RESUMO
Electronic hand hygiene monitoring systems allow the collection of large volumes of data. However, significant resources are required to validate and maintain these systems. Additionally, data are lacking on the correlation with clinically important outcomes. Direct observation of hand hygiene remains the gold standard for monitoring hand hygiene compliance.
RESUMO
Challenges for infection prevention and antimicrobial stewardship programs have arisen with the fourth wave of the coronavirus disease 2019 (COVID-19) pandemic, fueled by the delta variant. These challenges include breakthrough infections in vaccinated individuals, decisions to re-escalate infection prevention measures, critical medication shortages, and provider burnout. Various strategies are needed to meet these challenges.
RESUMO
Antipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.
Assuntos
Gestão de Antimicrobianos/métodos , Carbapenêmicos/uso terapêutico , Uso de Medicamentos/tendências , Prescrição Inadequada/prevenção & controle , Centros Médicos Acadêmicos , Formulários de Hospitais como Assunto , Humanos , Unidades de Terapia Intensiva , Análise de Séries Temporais Interrompida , Padrões de Prática Médica , VirginiaRESUMO
Rash in the returned traveler can provide a diagnostic dilemma for clinicians, but a detailed history including epidemiologic exposures can allow prompt diagnosis of etiologies uncommon in the United States. One such disease is Paederus dermatitis, an irritant contact dermatitis related to exposure to the rove beetle characterized by bullous lesions with surrounding erythema. Although cases and outbreaks have commonly been reported throughout the world, they are rarely reported in travelers returning to the United States. Here, we describe a patient who presented to an academic medical center in Virginia after travel to Sierra Leone with clinical presentation including exposure history and histopathology consistent with Paederus dermatitis. Our patient's clinic course is described in detail including treatment. Usual treatment includes antihistamines, topical steroids, and oral antibiotics, particularly with antimicrobials with activity against Pseudomonas sp. In addition, this case suggests a potential role for oral steroids in the treatment of this condition but further investigation is required. This case demonstrates the importance of considering a patient's travel and exposure history, as well as having familiarity with disease processes common in other parts of the world that are rarely seen in the United States.