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Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
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- 05 August 2015
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- 27 April 2015, pp ix-xxx
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Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals
- Erik R. Dubberke, Dale N. Gerding, David Classen, Kathleen M. Arias, Kelly Podgorny, Deverick J. Anderson, Helen Burstin, David P. Calfee, Susan E. Coffin, Victoria Fraser, Frances A. Griffin, Peter Gross, Keith S. Kaye, Michael Klompas, Evelyn Lo, Jonas Marschall, Leonard A. Mermel, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, Deborah S. Yokoe
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S81-S92
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- October 2008
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.
1. Increasing rates of CDI
C. difficile now rivals methicillin-resistant Staphylococcus aureus (MRSA) as the most common organism to cause healthcare-associated infections in the United States.
a. In the United States, the proportion of hospital discharges in which the patient received the International Classification of Diseases, Ninth Revision discharge diagnosis code for CDI more than doubled between 2000 and 2003, and CDI rates continued to increase in 2004 and 2005 (L. C. McDonald, MD, personal communication, July 2007). These increases have been seen in pediatric and adult populations, but elderly individuals have been disproportionately affected. CDI incidence has also increased in Canada and Europe.
b. There have been numerous reports of an increase in CDI severity.
c. Most reports of increases in the incidence and severity of CDI have been associated with the BI/NAP1/027 strain of C. difficile. This strain produces more toxins A and B in vitro than do many other strains of C. difficile, produces a third toxin (binary toxin), and is highly resistant to fluoroquinolones.
Strategies to Prevent Transmission of Methicillin-Resistant Staphylococcus aureus in Acute Care Hospitals
- David P. Calfee, Cassandra D. Salgado, David Classen, Kathleen M. Arias, Kelly Podgorny, Deverick J. Anderson, Helen Burstin, Susan E. Coffin, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Keith S. Kaye, Michael Klompas, Evelyn Lo, Jonas Marschall, Leonard A. Mermel, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Sanjay Saint, Robert A. Weinstein, Robert Wise, Deborah S. Yokoe
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S62-S80
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- October 2008
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). Our intent in this document is to highlight practical recommendations in a concise format to assist acute care hospitals in their efforts to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA). Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary, Introduction, and accompanying editorial for additional discussion.
1. Burden of HAIs caused by MRSA in acute care facilities
a. In the United States, the proportion of hospital-associated S. aureus infections that are caused by strains resistant to methicillin has steadily increased. In 2004, MRSA accounted for 63% of S. aureus infections in hospitals.
b. Although the proportion of S. aureus–associated HAIs among intensive care unit (ICU) patients that are due to methicillin-resistant strains has increased (a relative measure of the MRSA problem), recent data suggest that the incidence of central line–associated bloodstream infection caused by MRSA (an absolute measure of the problem) has decreased in several types of ICUs since 2001. Although these findings suggest that there has been some success in preventing nosocomial MRSA transmission and infection, many patient groups continue to be at risk for such transmission.
c. MRSA has also been documented in other areas of the hospital and in other types of healthcare facilities, including those that provide long-term care.
Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals
- Susan E. Coffin, Michael Klompas, David Classen, Kathleen M. Arias, Kelly Podgorny, Deverick J. Anderson, Helen Burstin, David P. Calfee, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Keith S. Kaye, Evelyn Lo, Jonas Marschall, Leonard A. Mermel, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, Deborah S. Yokoe
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S31-S40
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- October 2008
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their ventilator-associated pneumonia (VAP) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.
1. Occurrence of VAP in acute care facilities.
a. VAP is one of the most common infections acquired by adults and children in intensive care units (ICUs).
i. In early studies, it was reported that 10%-20% of patients undergoing ventilation developed VAP. More-recent publications report rates of VAP that range from 1 to 4 cases per 1,000 ventilator-days, but rates may exceed 10 cases per 1,000 ventilator-days in some neonatal and surgical patient populations. The results of recent quality improvement initiatives, however, suggest that many cases of VAP might be prevented by careful attention to the process of care.
2. Outcomes associated with VAP
a. VAP is a cause of significant patient morbidity and mortality, increased utilization of healthcare resources, and excess cost.
i. The mortality attributable to VAP may exceed 10%.
ii. Patients with VAP require prolonged periods of mechanical ventilation, extended hospitalizations, excess use of antimicrobial medications, and increased direct medical costs.
