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1	Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward Beggs, Clive B., Shepherd, Simon J., Kerr, Kevin G. January 2008 (has links) Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI). Continuous emphasis on this intervention has lead to the widespread opinion that HAI rates can be greatly reduced by increased hand hygiene compliance alone. However, this assumes that the effectiveness of hand hygiene is not constrained by other factors and that improved compliance in excess of a given level, in itself, will result in a commensurate reduction in the incidence of HAI. However, several researchers have found the law of diminishing returns to apply to hand hygiene, with the greatest benefits occurring in the first 20% or so of compliance, and others have demonstrated that poor cohorting of nursing staff profoundly influences the effectiveness of hand hygiene measures. Collectively, these findings raise intriguing questions about the extent to which increasing compliance alone can further reduce rates of HAI. In order to investigate these issues further, we constructed a deterministic Ross-Macdonald model and applied it to a hypothetical general medical ward. In this model the transmission of staphylococcal infection was assumed to occur after contact with the transiently colonized hands of HCWs, who, in turn, acquire contamination only by touching colonized patients. The aim of the study was to evaluate the impact of imperfect hand cleansing on the transmission of staphylococcal infection and to identify, whether there is a limit, above which further hand hygiene compliance is unlikely to be of benefit. The model demonstrated that if transmission is solely via the hands of HCWs, it should, under most circumstances, be possible to prevent outbreaks of staphylococcal infection from occurring at a hand cleansing frequencies <50%, even with imperfect hand hygiene. The analysis also indicated that the relationship between hand cleansing efficacy and frequency is not linear - as efficacy decreases, so the hand cleansing frequency required to ensure R0<1 increases disproportionately. Although our study confirmed hand hygiene to be an effective control measure, it demonstrated that the law of diminishing returns applies, with the greatest benefit derived from the first 20% or so of compliance. Indeed, our analysis suggests that there is little benefit to be accrued from very high levels of hand cleansing and that in most situations compliance >40% should be enough to prevent outbreaks of staphylococcal infection occurring, if transmission is solely via the hands of HCWs. Furthermore we identified a non-linear relationship between hand cleansing efficacy and frequency, suggesting that it is important to maximise the efficacy of the hand cleansing process. Staphylococcal infection Hospital ward Hand washing Healthcare staff
2	Prevalencia, resistencia e patogenicidade de Staphylococcus aureus colhidos no ambiente clinico odontologico / Prevalence, resistance and pathogenicity of Staphylococcus aureus isolated from dental clinic environment Motta, Rogério Heládio Lopes 17 February 2005 (has links) Orientadores : Thales Rocha de Mattos Filho, Francisco Carlos Groppo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-04T03:41:21Z (GMT). No. of bitstreams: 1 Motta_RogerioHeladioLopes_D.pdf: 659292 bytes, checksum: 254fb5f4f10c3501c081c5129d2db30f (MD5) Previous issue date: 2005 / Doutorado / Farmacologia, Anestesiologia e Terapeutica / Doutor em Odontologia Staphylococcus aureus Patogenicidade Staphylococcus aureus Pathogenicity
3	Methicillin-resistant Staphylococcus Aureus in Canadian Hospitals from 1995 to 2007: A Comparison of Adult and Pediatric Inpatients Locke, Tiffany 12 September 2013 (has links) The literature directly comparing the epidemiology of MRSA among adult and pediatric hospitalized patients is strikingly minimal. The objective of this thesis was to identify any differences between these two patient groups. The Canadian Nosocomial Infections Surveillance Program MRSA data (1995 to 2007: n=1,262 pediatric and 35,907 adult cases) were used to compare MRSA clinical and molecular characteristics and rates. Hospital characteristics were modeled using repeated measures Poisson regressions. The molecular and epidemiological characteristics of MRSA differed significantly between adults and children. Compared to children, MRSA in adults was more likely to be healthcare-associated, colonization, SCCmec type II, PVL negative, and resistant to most antibiotics. Rates of MRSA in Canada increased in both populations over time but were significantly higher in adults. The hospital characteristics associated with increased MRSA rates differed in adult and pediatric facilities. Implications for infection prevention and control strategies are discussed. Epidemiology Humans Cross Infection Hospitals Drug resistance, antimicrobial Infant Child Infant, newborn Child, preschool Age factors Sentinel Surveillance Population Surveilance Canada Hospitals, pediatric Community-Acquired Infections Hospitalization Methicillin Resistance Incidence Molecular Epidemiology Molecular Typing Cluster Analysis Staphylococcal Infection/epidemiology Healthcare Associated Infections Panton-Valentine leukocidin Age Groups Adult Aged Nosocomial Infections MRSA Adolescent Aged, 80 and over Young adult Drug Resistance, Multiple, Bacterial Infection Control Infection Control Practitioners Hospital Bed Capacity Bed Occupancy Pediatrics Epidemiologic Factors Health Facilities Risk Factors Length of Stay Patient Admission Staphylococcus aureus Public Health Agency of Canada
4	Methicillin-resistant Staphylococcus Aureus in Canadian Hospitals from 1995 to 2007: A Comparison of Adult and Pediatric Inpatients Locke, Tiffany January 2013 (has links) The literature directly comparing the epidemiology of MRSA among adult and pediatric hospitalized patients is strikingly minimal. The objective of this thesis was to identify any differences between these two patient groups. The Canadian Nosocomial Infections Surveillance Program MRSA data (1995 to 2007: n=1,262 pediatric and 35,907 adult cases) were used to compare MRSA clinical and molecular characteristics and rates. Hospital characteristics were modeled using repeated measures Poisson regressions. The molecular and epidemiological characteristics of MRSA differed significantly between adults and children. Compared to children, MRSA in adults was more likely to be healthcare-associated, colonization, SCCmec type II, PVL negative, and resistant to most antibiotics. Rates of MRSA in Canada increased in both populations over time but were significantly higher in adults. The hospital characteristics associated with increased MRSA rates differed in adult and pediatric facilities. Implications for infection prevention and control strategies are discussed. Epidemiology Humans Cross Infection Hospitals Drug resistance, antimicrobial Infant Child Infant, newborn Child, preschool Age factors Sentinel Surveillance Population Surveilance Canada Hospitals, pediatric Community-Acquired Infections Hospitalization Methicillin Resistance Incidence Molecular Epidemiology Molecular Typing Cluster Analysis Staphylococcal Infection/epidemiology Healthcare Associated Infections Panton-Valentine leukocidin Age Groups Adult Aged Nosocomial Infections MRSA Adolescent Aged, 80 and over Young adult Drug Resistance, Multiple, Bacterial Infection Control Infection Control Practitioners Hospital Bed Capacity Bed Occupancy Pediatrics Epidemiologic Factors Health Facilities Risk Factors Length of Stay Patient Admission Staphylococcus aureus Public Health Agency of Canada

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