Article Abstract:
Infections acquired in the hospital are an important health concern in underdeveloped countries, where medical supplies, educated medical staff and sterile working conditions are often lacking. This article describes the results of an investigation performed in a pediatric intensive care unit located in an urban hospital in Indonesia. Recommendations for reducing infections were developed on the basis of guidelines established by the Centers for Disease Control for preventing nosocomial (hospital-acquired) infections. The investigation revealed that there was no written policy regarding hand washing, none of the sinks for hand washing worked, the medical staff had little knowledge of disinfection and sterilization techniques, bottled water that was labeled as sterile was contaminated with bacteria, equipment was reused without proper cleaning, and clean medical supplies were stored in a room where contaminated waste products were discarded. Based on these findings the following recommendations were made: two sinks for washing hands should be installed; soap and antiseptics should be used for hand washing; disinfectants should be used to clean equipment; and unused medical supplies should be stored in a clean area. Many infections were caused by the contamination and improper use of medical devices such as catheters for removing urine and mechanical ventilators to assist breathing. It is concluded that advanced medical procedures can increase nosocomial infections when they are used improperly. When advanced medical technology is introduced into hospitals with limited resources, recommendations for controlling and preventing nosocomial infections should be provided. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
Staphylococcus aureus (S. aureus) is a common cause of nosocomial infections, that is, infections acquired in the hospital. Many different strains of S. aureus have become resistant to treatment with penicillin-like antibiotic drugs. These bacteria are called methicillin-resistant S. aureus (MRSA). Vancomycin is the drug of choice for treating infections with MRSA. However, it is expensive and has toxic side effects. Once MRSA is introduced into a hospital environment it is very hard to eliminate because it is easily spread from person to person through hand contact. This article describes the results of a seven-year study designed to reduce the spread of MRSA at the University of California at Davis Medical Center. Between 1983 and 1990, a strict program to reduce the spread of MRSA was implemented. The program involved isolating all patients who tested positive for MRSA. During the study period, a total of 319 patients with MRSA were identified. Sixty-eight percent of the patients who contracted MRSA were hospitalized for more than 30 days. The most common sites of infection included the lungs, wounds, nose, and blood. During the study period, there were four new cases of MRSA each month and a total of four major outbreaks. The practice of isolating patients as soon as they had a positive culture test for MRSA, and the testing of patients and staff who were in contact with the infected patient, reduced the spread of MRSA. At the same time, the hospital saved over $50,000 dollars in costs. It is concluded that patient isolation is effective in reducing the transmission of MRSA. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
Medical equipment and diagnostic devices that are used for invasive procedures, and have not been properly disinfected between patient use, are prime carriers of microorganisms that cause nosocomial (hospital-acquired) infections. Mycobacterium tuberculosis (M. tuberculosis) and Mycobacterium bovis (M. bovis) are usually present in the hospital environment and they cause tuberculosis. These bacteria can be transmitted from person to person in the air and on medical devices. Contaminated bronchoscopes (devices used to examine the inside of the lungs), for example, have been responsible for causing tuberculosis epidemics. Mycobacteria are more resistant to chemical disinfectants than almost all other types of bacteria. Also, strains of mycobacteria that do not cause tuberculosis are everywhere, especially in water supplies. When a study was performed to test the effectiveness of 14 different hospital disinfectants in killing M. tuberculosis and M. bovis, it was found that several of disinfectants that claimed to be effective against mycobacterium (two quaternary ammonium compounds) actually were not. The most effective agents tested were chlorine dioxide, 0.8 percent hydrogen peroxide with 0.06 percent peroxyacetic acid, and iodophor (an iodine-based disinfectant). Glutaraldehydes, phenolic, and chlorine were completely effective in inactivating M. tuberculosis and gave good results against M. bovis. Hydrogen peroxide and ethyl alcohol produced less favorable results. Proper disinfection of hospital equipment is important for reducing the risk of nosocomial infection. (Consumer Summary produced by Reliance Medical Information, Inc.)
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