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Introduction: The channeling of central venous catheters (CVC) is a technique used in intensive care units (ICUs) but it doesn't come without the risk of infection in the placement and subsequent handling., Objective: Evaluate the effectiveness of a prevention of infection following the introduction of new multifactorial strategies in the prevention program Central line-associated bloodstream infection (CLABSI) at ICU., Methodology: Comparative descriptive study in two periods, including all patients admitted in multipurpose ICUs of a tertiary hospital 2014. We analyzed 2014 data compared with 2013, to test the impact of new measures CRB prevention program. Variables: number of catheters, number of infections/1000 catheter days and path. Actions carried out were: prospective surveillance of the incidence rate, sequential program multifactorial prevention implementation of different measures, checklist for insertion of new catheters, introduction of weekly monitoring compliance, reporting episodes team are, continuing education for sanitary personal and implementation of the semipermeable transparent dressings with chlorhexidine gel., Results: The overall incidence density rate decreased from 3.1 episodes/1000 catheter days in 2013 to 2.3 episodes/1000 catheter days in 2014, improving in different units. The utilization ratio of the different accesses was: 35% humeral; 33% jugular; 25% subclavian; 10% femoral, and 13% hemodialysis catheter., Conclusions: The new measures applied to reduce the bacteremia have allowed a decrease in the rate of infection, what brings closer to the objective of the Bacteremia Zero program.

Background: Surgical site infection (SSI) after colorectal procedures represents a measurable quality indicator of a healthcare system. There is an increasing interest in comparing SSI rates between different hospitals and countries: however, the variability of the data regarding the incidence of SSI makes this comparison difficult. For the purposes of evaluation, data collection must be standardized and must include reliable post-discharge surveillance (PDS)., Aim: To determine impact and risk factors for PDS SSI after elective colorectal surgery., Methods: VINCat is a nosocomial infection surveillance programme in Catalonia, Spain. Between 2007 and 2011, 52 hospitals joined the programme. Hospitals performed active, prospective, standardized surveillance of elective colorectal resection. PDS was implemented by a multimodal approach and was mandatory within the first 30 days after surgery., Findings: During the study period, 13,661 elective colorectal procedures were included. SSI was diagnosed in 2826 (20.7%) patients, of whom 22.5% during PDS; of these, 52% required readmission. Patients with PDS SSI were younger (odds ratio: 1.57; 95% confidence interval: 1.29-1.91), predominantly female (1.40; 1.16-1.69), had more frequently undergone endoscopic procedures (1.56; 1.30-1.88) and had more incisional SSI (1.88; 1.54-2.28) than patients with in-hospital SSI., Conclusion: SSI rates in elective colorectal procedures at VINCat hospitals were inside the higher range of those reported by other national programmes. PDS SSI increased the overall rate of SSI, had a significant clinical impact, and accounted for almost a quarter of SSI. Younger age and laparoscopic procedures were the most relevant risk factors. Standardized multimodal PDS should be implemented for hospitals performing surveillance of colorectal surgery., (Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)

Unlabelled: Cardiovascular disease is the major cause of mortality in chronic kidney disease (CKD). Arterial stiffening is recognised as a critical precursor of cardiovascular disease. Available evidence indicates that lifestyle modifications are therapeutic interventions for preventing and treating arterial stiffening., Objective: To evaluate the influence of lifestyle modifications on the arterial vessel compliance in CKD patients not receiving renal replacement therapy (RRT). We measured the arterial vessel compliance in 50 CKD patients not receiving RRT (30 post-transplant, 20 pre-RRT). Noninvasive pulse wave analysis of radial artery was used to estimate large artery (C1) and small artery elasticity (C2) and was corrected for patients age. Renal transplant (RT) patients were younger than CKD patients. RT patients C1 normal in 13%. C2 lower than normal in 77% of cases and not associated with evaluated variables, but worse large artery compliance was observed. In CKD patients, C1 was normal in 55%. C1 was strongly associated with aerobic exercise. For CKD patients, exercise normalises large artery compliance. C2 was lower than normal in 90%. Small artery compliance was affected in majority of patients.