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Publisher: Elsevier   (Total: 3043 journals)

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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, 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: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 352, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (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   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, 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: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
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: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, 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: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, 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: 16, 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: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
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: 26, 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: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
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: 22, 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 Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, 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: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
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: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
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: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, 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: 13)
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: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, 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 Research     Full-text available via subscription   (Followers: 353, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, 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: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 325, 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: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 406, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, 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: 8)
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  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, 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: 8, 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: 6)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, 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: 25, 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: 45, 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: 233, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 58, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
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: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 22, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, 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: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 57, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
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: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, 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  
Animal Behaviour     Hybrid Journal   (Followers: 161, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of Infection Control
  [SJR: 1.259]   [H-I: 81]   [25 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0196-6553
   Published by Elsevier Homepage  [3043 journals]
  • Risk factors for health care–associated infections: From better
           knowledge to better prevention
    • Authors: Etelvina Ferreira; Elaine Pina; Mafalda Sousa-Uva; António Sousa-Uva
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Etelvina Ferreira, Elaine Pina, Mafalda Sousa-Uva, António Sousa-Uva
      Background Health care–associated infections (HCAIs) are preventable with adoption of recognized preventive measures. The first step is to identify patients at higher risk of HCAI. This study aimed to identify patient risk factors (RFs) present on admission and acquired during inpatient stay which could be associated with higher risk of acquiring HCAI. Methods A case-control study was conducted in adult patients admitted during 2011 who were hospitalized for >48 hours. Cases were patients with HCAIs. Controls were selected in a ratio of 3:1, case matched by the admission date. The likelihood of increased HCAI was determined through binary logistic regression. Results RFs identified as being the more relevant for HCAI were being a man (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.7), being aged >50 years (OR, 2.9; 95% CI, 1.3-6.9), and having an insertion of a central venous line during hospital stay (OR, 12.4; 95% CI, 5.0-30.5). Conclusions RFs that showed statistical significance on admission were the patient's intrinsic factors, and RFs acquired during hospitalization were extrinsic RFs. When a set of RFs were present, the presence of a central venous line proved to be the more relevant one.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.03.036
       
  • Fungal aerocontamination exposure risk for patients in 3 successive
           locations of a pediatric hematology unit department: Influence of air
           equipment and building structure on air quality
    • Authors: Anne-Pauline Bellanger; Gabriel Reboux; Florent Demonmerot; Houssein Gbaguidi-Haore; Laurence Millon
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Anne-Pauline Bellanger, Gabriel Reboux, Florent Demonmerot, Houssein Gbaguidi-Haore, Laurence Millon
      Background Invasive fungal infections (IFIs) play an important role in the mortality of immunocompromised patients. The pediatric hematology department (PHD) at Besançon University Hospital has relocated 3 times: (1) from a building without an air filtration system (B1), (2) to a renovated building with low air pressure (B2), and (3) to a new building with high air pressure and high-efficiency particulate air filters (B3). This study aimed to investigate how these relocations influenced the fungal exposure risk for the PHD's patients. Methods Air samples were taken monthly in patient rooms and weekly in corridors. The detection of opportunistic fungi species was used to assess IFI risk. Data were analyzed using univariate and multivariate random-effects negative binomial regression. Results A total of 1,074 samples from 29 rooms over a 10-year period showed that renovation of an old building with a basic ventilation system did not lead to a significant improvement of air quality (P = .004, multivariate analysis). Among factors linked to higher risk of patient rooms mold contamination was fungal contamination of the corridors (P < .001). Conclusions This study demonstrates that corridors can be used as reliable sentinel to prevent fungal contamination in patient rooms. Only relocation in building B3, equipped with laminar air flow, achieved adequate air quality.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.04.283
       
  • Psychosocial determinants of influenza vaccination intention: A
           cross-sectional study on inpatient nurses in Singapore
    • Authors: Dwee Wee Lim; Lay Tin Lee; Win Mar Kyaw; Angela Chow
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Dwee Wee Lim, Lay Tin Lee, Win Mar Kyaw, Angela Chow
      Nurses have the closest interaction with inpatients and could transmit influenza to patients. From a self-administered questionnaire survey among inpatient nurses at a tertiary hospital, we observed that the strongest factors associated with intention for future vaccination were perceived benefits of and motivations for vaccination (adjusted odds ratio [aOR], 3.30; 95% confidence interval [CI], 2.55-4.27), and perceived nonsusceptibility to influenza and preference for vaccination alternatives (aOR, 0.26; 95% CI, 0.20-0.34). These factors need to be addressed to increase vaccination uptake and prevent nosocomial transmission.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.03.017
       
