院内感染対策のための指針案及びマニュアル作成の
Contents
1. Mi amp E22. IL RAT Cb I TL SER NB HE 2
3. Id 1 3 1 4 VRE 1 1 VRE Hw 5 CIB 1 1 2 vf UA Z GER UR TET SAH HES E Tik VRE 95 IIB 1 1 3 O IB 1 1 4 VRE ICU 3 IA 1 1 5 VRE 1 16 IB
4. CH PRSP MRSA MDRP H5N1 3 3 1 IVA 3 1 1 AVA 23 12
5. 30 Il 0 1w v ANIC T ZR 3 2s H 8vw MM Vx ATI E H bUL lt RATS 9
6. IIIB 3 1 2 80 C C 10 7 IVA 3 1 3 VA 3 1 3 1 60 70C 10 0 025 250ppm 3 1 3 2 60C 5 2 3 4 3 1 4 CIA 3 1 5 80C 10 0 025 Q50ppm KERRE 30 C
7. IB 8 81 157 IVA 8 2 8 3 O157 IVA McNeil SA Malani PN Chenoweth CE Fontana RJ Magee JC Punch JD Mackin ML Kauffman CA Vancomycin re sistant enterococcal colonization and infection in liver transplant candidates and recipients a prospective surveillance study Clin Infect Dis 2006 Jan 15 42 2 195 203 Lodise TP McKinnon PS Tam VH Rybak MJ Clinical outcomes for pati
8. I I 4 3 lm 3 11 1 ICT I NB 2 2
9. Bul T6 RHEO ODMERKE Bon 4 4 CA 070413ver 3 0 18 H18 11 E HAICS
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11. 3 0 10 5 000ppm 10 100C1 6 4 2 4 m E S 2006 7 1 S 1 2
12. AIA 1 23 1 3 IIIA 1 23 1 4 CIA 1 23 2 1 23 2 1 38 IIA 1 23 2 2 IITB 1 23 3 1 23 3 1 28 IIIA 1 23 3 2 JIIA 1 24 CR BST 1 24 1 CR BSI 1 24 1 1 CR BSI AIA 1 24 1 2
13. TI NB 2 1 DH NB a 5 15 1 I NB 2 II NB 10 11 2006 1 3 CDC NNIS 02004 2005 2 CDC The National Healthcare Safety Network NHSN User Manual Last Updated 10 23 2006
14. E AEE Ax gt ZS PEROT TORA infection control committee ICC X ICT Ars E T Ls EROS EE LC Jic 1 NAMES biz WHEE ICC ICTA
15. I 4 ICT I 5 aadit I 5 11 1 I 2 I 3
16. 2 3 CIB 2 2 3 428 IB 2 2 4 CIB 3 3 1 WEDS ORG CREM AED EAE SAAS B 3 2 IB 3 3 IB 3 4 IIC 44 Baskin WN Acute complications associated with bedside placement of feeding tubes Nutr Clin Pract 2006 21 40 55 Lai PB Pang PC Chan SK et al Necrosis of the nasal ala after improper taping of a nasogastric tube Int
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18. al tH 1 I NB 2 1 11 3 1 NB 1 NB 4
19. I I 6 I NB 7 I NB 8 I NB 9 I NB 10 I 11 IL NB 3 WEL KEZ 1 infection control team ICT 72 23H 1ICC 1
20. 1A 2 4 AIA 2 5 IIIA 2 6 6 IA 3 1 1 IA 3 2 8 IA 4 1 1A 42 IIIA 43 SARS IB
21. 1 4 2 1 4 3 1 4 4 1 4 5 1 4 6 1 4 7 7 IA 1 5 1 IVA 1 5 2 1 IVA
22. I NB 3 I NB 4 H 5 II NB 5 5 1 D 1 I 2
23. 2 IA 1 1 2 AIA 2 1 2 1 1 IIIA 22 2 2 1 IIA 2 2 2 IIIA 2 2 3 IIIA 2 2 4 IIIB 2 2 5 IIB 2 3 2 3 1
24. wo http hwww kankyokansen org nintei seido html II NB 4 TRAE JEG FAX hp wwwkansensho orjp II NB 5 12 1 B I NB 2 I NB 9 11 5 13 5 4 1 I
25. AVA 42 IIIA 43 IVA 4 4 SARS IVA 51 CIA 5 2 QA 20C 0 2 0 4mg L ppm 60C 55 9 IVA 53
26. 1 IVA 42 ICT 4 IVA 43 ICT 7 IVA x 5 5 1 ICT 6 IB 6 6 1 ICT 1 1 7 IVA 6 2 ICT
27. ANA 2 5 7 IIIA 2 6 IIA 2 7 IA 2 8 CC difficile IIA 2 9 OI 2 10 B14 lA 3 1
28. 2 H 1 4 3 personal protective equipments PPE In 3 1 PPE 4 41 4 2 Wa ae ae EAT SPRL BEER 4 3
29. 1 ICT I 2 ICC D 1 I Q ICT ICT OFF T ICT I I I 2 11 R 2006 I I n
