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Publisher: Elsevier   (Total: 3175 journals)

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Showing 1 - 200 of 3175 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 8)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 28, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 33, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 376, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 235, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 14)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 129, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 28, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 14)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 10)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 21)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 6)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 42, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 7)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 54, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 14, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 7)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 23)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 1, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 14, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 18, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 374, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 333, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 9, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 429, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 50, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 42, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 42, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 190, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 62, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 61, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 166, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)

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Journal Cover American Journal of Infection Control
  [SJR: 1.259]   [H-I: 81]   [26 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0196-6553
   Published by Elsevier Homepage  [3175 journals]
  • Antimicrobial stewardship and infection prevention—leveraging the
           synergy: A position paper update
    • Authors: Mary Lou Manning; Edward J. Septimus; Elizabeth S. Dodds Ashley; Sara E. Cosgrove; Mohamad G. Fakih; Steve J. Schweon; Frank E. Myers; Julia A. Moody
      Pages: 364 - 368
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Mary Lou Manning, Edward J. Septimus, Elizabeth S. Dodds Ashley, Sara E. Cosgrove, Mohamad G. Fakih, Steve J. Schweon, Frank E. Myers, Julia A. Moody


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.01.001
       
  • Wearing long sleeves while prepping a patient in the operating room
           decreases airborne contaminants
    • Authors: Troy A. Markel; Thomas Gormley; Damon Greeley; John Ostojic; Jennifer Wagner
      Pages: 369 - 374
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Troy A. Markel, Thomas Gormley, Damon Greeley, John Ostojic, Jennifer Wagner
      Background The use of long sleeves by nonscrubbed personnel in the operating room has been called into question. We hypothesized that wearing long sleeves and gloves, compared with having bare arms without gloves, while applying the skin preparation solution would decrease particulate and microbial contamination. Methods A mock patient skin prep was performed in 3 different operating rooms. A long-sleeved gown and gloves, or bare arms, were used to perform the procedure. Particle counters were used to assess airborne particulate contamination, and active and passive microbial assessment was achieved through air samplers and settle plate analysis. Data were compared with Student's t-test or Mann-Whitney U, and P < .05 was considered to be significant. Results Operating room B demonstrated decreased 5.0- µm particle sizes with the use of sleeves, while operating rooms A and C showed decreased total microbes only with the use of sleeves. Despite there being no difference in the average number of total microbes for all operating rooms assessed, the use of sleeves specifically appeared to decrease the shed of Micrococcus. Conclusion The use of long sleeves and gloves while applying the skin preparation solution decreased particulate and microbial shedding in several of the operating rooms tested. Although long sleeves may not be necessary for all operating room personnel, they may decrease airborne contamination while the skin prep is applied, which may lead to decreased surgical site infections.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.016
       
  • Impact of home versus hospital dressing on bacterial contamination of
           surgical scrubs in the obstetric setting: A randomized controlled trial
    • Authors: Darcy H. Slizewski; Emily Heberlein; Jennifer F. Meredith; Laura Beth Jobe; Kacey Y. Eichelberger
      Pages: 379 - 382
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Darcy H. Slizewski, Emily Heberlein, Jennifer F. Meredith, Laura Beth Jobe, Kacey Y. Eichelberger
      Background The impact of the site where an obstetrician dresses in their surgical scrubs, home versus hospital, on total bacterial burden remains unknown. Therefore, our objective was to quantify the effect of dressing in surgical scrubs at home versus at the hospital on the bacterial contamination at the beginning of a scheduled shift. Methods This was a single blind randomized controlled trial. Eligible participants were resident physicians assigned to labor and delivery at a single institution during the study period, and participants were randomized daily to 1 of 4 arms based on the site where their scrubs were laundered (A) and where the resident dressed (B) (A/B): home/home, home/hospital, hospital/home, and hospital/hospital. At the beginning of the assigned shift, microbiologic samples from the chest pocket and pants' tie were collected with a sterile culture swab. Samples were plated on trypticase soy agar with 5% sheep blood before being incubated at 35°C-37°C for 48 hours, with observation every 24 hours. The primary outcome was total bacterial burden, defined as the sum of the colony forming units (CFUs) from the 2 sampling sites. Results There were 21 residents randomized daily for 4 days to 1 of 4 study arms, resulting in 84 observations. There were no baseline differences between the home- and hospital-dressed cohorts. Overall, 68% of sampled scrubs demonstrated some bacterial growth. There was no difference between the home- and hospital-dressed cohorts in percentage of samples demonstrating any bacterial growth after 72 hours (60% vs 76%, P = .14), nor in median bacterial burden at the beginning of a shift (2 [interquartile range, 0-7] vs 1 [interquartile range, 1-5] CFUs, P = .62). Finally, there was no difference in total bacterial burden at the beginning of a shift between the home- and hospital-dressed cohorts when stratified by site where the scrubs were laundered. Conclusions There was no significant difference in total bacterial burden of surgical scrubs at the start of a shift between cohorts who dressed at home versus at the hospital.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.09.009
       
