RESUMEN
Significant events impacting healthcare over the last several years have been associated with escalating rates of healthcare-associated infections. This has resulted in increased efforts to reinstitute well-established and evidence-based infection prevention practices, particularly for central line associated bloodstream infections. However, implementation of prevention initiatives beyond central lines has not received the same level of acknowledgement and response as being a considerable risk to patients. This article, authored by infection prevention, infectious disease, and vascular access professionals, provides emerging perspectives and technical aspects associated with the complete lifecycle of a vascular access device. The intent is to provide insight and perspective into enhancing current IP practices in the acute care hospital setting. This will also help prepare hospitals for upcoming broader surveillance and intervention activities aimed at reducing Hospital Onset Bacteremia and Fungemia (HOB) associated with all types of vascular access devices.
RESUMEN
Surgical site infections (SSIs) contribute to morbidity and mortality and increase the costs of patient care. Effective skin decontamination is recommended to reduce the risk of SSI and the transmission of antibiotic-resistant pathogens. A macrodilution broth method and an in vitro time-kill method were used to determine the antimicrobial properties of an alcohol-free 2% chlorhexidine gluconate (CHG) solution against seven bacterial strains, including clinically derived strains of Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA). The CHG solution reduced bacterial counts of drug-resistant Acinetobacter baumannii and community-associated MRSA by 99.9% within three minutes of exposure, and effectiveness was maintained with significant dilutions of the CHG solution.
Asunto(s)
Antiinfecciosos/uso terapéutico , Clorhexidina/análogos & derivados , Infección Hospitalaria/prevención & control , Infección de la Herida Quirúrgica/prevención & control , Acinetobacter baumannii/efectos de los fármacos , Antiinfecciosos/farmacología , Clorhexidina/farmacología , Clorhexidina/uso terapéutico , Recuento de Colonia Microbiana , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Evaluación Preclínica de Medicamentos , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Humanos , Resistencia a la Meticilina/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Cuidados Preoperatorios/métodos , Cuidados Preoperatorios/enfermería , Cuidados de la Piel/métodos , Cuidados de la Piel/enfermería , Soluciones , Staphylococcus aureus/efectos de los fármacos , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/microbiología , Factores de TiempoRESUMEN
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.