30. IIIA 5 1 3 AIA 5 1 4 AIB 5 1 5 IIIA 5 1 6 IITB 5 2 5 2 1 IIIA 5 2 2 5 2 2 1 IIIA 5 2 2 2 IIIA
31. IVA 6 4 TVA 6 5 1VA 7 7 1 IVA 7 2 JIIA 8 8 8 1 IVA 19 x 1 Updated U S Public Health Service Guidelines for the Management of Occupational Exposures to HBV HCV and HIV and Recommendations for Postexposure Prophylaxis MMWR Recomm Rep 2001 50 RR
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35. IIIA 1 6 1 1 6 2 IVA a 22 2 3 2 4 IIIA IIIA 101975 IIIA 2 IIIA 2 4 1
36. 6 7 47 6 8 6 9 1 2 7 1 SREB TT ABATE E CIBERICIRO FEDS 2 6 1 2 1 3 8 8 1 8 2 8 3 8 5 8 6 8 7 8 8 2006 ME ventilator associated pneumonia VAP 48
37. 3 4 11 11 1 11 2 5 24 B C pa Bul nili ES 12 12 1 12 2 1 1
38. I NB 8 4 I NB 9 I NB n mg Yd T 3 1 5 6 protective environment 1 I 2
39. TVA 7 6 IVA 7 7 IVB 7 8 79 9 IVA 7 9 70 9 IVA 7 10 8 IVA X 0201004 17 2 1 A Suzuki A Namba Y Matsuura M Horisawa A 1984 Bacterial contamination of floors and other surfaces in operating rooms a five year survey J Hyg Lond 93 3 559 566 Hedayati MT Mohseni Bandpi A amp Moradi
40. A IIIA 2 2 2 2 1 MIA 2 2 2 5 IA 2 2 3 1 m IIIA 2 3 2 3 1 Im 7 CIITA 15 2 4 2 4 1 IIIA 2 4 2 CIA 2 4 3 CIA 3 3 1 3 2 3 2 1 IA 3 2 2
41. CIA 8 8 1 CIA 82 IIIA X Goodman RA Buehler JW Koplan JP The epidemiologic field investigation science and judgment in public health practice Am J Epidemiol 1990 Jul 132 1 9 16 Centers for Disease Control and Prevention Prevention and control of influenza recommendations of the advisory commit tee on immunization practices ACIP MMWR Morb Mortal Wkly Rep 2002 51 RR03 1 31 3 Biellik RJ Clements CJ Strategies for minimizing nosocomial measles transmission Bull WHO 1997 75 4 367 375 William RJ Investigation of Outbreaks In Mayhall CG ed Hospital epidemiology and Infection Control 3rd edition Lip pincott Williams amp Wilikins 2004 2 Beck Sague CM Jarvis WR Brook JH Culver DH Potts A Gay E Shotts BW Hill B Anderson RL Weinstein MP Epi demic bacteremia due to Acinetobacter baumannii in five intensive care u
42. IVA 1 2 IVA 2 2 1 IIA 2 2 IIA 2 3 3 IA 2 4
43. 1 8 2006 2006 2006 box rd anc DE
44. 4 IA 4 3 1 72 CIA 44 1 3 6 1 14 IIIB 5 5 T IA 52 IA 5 3 B 19 IIA 6 6 1 IVA 6 2 IVA 6 3
45. JITB 6 7 IIIB 6 8 IA 6 9 CVA X Mortimer EA Jr Lipsitz PJ Wolinsky E Gonzaga AJ Rammelkamp CH Jr Transmission of staphylococci between newborns Importance of the hands to personne Am J Dis Child 1962 104 289 95 Larson E A causal link between handwashing and risk of infection Examination of the evidence Infect Control 1988 9 28 36 3 Pittet D Hugonnet S Harbarth S et al Effectiveness of a hospital wide programme to improve compliance with hand hy giene Infection Control Programme Lancet 2000 356 1307 1312 Ehrenkranz NJ Alfonso BC Failure of bland soap handwash to prevent hand transfer of patient bacteria to urethral cath eters Infect Control Hosp Epidemiol 1991 Nov 12 654 62 McFarland LV Mulligan ME Kwok RY Stamm WE Nosocomial acquisition of Clostridium difficile infection N Engl J Med 1989 Jan 26 320 204 10 Casewell M Phillips I Hands as route of transmission for Klebsiella species Br Med J 1977 Nov 19 2 6098 1315 7 7 Mortimer EA Jr Lipsitz PJ Wolinsky E Gonzaga AJ Rammelkamp CH Jr Transmission of staphy
