Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina

letters to the Editor

June 2006

negative AFB culture from a respiratory specimen in univariate analysis (patients with normal roentgenogram were the referent group). In summary, as we found for our analysis of AFB smear,1 the third specimen for AFB culture from a respiratory specimen added little additional diagnostic value in establishing a diagnosis of pulmonary tuberculosis. The overall benefit in sensitivity of the third specimen was 2%, and there was a slightly higher diagnostic value among HIV-infected patients (additional benefit in sensitivity of 3%); the difference among HIV infected and HIV seronegative was statistically significant for the first, but not the second culture. Because our follow-up study was based only on culture-positive cases, we were unable to calculate specificity or negative predictive value for AFB culture. At our institution, 2 specimens proved to be adequate in almost all patients in establishing a diagnosis of pulmonary tuberculosis, and the benefit of the third specimen was of little diagnostic value. Other institutions should evaluate their data because considerable cost savings could be incurred by requiring 2 rather than 3 specimens to evaluate a patient for pulmonary TB. Michael K. Leonard, Jr, MD Ekaterina Kourbatova, MD Henry M. Blumberg, MD Assistant Professor of Medicine Divsion of Infectious Diseases Emory University School of Medicine

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Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina To the Editor: I wish to bring to your readers’ attention a misinterpretation of results reported in the Discussion section of the article by Rosenthal et al, Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina. Am J Infect Control 2005;33:392-7. The authors’ discussion of our results for increasing hand hygiene compliance through patient empowerment (Partners In Your Care) was incorrectly reported. The objective of the reported study was to determine 2 postintervention phases: (1) no intervention and (2) visual reminder/ no patient empowerment. The study objective was to determine overall sustained compliance from baseline following the 2 postintervention phases. Based on this design, our findings showed an overall sustained increase in compliance of 56% from baseline (P < 001).1 It appears that, in reviewing the article, the authors did not present comparison data for the 2 postintervention phases showing a significant sustained compliance in relation to baseline. Maryanne McGuckin, Dr. ScEd., MT (ASCP) Senior Research Investigator, Adjunct Associate Professor, University of Pennsylvania School of Medicine Philadelphia, PA

E-mail: [email protected]

Reference

Reference

1. Leonard MK, Osterholt D, Kourbatova EV, Del Rio C, Wang W, Blumberg HM. How many sputum specimens are necessary to diagnose pulmonary tuberculosis? Am J Infect Control 2005;33:58-61.

1. McGuckin M, Taylor A, Martin V, Porten L, Salcido R. Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control 2004;32:235-8.

doi:10.1016/j.ajic.2006.01.006

doi:10.1016/j.ajic.2005.11.011