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PubMed1989

The rapid evaluation of intestinal bacterial growth using a conjugate of ursodeoxycholic acid with para-aminobenzoic acid.

From the standpoint of utilizing the distinctive feature of para-aminobenzoic acid (PABA) and the metabolism of intestinal bile acid, a conjugate of ursodeoxycholic acid with PABA (PABA-UDCA) was newly synthesized to study whether it can be a good material or not for the evaluation of the activity of intestinal bacterial growth. This compound was efficiently deconjugated in an incubation experiment with cholylglycine hydrolase resulting in the release of PABA. In a cultivation experiment, this compound was deconjugated by the same species of aerobic and anaerobic bacteria that deconjugated glycocholic acid. In an animal experiment, urinary excretions of PABA during 6 h following oral administration of 10 mg PABA-UDCA were determined. The control rat (n = 10) excreted 338.5 +/- 13.8 micrograms (mean +/- S.E.) of PABA. In contrast with this, the rats (n = 10) with intestinal antisepsis by the administration of polymyxin B and tinidazole excreted less PABA (14.0 +/- 2.5 micrograms; p less than 0.001), whereas the rats with intestinal bacterial overgrowth owing to the artificially made enteric blind loop excreted more PABA than the control rats did (673.6 +/- 70.2 micrograms; p less than 0.01). These observations indicate that this new compound is likely to offer a simple and rapid method for evaluation of intestinal bacterial growth.

4-Aminobenzoic Acid↗
PubMed2002

New and emerging therapies for sepsis.

OBJECTIVE: To review the recent advances related to the pathophysiology of sepsis and the rationale for recombinant human-activated protein C (drotrecogin alfa) and other antisepsis agents currently in Phase III trials. DATA SOURCES: A MEDLINE (1990-December 2001) search was performed to identify pertinent literature on the pathophysiology of sepsis and treatment strategies. The search was supplemented with AdisInsight (Adis International) using the search terms sepsis, severe sepsis, or septic shock combined with agents in Phase II or higher clinical development. Abstracts presented at infectious diseases and critical care meetings were also reviewed. STUDY SELECTION AND DATA EXTRACTION: Clinical efficacy studies were selected for drotrecogin alfa and other Phase III investigational agents. DATA SYNTHESIS: Our current understanding of the pathophysiology of sepsis underscores the contribution of increased coagulation and diminished fibrinolytic activity working in conjunction with an excessive and dysregulated inflammatory response. The loss of homeostatic balance among these systems results in a systemic inflammatory response with generalized coagulopathy, microvascular thrombosis, and, ultimately, acute organ failure and death. As a result of these advances, several compounds are now in various phases of development. A recombinant human form of endogenous activated protein C (drotrecogin alfa) was recently approved by the Food and Drug Administration for severe sepsis in adults who have a high risk of death. It possesses anticoagulant, profibrinolytic, and antiinflammatory properties. Other compounds currently in Phase III trials include tissue-factor pathway inhibitor, tumor-necrosis factor antibody fragment, platelet-activating factor acetylhydrolase, antithrombin III, and pyridoxylated hemoglobin polyoxyethylene. CONCLUSIONS: With the recent approval of drotrecogin alfa, there is renewed optimism that we can effectively reduce sepsis-associated mortality.

Adult↗
PubMed2005

Restructuring isolation: hospital architecture, medicine, and disease prevention.

This paper examines changing strategies of isolation in the New York Hospital between 1771 and 1930 by correlating the facilities available for isolation with changing reactions to internal disease incidence, changing medical rules and regulations, and shifting ward categories. To prevent internal "epidemics" of telltale diseases such as erysipelas, pyemia, and "hospital gangrene," what (or who) was isolated from what, and how that isolation was achieved, altered drastically. Traditional strategies of increasing the air space and flow around each patient gave way to Florence Nightingale's sanitary nursing, Joseph Lister's antisepsis, Joseph Grancher's barrier system of nursing, D. L. Richardson's aseptic nursing, and Charles Chapin's advocacy of individual cubicles. The larger social and medical transformations of the hospital colored all of these shifts. But the changing isolation strategies also reveal a transformation of the underlying understanding of the role that hospital architecture played in disease incidence.

