Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals: a challenge to hospital leadership
Article Abstract:
Ten strategic goals are described that hospital administrators can follow to control the spread of drug-resistant infectious organisms in hospitals. The goals were developed during a workshop in September, 1994 attended by hospital personnel, pharmaceutical industry representatives and government officials. Hospitals are facing a future in which serious infectious diseases could be untreatable because many organisms common in hospitals are becoming resistant to the most widely used antibiotics. Some strains of Staphylococcus aureus are resistant to most antibiotics, leading to the widespread use of vancomycin. However, the increased use of vancomycin has led to vancomycin resistance in enterococci. Pharmaceutical companies are unable to keep up and have little incentive to develop antibiotics that will be useless in just a few years. Guidelines for proper antibiotic use and good infection control procedures should be developed by all hospitals.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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The epidemiology of intravenous vancomycin usage in a university hospital: a 10-year study
Article Abstract:
Prevention or treatment of nosocomial, or hospital acquired, infections with intravenous vancomycin may have increased at tertiary care hospitals between 1981 and 1991. Vancomycin is an antibiotic used to treat infections caused by gram-positive bacteria, the most frequent cause of nosocomial infections in tertiary care hospitals. Researchers examined the use of different antibiotics to prevent or treat nosocomial infections at a university teaching hospital between 1981 and 1991. Approximately 1,000 grams (gm) of vancomycin were used during 1981, compared with approximately 20,000 gm during 1991. The use of penicillin remained approximately the same over the ten-year period. The use of vancomycin was higher in the hematology-oncology and bone marrow transplantation wards than in other parts of the hospital. Increased use of vancomycin among hematology-oncology patients may be associated with the use of plastic intravenous devices.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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The natural history of the systemic inflammatory response syndrome (SIRS): a prospective study
Article Abstract:
Systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock may represent increasingly severe stages of the body's inflammatory response to infection. During a nine-month period, researchers reviewed the medical records of 3,708 adults who were admitted to one of six hospital wards. Of these, 2,527 patients had at least two symptoms of SIRS. Within the 28-day follow-up period, 26% of the patients with SIRS symptoms developed sepsis, 18% developed severe sepsis, and 4% developed septic shock. Forty-four percent of the patients with sepsis, 58% of patients with severe sepsis, and 71% of patients with septic shock had progressed from a milder stage of inflammatory response to a more serious stage. The patients' rates of positive blood cultures for bacteria, end-organ failures, and death increased with each progressive stage of the body's inflammatory response to infection.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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