  • Implementation in the midst of complexity: Using ethnography to study
           health care–associated infection prevention and control
    • Authors: Mary Jo Knobloch; Kevin V. Thomas; Erin Patterson; Michele L. Zimbric; Jackson Musuuza; Nasia Safdar
      Pages: 1058 - 1063
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Mary Jo Knobloch, Kevin V. Thomas, Erin Patterson, Michele L. Zimbric, Jackson Musuuza, Nasia Safdar
      Background Contextual factors associated with health care settings make reducing health care–associated infections (HAIs) a complex task. The aim of this article is to highlight how ethnography can assist in understanding contextual factors that support or hinder the implementation of evidence-based practices for reducing HAIs. Methods We conducted a review of ethnographic studies specifically related to HAI prevention and control in the last 5 years (2012-2017). Results Twelve studies specific to HAIs and ethnographic methods were found. Researchers used various methods with video-reflexive sessions used in 6 of the 12 studies. Ethnography was used to understand variation in data reporting, identify barriers to adherence, explore patient perceptions of isolation practices and highlight the influence of physical design on infection prevention practices. The term ethnography was used to describe varied research methods. Most studies were conducted outside the United States, and authors indicate insights gained using ethnographic methods (whether observations, interviews, or reflexive video recording) as beneficial to unraveling the complexities of HAI prevention. Conclusions Ethnography is well-suited for HAI prevention, especially video-reflexive ethnography, for activating patients and clinicians in infection control work. In this era of increasing pressure to reduce HAIs within complex work systems, ethnographic methods can promote understanding of contextual factors and may expedite translation evidence to practice.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.06.024
       
  • Health care worker perspectives of their motivation to reduce health
           care–associated infections
    • Authors: Laura McClung; Chidi Obasi; Mary Jo Knobloch; Nasia Safdar
      Pages: 1064 - 1068
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Laura McClung, Chidi Obasi, Mary Jo Knobloch, Nasia Safdar
      Background Health care–associated infections (HAIs) are largely preventable, but are associated with considerable health care burden. Given the significant cost of HAIs, many health care institutions have implemented bundled interventions to reduce HAIs. These complex behavioral interventions require considerable effort; however, individual behaviors and motivations crucial to successful and sustained implementation have not been adequately assessed. We evaluated health care worker motivations to reduce HAIs. Methods This was a phenomenologic qualitative study of health care workers in different roles within a university hospital, recruited via a snowball strategy. Using constructs from the Consolidated Framework for Implementation Research model, face-to-face semi-structured interviews were used to explore perceptions of health care worker motivation to follow protocols on HAI prevention. Results Across all types of health care workers interviewed, patient safety and improvement in clinical outcomes were the major motivators to reducing HAIs. Other important motivators included collaborative environment that valued individual input, transparency and feedback at both organizational and individual levels, leadership involvement, and refresher trainings and workshops. We did not find policy, regulatory considerations, or financial penalties to be important motivators. Conclusions Health care workers perceived patient safety and clinical outcomes as the primary motivators to reduce HAI. Leadership engagement and data-driven interventions with frequent performance feedback were also identified as important facilitators of HAI prevention.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.05.002
       
  • Daily bathing strategies and cross-transmission of multidrug-resistant
           organisms: Impact of chlorhexidine-impregnated wipes in a
           multidrug-resistant gram-negative bacteria endemic intensive care unit
    • Authors: Jesus Ruiz; Paula Ramirez; Esther Villarreal; Monica Gordon; Inmaculada Saez; Alfonso Rodríguez; María Jesús Castañeda; Álvaro Castellanos-Ortega
      Pages: 1069 - 1073
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Jesus Ruiz, Paula Ramirez, Esther Villarreal, Monica Gordon, Inmaculada Saez, Alfonso Rodríguez, María Jesús Castañeda, Álvaro Castellanos-Ortega
      Background Health–care associated infections are a major cause of morbidity and mortality in critical care units. The aim of this study is to evaluate the effectiveness of chlorhexidine gluconate (CHG)–impregnated wipes in the daily bathing of patients in an intensive care unit (ICU) to prevent cross-transmission and colonization by multidrug-resistant organisms (MDROs) Methods Prospective cohort study with an intervention of 11 months. The intervention consisted of using CHG-impregnated wipes for the daily bathing of patients on mechanical ventilation or colonized by MDROs. Monthly trends in the number of patients colonized by MDROs and the incidence of nosocomial infections were evaluated. Results A total of 1,675 patients were admitted to the unit during the intervention period, and 430 (25.7%) were bathed with chlorhexidine wipes. A significant decrease was observed in the incidence of colonization by MDROs over the months (β = −0.209; r 2 = 0.549; P = .027), and in the number of patients colonized compared with the equivalent period of the previous year (22.0% vs 18.4%; P = .01). No significant decrease was observed in the incidence of nosocomial infection between the two periods (4.11% vs 4.57%; P = .355). No dermatologic problems were observed in the treated patients. Conclusions The use of CHG-impregnated wipes reduces cross-transmission and colonization by MDROs in the ICUs in an endemic situation because of multidrug-resistant Enterobacteriaceae.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.06.029
       