  • Waterborne Pseudomonas aeruginosa transmission in a hematology unit'
    • Authors: Mark I. Garvey; Craig W. Bradley; Elisabeth Holden
      Pages: 383 - 386
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Mark I. Garvey, Craig W. Bradley, Elisabeth Holden
      Background Pseudomonas aeruginosa is an important nosocomial pathogen that commonly colonizes hospital water supplies, including in taps and sinks. We report the transmission of P. aeruginosa from water to patients in a clinical hematology setting. Methods P. aeruginosa from water samples were compared to clinical isolates from hematology ward patients, via molecular typing (pulsed field gel electrophoresis). Results P. aeruginosa cultured from blood cultures from 3 patients was indistinguishable from water strains, by molecular typing. Based on infection control inspections, the transmission event was surmised to be due to cleaning of equipment, specifically an infusion therapy procedure tray used to transport intravenous drugs to patients, with water from an outlet colonized by P. aeruginosa. Conclusion We show the importance of holistic factors, such as disposal of patient waste water, cleaning of tap outlets, and cleaning of medical equipment, in the transmission of P. aeruginosa, and demonstrate that the role of waterborne transmission of this organism in a hematology setting cannot be overlooked. We suggest that appropriate management of water, including both holistic and engineering interventions, is needed to stop transmission of P. aeruginosa from water to patients.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.013
       
  • Epidemiologic surveillance of multidrug-resistant bacteria in a teaching
           hospital: A 3-year experience
    • Authors: Mirian Nicéa Zarpellon; Giselle Fukita Viana; Cecília Saori Mitsugui; Bruno Buranello Costa; Nathalie Kira Tamura; Elisabeth Eyko Aoki; Cesar Helbel; Sheila Alexandra Belini Nishiyama; Silvia Maria dos Santos Saalfeld; Maria Cristina Bronharo Tognim
      Pages: 387 - 392
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Mirian Nicéa Zarpellon, Giselle Fukita Viana, Cecília Saori Mitsugui, Bruno Buranello Costa, Nathalie Kira Tamura, Elisabeth Eyko Aoki, Cesar Helbel, Sheila Alexandra Belini Nishiyama, Silvia Maria dos Santos Saalfeld, Maria Cristina Bronharo Tognim
      Background The objective of this prospective study was to verify the effectiveness of a multidisciplinary surveillance program that was implemented in a teaching hospital in southern Brazil, to prevent and control the spread of multidrug-resistant organisms. Methods The program implemented involved establishment of prevention guidelines, hand-hygiene promotion, isolation of patients colonized or infected by such organisms, enforced contact precautions, and terminal cleaning and disinfection of isolation rooms. A microbiology service, previously provided by an external laboratory, was established in the hospital. Detection of bacteria-resistant genes and molecular typing were performed also. Results Statistically significant differences were observed between the pre- and post-intervention periods (P = .00198). Control measures were effective in blocking the dissemination of a previously endemic clone of Acinetobacter baumannii. Changes were observed in the dissemination pattern, from a monoclonal to a polyclonal mode. The incidence of vancomycin-resistant Enterococcus during the surveillance period was low. Only 2 isolates of BLAKPC -positive Klebsiella pneumoniae (distinct profiles), and 5 isolates of BLASPM -positive Pseudomonas aeruginosa (a single cluster), were detected. Conclusions These results indicate that the surveillance program implemented was effective in preventing the spread of multidrug-resistant organisms in the hospital.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.012
       
  • Survey to explore understanding of the principles of aseptic technique:
           Qualitative content analysis with descriptive analysis of confidence and
           training
    • Authors: Dinah J. Gould; Jane Chudleigh; Edward Purssell; Clare Hawker; Sarah Gaze; Deborah James; Mary Lynch; Nicola Pope; Nicholas Drey
      Pages: 393 - 396
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Dinah J. Gould, Jane Chudleigh, Edward Purssell, Clare Hawker, Sarah Gaze, Deborah James, Mary Lynch, Nicola Pope, Nicholas Drey
      Background In many countries, aseptic procedures are undertaken by nurses in the general ward setting, but variation in practice has been reported, and evidence indicates that the principles underpinning aseptic technique are not well understood. Methods A survey was conducted, employing a brief, purpose-designed, self-reported questionnaire. Results The response rate was 72%. Of those responding, 65% of nurses described aseptic technique in terms of the procedure used to undertake it, and 46% understood the principles of asepsis. The related concepts of cleanliness and sterilization were frequently confused with one another. Additionally, 72% reported that they not had received training for at least 5 years; 92% were confident of their ability to apply aseptic technique; and 90% reported that they had not been reassessed since their initial training. Qualitative analysis confirmed a lack of clarity about the meaning of aseptic technique. Conclusion Nurses' understanding of aseptic technique and the concepts of sterility and cleanliness is inadequate, a finding in line with results of previous studies. This knowledge gap potentially places patients at risk. Nurses' understanding of the principles of asepsis could be improved. Further studies should establish the generalizability of the study findings. Possible improvements include renewed emphasis during initial nurse education, greater opportunity for updating knowledge and skills post-qualification, and audit of practice.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.008
       