Cellulitis↗
PubMed2005

Risk of catheter-related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients.

BACKGROUND: Peripherally inserted central venous catheters (PICCs) are now widely used for intermediate and long-term access in current-day health care, especially in the inpatient setting, where they are increasingly supplanting conventional central venous catheters (CVCs) placed percutaneously into the internal jugular, subclavian, or femoral veins. Data on the risk of PICC-related bloodstream infection (BSI) with PICCs used in hospitalized patients are limited. STUDY OBJECTIVES: To determine the risk of PICC-related BSI in hospitalized patients. STUDY DESIGN: Prospective cohort study using data from two randomized trials assessing the efficacy of chlorhexidine-impregnated sponge dressing and chlorhexidine for cutaneous antisepsis. METHODS: PICCs inserted into the antecubital vein in two randomized trials during from 1998 to 2000 were prospectively studied; most patients were in an ICU. PICC-related BSI was confirmed in each case by demonstrating concordance between isolates colonizing the PICC at the time of removal and from blood cultures by restriction-fragment DNA subtyping. RESULTS: Overall, 115 patients had 251 PICCs placed. Mean duration of catheterization was 11.3 days (total, 2,832 PICC-days); 42% of the patients were in an ICU at some time, 62% had urinary catheters, and 49% had received mechanical ventilation. Six PICC-related BSIs were identified (2.4%), four with coagulase-negative staphylococcus, one with Staphylococcus aureus, and one with Klebsiella pneumoniae, a rate of 2.1 per 1,000 catheter-days. CONCLUSION: This prospective study shows that PICCs used in high-risk hospitalized patients are associated with a rate of catheter-related BSI similar to conventional CVCs placed in the internal jugular or subclavian veins (2 to 5 per 1,000 catheter-days), much higher than with PICCs used exclusively in the outpatient setting (approximately 0.4 per 1,000 catheter-days), and higher than with cuffed and tunneled Hickman-like CVCs (approximately 1 per 1,000 catheter-days). A randomized trial of PICCs and conventional CVCs in hospitalized patients requiring central access is needed. Our data raise the question of whether the growing trend in many hospital hematology and oncology services to switch from use of cuffed and tunneled CVCs to PICCs is justified, particularly since PICCs are more vulnerable to thrombosis and dislodgment, and are less useful for drawing blood specimens. Moreover, PICCs are not advisable in patients with renal failure and impending need for dialysis, in whom preservation of upper-extremity veins is needed for fistula or graft implantation.

Bacteremia↗
PubMed1978

Nitroblue tetrazolium and Limulus assays for bacteremia after dental extraction: effect of topical antiseptics.

Bacteremia that occurs after dental extraction is common. This study assessed the effect of topical antisepsis on the incidence and magnitude of post-extraction bacteremia. On hundred patients scheduled for elective tooth extraction were randomized among four groups: contr-l, mouthrinsing with sodium-p-toluene sulfonchloramide (chloramine-T), toothbrushing with chloramine-T, and irrigation with Lugol's solution. The results showed that 84% of the control group and 59% of the treatment groups had positive blood cultures (290 organisms isolated) after dental extraction. The duration and magnitude of these bacteremias were diminutive as documented by the six serial blood cultures taken for each patient, colony counts per milliliter of blood, and nitroblue tetrazolium and Limulus assays. Brushing the teeth or rinsing the mouth with chloramine-T before dental extraction significantly reduced the incidence of bacteremia (P less than .025) and the number of different organisms recovered from each patient (P less than .05). Thus, topical treatment with chloramine-T is a simple and effective means of reducing the incidence of postextraction bacteremia.

Adolescent↗
PubMed2001

A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates.

