The total number of new tuberculosis (TB) cases notified in Singapore among citizens, permanent residents and foreigners rose by 46% from 2004 to 2010. During this period, the proportion of foreigners increased from 29% to 47% of the total case burden. In 2008, the TB incidence rate among Singapore citizens and permanent residents increased for the first time in ten years, despite the on-going efforts of the Singapore TB Elimination Programme. Additional measures and resources are clearly needed to curb this rising trend. Pivotal to this is to address TB among foreigners. The political will to battle TB in Singapore must result in action to remove barriers to diagnosis, to enable all TB patients to undergo treatment under directly observed therapy (DOT), and to ensure that all healthcare providers who manage TB patients are responsible and accountable to the public health system.
Directly Observed Therapy ; Emigrants and Immigrants ; statistics & numerical data ; Humans ; Infection Control ; methods ; Singapore ; epidemiology ; Tuberculosis ; epidemiology ; ethnology ; prevention & control

OBJECTIVETo investigate the secular trend of infection rate, risk factor exposure rates for nosocomial pneumonia (NP), and to evaluate the nosocomial infection surveillance and control programs efficacy in an university hospital from 1993 to 2000.

METHODSAll 126 665 hospitalized patients from 1993 to 2000 were studied for NP. The independent risk factors for NP were analyzed by using case-control study method and logistic regression technique. The time-specific rates for NP and risk factor exposure were calculated annually.

RESULTSThe infection rates for NP were decreased by 50% from 1.20% in 1993 to 0.60% in 2000. The logistic regression analysis showed that the independent risk factors for NP were immunosuppressive therapy (OR = 2.72), chemotherapy (OR = 2.17), cancer (OR = 1.45), chronic obstructive pulmonary disease (COPD, OR = 1.88), ICU (OR = 3.18), coma (OR = 3.26), tracheotomy (OR = 14.95), hemodialysis (OR = 5.12), bone or lumbar puncture (OR = 1.82). The time-trends for exposure rates of COPD and bone or lumbar puncture were slightly decreased, however those for the others and the synthetic risk factors were not changed significantly.

CONCLUSIONThe infection rates for NP were significantly decreased in the case of no change for exposure rates of risk factors for NP, this suggests that the nosocomial infection surveillance and control programs were effective for lowering infection rate for NP in this hospital.

China ; epidemiology ; Cross Infection ; epidemiology ; prevention & control ; Hospitals, University ; statistics & numerical data ; Humans ; Infection Control ; methods ; Inpatients ; statistics & numerical data ; Prospective Studies ; Reproducibility of Results ; Respiratory Tract Infections ; epidemiology ; prevention & control ; Risk Factors ; Time Factors

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
Serratia Infections/*epidemiology/*prevention & control/transmission ; Risk Factors ; Risk Assessment/*methods ; Population Surveillance ; Neurosurgery/*statistics & numerical data ; Middle Aged ; Male ; Korea/epidemiology ; Intensive Care Units/*statistics & numerical data ; Infection Control/methods/statistics & numerical data ; Incidence ; Humans ; Follow-Up Studies ; Female ; Disease Transmission, Horizontal/prevention & control/statistics & numerical data ; Disease Outbreaks/prevention & control/statistics & numerical data ; Case-Control Studies ; Bacteriuria/*epidemiology/*prevention & control

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
Serratia Infections/*epidemiology/*prevention & control/transmission ; Risk Factors ; Risk Assessment/*methods ; Population Surveillance ; Neurosurgery/*statistics & numerical data ; Middle Aged ; Male ; Korea/epidemiology ; Intensive Care Units/*statistics & numerical data ; Infection Control/methods/statistics & numerical data ; Incidence ; Humans ; Follow-Up Studies ; Female ; Disease Transmission, Horizontal/prevention & control/statistics & numerical data ; Disease Outbreaks/prevention & control/statistics & numerical data ; Case-Control Studies ; Bacteriuria/*epidemiology/*prevention & control

Animals ; China ; epidemiology ; Humans ; Infection Control ; methods ; statistics & numerical data ; trends ; Prevalence ; Schistosomiasis japonica ; drug therapy ; epidemiology ; prevention & control ; Schistosomicides ; therapeutic use ; Snails ; parasitology

Coronavirus Infections ; epidemiology ; prevention & control ; Elective Surgical Procedures ; statistics & numerical data ; Female ; Humans ; Infection Control ; methods ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Male ; Occupational Health ; statistics & numerical data ; Orthopedic Procedures ; methods ; statistics & numerical data ; Outcome Assessment, Health Care ; Pandemics ; prevention & control ; statistics & numerical data ; Patient Safety ; statistics & numerical data ; Pneumonia, Viral ; epidemiology ; prevention & control ; Risk Assessment ; Safety Management ; Singapore ; Wounds and Injuries ; diagnosis ; epidemiology ; surgery

No abstract available.
Coronavirus Infections/*diagnosis/epidemiology/*prevention & control ; Cross Infection/*diagnosis/epidemiology/*prevention & control ; Disease Outbreaks/prevention & control/*statistics & numerical data ; Global Health/*trends ; Humans ; Incidence ; Population Surveillance/methods ; Republic of Korea/epidemiology