  • Environmental and body contamination from cleaning vomitus in a health
           care setting: A simulation study
    • Authors: Linh Phan; Yu-Min Su; Rachel Weber; Charissa Fritzen-Pedicini; Osayuwamen Edomwande; Rachael M. Jones
      Pages: 397 - 401
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Linh Phan, Yu-Min Su, Rachel Weber, Charissa Fritzen-Pedicini, Osayuwamen Edomwande, Rachael M. Jones
      Background Environmental service workers may be exposed to pathogens during the cleaning of pathogen-containing bodily fluids. Methods Participants with experience cleaning hospital environments were asked to clean simulated, fluorescein-containing vomitus using normal practices in a simulated patient room. Fluorescein was visualized in the environment and on participants under black lights. Fluorescein was quantitatively measured on the floor, in the air, and on gloves and shoe covers. Results In all 21 trials involving 7 participants, fluorescein was found on the floor after cleaning and on participants' gloves. Lower levels of floor contamination were associated with the use of towels to remove bulk fluid (ρ = −0.56, P = .01). Glove contamination was not associated with the number or frequency of contacts with environmental surfaces, suggesting contamination occurs with specific events, such as picking up contaminated towels. Fluorescein contamination on shoe covers was measured in 19 trials. Fluorescein was not observed on participants' facial personal protective equipment, if worn, or faces. Contamination on other body parts, primarily the legs, was observed in 8 trials. Fluorescein was infrequently quantified in the air. Conclusions Using towels to remove bulk fluid prior to mopping is part of the recommended cleaning protocol and should be used to minimize residual contamination. Contamination on shoes and the floor may serve as reservoirs for pathogens.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.003
       
  • Prevalence and predictive factors of urinary tract infection among
           patients with stroke: A meta-analysis
    • Authors: Tianyuan Yan; Chenxia Liu; Yingxia Li; Wei Xiao; Yating Li; Shuhui Wang
      Pages: 402 - 409
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Tianyuan Yan, Chenxia Liu, Yingxia Li, Wei Xiao, Yating Li, Shuhui Wang
      Background Urinary tract infection (UTI) is thought to be a common complication of stroke and is regarded as a potential risk factor for poor stroke outcomes. However, there is a controversy among predictive factors of stroke-associated UTIs. We aim to estimate the prevalence and predisposing factors of UTIs among patients with stroke. Methods PubMed, EMBASE, and Elsevier Science Direct were searched by 2 independent researchers. Sixteen studies with a total of 13,513 patients were included to evaluate the prevalence and predictive factors of stroke-associated UTIs published from the earliest records to March 10, 2017. Pooled effect sizes were calculated using the fixed effect model or random effect model according to I 2 and P values. Results The pooled prevalence of UTI was 19.0% (95% confidence interval [CI], 15%-22%; P < .01). The predisposing factors for UTIs include female sex (odds ratio [OR], 1.93; 95% CI, 1.55-2.41), older age (OR, 1.28; 95% CI, 1.09-1.50), higher modified Rankin Scale score (OR, 1.90; 95% CI, 1.43-2.53), and postvoid residual volume >100 mL (OR, 3.69; 95% CI, 2.09-6.52). Conclusions Approximately one-fifth of patients with stroke contracted at least 1 UTI after cerebral apoplexy. Female sex, older age, higher modified Rankin Scale score, and postvoid residual volume >100 mL were associated with higher risk of UTI.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.001
       
  • Cleaning and disinfection in home care: A comparison of 2 commercial
           products with potentially different consequences for respiratory health
    • Authors: Nancy Goodyear; Pia Markkanen; Christian Beato-Melendez; Hagir Mohamed; Rebecca Gore; Catherine Galligan; Susan Sama; Margaret Quinn
      Pages: 410 - 416
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Nancy Goodyear, Pia Markkanen, Christian Beato-Melendez, Hagir Mohamed, Rebecca Gore, Catherine Galligan, Susan Sama, Margaret Quinn
      Background Home care aides perform personal care and homemaking services in client homes, including cleaning and disinfection (C&D). Although C&D are performed to remove soil and dust, they are increasingly performed for infection prevention. Many C&D products contain respiratory irritants. The objective of this study was to evaluate 2 commercial products for C&D effectiveness on common household surfaces in seniors' homes. Methods Two C&D visits were conducted in 46 seniors' homes. One visit applied a bleach-containing cleaning product and the other applied an environmentally preferable product. Before and after C&D, the study team performed organic soil bioluminometer measurements on surfaces and collected cotton swab and wipe samples for total bacteria count, Staphylococcus aureus, and Clostridium difficile identification. Results Both products removed microorganisms from tested surfaces. S aureus was found in 7 households, 1 strain of which was methicillin-resistant. Both products removed S aureus from all surfaces. Bleach-containing products removed somewhat more soil than environmentally preferable products, although results were statistically significant for only 1 surface. Conclusions The study showed similar, not identical, C&D performance for 2 cleaning products with potentially different consequences for respiratory health. Additional research is needed to develop robust recommendations for safe, effective C&D in home care.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.09.033
       