UNLABELLED: Neonates who require a central venous catheter (CVC) for prolonged vascular access experience high rates of catheter-related bloodstream infection (CRBSI). PURPOSE: A multicenter randomized clinical trial was undertaken to ascertain the efficacy of a novel chlorhexidine-impregnated dressing (Biopatch Antimicrobial Dressing) on the CVC sites of neonates for the prevention of catheter tip colonization, CRBSI, and bloodstream infection (BSI) without a source. Setting. Six level III neonatal intensive care units. Patients Studied. Neonates admitted to study units who would require a CVC for at least 48 hours. METHODS: Eligible infants were randomized before catheter placement to 1 of the 2 catheter site antisepsis regimens: 1) 10% povidone-iodine (PI) skin scrub, or 2) a 70% alcohol scrub followed by placement of a chlorhexidine-impregnated disk over the catheter insertion site. A transparent polyurethane dressing (Bioclusive Transparent Dressing) was used to cover the insertion site in both study groups. Primary study outcomes evaluated were catheter tip colonization, CRBSI, and BSI without an identified source. RESULTS: Seven hundred five neonates were enrolled in the trial, 335 randomized to receive the chlorhexidine dressing and 370 to skin disinfection with PI (controls). Neonates randomized to the antimicrobial dressing group were less likely to have colonized CVC tips than control neonates (15.0% vs 24.0%, relative risk [RR]: 0.6 95% confidence interval [CI]: 0.5-0.9). Rates of CRBSI (3.8% vs 3.2%, RR: 1.2, CI: 0.5-2.7) and BSI without a source (15.2% vs 14.3%, RR: 1.1, CI: 0.8-1.5) did not differ between the 2 groups. Localized contact dermatitis from the antimicrobial dressing, requiring crossover into the PI treatment group, occurred in 15 (15.3%) of 98 exposed neonates weighing </=1000 g. No neonates in the PI group developed contact dermatitis. CONCLUSION: The novel chlorhexidine-impregnated dressing, replaced weekly, was as effective as cutaneous disinfection with 10% PI and redressing the site every 3 to 7 days for preventing CRBSI and BSI without a source in critically ill neonates requiring prolonged central venous access. The risk of local contact dermatitis under the chlorhexidine dressing limits its use in low birth weight infants who require prolonged central access during the first 2 weeks of life.

Administration, Cutaneous↗
PubMed2002

Evaluation and treatment of neonates with suspected late-onset sepsis: a survey of neonatologists' practices.

OBJECTIVE: To ascertain current diagnostic and treatment practices for suspected late-onset sepsis in infants in neonatal intensive care units (NICUs) and identify areas that may benefit from clinical practice guidelines. METHODS: During June 2000, we conducted a multicenter survey of neonatologists and infection control professionals regarding practices related to late-onset sepsis in NICUs at children's hospitals participating in the Pediatric Prevention Network. RESULTS: Personnel at 35 hospitals with NICUs completed surveys; 34 were infection control professionals, and 278 were neonatology clinicians, primarily attending neonatologists or neonatology fellows. At these facilities, coagulase-negative staphylococci (CoNS) were the most frequent blood culture isolate from infants with late-onset sepsis accounting for 54% of bloodstream infections. When late-onset sepsis was suspected, 83% of clinicians drew only 1 blood culture when no central venous catheter was present or when a central vascular was present with no blood return. Thirty-two percent obtained 1 or more C-reactive protein concentration determinations. Sixty percent of clinicians prescribed a vancomycin-containing regimen for a 900 g, 3-week-old infant with suspected late-onset sepsis. The presence of a central venous catheter or shock increased empiric vancomycin use. The presence of methicillin-resistant Staphylococcus aureus in the NICU did not increase vancomycin use, but a vancomycin restriction policy decreased empiric vancomycin use. Clinicians at an individual NICU tended to have similar empiric antibiotic-prescribing practices: in 29 (83%) of 35 centers > or =75% of respondents had similar practice with regard to prescribing a vancomycin-containing regimen for empiric therapy. Forty-seven percent to 85% completed a full course of antimicrobials when a single blood culture was obtained and grew CoNS, but a significantly lower percentage of respondents (22%-47%) completed a full course when 1 of 2 blood cultures obtained grew CoNS. Eleven percent of respondents removed an umbilical catheter at the time of suspected sepsis, but fewer than 5% removed a nonumbilical central venous catheter for suspected sepsis. Most (> or =61%) retained a nonumbilical catheter despite documentation of CoNS bacteremia. CONCLUSIONS: Neonatologists varied in management of suspected late-onset sepsis, particularly that caused by CoNS. Procedures to prevent CoNS-positive blood cultures and to differentiate CoNS contaminants from pathogens are needed. For safely decreasing vancomycin use in NICUs, clinical practice guidelines should be developed, implemented, and evaluated. The guidelines should include optimal skin antisepsis and catheter disinfection before obtaining blood for culture, obtaining 2 blood cultures and using adjunctive tests and information to help differentiate contaminants from pathogens, and restriction on empiric vancomycin use.

