METHOD: A prospective cohort-targeted comprehensive surveillance study on NI associated with usage of devices was conducted in three ICUs in Malaysia using a developed NI surveillance form. Patients who developed infection outside an ICU were excluded from the study.
RESULTS: The device associated NI was 21.1%. The mean duration for development of NI was 10.0 +/- 7.44 days in ICU. The major device-associated infections were nosocomial pneumonia (18.7%) followed by bacteremia (8.5%) and urinary tract infections (4.7%) respectively. NI incidence density rate was 20.6 per 1,000 patient-days. Bacteremia, urinary tract infection (UTI) and nosocomial pneumonia (NP) rates were 8.9, 4.7 and 20.5 per 1,000 patient-days, respectively. Acinetobacter species, Klebseilla pneumoniae, Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus were the predominant pathogens isolated from the NIs subjects during the study period in the three ICUs.
CONCLUSION: Analysis of the rate of the NIs associated with usage of devices in the three ICUs showed that it is highly correlated with the use of mechanical ventilation devices, followed by intravascular devices and usage of indwelling urinary catheters.
METHODS: We did a randomised, controlled, assessor-masked trial at ten Australian hospitals. Our hypothesis was CRBSI equivalence for central venous access devices and non-inferiority for peripheral arterial catheters (both 2% margin). Adults and children with expected greater than 24 h central venous access device-peripheral arterial catheter use were randomly assigned (1:1; stratified by hospital, catheter type, and intensive care unit or ward) by a centralised, web-based service (concealed before allocation) to infusion set replacement every 7 days, or 4 days. This included crystalloids, non-lipid parenteral nutrition, and medication infusions. Patients and clinicians were not masked, but the primary outcome (CRBSI) was adjudicated by masked infectious diseases physicians. The analysis was modified intention to treat (mITT). This study is registered with the Australian New Zealand Clinical Trials Registry ACTRN12610000505000 and is complete.
FINDINGS: Between May 30, 2011, and Dec, 9, 2016, from 6007 patients assessed, we assigned 2944 patients to 7-day (n=1463) or 4-day (n=1481) infusion set replacement, with 2941 in the mITT analysis. For central venous access devices, 20 (1·78%) of 1124 patients (7-day group) and 16 (1·46%) of 1097 patients (4-day group) had CRBSI (absolute risk difference [ARD] 0·32%, 95% CI -0·73 to 1·37). For peripheral arterial catheters, one (0·28%) of 357 patients in the 7-day group and none of 363 patients in the 4-day group had CRBSI (ARD 0·28%, -0·27% to 0·83%). There were no treatment-related adverse events.
INTERPRETATION: Infusion set use can be safely extended to 7 days with resultant cost and workload reductions.
FUNDING: Australian National Health and Medical Research Council.
Methods: In this study, a total of 42 swab samples were collected from the surface of various fitness equipment such as back machines, exercise mats, dip stations, dumbbells, and treadmills. Identification of the bacterial isolates was conducted using biochemical tests and further analysed molecularly using the PCR method targeting nuc gene (270 bp). The nuc gene encodes for the thermonuclease enzyme, a virulent factor of S. aureus.
Results: The findings showed 31 out of 42 swab samples (73.81%) were positive with S. aureus.
Conclusion: This study showed that gymnasium equipment is a potential reservoir for S. aureus and might play an important role in transmitting the pathogen to humans.
Objective: This study was undertaken to assess the presence of S. aureus on the surface of fitness equipment from selected gymnasiums in Kuching and Kota Samarahan, Sarawak (Malaysia).