  • The efficacy of self-disinfecting bedrail covers in an intensive care unit
    • Authors: Lisa M. Esolen; Lokendra Thakur; Abraham J. Layon; Thomas A. Fuller; Deni-Jo Harrington; Kunal Jha; Subhashinie Kariyawasam
      Pages: 417 - 419
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Lisa M. Esolen, Lokendra Thakur, Abraham J. Layon, Thomas A. Fuller, Deni-Jo Harrington, Kunal Jha, Subhashinie Kariyawasam
      Background Hospital surfaces are considered important vectors in the spread of nosocomial pathogens. This study evaluated microbial counts on novel antimicrobial bedrail covers over a 2-week period in a critical care environment. Methods Disposable bedrail covers (Aionx Inc, Hershey, PA) made of a copper and silver polymer and capable of conducting an imperceptible surface potential, were installed in a case-control manner on a series of occupied intensive care unit beds. Seventeen bedrails were covered with the study bedrail surface, and 17 were left uncovered. Two hundred seventy-two microbial surface cultures were obtained from both study and control bedrails and analyzed for microbial growth by bacterial enumeration and speciation. Results The bedrails covered with the study surface demonstrated >80% average decrease in colony forming units across the study period of 15 days. Conclusions These novel, detachable bedrail covers successfully demonstrated significant bacterial count reduction in an intensive care unit setting. This may have implications for acquisition of hospital-acquired infections.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.09.026
       
  • The development of hand hygiene compliance imperatives in an emergency
           department
    • Authors: Annette Jeanes; Pietro G. Coen; Nicolas S. Drey; Dinah J. Gould
      Pages: 441 - 447
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Annette Jeanes, Pietro G. Coen, Nicolas S. Drey, Dinah J. Gould
      Background Monitoring results showing poor hand hygiene compliance in a major, busy emergency department prompted a quality improvement initiative to improve hand hygiene compliance. Purpose To identify, remove, and reduce barriers to hand hygiene compliance in an emergency department. Methods A barrier identification tool was used to identify key barriers and opportunities associated with hand hygiene compliance. Hand hygiene imperatives were developed and agreed on with clinicians, and a framework for monitoring and improving hand hygiene compliance was developed. Results Barriers to compliance were ambiguity about when to clean hands, the pace and urgency of work in some areas of the department, which left little time for hand hygiene and environmental and operational issues. Sore hands were a problem for some staff. Expectations of compliance were agreed on with staff, and changes were made to remove barriers. A monitoring tool was designed to monitor progress. Gradual improvement occurred in all areas, except in emergency situations, which require further improvement work. Conclusions The context of care and barriers to compliance should be reflected in hand hygiene expectations and monitoring. In the emergency department, the requirement to deliver urgent live-saving care can supersede conventional hand hygiene expectations.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.014
       
  • National Healthcare Safety Network laboratory-identified Clostridium
           difficile event reporting: A need for diagnostic stewardship
    • Authors: Clare Rock; Zoi Pana; Surbhi Leekha; Polly Trexler; Jennifer Andonian; Avinash Gadala; Karen C. Carroll; Lisa L. Maragakis
      Pages: 456 - 458
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Clare Rock, Zoi Pana, Surbhi Leekha, Polly Trexler, Jennifer Andonian, Avinash Gadala, Karen C. Carroll, Lisa L. Maragakis
      We describe the proportion of health care facility-onset Clostridium difficile infection (HO-CDI) National Healthcare Safety Network laboratory-identified events at our facility that were deemed nontrue HO-CDIs. Reasons included testing in a patient without significant diarrhea or with recent laxative use, or delayed testing. Standardized infection ratios using only true HO-CDI in the numerator were improved compared with publically reported standardized infection ratios. A prioritization matrix identifies which clinical services could benefit most from directed diagnostic stewardship interventions.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.011
       
  • Screening for Clostridium difficile colonization on admission to a
           hematopoietic stem cell transplant unit may reduce hospital-acquired C
           difficile infection
    • Authors: Janice Cho; Maria Teresa Seville; Sahil Khanna; Darrell S. Pardi; Priya Sampathkumar; Purna C. Kashyap
      Pages: 459 - 461
      Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4
      Author(s): Janice Cho, Maria Teresa Seville, Sahil Khanna, Darrell S. Pardi, Priya Sampathkumar, Purna C. Kashyap
      Clostridium difficile infection rates are higher in patients undergoing hematopoietic stem cell transplants. In our study, patients undergoing hematopoietic stem cell transplants or chemotherapy were screened for C difficile colonization at admission and placed on contact precautions if they were positive. Patient's colonized with C difficile contribute to the overall burden of C difficile infection in hospitals.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2017.10.009
       
  • Managing social media rumors and misinformation during outbreaks
    • Authors: Santosh Vijaykumar; Glen Nowak; Itai Himelboim; Yan Jin
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Santosh Vijaykumar, Glen Nowak, Itai Himelboim, Yan Jin


