VOLUME 22, NUMBER 6 JUNE 2001

An Official J o u r n a l of The Society for Hea l thcare Epidemiology of America

PUBLISHED FOR THE SOCIETY BY SLACK INCORPORATED

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY*

E D I T O R I A L Prevention of Postoperative Wound Infections: To Cover Up? CHRISTINA M.J.E. VANDENBROUCKE-GRAULS, MD, PHD; JAN A. KLUYTMANS, MD, P H D 335

O R I G I N A L A R T I C L E S Routes and Sources of Staphylococcus aureus Transmitted to the Surgical Wound During Cardiothoracic Surgery: Possibility of Preventing Wound Contamination by Use of Special Scrub Suits ANN TAMMELIN, MD; ANNA HAMBR/EUS, MD; ELISABETH STAHLE, MD 338

Factors Associated With Postoperative Infection JAMES D. SCOTT, PHARMD; ALAN FORREST, PHARMD; STEVE FEUERSTEIN, BS; PAUL FTTZPATRICK, BA, MS; JEROME J. SCHENTAG, PHARMD 347

Anesthesia-Associated Carbon Monoxide Exposures Among Surgical Patients MICHELE L. PEARSON, MD; WILLIAM C. LEVINE, MD, MSc; ROBERT J. FINTON, MSPH;

CHARLES T. INGRAM, MD, MSc; KATHLEEN B. GAY, MD, MPH; GERDA TAPELBAND, MD;

J. DAVID SMITH, BS; WILLIAM R. JARVIS, MD 352

Microbiology and Risk Factors for Catheter Exit-Site and -Hub Colonization in Neonatal Intensive Care Unit Patients LUDO M. MAHIEU, MD; JOZEF J. D E DOOY, MD: AIME 0 . D E MUYNCK, MD, PHD;

GUILLAUME VAN MELCKEBEKE, MD; MARGARETA M. IEVEN, PHD; PATRICK J. VAN REEMPTS, MD, PHD 357

HACCP and Food Hygiene in Hospitals: Knowledge, Attitudes, and Practices of Food-Services Staff in Calabria, Italy ITALO F. ANGELILLO, DDS, MPH; NUNZIA M.A. VIGGIANI, MD; ROSA M. GRECO, MD; DANIELA RITO, MD;

THE COLLABORATIVE GROUP 363

The Epidemiology of Invasive Pulmonary Aspergillosis at a Large Teaching Hospital CLARE F. PEGUES, RN, MPH; ERIC S. DAAR, MD; A. REKHA MURTHY, MD 370

CONCISE C O M M U N I C A T I O N S Do New Surgeons Have Higher Surgical-Site Infection Rates? REBECCA WURTZ, MD, MPH; BETH WITTROCK, RN; MARY ALICE LAVIN, RN; ANNE ZAWACH, RN, MPH 375

Two-Year Trends of Peripherally Inserted Central Catheter-line Complications at a Tertiary-Care Hospital: Role of Nursing Expertise DUANE FUNK, MD; JANET GRAY, RN; PIERRE J. PLOURDE, MD 377

Differences in Antimicrobial Susceptibility Among Hospitals in an Integrated Health System TERESA J. LUBOWSH, PHARMD; JOHN L WOON, PHARMD; PATRICIA HOGAN, BSMT; CHING-CHANG HWANG, P H D 379

Continued inside.

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ADVANCED WOUND CARE 'Shapiro JM, Bond EL, Garman JK. Use of chlorhexidine dressing to reduce a division of ETHICON, INC. microbial colonization of epidural catheter. Anesthesiology. 1990:73:625-631.

v ^ P.O. Box 151, Somerville, New Jersey 08876-0151 Capitalized product names are trademarks of ETHICON, INC. © ETHICON, INC. 2001

Vol. 22 No. (i June 2001

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY*

C O N X E N X S

Continued from cover

Bloodborne Pathogen Exposures in a Developmental Center: 1 9 9 3 - 2 0 0 0 GHAN-SHYAM LOHIYA, MD, MS; LILIATAN-FIGUEROA, MD; SONIA LOHIYA 382

Nosocomial Infections in a Community Hospital in Mexico M. DE LOURDES GARCIA-GARCIA, MD, DR SC; AIDA JIMENEZ-CORONA, MD, Ms Sc; M. EUGENIA JIMENEZ-CORONA, MD, Ms Sc; MIGUELINA SOLIS-BAZALDUA, MD, MPH; CARLOS 0 . VILLAMIZAR-ARCINIEGAS, MD, MPH; JOSE LUIS VALDESPINO-GOMEZ, MD, MPH 386

Infrequent Isolation of Multiresistant Acinetobacter baumannii From the Staff Tending a Colonized Patient With Severe Burns TEEMU PAAVILAINEN, MD; MARKKU ALANEN, MD, P H D ; MIKA MAKELA, MD, P H D ; MARIANNE ROUTAMAA, RN; HELINA JARVINEN, MD; PENTTI HUOVINEN, MD, P H D ; PIRKKO KOTILAINEN, MD, P H D 388

The Effects of Contamination on Biological Monitoring CYNTHIA L. KLEINEGGER, DDS, MS; DENNIS L. YEAGER, MT; JUDITH K. HULING, MT; DAVID R. DRAKE, P H D 391

READER'S FORUM Surveillance of Hospital-Acquired Infection in England, Germany, and The Netherlands: Will International Comparison of Rates B e Possible? ROSA COELLO, MD, MSc; PETRA GASTMEIER, MD; ANNETTE S. DE BOER, M S C 393