  • Methodologic considerations of household-level methicillin-resistant
           Staphylococcus aureus decolonization among persons living with HIV
    • Authors: Jason E. Farley; Laura E. Starbird; Jill Anderson; Nancy A. Perrin; Kelly Lowensen; Tracy Ross; Karen C. Carroll
      Pages: 1074 - 1080
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Jason E. Farley, Laura E. Starbird, Jill Anderson, Nancy A. Perrin, Kelly Lowensen, Tracy Ross, Karen C. Carroll
      Background People living with HIV (PLWH) have a higher prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and likelihood of recurrent infection than the general population. Simultaneously treating MRSA-colonized household members may improve success with MRSA decolonization strategies. This article describes a pilot trial testing household-level MRSA decolonization and documents methodologic and pragmatic challenges of this approach. Methods We conducted a randomized controlled trial of individual versus individual-plus-household MRSA decolonization to reduce recurrent MRSA. PLWH with a history of MRSA who are patients of an urban HIV clinic received a standard MRSA decolonization regimen. MRSA colonization at 6 months was the primary outcome. Results One hundred sixty-six patients were referred for MRSA screening; 77 (46%) enrolled. Of those, 28 (36%) were colonized with MRSA and identified risk factors consistent with the published literature. Eighteen were randomized and 13 households completed the study. Conclusions This is the first study to report on a household-level MRSA decolonization among PLWH. Challenges included provider referral, HIV stigma, confidentiality concerns over enrolling households, and dynamic living situations. Although simultaneous household MRSA decolonization may reduce recolonization, recruitment and retention challenges specific to PLWH limit the ability to conduct household-level research. Efforts to minimize these barriers are needed to inform evidence-based practice.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.05.010
       
  • Bacterial biofilm-based catheter-associated urinary tract infections:
           Causative pathogens and antibiotic resistance
    • Authors: Nargis Sabir; Aamer Ikram; Gohar Zaman; Luqman Satti; Adeel Gardezi; Abeera Ahmed; Parvez Ahmed
      Pages: 1101 - 1105
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Nargis Sabir, Aamer Ikram, Gohar Zaman, Luqman Satti, Adeel Gardezi, Abeera Ahmed, Parvez Ahmed
      Background We sought to determine the incidence of bacterial biofilm-based catheter-associated urinary tract infections, identify variables affecting biofilm formation, and identify etiologic bacterial pathogens and antibiotic-resistance patterns associated with biofilm-based catheter-associated urinary tract infections (CAUTIs) in our setup. Methods Patients who developed at least 2 symptoms of urinary tract infection after at least 2 days of indwelling urinary catheters were included. Urine was collected aseptically from catheter tubing and processed per standard microbiologic practices. Bacterial pathogens were identified on the basis of gram staining, colony morphology, and biochemical reactions. The detection of the biofilm was done using the tube adherence method. Drug susceptibility testing was done using the Kirby-Bauer disc diffusion method. Findings Biofilm was detected in 73.4% isolates, whereas 26.6% of isolates were nonbiofilm producers. Mean duration of catheterization after which biofilm was detected was 5.01 ± 1.31 days. A latex catheter was used in 69.5% of patients, whereas a silicone catheter was used in 30.4% of patients. Escherichia coli was found to be the most common pathogen isolated (52.3%), whereas Enterobacter cloacae exhibited the highest biofilm production (87.5%) among isolated pathogens. Among biofilm producers, the highest resistance was observed with ampicillin (100%). Fosfomycin exhibited the lowest resistance (17.2%). Significant association with biofilm was detected for gender, duration of catheterization, and type of catheter. Conclusion Biofilm-based CAUTI is an emerging problem. E coli was the most frequent isolate. High antibiotic resistance was observed in biofilm-producing strains. Using the variables affecting biofilm formation, tailored intervention strategies can be implemented to reduce biofilm-based CAUTIs.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.05.009
       