Bacterial Infections↗
PubMed1995

[Evaluation and control of the microbiological quality of hands in foodhandlers].

Microbiological analyses of workers' hands were made for the common indicators, including aerobic mesophilic plate counts (APC), as well as the common food pathogens. Opportunities were observed for cross-contamination of roast beef by workers' hands during slicing operations. Workers' hands showed APC counts of up to 10(7) CFU/hand and the presence of S. aureus and C. perfringens. Salmonella spp were not isolated from hands. These results show that handling of these foods by such workers would be a risk in transmitting pathogenic microorganisms to the foods and is apparent that it is necessary for these workers to take care of personal hygiene. Decimal reductions obtained in the microbiological counts after washing and antisepsis of workers' hands were at 2,6 logs cycles and still demonstrated the importance of this practice in food services by the fact that pathogens such as S. aureus and C. perfringens were inhibited or killed.

Brazil↗
PubMed2001

Recombinant human activated protein C, drotrecogin alfa (activated): a novel therapy for severe sepsis.

Sepsis remains a major cause of death in hospitalized patients. Despite a massive research effort over the past 2 decades to identify innovative therapies for sepsis, current treatment strategies consist primarily of antiinfective agents and a variety of supportive measures. Activated protein C, an endogenous protein that inhibits thrombosis and inflammation while promoting fibrinolysis, plays an important role in the pathogenesis of sepsis. Recombinant human activated protein C, drotrecogin alfa (activated), when compared with placebo in a randomized, double-blind study of 1690 patients with severe sepsis (Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis [PROWESS] trial), decreased the relative risk of death at 28 days by 19.4% (95% confidence interval 6.6-30.5%, p=0.005), although there was a trend for more serious bleeding (3.5% vs 2.0%, p=0.06) with its use. Drotrecogin alfa is the first antisepsis drug found to have a mortality benefit. It should be administered only to patients with severe sepsis who meet the PROWESS study inclusion criteria and should be avoided when risk factors for bleeding are present. Ongoing research will help determine the cost-effectiveness of drotrecogin alfa, as well as its role in critically ill populations not studied in the PROWESS trial.

Animals↗
PubMed1993

Treatment of head injuries in the American Civil War.

At the time of the American Civil War (1861-1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery.

Brain Injuries↗
PubMed2006

Three-year follow-up of an outbreak of Serratia marcescens bacteriuria in a neurosurgical intensive care unit.

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.

Bacteriuria↗
PubMedDate not supplied

Elimination of central line-associated bloodstream infections: application of the evidence.

Central line-associated bloodstream infections are considered to be an avoidable complication of care delivery. In addition to considerable morbidity and use of resources, central line-associated bloodstream infections carry an attributable morality between 12% and 25%. The estimated cost per infection is approximately 25,000 US dollars. Research over the last decade has focused on a number of care activities that have been shown to reduce the incidence of bloodstream infections related to central line placement in the critically ill patient. A significant reduction or elimination of central line-associated bloodstream infections can occur with implementation of a comprehensive central line-associated bloodstream infection prevention program that includes staff education, hand hygiene, use of maximal sterile barrier precautions, chlorhexidine gluconate skin antisepsis, avoidance of femoral lines, empowerment of staff to stop the procedure if sterile technique is broken, and daily assessment of the continued need for a central line. This article focuses on strategies for implementing a comprehensive central line-associated bloodstream infections prevention program and a tool and process for defect analysis as part of a statewide collaborative in Michigan.

Catheterization, Central Venous↗
PubMed2002

The human antimicrobial peptide LL-37 is a multifunctional modulator of innate immune responses.

