involving classic scabies and the other involving Norwegian scabies. The scabies control costs totaled CDN$200,000, and the facility received negative publicity for a short period after the outbreak.

Using pulsed-field gel electrophoresis, we genotyped 21 methicillin-resistant Staphylococcus aureus isolates from patients attending an adult cystic fibrosis unit. Eleven patients exhibited pulsotypes related to 2 locally endemic strains. Eleven chronically colonized patients were assessed over a period of up to 2 years, and all demonstrated a retention of strain type.