Strategies to Prevent Surgical Site Infections in Acute Care Hospitals
- Deverick J. Anderson, Keith S. Kaye, David Classen, Kathleen M. Arias, Kelly Podgorny, Helen Burstin, David P. Calfee, Susan E. Coffin, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Michael Klompas, Evelyn Lo, Jonas Marschall, Leonard A. Mermel, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, Deborah S. Yokoe
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S51-S61
- Print publication:
- October 2008
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals to implement and prioritize their surgical site infection (SSI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.
1. Burden of SSIs as complications in acute care facilities.
a. SSIs occur in 2%-5% of patients undergoing inpatient surgery in the United States.
b. Approximately 500,000 SSIs occur each year.
2. Outcomes associated with SSI
a. Each SSI is associated with approximately 7-10 additional postoperative hospital days.
b. Patients with an SSI have a 2-11 times higher risk of death, compared with operative patients without an SSI.
i. Seventy-seven percent of deaths among patients with SSI are direcdy attributable to SSI.
c. Attributable costs of SSI vary, depending on the type of operative procedure and the type of infecting pathogen; published estimates range from $3,000 to $29,000.
i. SSIs are believed to account for up to $10 billion annually in healthcare expenditures.
1. Definitions
a. The Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System and the National Healthcare Safety Network definitions for SSI are widely used.
b. SSIs are classified as follows (Figure):
i. Superficial incisional (involving only skin or subcutaneous tissue of the incision)
ii. Deep incisional (involving fascia and/or muscular layers)
iii. Organ/space
Strategies to Prevent Central Line–Associated Bloodstream Infections in Acute Care Hospitals
- Jonas Marschall, Leonard A. Mermel, David Classen, Kathleen M. Arias, Kelly Podgorny, Deverick J. Anderson, Helen Burstin, David P. Calfee, Susan E. Coffin, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Keith S. Kaye, Michael Klompas, Evelyn Lo, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, Deborah S. Yokoe
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S22-S30
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- October 2008
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their central line–associated bloodstream infection (CLABSI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.
1. Patients at risk for CLABSIs in acute care facilities
a. Intensive care unit (ICU) population: The risk of CLABSI in ICU patients is high. Reasons for this include the frequent insertion of multiple catheters, the use of specific types of catheters that are almost exclusively inserted in ICU patients and associated with substantial risk (eg, arterial catheters), and the fact that catheters are frequently placed in emergency circumstances, repeatedly accessed each day, and often needed for extended periods.
b. Non-ICU population: Although the primary focus of attention over the past 2 decades has been the ICU setting, recent data suggest that the greatest numbers of patients with central lines are in hospital units outside the ICU, where there is a substantial risk of CLABSI.
2. Outcomes associated with hospital-acquired CLABSI
a. Increased length of hospital stay
b. Increased cost; the non-inflation-adjusted attributable cost of CLABSIs has been found to vary from $3,700 to $29,000 per episode
Executive Summary: A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals
- Deborah S. Yokoe, Leonard A. Mermel, Deverick J. Anderson, Kathleen M. Arias, Helen Burstin, David P. Calfee, Susan E. Coffin, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Keith S. Kaye, Michael Klompas, Evelyn Lo, Jonas Marschall, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Kelly Podgorny, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, David Classen
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S12-S21
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- October 2008
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Preventable healthcare-associated infections (HAIs) occur in US hospitals. Preventing these infections is a national priority, with initiatives led by healthcare organizations, professional associations, government and accrediting agencies, legislators, regulators, payers, and consumer advocacy groups. To assist acute care hospitals in focusing and prioritizing efforts to implement evidence-based practices for prevention of HAIs, the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America Standards and Practice Guidelines Committee appointed a task force to create a concise compendium of recommendations for the prevention of common HAIs. This compendium is implementation focused and differs from most previously published guidelines in that it highlights a set of basic HAI prevention strategies plus special approaches for use in locations and/or populations within the hospital when infections are not controlled by use of basic practices, recommends that accountability for implementing infection prevention practices be assigned to specific groups and individuals, and includes proposed performance measures for internal quality improvement efforts.
Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals
- Evelyn Lo, Lindsay Nicolle, David Classen, Kathleen M. Arias, Kelly Podgorny, Deverick J. Anderson, Helen Burstin, David P. Calfee, Susan E. Coffin, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Keith S. Kaye, Michael Klompas, Jonas Marschall, Leonard A. Mermel, David A. Pegues, Trish M. Perl, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, Deborah S. Yokoe
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue S1 / October 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. S41-S50
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- October 2008
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.
