| 1. |
- Axelsson, Inge, 1947-, et al.
(author)
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Luftvägsinfektioner hos barn och vuxna
- 2009
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In: Läkemedelsboken 2009-2010. - Stockholm : Apoteket AB. ; , s. 670-695
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Book chapter (other academic/artistic)abstract
- Luftvägsinfektioner är en av de vanligaste orsakerna till ett akut besök i sjukvården. Antalet läkarbesök och antibiotikarecept ökar markant några veckor efter daghemseller skolstarten och minskar under lovperioder. Hos läkare och allmänhet finns en ökad medvetenhet om nödvändigheten av att vara försiktig med antibiotika. Flera studier har visat att nyttan av antibiotika är liten vid flera av våra vanligaste bakteriella infektioner, vilket också framkommit i de nya nationella rekommendationerna för handläggning av öroninflammationer (år 2000), halsinfektioner (år 2001), bihåleinfektioner (år 2005) och nedre luftvägsinfektioner (år 2008) (, ). En hög följsamhet till barnvaccinationsprogrammet och en hög vaccinationsgrad av äldre mot influensa och pneumokocker förebygger infektioner och bakteriella komplikationer och medför minskad morbiditet och mortalitet. Förbättrad basal hygien, speciellt i småbarnsgrupper, med handtvätt, pappersnäsdukar och pappershanddukar kan minska infektionsspridning och sjuklighet i luftvägsinfektioner.
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| 2. |
- Hammarskjöld, Fredrik, et al.
(author)
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Possible transmission of Candida albicans on an intensive care unit : intensive care unit
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Other publication (other academic/artistic)abstract
- Background: Nosocomial transmission of Candida spp. has not fully been explored and previous studies have shown conflicting results.Aim: To evaluate the possible nosocomial transmission of Candida spp. on an intensive care unit (ICU).Methods: We conducted a prospective study over 19 month, including all patients on our ICU with growth of Candida spp. from surveillance and directed cultures. Molecular typing, with rep-PCR (DiversiLab) was used to define genotype relationships between the C. albicans and C. glabrata isolates. Candida isolates obtained from blood cultures taken from patients in our county outside the ICU, were used as a reference. Temporal cluster analysis was performed to evaluate genotype distribution over time.Findings: Seventy-seven patients with 78 ICU stays, representing twelve per cent of all ICU stays, were found to harbour 180 isolates of Candida spp. Molecular typing revealed 27 C. albicans genotypes and ten of C. glabrata. Possible clustering, indicated by overlapping stays of patients with indistinguishable candida genotypes was observed on seven occasions with C. albicans and on two occasions with C. glabrata. Two C. albicans genotypes were found significantly more often in the ICU group compared to the reference group. Moreover, C. albicans genotypes isolated from more than one patient were significantly more often found in the ICU group. Temporal cluster analysis revealed a significantly increased number of pairs with indistinguishable genotypes at a 21-dayinterval, indicating clustering.Conclusion: This study indicates transmission of C. albicans between ICU patients based on genotyping and temporal cluster analysis.
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| 3. |
- Hammarskjöld, Fredrik, et al.
(author)
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Sustained low incidence of central venous catheter-related infections in a Swedish county hospital following implementation of a hygiene program : a six year follow-up study
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Other publication (other academic/artistic)abstract
- Background: There are limited data on the long term-effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors, over a six year period.Methods: A continuous prospective study aiming to include all CVCs used at our hospital during the years 2004-2009, evaluating colonization, CRI, CRBSI and possible risk factors.Results: 2772 CVCs were used during the study period. Data on culture results and catheterization time were available for 2045 CVCs used in 1674 patients. The incidences of colonization, CRI and CRBSI were 7.0, 2.2 and 0.6 per 1000 CVC-days. Analysis of quarterly incidences revealed one occasion with increasing infection rates. Catheterization time was a risk factor for CRI, but not for CRBSI. Other risk factors for CRI were hemodialysis, CVC use in the internal jugular vein compared to the subclavian vein. Hemodialysis was the only risk factor for CRBSI.Conclusion: We found that that a CRI prevention program adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.
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| 4. |
- Malmvall, Bo-Erik, et al.
(author)
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Reduction of antibiotics sales and sustained low incidence of bacterial resistance : report on a broad approach during 10 years to implement evidence-based indications for antibiotic prescribing in Jönköping County, Sweden
- 2007
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In: Quality Management in Health Care. - 1063-8628 .- 1550-5154. ; 16:1, s. 60-67
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Journal article (peer-reviewed)abstract
- Background: Increased prevalence of resistance in major pathogens decreases the possibility to treat common infectious conditions. In the beginning of the 1990s, resistant pneumococci spread among children in southern Sweden, which alarmed both the profession and the medical authorities. We describe the measures taken to curb the spread of resistance and to reduce the use of antibiotics in outpatient care.Method: A national organization, Strama (Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance), was initiated in 1994 and a regional committee was formed in Jönköping County in 1995. A multifaceted program was started aiming at reducing antibiotic use in the county by 25% and that the prevalence of resistant pneumococci should not increase.Results: The efforts by the Jönköping County committee has resulted in a 31% total reduction of the consumption of antibiotic drugs in primary care between 1993 and 2005 and a 50% reduction among children aged 0 to 4 years. There has been no increase in the prevalence of resistant pneumococci or Haemophilus influenzae in the county. The decrease in antibiotic use was greater than the average in Sweden.Conclusion: Our regional efforts have been successful. This has probably been achieved by a sustained strategy including repeated campaigns in the media, information to the profession, implementation of guidelines, and feedback to the profession on data on antibiotic prescribing and resistance. We believe it is of outmost importance not only to inform the profession but also the public on the limited effects of antibiotics in most respiratory tract infections.
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| 5. |
- Taxbro, Knut, et al.
(author)
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A prospective observational study on 249 subcutaneous central vein access ports in a Swedish county hospital
- 2013
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In: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 52:5, s. 893-901
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Journal article (peer-reviewed)abstract
- Background. Reliable central vein access is a fundamental issue in modern advanced oncological care. The aim of this study was to determine the incidence of complications and patient perception regarding central vein access ports. Methods. We prospectively studied 249 single lumen access ports implanted between 1 July 2008 and 15 March 2010 in a mixed patient population at a 500-bed secondary level hospital in Sweden. We determined the number of catheter days, infection rate and mechanical complications, as well as patient satisfaction regarding the access port, over a six-month follow-up period. Results. Two hundred and forty-four different patients received 249 ports yielding a total of 37 763 catheter days. Ultrasound and fluoroscopic guidance was used in 98% of procedures. Vein access was obtained percutanously by an anaesthesiologist in all cases. There was no case of pneumo- or haemothorax. The incidence of catheter-related bloodstream infection, was 0.05/1000 catheter days and the incidence of pocket/tunnel infection was 0.39/1000 catheter days. Clinically apparent deep vein thrombosis occurred in four patients (1.6%). Patient satisfaction was overall high. Conclusion. These results confirm that our team-based approach with written easily accessible evidence-based guidelines and a structured education programme leads to a very low complication rate and a high degree of patient satisfaction.
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