  • Improving compliance with surgical antibiotic prophylaxis guidelines: A
           multicenter evaluation
    • Authors: Cristiane Schmitt; Rubia Aparecida Lacerda; Ruth Natalia Teresa Turrini; Maria Clara Padoveze
      Pages: 1111 - 1115
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
      Background Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. Methods This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics. Six attributes of compliance with SAP guidelines were evaluated; full compliance was defined whenever all these attributes were met. Logistic and linear regressions were used to investigate the association between compliance, patients, and hospital characteristics. Results Full compliance was 10% and was associated with weekly hours of infection control personnel per intensive care unit bed (95% CI, 0.2–0.1), hospital-wide dissemination of SAP guidelines (95% CI, 1.2–25.1), monitoring (95% CI, 1.2–25.1), and feedback of compliance rates (95% CI, 3.8–25.2). Daytime procedures had greater compliance regarding drug dose (odds ratio [OR], 3.38; 95% confidence interval [CI], 1.72-6.65) and initial time (OR, 2.30; 95% CI, 1.24-4.25). Spinal procedures achieved greater compliance with initial time (OR, 1.83; 95% CI, 1.12-3.01) and duration (OR, 1.59; 95% CI, 1.7-2.16). Conclusions A low level of compliance was identified, which pointed out the need for an innovative stewardship approach to improve adherence to SAP guidelines. Targeted training programs need to be developed to ensure dissemination of guidelines among surgeons. Monitoring, feedback, and closer interaction between the infection control personnel and the surgical team are key factors for better compliance rates of SAP.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.05.004
       
  • A concealed observational study of infection control and safe injection
           practices in Jordanian governmental hospitals
    • Authors: Omar M. AL-Rawajfah; Ahmad Tubaishat
      Pages: 1127 - 1132
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Omar M. AL-Rawajfah, Ahmad Tubaishat
      Background The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. Methods A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. Results A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. Conclusions This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.04.293
       
  • Health problems and disinfectant product exposure among staff at a large
           multispecialty hospital
    • Authors: Megan L. Casey; Brie Hawley; Nicole Edwards; Jean M. Cox-Ganser; Kristin J. Cummings
      Pages: 1133 - 1138
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Megan L. Casey, Brie Hawley, Nicole Edwards, Jean M. Cox-Ganser, Kristin J. Cummings
      Background Hospital staff expressed health concerns after a surface disinfectant product containing hydrogen peroxide, peracetic acid, and acetic acid was introduced. We sought to determine if this product posed a health hazard. Methods An interviewer-administered questionnaire on work and health characteristics was completed by 163 current staff. Symptoms that improved away from work were considered work-related. Forty-nine air samples were taken for hydrogen peroxide, peracetic acid, and acetic acid. Prevalence ratios (PRs) were calculated using Poisson regression, and standardized morbidity ratios (SMRs) were calculated using nationally representative data. Results Product users reported higher prevalence of work-related wheeze and watery eyes than nonusers (P < .05). Workers in the department with the highest air measurements had significantly higher prevalence of watery eyes (PR, 2.88; 95% confidence interval [CI], 1.18-7.05) than those in departments with lower air measurements, and they also had a >3-fold excess of current asthma (SMR, 3.47; 95% CI, 1.48-8.13) compared with the U.S. population. Conclusions This disinfectant product was associated with mucous membrane and respiratory health effects. Risks of mucous membrane irritation and asthma in health care workers should be considered in development of disinfection protocols to protect patients from hospital-acquired infections. Identification of optimal protocols that reduce worker exposures while maintaining patient safety is needed.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.04.003
       
  • A prospective clinical trial to assess peripheral venous
           catheter–related phlebitis using needleless connectors in a surgery
           department
    • Authors: Ohad Ronen; Fanny Shlomo; Gila Ben-Adiva; Zehava Edri; Lilach Shema-Didi
      Pages: 1139 - 1142
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Ohad Ronen, Fanny Shlomo, Gila Ben-Adiva, Zehava Edri, Lilach Shema-Didi
      Background The use of intravascular catheters is often complicated by phlebitis, which is associated with increased morbidity and extended duration of hospitalization. We conducted a study to investigate the impact of needleless intravenous access devices on the rate of phlebitis in peripheral venous catheters (PVCs). Methods We prospectively recruited patients in 2 phases. The first group was treated with a regular cap, and the second group was treated with a needleless connector. The incidence of catheter-related phlebitis (CRP) was recorded as the primary end point. Results A total of 620 PVCs using regular caps were inserted into 340 patients and CRP rates were recorded. In the second phase of the study, 169 PVCs using needleless connectors were inserted into 135 patients. In the group treated with the regular cap, the CRP rate was 60% compared with 7% in the group treated with the needleless cap (P < .001). Consequently, the number of catheter replacements was decreased from 1.9 on average to 1.3 (P < .001). In both phases, patients who developed phlebitis had a statistically significant longer mean hospitalization period (P < .001), as were patients in the regular cap group (P < .01). Conclusions The use of needleless connectors was found to be associated with a significant reduction of CRP in peripheral veins in a surgery department setting. The decreased morbidity resulted in a lower number of catheter replacements and duration of hospitalization.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.05.001
       
