RESUMO
OBJECTIVE: To report the effectiveness of use of comprehensive infection control measures to reduce the incidence of Clostridium difficile (CD) in an acute-care teaching hospital. METHODS: All CD infections were reviewed by the infection control coordinator from 1987 to 1996. The Centers for Disease Control and Prevention's nosocomial infection definition was used. CD-inclusion criteria remained unchanged during the study period. Interventions were started in 1990. INTERVENTIONS: The interventions used were: (1) Isolation policy-revision and enforcement, which included universal precautions policy, (2) educational program-monthly to all health care workers, (3) phenolic disinfectant for environmental cleaning, (4) triclosan (0.03%) soap for handwashing, (5) centralization of sterilization department, (6) cart-washer installation, and (7) aggressive surveillance activity. RESULTS: From 1987 to 1989, before the interventions, a total of 466 CD infections (mean 155 per year) occurred. From 1990 to 1996, after the interventions, 475 infections (mean 67 per year) occurred. Incidence of CD decreased by 60% from 1990 to 1996. CONCLUSION: The sustained decrease of nosocomial CD during the 7-year period demonstrated the effectiveness of aggressive infection control measures that involve multiple disciplines.
Assuntos
Clostridioides difficile , Infecção Hospitalar/prevenção & controle , Enterocolite Pseudomembranosa/prevenção & controle , Controle de Infecções/métodos , Feminino , Hospitais Comunitários , Hospitais de Ensino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Política Organizacional , Avaliação de Programas e Projetos de Saúde , VirginiaAssuntos
Antibacterianos/uso terapêutico , Endocardite Bacteriana/tratamento farmacológico , Enterococcus faecium/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções Relacionadas à Prótese/tratamento farmacológico , Virginiamicina/uso terapêutico , Antibacterianos/farmacologia , Resistência Microbiana a Medicamentos , Endocardite Bacteriana/microbiologia , Enterococcus faecium/isolamento & purificação , Feminino , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/microbiologia , Vancomicina/farmacologiaRESUMO
We report a case of delayed external ocular Nocardia asteroides infection following scleral buckling for rhegmatogenous detachment. Surgical removal of the exoplant material allowed isolation and identification of the organism. Topical and systemic antibiotic therapy following exoplant removal yielded a favorable result.