46. CITA 65 200ppm 1000ppm 200ppm 9 IA 7 71 CIA 7 2 IA 73 Burkholderia cepacia
47. O I NB Sm m Het 5 9 1 Yi GAVERE At En e eco x y SARS 5 9 2 FRR O Sum Im a B B Hbc SHE BAS Ate b c D Bl Fy IO Ww 7 11 5 9 3 Q D
48. IIIA IIA IB Kel AIA 25 5 5 2 i59 SEX ToS CER BOEKIEDZIU T Z7r4A Z WR VAD eR QTA 5 5 3 1 1 b AP RAE 5 5 4 BRAD dUAMENERSS AU CA 5 6 5 6 1 IIIA 5 6 2 IIA 5 6 2 1 5 6 2 2 5 6 3 1 IIA 5 6 4
49. FETP 5 5 2 2 3 4 CIB 5 3 5 3 1 2 3 IIO 5 32 AIA 6 6 1 AIA 6 2 56 6 2 1 IIIA 6 2 2 CIA 7 7 1
50. P IIIA 32 1 2 IIA 3 3 CRIM CRU 15 IIIA 3 4 CRM CRW JIIA 3 5 RW IA 3 6 CMA CRY IIIA 3 7 2 71 IVA 3 8 JIIA 4 1 IIIA 42
51. 1 1 P IB 0 1 1 000ppm 1 IVA 5 4 1 5 4 2 5 4 3 5 4 4 5 4 5 5 4 6 5 4 7 5 4 8 CITA IA 1 1 JIIA 1 1 IIB IIIB 0 1 0 1 0 05
52. 5 1 3 2 5 1 4 I IVA 6 IVA 6 1 6 2 6 3 6 4 6 5 6 6 6 7 6 8 6 9 8
53. IIIA 1 I RCT meta analysis II RCT IV RCT Randomized Controlled Trial 2 A B C d e
54. IIIA 5 6 5 AIA 6 6 1 797 IA 62 IA 63 427 IB 6 4 TITB 6 5 AIA 6 6 IITB 6 7 Rik 32 IA 6 8 TPN 28 IIIA 6 9
55. QIB 2 3 2 7 A 2 3 3 2 IIIA 24 2 4 1 2 IB 3 1 IIIA 32 gt 4 IA 3 5 IIIA 3 4 CITA 3 5 1 IITA 3 6 IIIA 3 7 IA 30 3 8 IIIA 3 9
56. bench study 2 3 1 1 1 IVA 1 1 1 1 1 1 1 1 1 1 2 1 1 1 3
57. IVA 4 4 1 VO 42 IVA 43 IVA 5 18 7 Jl 5 2 IVA 5 1 1 5 1 2 1 xd el 5 1 3 1 5 1 3 1
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61. b Medline PubMed Cochrane Library Best Evidence Evidence Based Medicine ACP Journal Club 2 c Sackett Chest 1989 95 2S 4S IV 1 IV 2 RCT IC RCT
62. VB 7 8 ICT IVA 7 4 ICT IIIA 7 5 1ICT 1 A 7 6 1ICT MRSA CIITA 8 8 1 ICT IA 8 2 ICT
63. Ho Foy A IA 10 10 1 30 45 7 IA 10 2 IIB 11 11 1 IIA 12 12 1 CITA X Tolentino Delosreyes AF Ruppert SD Shiao SY Evidence based practice use of the ventilator bundle to prevent ventilator associated pneumonia Am J Crit Care 2007 16 20 27 Conly JM Hill S Ross J Lertzman J Louie TT Handwashing practices in an intensive care unit The effects of an educa tional program and its relationship to infection rates Am J Infect Conctrol 1989 17 330 338 Sierra R Ben tez E Le n C Rello J Prevention and diagnosis of ventilator associated pneumonia A survey on current prac tices in Southern Spanish ICUs Chest 2005 128 1667 1673 NNIS System National Nosocomial Infections Surveillance NNIS System report data summary from January 1992 through June 2003 issued August 2003 Am J Infect Control 2003 31 481 498 Pierce AK Sanfo
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65. IA 1 24 1 3 IIIA 1 24 1 4 0 IIIA 1 24 2 1 25 2 1 1 IB 135 1 25 1 1 25 1 1 7 9 IB 1 25 1 2 ICU 4 IIB 2 2 1 2 1 1 IITB 2 2 2 2 1 6 40 IIIB 2 3 2 3 1 96