  • Promoting appropriate urine culture management to improve health care
           
    • Authors: Robert Garcia; Eric D. Spitzer
      Pages: 1143 - 1153
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Robert Garcia, Eric D. Spitzer
      Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection. Moreover, national guidelines that provide evidence-based direction on core processes that form the basis for subsequent clinical therapy decisions or surveillance interpretations; that is, the appropriate ordering and collection of urine for laboratory testing and the treatment of patients with symptomatic urinary tract infection, are not widely known or lack adherence. This article provides published evidence on the influence of inappropriate ordering of urine specimens and subsequent treatment of asymptomatic bacteriuria and associated adverse effects; reviews research on bacterial contamination and preservation; and delineates best practices in the collection, handling, and testing of urine specimens for culture or for biochemical analysis in both catheterized and noncatheterized patients. The goal is to provide infection preventionists (IPs) with a cohesive evidence-based framework that will assist them in facilitating the implementation of a urine culture management program that reduces patient harms, enhances the accuracy of catheter-associated urinary tract infection surveillance, improves antibiotic stewardship, and reduces costs.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.03.006
       
  • On the hands of patients with Clostridium difficile: A study of spore
           prevalence and the effect of hand hygiene on C difficile removal
    • Authors: Anna K. Barker; Caroline Zellmer; Jessica Tischendorf; Megan Duster; Susan Valentine; Marc Oliver Wright; Nasia Safdar
      Pages: 1154 - 1156
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Anna K. Barker, Caroline Zellmer, Jessica Tischendorf, Megan Duster, Susan Valentine, Marc Oliver Wright, Nasia Safdar
      The prevalence of Clostridium difficile spores was assessed in 48 observations of infected inpatients. Participants were randomized to hand hygiene with either alcohol-based handrub or soap and water. C difficile was recovered in 14.6% of pre-hand hygiene observations. It was still present on 5 of these 7 participants after hand hygiene (3/3 using alcohol-based handrub; 2/4 using soap and water).

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.03.005
       
  • Prevalence of Clostridium difficile infection in acute care hospitals,
           long-term care facilities, and outpatient clinics: Is Clostridium
           difficile infection underdiagnosed in long-term care facility
           patients'
    • Authors: Amar Krishna; Amina Pervaiz; Paul Lephart; Noor Tarabishy; Swapna Varakantam; Aditya Kotecha; Reda A. Awali; Keith S. Kaye; Teena Chopra
      Pages: 1157 - 1159
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Amar Krishna, Amina Pervaiz, Paul Lephart, Noor Tarabishy, Swapna Varakantam, Aditya Kotecha, Reda A. Awali, Keith S. Kaye, Teena Chopra
      Clostridium difficile infection is a common cause of diarrhea in long-term care facility (LTCF) patients. The high prevalence of C difficile infection in LTCFs noted in our study calls for a critical need to educate LTCF staff to send diarrheal stool for C difficile testing to identify more cases and prevent transmission.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.04.288
       
  • Outbreak of CTX-M-15–producing Enterobacter cloacae associated with
           therapeutic beds and syphons in an intensive care unit
    • Authors: A. Bousquet; N. van der Mee-Marquet; C. Dubost; C. Bigaillon; S. Larréché; S. Bugier; C. Surcouf; S. Mérat; H. Blanchard; A. Mérens
      Pages: 1160 - 1164
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): A. Bousquet, N. van der Mee-Marquet, C. Dubost, C. Bigaillon, S. Larréché, S. Bugier, C. Surcouf, S. Mérat, H. Blanchard, A. Mérens
      An outbreak of extended-spectrum β-lactamase–producing Enterobacter cloacae (ESBL-ECL) occurred in our intensive care unit (ICU) and involved 18 patients (8 infected and 10 colonized). The mean age of patients was 69 years, and all infected patients had underlying medical conditions. Within hours' recognition of the spread of ESBL-ECL, the infection control team requested for staff education, reinforcement of infection control measures, and environmental screening. New transmissions were observed in the institution after weeks of enhanced infection control measures. Microbial swabbing revealed bacterial contamination of some mattresses and syphons with epidemiologic links between environmental, screening, and clinical isolates. This outbreak resulted in the temporary closure of the ICU for complete biocleaning.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.04.010
       