LETTERS TO THE EDITOR Detection of Carriage of Vancomycin-Resistant Enterococci in an Intensive Care Unit in B u e n o s Aires MARCELO E. MARIN, P H D ; OSCAR PODESTA, P H D ; PAULA LLAMBIAS, P H D ; FRANCISCA GALDON, P H D ; VrviANA M. SCILINGO, P H D ; DANIEL STAMBOULIAN, MD; RICARDO H. ROMERO, MD; GUSTAVO D. LOPARDO, MD 332

Nelfinavir in Expanded Postexposure Prophylaxis Causing Acute Hepatitis With Cholestatic Features: Two Case Reports MARCIA TRAPE, MD; SANDRA BARNOSKY, APN 333

MEDICAL NEWS GINA PUGLIESE, RN, MS; MARTIN S. FAVERO, P H D 398

SHEA NEWS ANDREAS VOSS, MD, P H D 400

To view abstracts of these articles, visit us on the Internet at http://wjvw.slackinc.com/jjeneral/iche

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INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY is listed in Index Medicus, Current Contents-Clinical Practice, Hospital Literature Index, Cumulative Index to Nursing & Allied Health Literature, Nursing Abstracts, Laboratory Performance Information Exchange System, and RNdex Top 100.

June 2001

EDITORIAL OFFICES Vanderbilt University School of Medicine A-1131 Medical Center North Nashville, TO 37232-2637 (615) 343-1095; (615) 343-1882 (FAX) Email: iche@mcmail.vanderbilt.edu EDITOR Michael D. Decker, MD, MPH MANAGING EDITOR Susan Cantrell STATISTICAL EDITOR Beverly G. Mellen, PhD SENIOR ASSOCIATE EDITORS C. Glen Mayhall, MD Gina Pugliese, RN, MS William Schafmer, MD ASSOCIATE EDITORS Donald A. Goldmann, MD Didier Pittet, MD, MS Andreas Widmer, MD, MS SECTION EDITORS Beyond Infection Control: The New Hospital Epidemiology Bryan P Simmons, MD Stephen B. Kritchevsky, PhD Memphis, Tennessee Wing Hong Seto, MD Hong Kong Disinfection and Sterilization William A. Rutala, PhD, MPH Chapel Hill, North Carolina Emerging Infectious Diseases Larry J. Strausbaugh, MD Pordand, Oregon Robert W. Pinner, MD Adanta, Georgia From the Laboratory Marcus Zervos, MD Royal Oak, Michigan Fred C. Tenover, PhD Adanta, Georgia Information Management JohnASellick,DO Buffalo, New York The International Perspective Mary D. Netdeman, MD, MS Richmond, Virginia Issues in Surgery JamesT.Lee.MD.PhD St. Paul, Minnesota Medical News Gina Pugliese, RN, MS Chicago, Illinois Martin S. Favero, PhD Irvine, California Practical Healthcare Epidemiology Loreen A Herwaldt, MD Iowa City, Iowa SHEA News Andreas Voss, MD, PhD Nijmegen, The Netherlands Statistics for Hospital Epidemiology David Birnbaum, PhD, MPH Sidney, British Columbia, Canada Topics in Long-Term Care Philip W. Smith, MD Omaha, Nebraska Topics in Occupational Medicine David Weber, MD, MPH Chapel Hill, North Carolina

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY8

EDITORIAL A D V I S O R Y B O A R D

Jacques F. Acar, MD J. Wesley Alexander, MD

Paul Arnow, MD Graham A.J. Ayliffe, MD

Neil L. Barg, MD Manuel Bastanzuri, MD

Elizabeth Ann Bolyard, RN, MPH, CIC John M. Boyce, MD

Professor Dr. Ilja Braveny Christian Brun-Buisson, MD

Charles Bryan, MD Donald E. Craven, MD

Sue Crow, MSN, RN, CIC Franz Daschner, MD

Leigh G. Donowitz, MD Charles E. Edmiston, Jr., PhD

Theodore C. Eickhoff, MD Bruce Farber, MD

Victoria J. Fraser, MD Peter C. Fuchs, MD, PhD Richard A. Garibaldi, MD

Robert Gaynes, MD Velvl Greene, PhD, MPH

David W. Gregory, MD David K. Henderson, MD Peter N.R. Heseltine, MD

Karen Hoffmann, RN, CIC, MS Marguerite McMillan Jackson, RN, PhD

Janine Jagger, MPH, PhD William R. Jarvis, MD

Douglas S. Kernodle, MD Robert H. Latham, MD

Lewis B. Lefkowitz, MD Hsieh-Shong Leu, MD, MSc

Jack Levy, MD Victor Lorian, MD

Dennis G. Maki, MD William J. Martone, MD

Allison McGeer, MD John E. McGowan, Jr., MD

Jonathan L Meakins, MD, DSc Robert R. Muder, MD

Joseph M. Mylotte, MD, CIC Lindsay Nicolle, MD Juhani Ojajarvi, MD

Michael T. Osterholm, PhD, MPH Jan Evans Patterson, MD

Sindy M. Paul, MD Michael A. Pfaller, MD

Samuel Ponce de Leon, MD, MSc Isaam Raad, MD

Manfred L. Rotter, MD, DipBact Theodore Sacks, MD

William E. Scheckler, MD Kent Sepkowitz, MD Denis Spelman, MD

Michael L. Tapper, MD Clyde Thornsberry, PhD Professor Leonid P Titov

Timothy R. Townsend, MD Antoni Trilla, MD, PhD

Professor Wang Shu-Qun J. John Weems, Jr., MD

Robert A. Weinstein, MD Professor Dr. W. Weuffen

Sergio B. Wey, MD Rebecca Wurtz, MD

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