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67. 1 1 1 4 1 1 1 5 1 1 1 6 7 1 1 2 IVA 1 2 IVA 1 5 50 0842 2 2 1 2 1 1 3 2 1 1 1 IVA 2 1 1 2 IVA 2 1 1 3 IVA 2 1 1 4
68. IIIA 3 10 IB 41 IIIA 5 1 AHA 5 2 4 IA 5 3 i A 6 1 IIB 1 2 3 5 6 7 8 9 0 1 2 3 4 5 6 Garibaldi RA Burke JP Dickman ML Smith CB Factors predisposing to bacteria during indwelling urethral catheteriza tion N Engl J Med 1974 291 215 8 Kunin CM McCormack RC Prevention of catheter induced urinary tract infections by sterile closed drainage N Engl J Med 1966 274 1155 62 CDC Guideline for prevention of catheter associated urinary tract infections http www cdc gov nciod hip Guide uritract htm 1982 ICU CPG
69. G O AIA f 61 ER JIA 62 BI NAP1 027 IB 6 3 BI NAP1 027 CIB 52 64
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73. IIIA 5 1 576 IIIA 52 IIIA 6 1 IIA 6 2 CIB 6 3 IIIA 6 4 CIA 6 5 CIITA 6 6
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84. 4 1 JIIA 4 1 1 IIIA 4 1 2 IIIB 413 IIIA 4 1 4 3 IITB 5 5 1 5 1 1 IIIA 5 1 1 1 IIIA 5 1 2
85. 5 1 80C 10 IA 52 o IA 5 3 IA 5 4 AIB 5 5 AIB 6 1 QIIA 3924 6 2 IIIB 6 3 1 IIA 6 4 3 UC 6 5 JIIA 6 6 IIIA 6 7 P IIIA 6 8 IIIA 6 9
86. ICU Steere AC Mallison GF Handwashing practices for the prevention of nosocomial infections Ann Intern Med 1975 83 683 90 Kass EH Schneiderman LJ Entry of bacteria into the urinary tract of patients with inlying catheters N Engl J Med 1957 256 556 7 Desautels RF Walter CW Graves RC et al Technical advances in the prevention of urinary tract infection J Urol 1962 87 487 90 Kunin CM Detection prevention and management of urinary tract infections 3rd ed Philadelphia Lea and Febiger 1979 Saint S Veenstra DL Sullivn SD Chenoweth C Fendrick M The potential clinical and economic benefits of silver alloy urinary catheters in preventing urinary tract infection Arch Intern Med 2000 160 2670 5 Karchmer TB Eve T Giannetta RN A randomized crossover study of silver coated urinary catheters in hospitalized patients Arch Intern Med 2000 160 3294 98 Rupp ME Fitzgerald t Marion N Effect of silver coated urinary catheters Efficacy cost effectiveness and antimicrobial resistance Am J Infect Control 2004 32 445 50 Stamm WE Guidelines for the prevention of catheter associated urinary tract infections Ann Intern med 1975 82 386 90 Marrie TJ Major H Gurwith M et al Prolonged outbreak of nosocomial urinary tract infection with a single strain of Pseu domonas aeruginosa Can Med J 1978 119 593 6 Warren JW Platt
87. MRSA 1 2 1 MRSA MRSA T IIB 1 2 7 MRSA 7 IIA Ali ERIS MDRP 1 3 1 SAUTER MEE ORRE ICU 024 ITA 1 3 2 7 CIA 1 4 1 IIB 2 2 1 22 2 3 2 4 2 5 BCR TREC RUE EEDTUSIBGWCBS ak N95 CIA GBR OTIZUCEEO 4 D AIA
88. 3 ICT 41 2000 2001 CS 4 2002 E 2006 2006 1 I D ICT
