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The use of serum procalcitonin helps to differentiate bacterial from viral lower respiratory infections and may reduce the use of unnecessary antibiotics.
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Influenza had a major impact on the nations hospitals this season, filling up intensive care units and leading to staff shortages. Currently, there is no standard that requires immunization of health care workers, but the Joint Commission requires hospitals to be in compliance with applicable laws and regulations. A vaccine against the H5N1 virus could be in clinical trials by this summer.
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Receipt of vancomycin antedated isolation of MRSA with reduced susceptibility to vancomycin in 25 patients. Fortunately, there are several alternatives to vancomycin for many of these isolates. There are, in addition, a large number of antibiotics in the pipeline with activity against Gram-positive organisms.
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A formulary switch from levofloxacin to gatifloxacin as the preferred quinolone in a long-term care facility was associated with a significant increase in the incidence of Clostridium difficile-associated diarrhea (CDAD). A case-control study showed that duration of gatifloxacin was independently associated with illness. Switching back to levofloxacin was followed by a decrease in incidence of CDAD to prior levels.
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An antibiotic preparation meant for addition to animal feed was found to be contaminated with antibiotic resistance genes. Fortunately, the genes being used generally encode for resistance mechanisms that are already highly prevalent in gastrointestinal bacteria.
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A total of 6.2% of hospital employees were nasal carriers of MRSA, with the rate highest among workers in long-term care (36%). In 4 of 10 families surveyed, family members were colonized by the same MRSA as the employee.
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In light of the recent rabies outbreak due to transplant of infected organs, the Centers for Disease Control and Prevention (CDC) is reiterating that exposure to feces, urine, blood, or other body fluids is not considered a risk for rabies transmission. The rabies virus cannot survive on surfaces in the environment for any substantial period of time.
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The Centers for Disease Control and Preventions new draft guidelines for patient isolation have been criticized for not being aggressive enough in identifying and eradicating patient reservoirs of multidrug-resistant organisms (MDROs). However, the guidelines include a section on enhanced surveillance and infection control measures for ICPs who want to ratchet up their efforts against MDROs.