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.03.014
       
  • Unusual presentation of Middle East respiratory syndrome coronavirus
           leading to a large outbreak in Riyadh during 2017
    • Authors: Hala Amer; Abdulrahman S. Alqahtani; Hind Alzoman; Nawfal Aljerian; Ziad A. Memish
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Hala Amer, Abdulrahman S. Alqahtani, Hind Alzoman, Nawfal Aljerian, Ziad A. Memish
      Background The hallmark of Middle East respiratory syndrome coronavirus (MERS-CoV) disease is the ability to cause major health care-associated nosocomial outbreaks with superspreading events leading to massive numbers of cases and excessive morbidity and mortality. In this report, we describe a patient who presented with acute renal failure requiring hemodialysis and became a MERS-CoV superspreader, igniting a recent multihospital outbreak in Riyadh. Material and Results Between May 31 and June 15, 2017, 44 cases of MERS-CoV infection were reported from 3 simultaneous clusters from 3 health care facilities in Riyadh, Saudi Arabia, including 11 fatal cases. Out of the total reported cases, 29 cases were reported from King Saud Medical City. The cluster at King Saud Medical City was ignited by a single superspreader patient who presented with acute renal failure. After 14 hours in the open area of the emergency department and 2 hemodialysis sessions he was diagnosed with MERS-CoV. One hundred twenty contacts who had direct unprotected exposure were screened. Among those contacts, 9 out of 107 health care workers (5 nurses, 3 physicians, and 1 paramedic) and 7 out of 13 patients tested positive for MERS-CoV. Conclusions This hospital outbreak demonstrated the difficulties in diagnosing pneumonia in patients with renal and cardiac failure, which leads to delayed suspicion of MERS-CoV and hence delay in applying the proper infection control procedures. In MERS-CoV endemic countries there is an urgent need for developing rapid point-of-care testing that would assist emergency department staff in triaging suspected cases of MERS-CoV to ensure timely isolation and management of their primary illness and prevent major MERS-CoV outbreaks.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.023
       
  • Environmental effectiveness of pulsed-xenon light in the operating room
    • Authors: Sarah Simmons; Charles Dale; James Holt; Deborah G. Passey; Mark Stibich
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Sarah Simmons, Charles Dale, James Holt, Deborah G. Passey, Mark Stibich
      Background Manual cleaning and disinfection of the operating room (OR) environment may be inadequate due to human error. No-touch technologies, such as pulsed-xenon ultraviolet light (PX-UV), can be used as an adjunct to manual cleaning processes to reduce surface contamination in the OR. This article reports the cumulative results from 23 hospitals across the United States that performed microbiologic validation of PX-UV disinfection after manual cleaning. Methods We obtained samples from 732 high-touch surfaces in 136 ORs at 23 hospitals, after manual terminal cleaning, and again after PX-UV disinfection (n = 1464 surface samples). Samples were enumerated after incubation, and the results are reported as total colony-forming units (CFU). Results The average CFU after manual cleaning ranged from 5.8 to 34.37, and after PX-UV, from 0.69 to 6.43. With manual cleaning alone, 67% of surfaces were still positive for CFUs; after PX-UV disinfection, that number decreased to 38% of all sampled surfaces—a 44% reduction. When comparing manual cleaning to PX-UV, the reduction in CFU count was statistically significant. Conclusion When used after the manual cleaning process, the PX-UV device significantly reduced contamination on high-touch surfaces in the OR.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.027
       
  • Nonventilator hospital-acquired pneumonia: Epidemiology to support
           prevention strategies
    • Authors: Karen K. Giuliano
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Karen K. Giuliano


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.03.007
       
  • Rapid diagnostics for bloodstream infections: A primer for infection
           preventionists
    • Authors: Charles E. Edmiston; Robert Garcia; Marsha Barnden; Barbara DeBaun; Helen Boehm Johnson
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Charles E. Edmiston, Robert Garcia, Marsha Barnden, Barbara DeBaun, Helen Boehm Johnson
      Accurate and rapid antimicrobial susceptibility testing with pathogen identification in bloodstream infections is critical to life results for early sepsis intervention. Advancements in rapid diagnostics have shortened the time to results from days to hours and have had positive effects on clinical outcomes and on efforts to combat antimicrobial resistance when paired with robust antimicrobial stewardship programs. This article provides infection preventionists with a working knowledge of available rapid diagnostics for bloodstream infections.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.022
       
  • Virtual Zika transmission and spread on Twitter
    • Authors: Sora Yasri; Viroj Wiwanitkit
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Sora Yasri, Viroj Wiwanitkit


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.01.030
       
  • Long-term care facility National Healthcare Safety Network enrollment
           challenges, 2016
    • Authors: Sarah Sutherland; Rebecca Meyer
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Sarah Sutherland, Rebecca Meyer
      The Centers for Medicare & Medicaid Services has a national goal to increase the number of long-term care facilities reporting Clostridium difficile infection data to the Centers for Disease Control and Prevention. A partnership between the Tennessee Department of Health and the quality improvement organization, Qsource, helped facilitate successful enrollment into the National Healthcare Safety Network for nursing homes in the state of Tennessee.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.008
       
