Impact of alcohol hand-rub use on meticillin-resistant Staphylococcus aureus: an analysis of the literature.

We aimed to evaluate the impact of alcohol hand disinfection with alcohol hand rub (AHR) as surrogate parameter of compliance or with compliance observations on the meticillin-resistant Staphylococcus aureus (MRSA) situation in hospital settings. Medline was searched for the keywords 'hand hygiene', 'compliance', 'disinfection', 'time series analysis' combined with 'meticillin-resistant Staphylococcus aureus/MRSA'. Data were included only from studies reporting exact numbers of AHR and/or compliance observations of MRSA situations over time. The literature search resulted in 272 hits, of which 12 studies met the inclusion criteria. The amount of AHR ranged between 3 and 78 mL/patient-day (pd) at the beginning and increased to 12 to 103 mL/pd at the end of the intervention studies. Compliance with hand disinfection ranged between 20% and 64% at the beginning and between 42% and 71% at the end. An increase in AHR correlated significantly with an improvement in the MRSA situation (r=0.78), whereas there was no such correlation between compliance and MRSA. An increased consumption of AHR was associated with a significant reduction of MRSA rates.

Speech understanding with the CIS and the n-of-m strategy in the MED-EL COMBI 40+ system.

Speech tests have been performed on 6 subjects for comparing the standard 12-channel continuous interleaved sampling (CIS) strategy (CIS12), the 7-channel CIS strategy (CIS7) and the 7-of-12 strategy in the MED-EL COMBI 40+ system. An ABAB experimental design was used whereby each strategy was reversed and replicated. Speech tests were performed in quiet (vowels, consonants, monosyllables, sentences) and noise (sentences). Results showed that for vowels, CIS12 is significantly superior to CIS7, for consonants and sentences CIS12, CIS7 and 7-of-12 performed equally well, and that for monosyllables 7-of-12 is significantly superior to both CIS12 and CIS7. In addition, 7-of-12 is superior to CIS7 by almost the same amount as CIS12, but in this case the difference is not significant. Further, all strategies have been found to be equally robust in noise with respect to sentence understanding. The differences between CIS12 and 7-of-12 on the one hand and CIS7 on the other hand may be attributed to decreased spectral resolution of the latter. The fact that - in contrast to what has been reported for the SPEAK strategy - 7-of-12 is equally robust in noise as the CIS strategies is explained by the use of higher stimulation rates, wider frequency bands and a higher percentage of channels stimulated in each cycle.