The Relationship between Hospital Infection Surveillance and Control Activities and Antibiotic Resistant Pathogen Rates

Objective: The purpose of the study was to examine the relationship of surveillance and control activities in Canadian hospitals with rates of nosocomial methicillin-resistant S. aureus (MRSA), C. difficile associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE). Methods: Surveys were sent to Infection Control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals. Results: One hundred and twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1,000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found hospitals that reported infection rates by specific risk groups (r = - 0.27, p < 0.01) and that kept attendance records of infection control teaching activities (r = - 0.23, p < 0.01) were associated with lower MRSA rates. Multiple stepwise regression analysis found larger hospitals (r = 0.25, p < 0.01) and hospitals where infection control committees or staff had the direct authority to close a ward or unit to further admissions due to outbreaks (r = 0.22, p < 0.05) were associated with higher CDAD rates. Multiple logistic regression analysis found larger hospitals (OR = 1.6, CI 1.2 - 2.0, p = 0.003) and teaching hospitals (OR = 3.7, CI 1.2 - 11.8, p = 0.02) were associated with the presence of VRE. Hospitals were less likely to have VRE when infection control staff frequently contacted physicians and nurses for reports of new infections (OR = 0.5, CI 0.3 - 0.7, p = 0.02) and there were in-service programs for updating nursing and ancillary staff on current infection control practices (OR = 0.2, CI 0.1 - 0.7, p = 0.01). Conclusions: Surveillance and control activities were associated with MRSA and CDAD rates and the presence of VRE. Surveillance and control activities might be especially beneficial in large and teaching hospitals.

State-Selective Photodissociation Dynamics of Formaldehyde: Near Threshold Studies of the H+HCO Product Channel

The laser-induced photodissociation of formaldehyde in the wavelength range 309<λ<330nm 309<λ<330nm has been investigated using H (Rydberg) atom photofragment translational spectroscopy. Photolysis wavelengths corresponding to specific rovibronic transitions in the A ˜ A 2 1 ←X ˜ A 1 1 ÃA21←X̃A11 2 1 0 4 3 0 201403 , 2 2 0 4 1 0 202401 , 2 2 0 4 3 0 202403 , 2 3 0 4 1 0 203401 , and 2 1 0 5 1 0 201501 bands of H 2 CO H2CO were studied. The total kinetic energy release spectra so derived can be used to determine partial rotational state population distributions of the HCO cofragment. HCO product state distributions have been derived following the population of various different N K a NKa levels in the A ˜ A 2 1 ÃA21 2 2 4 3 2243 and 2 3 4 1 2341 states. Two distinct spectral signatures are identified, suggesting competition between dissociation pathways involving the X ˜ A 1 1 X̃A11 and the a ˜ A 2 3 ãA23 potential energy surfaces. Most rovibrational states of H 2 CO(A ˜ A 2 1 ) H2CO(ÃA21) investigated in this work produceH+HCO(X ˜ A ′ 2 ) H+HCO(X̃A′2) photofragments with a broad kinetic energy distribution and significant population in high energy rotational states of HCO. Photodissociation via the A ˜ A 2 1 ÃA21 2 2 4 3 2243 1 1,1 11,1 (and 1 1,0 11,0 ) rovibronic states yields predominantly HCO fragments with low internal energy, a signature that these rovibronic levels are perturbed by the a ˜ A 2 3 ãA23 state. The results also suggest the need for further careful measurements of the H+HCO H+HCO quantum yield from H 2 CO H2CO photolysis at energies approaching, and above, the barrier to C–H bond fission on the a ˜ A 2 3 ãA23 potential energy surface.