  • Is retained bone debris in cannulated orthopedic instruments sterile after
           autoclaving'
    • Authors: Kenneth Smith; Ibukunoluwa Araoye; Shawn Gilbert; Ken Waites; Bernard Camins; Michael Conklin; Brent Ponce
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Kenneth Smith, Ibukunoluwa Araoye, Shawn Gilbert, Ken Waites, Bernard Camins, Michael Conklin, Brent Ponce
      Aims Cannulated surgical instruments may retain biologic debris after routine cleaning and sterilization. Residual debris after cleaning is assumed to be sterile; however, there is no experimental basis for this assumption. The purpose of this study was to determine the sterility of retained biodebris found within cannulated surgical instruments after autoclave sterilization. Materials and Methods Fifteen cannulated drill bits were used to drill pig scapulae to create a plug of bone that was exposed to a mixture of Bacillus cereus, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus for 60, 120, or 180 minutes prior to sterilization. The drill bits were autoclave sterilized using standard settings. The “sterilized” bone cores were then incubated in solution and streak-plated on blood agar. Results All 3 positive controls were positive for the experimental bacteria. Two negative controls were positive for contaminant bacteria. A B. cereus strain was recovered from 1 of the experimental group drill bits in the 180-minute group. Pulsed-field gel electrophoresis confirmed that the recovered B. cereus strain was identical to the experimental inoculate. Conclusion Retained biodebris in cannulated drills may not be sterile after standard autoclave sterilization. In addition, delay of surgical instrument reprocessing may increase the risk of resistant contamination.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.024
       
  • A collaborative program to increase adult pneumococcal vaccination rates
           among a high-risk patient population receiving care at urgent care clinics
           
    • Authors: Nicholas Lehman; Carrie F. Koenigsfeld; Geoffrey C. Wall; Catherine Renner; Danielle Hahn; Brian Sheesley; Lisa A. Veach; Adam Bjornson
      Abstract: Publication date: Available online 13 April 2018
      Source:American Journal of Infection Control
      Author(s): Nicholas Lehman, Carrie F. Koenigsfeld, Geoffrey C. Wall, Catherine Renner, Danielle Hahn, Brian Sheesley, Lisa A. Veach, Adam Bjornson
      Objective We report a project that utilized pharmacy students to increase pneumococcal vaccination rates in patients aged 19-64 years with high-risk medical conditions within urgent care clinics. The study also sought to better identify the number of patients previously vaccinated for pneumococcal disease. A total of 1,178 patients were considered eligible for pneumococcal vaccination during the study period, 287 (24.4%) of whom were determined to be previously vaccinated through chart assessment or patient interview. Of the remaining 891 patients, chart documentation of pneumococcal vaccination administered at the time of the urgent care visit was present for 96 patients (10.7%) in the intervention clinics compared with 6 patients in 2 control clinics who received the usual standard of care (P < .0001).

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.020
       
  • Wettability of hands during 15-second and 30-second handrub time
           intervals: A prospective, randomized crossover study
    • Authors: Helga Paula; Robert Becker; Ojan Assadian; Claus-Dieter Heidecke; Axel Kramer
      Abstract: Publication date: Available online 11 April 2018
      Source:American Journal of Infection Control
      Author(s): Helga Paula, Robert Becker, Ojan Assadian, Claus-Dieter Heidecke, Axel Kramer
      Objective At present, the shortest recommended application time of alcoholic handrubs is an application interval of 30 seconds. However, application times shorter than 30 seconds are regularly practiced. Therefore, the aim of this study was to investigate whether a 15-second application time achieves a comparable wettability of hands to a 30-second handrub application. Setting The wettability of 20 healthy volunteers' hands was compared after 15 seconds or 30 seconds of application time of an ultraviolet-light–active handrub, both before and after training in the application technique. Images of the ventral side and dorsal side of the hands were evaluated by computer software. Both groups' outcomes were analyzed with regard to the spread of the handrub on hands. Results There was no difference between the wetted areas of the hands after 15 seconds or 30 seconds of handrub application. A significant difference was observed between the wetted areas of hands in trained volunteers compared with untrained volunteers, irrespective of application time. Conclusion Based on our results, a 15-second application time is equal to 30-second application time in terms of wettability of hands. The improvement of wettability after training underlines the necessity to instruct new and untrained health care workers in hand antisepsis. Using fluorescent handrubs may be a feasible method to control and retrain hand hygiene techniques of long-time employees.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.015
       
  • Environmental considerations in the selection of isolation gowns: A life
           cycle assessment of reusable and disposable alternatives
    • Authors: Eric Vozzola; Michael Overcash; Evan Griffing
      Abstract: Publication date: Available online 11 April 2018
      Source:American Journal of Infection Control
      Author(s): Eric Vozzola, Michael Overcash, Evan Griffing
      Background Isolation gowns serve a critical role in infection control by protecting healthcare workers, visitors, and patients from the transfer of microorganisms and body fluids. The decision of whether to use a reusable or disposable garment system is a selection process based on factors including sustainability, barrier effectiveness, cost, and comfort. Environmental sustainability is increasingly being used in the decision-making process. Life cycle assessment is the most comprehensive and widely used tool used to evaluate environmental performance. Methods The environmental impacts of market-representative reusable and disposable isolation gown systems were compared using standard life cycle assessment procedures. The basis of comparison was 1,000 isolation gown uses in a healthcare setting. The scope included the manufacture, use, and end-of-life stages of the gown systems. Results At the healthcare facility, compared to the disposable gown system, the reusable gown system showed a 28% reduction in energy consumption, a 30% reduction in greenhouse gas emissions, a 41% reduction in blue water consumption, and a 93% reduction in solid waste generation. Conclusions Selecting reusable garment systems may result in significant environmental benefits compared to selecting disposable garment systems. By selecting reusable isolation gowns, healthcare facilities can add these quantitative benefits directly to their sustainability scorecards.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.002
       