89. CIB 4 41 IIIA 5 5 1 5 IVA X Weber DJ Rutala WA Environmental issues and nosocomial infections In Wenzel RP ed Prevention and control of noso comial infections 2nd ed Baltimore Williams and Wilkins 1993 420 49 Spach DH Silverstein FE Stamm VE Transmission of Infection by Gastrointestinal Endoscopy and Bronchoscopy Ann Intern Med 1993 15 118 2 117 128 Singh J Bhatia R Gandhi JC et al Outbreak of viral hepatitis B in a rural community in India linked to inadequately steril ized needles and syringes Bull World Health Organ 1998 76 93 8 ON PREC KORE 2005 2005 75 9 7 89 a Mourouga SD Copin P Bessmert G et al Routine disinfection of environmental surfaces Myth or reality J Hosp Infect 1999 Jun 42 2 113 7 0209003 5 200442 H 9 29 1 1 1 1 1
90. I 5 2 5 I NB 5 3 4 11 R 2006 5 3 1 I NB 5 322 I NB 5 33
91. 1 P M 5 2 2 1 I 5 2 2 ICT I 52 I 5 2 4 http www kansensho or jp
92. B19 OCA D W KR SARS wa Fi Ed MRSA Clostridium difficile Acinetobacter baumannii VRE respiratory syncytial RS AE RAE HE G o O ERES fade a E NE cH KE
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94. 80 10 IIB 2 1 4 1 2 5 IIIA 2 1 4 1 2 6 MIB JIIA 2 1 4 2 1 AIA IIA 2 1 4 3 1 IVA EL E 3 2 2 1 000 mm 6 JIIA 3 1 3 2 3 3 3 4 2 5 JIIA 3 1 1
95. IIIA 8 81 IIIA 82 P AIA 8 3 IC 9 91 71 IA 92 IIIA 9 3 IIIA 10 10 1 2 B x Edwards LD The epidemiology of 2056 remote site infections and 1966 surgical wound infections occurring in 1865 pa tients a four year study of 40 923 operations at Rush Presbyterian St Luke s Hospital Chicago Ann Surg 1976 184 758 6
96. 598 614 6 625 1 1 1 1 VA 1 2 Gnfection control committee ICC IVA 1 3 7 IVA 1 4 1 IVA 1 5 7 VB 1 6 ICT IVB 2 ICT 2 1
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101. personal protective equipments PPE 3 1 PPE 1 6 R 4 4 1 4 2 4 3 5
102. 47 IB 2 4 2 4 1 IIIB 25 5 2 5 1 IIIA 2 6 2 6 1 GEAR ER PO QIIA 2 7 2 7 1 9 IB 2 8 2 8 1 IIB 2 8 0 D7 3 7 BRA 2 8 2 1 IIIA x Gallagher Allred CR Voss AC Finn SC et al Malnutrition and clinical outcomes the case for medical nutritional therapy J Am Diet Assoc 1996 96 361 366 Reilly JJ Jr Hull SF Albert N et al Economic impact of malnutrition a model system for hospitalized patients JPEN
103. CIB 3 2 IIIB 3 3 IIIA 4 4 1 CIA 4 2 AIA 5 51 8 9 IB 5 2 1 T B 5 3 1 IB x Dellit TH Owens RC McGowan JE et al Infectious Diseases Society of America and the Society for Healthcare Epidemi ology of America Guidelines for developing an institutional program to enhance antimicrobial stewardship Clin Infect Dis 2007 44 159 177 CDC Management of Multidrug Resistant Organisms in Healthcare Settings 2006 http www cdc gov ncidod dhqp p
104. I NB 5 3 4 I NB 5 3 5 I NB 5 4 Centers for Disease Control and Prevention CDC 9 BEU 5 9 D personal protective equipment PPE
105. IVA IVA 51 N95 IVA 2 6 MDR TB XDR TB IVA 2 7 IVA 3 1 S AIA 3 2 AIB 4 1 SARS
106. 5 1 5 2 6 6 1 6 2 24 6 3 10wwv 0 5wvy 0 1 0 5w v 2 7 3 6 4 B OBE H 6 5 4 12 24 6 6
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112. I NB 2 I NB 5 5 Ht 1 I NB 2 I NB 3 I NB 4 30cm I NB 5 I NB 5 11 6 II NB 7