1. Burden of CAUTIs
a. Urinary tract infection is the most common hospital-acquired infection; 80% of these infections are attributable to an indwelling urethral catheter.
b. Twelve to sixteen percent of hospital inpatients will have a urinary catheter at some time during their hospital stay.
c. The daily risk of acquisition of urinary infection varies from 3% to 7% when an indwelling urethral catheter remains in situ.
2. Outcomes associated with CAUTI
a. Urinary tract infection is the most important adverse outcome of urinary catheter use. Bacteremia and sepsis may occur in a small proportion of infected patients.
b. Morbidity attributable to any single episode of catheterization is limited, but the high frequency of catheter use in hospitalized patients means that the cumulative burden of CAUTI is substantial.
c. Catheter use is also associated with negative outcomes other than infection, including nonbacterial urethral inflammation, urethral strictures, and mechanical trauma.
Zinc homeostasis in 1–4 year olds consuming diets typical of US children
- Ian J. Griffin, Mary Frances Lynch, Keli M. Hawthorne, Zhensheng Chen, Maria G. Hamzo, Steven A. Abrams
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- Journal:
- British Journal of Nutrition / Volume 98 / Issue 2 / August 2007
- Published online by Cambridge University Press:
- 01 August 2007, pp. 358-363
- Print publication:
- August 2007
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Few data have evaluated Zn balance in young children after the first year of life. The objective of the present study was to study the relationships among Zn intake, absorption, endogenous faecal excretion, and retention in a group of healthy children. Thirty children, aged 15–48 months, were studied on a diet representative of their usual daily mineral intake. Zn absorption was assessed using a dual-tracer stable-isotope technique. Endogenous Zn faecal excretion and Cu absorption were determined in a subset of children. We found that Zn intake from the in-patient weighed dietary record (5·0 (sd 2·1) mg/d) was significantly greater than the current estimated average requirement (EAR; 2·5 mg/d; P < 0·0001). Neither fractional Zn absorption, urinary Zn excretion, nor endogenous faecal Zn excretion was significantly related to Zn intake (r2 < 0·1; P>0·4, for all). Absolute Zn absorption was significantly related to Zn intake (r2 0·696; P < 0·0001), as was Zn retention (r2 0·506; P < 0·0001). Cu absorption was relatively high (75·1 (sd 10·8) %) despite the high Zn intake. The EAR for Zn based on this dataset would appear to be between 4·2 and 4·7 mg/d to allow for a net average retention of 120 μg/d consistent with growth needs. We concluded that at relatively high Zn intakes there was little evidence of down regulation of absorption or up regulation of urinary or endogenous faecal Zn excretion across the intake range studied. Zn retention was positively correlated with intake. A Zn intake between 4·2 and 4·7 mg/d should meet the requirement for normal growth for this age group.
Research in the Etiology of Down's Syndrome1 Intricacies and Pitfalls
- Arnold R. Kaplan, Roland Fischer, Steven Zsako, Frances Griffin, Edward V. Glanville
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- Acta geneticae medicae et gemellologiae / Volume 14 / Issue 1 / January 1965
- Published online by Cambridge University Press:
- 01 August 2014, pp. 93-96
- Print publication:
- January 1965
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Cytological studies have shown that Down's syndrome (“ mongolism ”) is the result of a chromosomal anomaly which occurs either in one of the parent's germ cells or at a very early stage in (embryonic) development of the affected individual. The chromosomal anomaly involves the occurrence of a third number 21 chromosome, in addition to the normal complement of two, either separately (i. e., trisomy-21) or attached to one of the other acrocentric chromosomes (i. e., translocation to one of the chromosomes numbered 13-15 or 22 — Denver Report, 1960). Epidemiological studies have indicated that numerous factors are related to, and may affect, incidence of the chromosomal anomalies resulting in Down's syndrome. Studies by Collmann and Stoller (1962a, b) imply fluctuations of annual incidence with a 5-6 year periodicity, a higher incidence in urban compared to rural areas and a clusteting of affected births in certain geographic regions. Collmann and Stoller postulated an “ infectious agent, probably a virus ”, to account for their data. No connection, however, can yet be drawn between such a hypothesis and the established cytogenetic anomaly. Periodic fluctuations in incidence, which are characteristic of recurrent epidemics (Gordon, 1962), have also been reported for congenital anomalies other than Down's syndrome, such as anencephaly, spina bifida, and hydrocephaly (Collmann and Stoller, 1962b; Guthkelch, 1962; Alter, 1962; Slater, Watson and McDonald, 1964).