The role of LL-37, a human cationic antimicrobial peptide, in the immune system is not yet clearly understood. It is a widely expressed peptide that can be up-regulated during an immune response. In this report, we demonstrate that LL-37 is a potent antisepsis agent with the ability to inhibit macrophage stimulation by bacterial components such as LPS, lipoteichoic acid, and noncapped lipoarabinomannan. We also demonstrate that LL-37 protects mice against lethal endotoxemia. In addition to preventing macrophage activation by bacterial components, we hypothesized the LL-37 may also have direct effects on macrophage function. We therefore used gene expression profiling to identify macrophage functions that might be modulated by LL-37. These studies revealed that LL-37 directly up-regulates 29 genes and down-regulated another 20 genes. Among the genes predicted to be up-regulated by LL-37 were those encoding chemokines and chemokine receptors. Consistent with this, LL-37 up-regulated the expression of chemokines in macrophages and the mouse lung (monocyte chemoattractant protein 1), human A549 epithelial cells (IL-8), and whole human blood (monocyte chemoattractant protein 1 and IL-8), without stimulating the proinflammatory cytokine, TNFalpha. LL-37 also up-regulated the chemokine receptors CXCR-4, CCR2, and IL-8RB. These findings indicate that LL-37 may contribute to the immune response by limiting the damage caused by bacterial products and by recruiting immune cells to the site of infection so that they can clear the infection.

Adjuvants, Immunologic↗
PubMed1997

Prophylactic antibiotics in cataract operations.

The rationale for prophylactic antibiotics in cataract operations must be continually reevaluated in light of cost-effectiveness and adverse reactions. The principles learned from wound infections associated with general surgical procedures should be applied to the limited knowledge about the rare event of endophthalmitis. Herein the literature on experimental and clinical wound infections in general surgical procedures is reviewed, with analysis of microbial flora, pathophysiology of wound infections, and pharmacokinetics of antibiotics. Experimental and clinical studies on prophylactic antibiotics to prevent endophthalmitis are reviewed, including information on topically applied antibiotics, chemical antisepsis, and administration of subconjunctival, intracameral, and systemic antibiotics. In addition, the benefits, limitations, and risks of the various types of prophylactic antibiotics are discussed. Because of the limited data on prophylactic antibiotics in cataract operations, providing dogmatic statements is difficult. General recommendations are offered based on the currently available literature, and a stratified approach is suggested based on wound construction and number of anterior segment maneuvers.

Anti-Bacterial Agents↗
PubMed1993

Surgery, sterilization and sterility.

The history of sterilization was not linked from the first with surgery. Surgery came first, fully 600 years before the principles of asepsis and anesthesia were even introduced in the middle of the 1800s. Also in the 1800s, the beginnings of thermal sterilization were being developed in the food industry. The basic principles of antisepsis and prevention of wound suppuration, including the destruction of germs on instruments, dressings, the hands of the surgeon and his assistants, and everything else in contact with the wound were clearly elucidated by Lister in the 1870s and remain the inviolate principles of surgical asepsis today. In general, the marriage between the surgeons and the sterilizers was a successful one; the major handicap to eternal bliss and harmony, however, was an incompatibility between the partners. As in many marriages, the partners made unwarranted demands upon each other, and became frustrated when these demands were unfulfilled. The field of surgical sterilization and surgical safety is less confused by technical inconsistencies than it is by semantic nightmares, such that we will never reach a universal definition of sterility. However, we do not really need a universal definition of sterility. Rather we should learn how to translate sterility tests in terms of the real world infections hazards.

Attitude of Health Personnel↗
PubMed1999

Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.