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116. IIA 3 6 2 CIB X Kenyon A Ridzon R Luskin Hawk R et al A Nosocomial outbreak of Multidrug Resistant Tuberculosis Ann Intern Med 1997 127 1 32 36 Pavelchak N DePersis RP London M et al Identification of factors that disrupt negative air pressurization of respiratory isolation rooms Infect Control Hosp Epidemiol 2000 21 191 5 PRA HEAS 02 2004 Haley CE McDonald RC Rossi L Jones WD Jr Haley RW Luby JP Tuberculosis epidemic among hospital personnel Infect Control Hosp Epidemiol 1989 10 204 10 Ryan MG Developing a respiratory protection program Understanding the written elements AAOHN J 2001 49 293 307 Drinka PJ Krause P Nest L Goodman BM Gravenstein S Risk of acquiring influenza A in a nursing home from a culture positive roommate Infect Control Hosp Epidemiol 2003 24 872 4 7 Seto WH Tsang D Yung RWH et al Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome SARS Lancet 2003 361 1591 1620 16 Chang VT Nelson K The role of physical proximity in nosocomial diarrhea Clin Infect Dis 2000 31 717 22 Trick WA Weinstein RA et al Comparison of routine glove use and contact isolation precautio
117. ik 3 7 i siue ea MM COO i i 15 lect iov ur MN T 18 ONES SUSHI ME ME 21 MM 23 D 1 29 E A E 30 i 32 EES 35 i 38 AAE TEES S S 44 47 i 51 Vidi qe soin m UE E 55 Evidence based Clinical Practice Guideline 18 a
118. 1 CIB 2 7 HBV CIB 3 C 3 1 D HCV AST GOT ALT GPT 1 3 6 1 O IB 3 2 IB 3 5 HCV ALT HCV RNA 7 ITA 18 3 4 HCV RNA 3 IIIA 4 HIV 4 1 HIV HTIV CIA 42 HIV HIV 1 IIIA 43 HIV 1 HIV
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122. AIA CIITA 2 1 1 2 12 2 1 3 2 1 4 IIIA 3 IIIA 2 1 4 1 2 1 4 2 2 1 4 3 2 1 4 1 1 1 Bw CIB 2 1 4 1 2 IIA 2 1 4 1 2 1 CIA 2 1 4 1 2 2 IIIA 2 1 4 1 2 3 ANB 2 1 4 1 2 4
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124. http www cdc gov ncidod dhqp pdf nhsn NHSN_Manual_ 20Patient_Safety_Protocol102306 pdf 3 Garner JS Guideline for isolation precaution in hospitals Infect Control Hosp Epidemiol 1996 17 53 80 4 Garner JS CDC 1996 11 11 R 2006 2006 1 070330 ver 1 1 1 EZER DEC ET 1 1 1 BIRI 1 2
125. 5 7 IVA 7 IVA MIA IIIB S CIB 4 1 4 2 4 3 4 4 4 5 1VA 1 6 4m IVA Im IIIA IIIB 1 IIB 4 5 1 JIIB 4 5 2 IIIA 24 5 5 1 5 2 5 3 5 4 5 5 Sid 512 5 1 3 5 1 4 5 1 5 5 1 6 5 17 2 2 1 5 22 5 2 3 5 2 4 5 5 5
126. 7 2 Bilski B Needlestick injuries in nurses the Poznan study Int J Occup Med Environ Health 2005 18 251 4 30 Krasinski K LaCouture R Holzman RS Effect of changing needle disposal systems on needle puncture injuries Infect Con trol 1987 Feb 8 59 62 Krasinski K LaCouture R Holzman RS Effect of changing needle disposal systems on needle puncture injuries Infect Con trol 1987 Feb 8 59 62 Thrig M Cookson ST Campbell K Hartstein AL Jarvis WR Evaluation of the acceptability of a needleless vascular access system by nurses Am J Infect Control 1997 Oct 25 434 8 14 1 1 1 IA 1 2 1 2 1 IA 1 2 1 1
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