The Eighth conversation on Infectio...

The Eighth conversation on Infectious Diseases was held at the Kimberly-Clark corporate facility in Roswell, Ga, Dec 8-10 2003 An elegant reception and dinner, sponsored through Kimberly-Clark, was held Monday evening to welcome participants and provide them with an opportunity to network with internationally known speakers to discuss critical infectious disease concerns

The discourse addressed a range of infectious disease issues of interest to perioperative and infection dominion government practitioners. Speakers challenged participants to consider their infection reign over practices; provided current information forward familiar, emerging, and resistant organisms; and discussed infection prevention, disinfection and sterilization issues, and to what extent integrating human factors training can improve infection control

unadorned ACUTE RESPIRATORY SYNDROME

John A. Jernigan, MD M chief of the interventions and evaluations section of the Division of Healthcare Quality Promotion at the Center for Disease command and Prevention's (CDC's) National Center for Infectious Diseases, Atlanta, explored the fresh severe acute respiratory syndrome (SARS) outbreak. He reviewed initial signs of the worldwide outbreak of SARS and precepts learned. To prevent future outbreaks, early recognition is absolutely necessary. This will hang on the ability of the health care community to combine clinical and epidemiological features to make a diagnosis.

Early recognition is important, said Dr Jernigan, because simple infection sway measures can reduce transmission. Recognizing and isolating patients with SARS can contribute to reduc transmission rates. The incubation period for SARS is couple to 10 days. Early symptoms commonly reported by means of patients include fever, chills or rigors, headaches, myalgias, and malaise. febrile affection may resolve before respiratory symptoms appear. Respiratory symptoms oftentimes begin three to seven days after the storm of symptoms and peak in the other week, according to Dr Jernigan.

HAND HYGIENE

Elaine L Larson, RN PhD CIC, FAAN, professor of pharmaceutical and therapeutic research at the Columbia University educate of Nursing, New York, provided the background evidence forward which the CDC hand hygiene guideline is based, including research upon skin condition, surgical hand preparation, and general hand washing. Dr Larson also reviewed the hand hygiene guideline, which was released in October 2002 and identified areas of change from the previous recommendation.

Skin hygiene is a critical factor in preventing transmission of infectious organisms. The strange guideline promotes the use of alcohol-based productions which have been found to be les damaging to skin and easier to use. This comes in higher hand-washing compliance among health care workers. The guideline encourages the use of an appropriate hand lotion after using an alcohol-based fruit because the lotion acts as a gelatine to help prevent skin enclosed spaces from shedding, thus promoting skin health.

Dr Larson reported single interesting occurrence about the use of alcohol-based products--the proceeding of skin irritation in a small portion of young females. This reaction was resolv after the women did not use an alcohol-based returns for a few weeks and then switched to a different alcohol-based performance Dr Larson reported that there was no known reason for this event in this small segment.

ANTIBIOTIC-RESISTANT ORGANISMS

Barry M Farr, MD MSc professor of medicine and epidemiology at the University of Virginia Health theory Charlottesville, Va, provided insight into preventing the spread of antibiotic-resistant organisms. High frequent occurrence of antibiotic use in hospitals provides a selective advantage for antibiotic-resistant pathogens, so as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, to survive, proliferate, and spread.

Dr Farr reviewed mechanisms for progression in a continuously ascending gradation of antibiotic resistant organisms that health care providers ne to consider, including

* random genetic mutation;

* plasmid swapping during conjugation;

* change of transposons to plasmids or chromosomes;

* transduction on bacteriophages (ie, acquisition of resistant gene from a freshly killed cell and incorporation into a chromosome or plasmid); and

* binary fission (ie, replication).

Possible superintend measures to prevent the proceeding of resistant organisms include preventing their spread via appropriate hand hygiene, controlling the use of antibiotics, identifying colonized patients with active surveillance agricultures and using barrier precautions.

Dr Farr detailed initiatives that contributed to the University of Virginia Health System's succes in reducing or eliminating outbreaks of infections caused through resistant organisms. The organization followed by implementing active surveillance of cultures; strict contact precautions, including using gown and gloves; meticulous hand hygiene; and isolation of patients base to have positive cultures for resistant organisms.