  • Dissemination of a nonpathogenic viral DNA surrogate marker from
           high-touch surfaces in rooms of long-term care facility residents
    • Authors: Heba Alhmidi; Sreelatha Koganti; Jennifer L. Cadnum; Annette L. Jencson; Amrita John; Curtis J. Donskey
      Pages: 1165 - 1167
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Heba Alhmidi, Sreelatha Koganti, Jennifer L. Cadnum, Annette L. Jencson, Amrita John, Curtis J. Donskey
      A nonpathogenic DNA marker inoculated onto the television remote controls in rooms of 2 ambulatory long-term care facility (LTCF) residents disseminated to the hands of the LTCF residents, to high-touch surfaces in the room and on the ward, and to shared portable equipment. These findings suggest that contaminated high-touch surfaces in rooms of ambulatory LTCF residents are a potential source for widespread dissemination of pathogens.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.04.007
       
  • Using inherent and elective behavior to improve hand hygiene monitoring in
           health care
    • Authors: Carolyn Dawson; Fiona Wells; Jamie Mackrill; Kate Prevc
      Pages: 1168 - 1170
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Carolyn Dawson, Fiona Wells, Jamie Mackrill, Kate Prevc
      This study established a method for collecting hand hygiene (HH) performance data based on behavioral drivers (inherent or elective) that can be used by infection preventionists (IPs) to improve practice. Further, we explored the influence that task and setting has on HH behavior. A significant effect was found between task and setting that has implications for improving the usefulness of HH measurement, with positive feedback reported regarding the new measurement method.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.03.032
       
  • The virus defeating Madam Mim
    • Authors: Antonio Perciaccante; Alessia Coralli
      First page: 1171
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Antonio Perciaccante, Alessia Coralli


      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.07.017
       
  • Multiple interventions in a postanesthesia care unit: Impact on hand
           hygiene compliance
    • Authors: Camila Marques dos Santos; Rachel Carvalho; Alexandra R. Toniolo; Julia Y. Kawagoe; Fernando G. Menezes; Claudia V. Silva; Priscila Gonçalves; Helena Maria F. Castagna; Luci Correa
      Pages: 1171 - 1173
      Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10
      Author(s): Camila Marques dos Santos, Rachel Carvalho, Alexandra R. Toniolo, Julia Y. Kawagoe, Fernando G. Menezes, Claudia V. Silva, Priscila Gonçalves, Helena Maria F. Castagna, Luci Correa


      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.07.007
       
  • Isolation and identification of human coronavirus 229E from frequently
           touched environmental surfaces of a university classroom that is cleaned
           daily
    • Authors: Tania S. Bonny; Saber Yezli; John A. Lednicky
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Infection Control
      Author(s): Tania S. Bonny, Saber Yezli, John A. Lednicky
      Frequently touched surfaces of a university classroom that is cleaned daily contained viable human coronavirus 229E (CoV-229E). Tests of a CoV-229E laboratory strain under conditions that simulated the ambient light, temperature, and relative humidity conditions of the classroom revealed that some of the virus remained viable on various surfaces for 7 days, suggesting CoV-229E is relatively stable in the environment. Our findings reinforce the notion that contact transmission may be possible for this virus.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.07.014
       
  • Cost-benefit analysis of different air change rates in an operating room
           environment
    • Authors: Thomas Gormley; Troy A. Markel; Howard Jones; Damon Greeley; John Ostojic; James H. Clarke; Mark Abkowitz; Jennifer Wagner
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Infection Control
      Author(s): Thomas Gormley, Troy A. Markel, Howard Jones, Damon Greeley, John Ostojic, James H. Clarke, Mark Abkowitz, Jennifer Wagner
      Background Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. Methods The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry. Results Simply increasing air change rates in the operating rooms tested did not necessarily provide an overall cleaner environment, but did substantially increase energy consumption and costs. Additionally, and unexpectedly, significant differences in microbial load and air velocity were detected between the sterile fields and back instrument tables. Conclusions Increasing the ventilation rates in operating rooms in an effort to improve clinical outcomes and potentially reduce surgical site infections does not necessarily provide cleaner air, but does typically increase operating costs. Efficient distribution or management of the air can improve quality indicators and potentially reduce the number of air changes required. Measurable environmental quality indicators could be used in lieu of or in addition to air change rate requirements to optimize cost and quality for an operating room and other critical environments.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.07.024
       