  • Estimating the attributable costs of hospital-acquired infections requires
           a distinct categorization of cases based on time of infection
    • Authors: Klaus Kaier; Martin Wolkewitz; Thomas Heister
      Abstract: Publication date: Available online 11 April 2018
      Source:American Journal of Infection Control
      Author(s): Klaus Kaier, Martin Wolkewitz, Thomas Heister


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.014
       
  • Effect of pulsed xenon ultraviolet room disinfection devices on microbial
           counts for methicillin-resistant Staphylococcus aureus and aerobic
           bacterial colonies
    • Authors: John E. Zeber; Christopher Pfeiffer; John W. Baddley; Jose Cadena-Zuluaga; Eileen M. Stock; Laurel A. Copeland; Janet Hendricks; Jwan Mohammadi; Marcos I. Restrepo; Chetan Jinadatha
      Abstract: Publication date: Available online 11 April 2018
      Source:American Journal of Infection Control
      Author(s): John E. Zeber, Christopher Pfeiffer, John W. Baddley, Jose Cadena-Zuluaga, Eileen M. Stock, Laurel A. Copeland, Janet Hendricks, Jwan Mohammadi, Marcos I. Restrepo, Chetan Jinadatha
      Background Inadequate environmental disinfection represents a serious risk for health care–associated infections. Technologic advancements in disinfection practices, including no-touch devices, offer significant promise to improve infection control. We evaluated one such device, portable pulsed xenon ultraviolet (PX-UV) units, on microbial burden during an implementation trial across 4 Veterans Affairs hospitals. Methods Environmental samples were collected before and after terminal room cleaning: 2 facilities incorporated PX-UV disinfection into their cleaning protocols and 2 practiced manual disinfection only. Specimens from 5 high-touch surfaces were collected from rooms harboring methicillin-resistant Staphylococcus aureus (MRSA) or aerobic bacteria colonies (ABC). Unadjusted pre-post count reductions and negative binomial regression modeled PX-UV versus manual cleaning alone. Results Seventy samples were collected. Overall, PX-UV reduced MRSA and ABC counts by 75.3% and 84.1%, respectively, versus only 25%-30% at control sites. Adjusting for baseline counts, manually cleaned rooms had significantly higher residual levels than PX-UV sites. Combined analyses revealed an incident rate ratio of 5.32 (P = .0024), with bedrails, tray tables, and toilet handrails also showing statistically superior PX-UV disinfection. Conclusions This multicenter study demonstrates significantly reduced disinfection across several common pathogens in facilities using PX-UV devices. Clinical impact of laboratory reductions on infection rates was not assessed, representing a critical future research question. However, such approaches to routine cleaning suggest a practical strategy when integrated into daily hospital operations.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.001
       
  • Nonventilator hospital-acquired pneumonia: Where do we go from here'
    • Authors: Karen K. Giuliano
      Abstract: Publication date: Available online 11 April 2018
      Source:American Journal of Infection Control
      Author(s): Karen K. Giuliano


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.017
       
  • Rate of contamination of hospital privacy curtains in a burns/plastic
           ward: A longitudinal study
    • Authors: Kevin Shek; Rakesh Patidar; Zeenib Kohja; Song Liu; Justin P. Gawaziuk; Monika Gawthrop; Ayush Kumar; Sarvesh Logsetty
      Abstract: Publication date: Available online 11 April 2018
      Source:American Journal of Infection Control
      Author(s): Kevin Shek, Rakesh Patidar, Zeenib Kohja, Song Liu, Justin P. Gawaziuk, Monika Gawthrop, Ayush Kumar, Sarvesh Logsetty
      Background Since hospital patient privacy curtains can harbor bacteria, are high-touch surfaces, and are cleaned infrequently, they may be involved in pathogen transmission. The aim of this longitudinal prospective study was to understand curtain contamination to inform curtain hygiene protocols, thereby minimizing the role of curtains in pathogen transmission. Methods Over 21 days, cultures of 10 freshly laundered curtains (8 test curtains surrounding patient beds and 2 controls in an unoccupied staff room) were taken in the Regional Burns/Plastics Unit. Contact plates were used to sample the curtains near the edge hem where they are most frequently touched. Microbial contamination and the presence of methicillin-resistant Staphylococcus aureus (MRSA) were determined. Results By day 3, test curtains showed increased microbial contamination (mean colony-forming units [CFU]/cm2 = 1.17) compared to control curtains (mean CFU/cm2 = 0.19). Test curtains became increasingly contaminated over time, with mean CFU/cm2 for days 17 and 21 of 1.86 and 5.11, respectively. By day 10, 1/8 test curtains tested positive for MRSA, and 5/8 were positive by day 14. Conclusions Patient privacy curtains became progressively contaminated with bacteria, including MRSA. Between days 10 and 14 after being hung, curtains showed increased MRSA positivity. This may represent an opportune time to intervene, either by cleaning or replacing the curtains.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.03.004
       
