Volume 19 Number April 1991
RISK OF NGSGCOMIAL INFBCIION lN A NEONATAL INIENSIVB CARB UNIT. 1. Shcldm.’ RN, BS. R.W. Lyons, MD. SL Francis Hospital atal Medical Center, Hat&d, Cl’. Sevenof~bPbiesrdmiaedtomIS-bednanastintanivecpn lmit(NIcu)acqtdKd18-ial-(Nl)wltikinlhcltniL Thaewerc12infwtionsIlalopatiemdays. lYENIcuinwhlcbpmspective~~wasdaufar3m~in1990ispartofa600 bed wmmunity machlng hospital. CDC de6nittoos of Nl were used. Statistical signiliwas cvaluatcd by Fish& wt test Each baby was evaluamd for the folkwlng liaks on admii low birth weight (LBW) (
EVALUATION OF UNlVERSAL PRBCAIJTIONS ON THE INCIDENCE OF MRSA. cLmTRiDnJM DIFFI~ILE AND Rsv m A LARGE TEACHING HOSPITAL. B. Ktwb,* RSN. BSN. S. Atamian, EA. RN, CIC, N. VaUmde. BS. MI’, CIC. M. spenm. RN, BSN, CIC. C. Hopkins, MD. Massachusas Gmf%al Hospital, Boston, MA. A Universal Pmxttlons p~gram was bnplnmuEd in a llMJf&bed teaching hospital in March. 1988. The sysan was based on amsldcring blood and all body Raids as potentially infcUloas and utilized cady To evaluate the impact of this approach. a nmJspahve lwiew of MRSA, C. [email protected]
~e and RSV cases and/or dosten was eonducad. A cluster was &fitted ss a gtuup or series of casts which occurred within a specified period of time that appeatui to be t&ted to cross ccmtamination. 1. An MRSA cluster was defined as two or more cases within a 30 day period per nursing tmit The month c&ted for the duster was the month in whkh the second case was identlftcd. 2. A C. [email protected]
cluster was defined as three or,mom eases within a 3&day period per nursing tmit. ‘Ihe month c&Red for the duster was the month in which the third case occoned. RSV casw were cmsideted noscwmial if they occorred after live days of hospitalization, while MRSA and C. [email protected]
& were considered nosocomial aftcr three days of hospitaliiott. Findings: I. Them was mt a statistically significant inetease in MRSA. In 1988. there welt 47 nosocomial case3 (NC) with 10 cktsfers. In 1989, there v/en 57 NC with 10 clusters. In 19% there wct’e 73 NC with 14 chtstetx 2. initial findings after the ltnplemcntation of UP. demararnrcd ao increase in C. d&i& ciusten possibly t&ted to tlk? pmctice of sharing commodes sod other fecal cotnamiMted qttipnm. Alier the implementation of c4mIml meastors in Jme. 1989, then was a statistically significant decrease in cases sod clusters. In 1988. there were 79 NC with 5 cIustetx. In 1989, the wem 105 NC with 10 clusters. 1n 1990. then: were 71 case4 with 4 clustelx. 3. RSV cases wett rwiewd for the season prior to U.P. sod thtee seasons following. ‘lkrc appeawl to bc a dcaease in tk incidence of nosocomial RSV since U.P. In 1988, then wen 64 cases with 8 NC (12%). In 1989. there were 50 cases with 7 NC (14%). In 1990. there were 58 cases with 6 NC (10.3%). Conclusion:
The implemented approach to Universal Ptecatttions do&? not appear to incnasx but appears to declwse transmission of these three nosommial Pathogens.
BLBNDBR-RELA-iXD PSEUDOMONAS MONJA. M.Joms,*RN,ClC,B.Hrmy,MD. hfedidcancr,~slamulliveffiFlooDcgofMaBcim, unlvemity Hospital. Hersky. PA.
(PA)~occasmditt7nm~ses ina27-hedmamalimmsiveMmlt(Nxc!u)fmmAtamh~ ApIil.1990. bmzstigsknmvaledmaedarlmhitimaao&lms amldheasot.uccofmmwmlalgrsan~vcmd(GNR~lnfwOm AllammtesMPAadtmedframtkir~achaalaqdnks GIher cmmmmudes included enaomeMmw. mdlw#ataymagias Flldmcmvmn.~ ofpmvdemdinFrrfommlaglvenbyNGatbeuslngaRaaelptuap UseoftheplmpbadbamswcdlttMank Nootkrmames lttc&edIhisfomuladmbtgmecpidcmicpcdod Fommlawx ptepamdinasatcUimplmmacyliumpowdardeailtwaushtg “ckd’tecWqmina3-piecsblmder. [email protected]
htnmtdlsmsem~aulwasairdricd. stuveillancectdhuesofrrspintory~sqpipwrwenacg tive. Howew.PAwasatlnuedfmmthe3-piecebwuad tetii~mfri~ -mtal fommla. lllcsek? matdtdtboseOwnmcbplrspintsNoagmisms theformulapowkrasmlkwater,exdmdlnglhapossiityof~ sic matlllpnutKn. . . Tap water in ths NICU aml phammcy also -VeforpA. ‘Iheteclmlqacforpqauingpmwkmdint%mformulawa5revi.wd. [email protected]
~remachimwashaiwcmohmimd,md tbcaseofmcRazclfcedblgptmpwastleuwed DluhgIheeigtamanpIsafmrtlr.contld rmasme%-bcguq mfwiherwsesofPAplaunmiasr&tedtomtemlfcediogomumd in NICU. LmngtbEeightmonthsafleroteonmol ntWmmSwmbeyo. mi%rt&asesofPA ~asslatcdto~fwdhtgowutmd in Nlcu. weczmckkdthatdteconsminrtionofthcmconstlM?.dinf~ fmmaladlublgpqandonwuthc.%mrceofinfeclionin5ofthe7 mumas Useofaf~pumpmayhaveumtdbotcdtolncm=ed Ukdlhmd of apirpnm with comamioated feedll.