  • Use of an annual art competition to promote Web site traffic and engage
           children in antimicrobial stewardship in Pennsylvania
    • Authors: Nkuchia M. M'ikanatha; Courtney Yealy; Anna-Marie Warrington; Tabitha Reefer; Sameh W. Boktor; Natalie Mueller; Mary Leonard; Nicole M. Hackman
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Infection Control
      Author(s): Nkuchia M. M'ikanatha, Courtney Yealy, Anna-Marie Warrington, Tabitha Reefer, Sameh W. Boktor, Natalie Mueller, Mary Leonard, Nicole M. Hackman
      We used Google Analytics to assess whether annual kids' art competitions changed traffic to a Web site on appropriate antibiotic use. We found that announcements about kids' art competitions correlated with increased traffic to the Web site, suggesting that this innovation has promise in promoting antimicrobial stewardship efforts.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.06.035
       
  • Description of a restriction program for gram-positive antimicrobial
           agents at an academic medical center
    • Authors: Anita Molayi; Andrew Kirk; John Markley; Shaina Bernard; Perry Taylor; Kakotan Sanogo; Kimberly Lee; Amy Pakyz; Michelle Doll; Gonzalo Bearman; Michael P. Stevens
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Infection Control
      Author(s): Anita Molayi, Andrew Kirk, John Markley, Shaina Bernard, Perry Taylor, Kakotan Sanogo, Kimberly Lee, Amy Pakyz, Michelle Doll, Gonzalo Bearman, Michael P. Stevens
      This report examines the effectiveness of antimicrobial restriction at 1 tertiary care health care system by analyzing the consumption of restricted versus nonrestricted gram-positive agents over time for medical versus surgical units. Significant reductions in restricted antibiotic use were detected in 57% of medical units versus none of the surgical units. There were no significant reductions in nonrestricted antibiotic use. We think looking at antibiotic consumption by service line provides opportunities for targeted antibiotic restriction program refinement.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.08.038
       
  • Outbreak of group A Streptococcus emm94.0 affecting people who inject
           drugs in southwest England, April 2017
    • Authors: Rachel M. Kwiatkowska; Petra Manley; Ben Sims; Theresa Lamagni; Derren Ready; Juliana Coelho; Layth Alsaffar; Charles R. Beck; Fiona Neely
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Infection Control
      Author(s): Rachel M. Kwiatkowska, Petra Manley, Ben Sims, Theresa Lamagni, Derren Ready, Juliana Coelho, Layth Alsaffar, Charles R. Beck, Fiona Neely
      We report an outbreak of invasive and noninvasive group A Streptococcus during April 2017 among people who inject drugs in southwest England. To date we have identified 14 cases linked to a specific town, all confirmed as group A Streptococcus emm94.0, a strain type not previously reported in the area. We have yet to identify a source for this ongoing outbreak. Actions described here may help reduce the burden of infection in vulnerable populations.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.08.011
       
  • Leadership line care rounds: Application of the engage, educate, execute,
           and evaluate improvement model for the prevention of central
           line–associated bloodstream infections in children with cancer
    • Authors: Angie Owings; JoBeth Graves; Sherry Johnson; Craig Gilliam; Mike Gipson; Hana Hakim
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Infection Control
      Author(s): Angie Owings, JoBeth Graves, Sherry Johnson, Craig Gilliam, Mike Gipson, Hana Hakim
      To prevent central line–associated bloodstream infections (CLABSIs), leadership line care rounds (LLCRs) used the engage, educate, execute, and evaluate improvement model to audit compliance, identify barriers and opportunities, empower patients and families, and engage leadership. Findings of excellence and improvement opportunities were communicated to unit staff and managers. LLCRs contributed to compliance with CLABSI prevention interventions.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.08.032
       
  • Chlorhexidine gluconate bathing practices and skin concentrations in
           intensive care unit patients
    • Authors: Haleema Alserehi; Mala Filippell; Michele Emerick; Marie Kristine Cabunoc; Michael Anne Preas; Corey Sparkes; J. Kristie Johnson; Surbhi Leekha
      Abstract: Publication date: Available online 6 October 2017
      Source:American Journal of Infection Control
      Author(s): Haleema Alserehi, Mala Filippell, Michele Emerick, Marie Kristine Cabunoc, Michael Anne Preas, Corey Sparkes, J. Kristie Johnson, Surbhi Leekha
      In this 2-phase real-world evaluation of chlorhexidine gluconate (CHG) skin concentrations in intensive care unit patients, we found lower skin CHG concentrations when rinsing with water after CHG solution bath (compared with no rinse), but no significant difference in concentrations between the use of CHG solution without rinse and preimpregnated CHG wipes. CHG concentration audits could be useful in assessing the quality of bathing practice, and CHG solution without rinsing may be an alternative to preimpregnated CHG wipes.