  • Necessity for additional sensitivity analysis and the clinical
           implications of risk identification with nonventilator hospital-acquired
           pneumonia
    • Authors: Subhikshya Tiwari; Johnson Ukken; Mary Froehlich; Jinwook Hwang; Too J. Min; Wen Yu; Mutsumi Kioka; Ji Won Yoo
      Abstract: Publication date: Available online 10 April 2018
      Source:American Journal of Infection Control
      Author(s): Subhikshya Tiwari, Johnson Ukken, Mary Froehlich, Jinwook Hwang, Too J. Min, Wen Yu, Mutsumi Kioka, Ji Won Yoo


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.028
       
  • Speaking up about hand hygiene failures: A vignette survey study among
           healthcare professionals
    • Authors: David L.B. Schwappach
      Abstract: Publication date: Available online 9 April 2018
      Source:American Journal of Infection Control
      Author(s): David L.B. Schwappach
      Background Speaking up by healthcare professionals (HCPs) is an important resource to reduce risks to patient safety. Due to complex tradeoffs, HCPs are often reluctant to voice their concerns. A survey investigated HCPs' likelihood to speak up. Methods A cross-sectional survey study among HCPs in 5 Swiss hospitals addressed speaking-up behaviors, safety climate, and likelihood to speak up about poor hand hygiene practice described in a vignette. Likelihood to speak up was analyzed using a multilevel regression model. Results Of surveyed HCPs (n = 1217), 56% reported that they would speak up to a colleague with poor hand hygiene practice. Nurses as compared to doctors rated the situation as more realistic (5.25 vs 4.32, P < .001), felt more discomfort with speaking up (4.00 vs 3.34, P < .001), and reported a slightly lower likelihood of speaking up (4.41 vs 4.77, P < .001). Clinical function (hierarchy) was strongly associated with speaking-up behavior (P < .001). Higher risk of harm to the patient (P < .001) and higher frequencies of past speaking-up behaviors (P = .006) were positively associated with the likelihood to speak up. Higher frequencies of past withholding voice (P = .013) and higher levels of resignation (P = .008) were both associated with a lower likelihood to speak up. Conclusions Infection control interventions should empower HCPs to speak up about non-adherence with prevention practices by addressing authority gradients and risk perceptions and by focusing on resignation.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.026
       
  • Guiding hand hygiene interventions among future healthcare workers:
           implications of knowledge, attitudes, and social influences
    • Authors: Shamsul Arfin Qasmi; Sayed Mustafa Mahmood Shah; Hafiz Yahya Iftikhar Wakil; Sarmad Pirzada
      Abstract: Publication date: Available online 9 April 2018
      Source:American Journal of Infection Control
      Author(s): Shamsul Arfin Qasmi, Sayed Mustafa Mahmood Shah, Hafiz Yahya Iftikhar Wakil, Sarmad Pirzada
      Background Medical students in their clinical years play an important role in healthcare delivery, yet poor levels of hand hygiene (HH) compliance in this population raise the risk for propagating nosocomial infections. To date, there has been a lack of dedicated interventions showing sustainable improvements in HH in this population. Methods A multicenter, cross-sectional study was conducted among 450 medical students in their clinical years (third to fifth years). A self-administered, pre-validated questionnaire based on the World Health Organization's “Knowledge” and “Perception” questionnaires was used to explore HH knowledge, attitudes, practices, and desired interventions. Results Self-reported HH compliance was found to be low (56.8%), and moderate HH knowledge (61.8%) was observed among all study respondents. Public university students expressed greater knowledge than students in private and semi-private universities. Superior HH practices were associated with better individual HH attitudes, positive perceived HH attitudes in other healthcare workers (HCWs), and higher HH knowledge scores. The highest-rated interventions for improving HH compliance included role-modeling by HCWs, display of “clear HH instructions,” and “ensuring availability of hand sanitizers.” Conclusion Our results call for a multifaceted approach to improve HH compliance among medical students, by ensuring adequate HH supplies/hand sanitizers, providing HH training in curricula, and effecting a cultural change mediated by professional modeling and open communication.

      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.02.019
       
  • Comments on Multidrug-resistant acinetobacter: Risk factors and outcomes
           in veterans with spinal cord injuries and disorders
    • Authors: Kamyar Mansori
      Abstract: Publication date: Available online 9 April 2018
      Source:American Journal of Infection Control
      Author(s): Kamyar Mansori


      PubDate: 2018-04-15T20:28:07Z
      DOI: 10.1016/j.ajic.2018.01.029
       
  • APIC Masthead
    • Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4


      PubDate: 2018-04-15T20:28:07Z
       
  • Information for Readers
    • Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4


      PubDate: 2018-04-15T20:28:07Z
       
  • Information for Authors
    • Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4


      PubDate: 2018-04-15T20:28:07Z
       
  • True to form—APIC 2018 will deliver!
    • Abstract: Publication date: April 2018
      Source:American Journal of Infection Control, Volume 46, Issue 4


      PubDate: 2018-04-15T20:28:07Z
       
 
 
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