title: Infection control experience in a cooperative care center for transplant patients.
abstract: OBJECTIVE
  To characterize infection control experience during a 6.5-year period in a cooperative care center for transplant patients.
  
  
  METHODS
  Descriptive analysis.
  
  
  METHODS
  A cooperative care center for transplanted patients, in which patients and care partners are housed in a homelike environment, and care partners assume responsibility for patient care duties.
  
  
  METHODS
  Nine hundred ninety one transplant patients.
  
  
  METHODS
  Infection control definitions from the Centers for Disease Control and Prevention were used to ascertain infection rates. Environmental cultures were used to detect methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Clostridium difficile, and fungi during the first 18 months. Surveillance cultures were performed for a subset of patients and care partners.
  
  
  RESULTS
  From June 1999 through December 2005, there were 19,365 patient-days observed. The most common healthcare-associated infection encountered was intravascular catheter-related bloodstream infection, with infection rates of 5.74 and 4.94 cases per 1,000 patient-days for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) patients, respectively. C. difficile-associated diarrhea was observed more frequently in HSCT patients than in SOT patients (3.97 vs 0.57 cases per 1,000 patient-days; P < .0001). There was no evidence of environmental contamination with MRSA, VRE, or C. difficile. Acquisition of MRSA was not observed. Acquisition of VRE was documented.
  
  
  CONCLUSIONS
  This study documented that cooperative care was associated with some risk of healthcare-associated infection, most notably intravascular catheter-associated bloodstream infection and C. difficile-associated diarrhea, it appears the incidences of these infections were roughly commensurate with those in other care settings.
authors.affiliation: Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-4031, USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nusair
authors.forename: Dawn
authors.initials: D
authors.lastname: Jourdan
authors.forename: Sharon
authors.initials: S
authors.lastname: Medcalf
authors.forename: Nedra
authors.initials: N
authors.lastname: Marion
authors.forename: Peter C
authors.initials: PC
authors.lastname: Iwen
authors.forename: Paul D
authors.initials: PD
authors.lastname: Fey
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Reed
authors.forename: Alan
authors.initials: A
authors.lastname: Langnas
authors.forename: Mark E
authors.initials: ME
authors.lastname: Rupp
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000302:isolation & purification; D003299:Cooperative Behavior; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003695:Delivery of Health Care / Q000379:methods*; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006095:Gram-Positive Cocci / Q000302:isolation & purification; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D016377:Organ Transplantation / Q000009:adverse effects