      PubDate: 2017-10-13T17:15:11Z
      DOI: 10.1016/j.ajic.2017.08.022
       
  • Nurse-driven protocols and the prevention of catheter-associated urinary
           tract infections: A systematic review
    • Authors: Danielle J. Durant
      Abstract: Publication date: Available online 2 October 2017
      Source:American Journal of Infection Control
      Author(s): Danielle J. Durant
      Background Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-acquired conditions and no longer reimbursable from Medicare as of 2008. Nurse-driven protocols (NDPs), which provide a medically approved rubric for professional nurses to make autonomous care decisions, can facilitate appropriate catheter use and timely removal, as advised in the Centers for Disease Control and Prevention's 2009 CAUTI prevention guidelines. However, little attempt has been made to systematically evaluate their effect on clinical outcomes. Methods A systematic review of studies published in the United States since 2006 was performed, following guidelines from the Institute of Medicine. Sources included CINAHL, Medline, professional agencies, hand-searching, and expert consultation. Clinical predictors and prevalence of CAUTI were examined and synthesized qualitatively; heterogeneity of outcomes made a statistical meta-analysis inappropriate. Results Twenty-nine studies were found eligible for inclusion. All used a case-control (pre-post) approach, and all reported reductions in clinical predictors of CAUTI, particularly indwelling-urinary catheter utilization and CAUTI rates. However, the number of CAUTIs remained unchanged in 1 study. A formal quality assessment revealed a high risk of bias; included studies met an average of 4.9 out of 11 quality indicators. Specifically, many did not use standardized measures. Conclusions NDPs appear to have a positive impact on the clinical predictors and prevalence of CAUTI. However, this review identified need for improving the study design of quality improvement projects conducted within the patient care setting.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.07.020
       
  • APIC Masthead
    • Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10


      PubDate: 2017-10-06T16:56:49Z
       
  • Information for Readers
    • Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10


      PubDate: 2017-10-06T16:56:49Z
       
  • Information for Authors
    • Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10


      PubDate: 2017-10-06T16:56:49Z
       
  • International Infection Prevention Week: A time to celebrate infection
           preventionists and raise awareness of the profession
    • Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10


      PubDate: 2017-10-06T16:56:49Z
       
  • Erratum
    • Abstract: Publication date: 1 October 2017
      Source:American Journal of Infection Control, Volume 45, Issue 10


      PubDate: 2017-10-06T16:56:49Z
       
  • Skin antisepsis with 0.05% sodium hypochlorite before central venous
           catheter insertion in neonates: A 2-year single-center experience
    • Authors: Matilde Ciccia; Roksana Chakrokh; Dario Molinazzi; Angela Zanni; Patrizia Farruggia; Fabrizio Sandri
      Abstract: Publication date: Available online 28 September 2017
      Source:American Journal of Infection Control
      Author(s): Matilde Ciccia, Roksana Chakrokh, Dario Molinazzi, Angela Zanni, Patrizia Farruggia, Fabrizio Sandri
      Aim The study reports a 2-year single-center experience of the practice of skin antisepsis using a 0.05% sodium hypochlorite solution before central venous catheter placement in neonates. Methods Eligible subjects included any hospitalized neonate who needed a central line for at least 48 hours. Infants were excluded if they had a generalized or localized skin disorder. An ad hoc Excel (Microsoft Corp, Redmond, WA) file was used to record the data from each patient. The catheter sites were monitored daily for the presence of contact dermatitis. Central line-associated bloodstream infection was diagnosed according to Centers for Disease Control and Prevention definition. Results One hundred five infants underwent central venous catheter placement and were enrolled. A total of 198 central lines were inserted. The median gestational age was 31 weeks (range, 23-41 weeks) and median birth weight was 1,420 g (range, 500-5,170 g). There were no signs of 0.05% sodium hypochlorite-related skin toxicity in any infant. Of 198 catheters (1,652 catheter-days) prospectively studied, 9 were associated with bloodstream infections (5.4 per 1,000 catheter-days). Conclusion During the observation period, no local adverse effects were observed suggesting that 0.05% sodium hypochlorite may be a safe choice in this context.

      PubDate: 2017-10-06T16:56:49Z
      DOI: 10.1016/j.ajic.2017.08.012
       
 
 
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