EXECUTIVE SUMMARY The "Guideline for Prevention of Surgical Site Infection, 1999" presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.1,2 Part I, "Surgical Site Infection: An Overview," describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis. Part II, "Recommendations for Prevention of Surgical Site Infection," represents the consensus of the Hospital Infection Control Practices Advisory Committee (HICPAC) regarding strategies for the prevention of SSIs.3 Whenever possible, the recommendations in Part II are based on data from well-designed scientific studies. However, there are a limited number of studies that clearly validate risk factors and prevention measures for SSI. By necessity, available studies have often been conducted in narrowly defined patient populations or for specific kinds of operations, making generalization of their findings to all specialties and types of operations potentially problematic. This is especially true regarding the implementation of SSI prevention measures. Finally, some of the infection control practices routinely used by surgical teams cannot be rigorously studied for ethical or logistical reasons (e.g., wearing vs not wearing gloves). Thus, some of the recommendations in Part II are based on a strong theoretical rationale and suggestive evidence in the absence of confirmatory scientific knowledge.It has been estimated that approximately 75% of all operations in the United States will be performed in "ambulatory," "same-day," or "outpatient" operating rooms by the turn of the century.4 In recommending various SSI prevention methods, this document makes no distinction between surgical care delivered in such settings and that provided in conventional inpatient operating rooms. This document is primarily intended for use by surgeons, operating room nurses, postoperative inpatient and clinic nurses, infection control professionals, anesthesiologists, healthcare epidemiologists, and other personnel directly responsible for the prevention of nosocomial infections. This document does not: Specifically address issues unique to burns, trauma, transplant procedures, or transmission of bloodborne pathogens from healthcare worker to patient, nor does it specifically address details of SSI prevention in pediatric surgical practice. It has been recently shown in a multicenter study of pediatric surgical patients that characteristics related to the operations are more important than those related to the physiologic status of the patients.5 In general, all SSI prevention measures effective in adult surgical care are indicated in pediatric surgical care. Specifically address procedures performed outside of the operating room (e.g., endoscopic procedures), nor does it provide guidance for infection prevention for invasive procedures such as cardiac catheterization or interventional radiology. Nonetheless, it is likely that many SSI prevention strategies also could be applied or adapted to reduce infectious complications associated with these procedures. Specifically recommend SSI prevention methods unique to minimally invasive operations (i.e., laparoscopic surgery). Available SSI surveillance data indicate that laparoscopic operations generally have a lower or comparable SSI risk when contrasted to open operations.6-11 SSI prevention measures applicable in open operations (e.g., open cholecystectomy) are indicated for their laparoscopic counterparts (e.g., laparoscopic cholecystectomy). Recommend specific antiseptic agents for patient preoperative skin preparations or for healthcare worker hand/forearm antisepsis. Hospitals should choose from products recommended for these activitie

Humans↗
PubMed1999

[Recent clinical trials for sepsis: analysis of the results and future perspectives].

Recent clinical trials with experimental immunotherapeutic agents for sepsis have not proven their overall benefit yet although some studies suggested significant effect of these antisepsis therapies. This review article summarizes the results of these trials, their analysis, lessons learned from past failure, and future perspectives for immunotherapies as anti-sepsis treatments.

Animals↗
PubMed1999

[Nursing and the prevention of biological risks: from education to professional activity].

OBJECTIVE: To discover the training nursing students receive regarding prevention and control of infection inside hospital settings and the means of self-protection as well as making people aware of the need to improve this training if deemed necessary. METHODS: This is a transversal descriptive study which took place in the nursing schools in Spain. Data was gathered by means of a questionnaire each respondent filled in by themselves. The lack of a response was also studied. A followup meeting was held with those who participated in this study to seek consensus in the search for solutions to those necessary changes detected. RESULTS: 86% responded to the questionnaire. During the course of career preparation, these were the average number of hours dedicated to various areas of study: 34.5 to Biological Statistics, 40 to Epidemiology, 28 to Infectious Diseases, 29 to Microbiology, 9 to Infection Control, 11 to Concepts of Aspesis and Antisepsis, and 36 to Methods of Research and Investigation. More than 50% of the professors teaching these classes are licensed nurses. Student followup during their clinical practice was carried out basically by nurses in university hospitals. 39% of nursing schools teach the concept and content for universal precautions prior to clinical practice. In the majority of public nursing schools, the followup of a student after a biological accident is carried out by the preventive medicine service, whereas this is done by the school insurance company in private nursing schools. Therefore, significant differences exist. COMMENTS: The theoretical knowledge taught is adequate; the number of hours dedicated to each subject varies among the schools; it is necessary to come to an agreement on the minimum levels of training required before engaging in clinical practice in a safe manner. Universal precautions should be taught in all schools before clinical practice occurs.

Cross-Sectional Studies↗