医療機関における院内感染対策マニュアル 作成のための
Contents
1. 1996 CDC 1 1 IVA 1 2 IVA 22. JIA 62 BI NAP 1 027 IB 6 3 BI NAP1 027 CIB 2 64 CITA 65 200ppm 1000ppm
3. FER aR AT VEROT SE BREED IE DERE 1 ik 3 7 Se i i 15 lect iov ur MN T 18 ONES SUSHI ME ME 21 MM 23 D 1 29 30 i 32 EES 35 i 38 AAE TEES S S 44
4. 1 1 1 IVA 1 1 1 1 1 1 1 1 1 1 2 1 1 1 3 1 1 1 4 1 1 1 5 1 1 1 6 7 1 1 2
5. 2 1 IIA 2 2 IA 2 3 3 IA 2 4 ANA 2 5 7 IIIA 2 6 IIA 2 7 IA 2 8 CC diff
6. IA 5 2 IA 5 3 B 19 IIA 6 6 1 IVA 6 2 IVA 6 3 IVA 6 4 TVA 6 5
7. 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 patients with bacteremia caused by vancomycin resistant enterococcus in a level 1 trauma center Clin Infect Dis 2002 Apr 1 34 7 922 9 3 DiazGranados CA Jernigan JA Impact of vancomycin resistance on mortality among patients with neutropenia and entero coccal bloodstream infection J Infect Dis 2005 Feb 15 191 4 588 95 Joels CS Matthews BD Sigmon LB Hasan R Lohr CE Kercher KW Norton J Sing RF Heniford BT Clinical character istics and outcomes of surgical patients with vancomycin resistant enterococcal infections Am Surg 2003 Jun 69 6 514 9 Dantas SR
8. IIIA 41 IIA 42 GIA 43 WETS 314 IA 5 1 IIIA 5 2 A P IIIA 6 1 16 IIA 6 2 1 15 3 157 IIA 6 3 high efficiency particulate air filter HEPA IIIA 6 4
9. IVA 3 1 S AIA 3 2 AIB 4 1 SARS IVA 42 IIIA 4 3 IVA 4 4 SARS
10. CIB 3 4 2 IIIA 3 5 3 5 1 IA 3 5 2 MIA 3 5 9 IIA 3 5 4 IIA 3 6 3 6 1 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 HEAS
11. 1 A 7 6 1ICT MRSA CIITA 8 8 1 ICT IA 8 2 ICT IVA 8 3 ICT Es Bis COPE HC RACH O3 HAT S CIA 9 9 1 IVA 9 2 B
12. IIIA 9 3 IIIA 10 10 1 2 B 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 66 Simchen E Rozin R Wax Y The Israeli Study of Surgical Infection of drains and the risk of wound infection in operations for hernia Surg Gynecol Obstet 1990 170 331 7 Zerr KJ Furnary AP Grunkemeier GL Bookin S Kanhere V Starr A Glucose control lowers the risk of wound infection in diabetics after open heart operations Ann Thorac Surg 1997 63 356 61 Furnary AP Zerr KJ Grunkemeier GL Starr A Continuous intravenous insulin infusion reduces the incidence of deep ster nal wound infection in diabetic patients after cardiac surgical procedures Ann Thorac Surg 1999 67 352
13. IIIA 6 1 IIA 6 2 CIB 6 3 IIIA 6 4 IIA 6 5 CIITA 6 6 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 Imp
14. CE A VRSA VRE rdc NR a nw RS A BEIDE L V BREADS RYERSS KIE CH
15. 35 19 21 28 30 IB 228 32 TB 05019255535 ITA 3 5 1 1 1 gt 19 25 35 38 3 5 2 70 1 3 5 19 23 35 38 2 3 ITA 3 6 1 3 6 2 3 6 3
16. 9 IB 2 8 2 8 1 9 IIIB 2 8 0 D7 3 7 BRA 2 8 2 1 IIIA 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 12 371 376 1988 Moore EE Jones TN Benefits of immediate jejunostomy feeding after major abdominal trauma a prospective randomized study J Trauma 1986 26 784 881 Lipman TO Bacterial translocation and enteral nutrition in humans an outsider looks in JPEN 1995 19 156 165 Reynolds JV Kanwar S Welsh FK et al Does the route of feeding modify gut barrier function and clinical outcome in pa tients after major upper gastrointestinal surgery JPEN 1997 21 196 201 Braunschweig CL Levy P Sheean PM et al Enteral compared with parenteral nutrition a meta analysis Am J Clin Nutr
17. RW IA 3 6 CMA CRY IIIA 3 7 2 71 IVA 3 8 JIIA 4 1 IIIA 42 CIA 5 1 fu 576 IIIA 52
18. 1VA 7 7 1 IVA 7 2 JIIA 8 8 8 1 IVA 19 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 11 1 52 2 Occupational exposure to bloodborne pathogens OSHA Final rule Fed Regist 1991 56 235 64004 182 3 Poland GA Jacobson RM Clinical practice prevention of hepatitis B with the hepatitis B vaccine N Engl J Med 2004 351 27 2832 8 4 Puro V Cicalini S De Carli G Soldani F Ippolito G Towards a standard HIV post exposure prophylaxis for healthcare workers in Europe Euro Surveill 2004 9 6 40 3 5 Beasley RP Hwang LY Lee GC et al Prevention of perinatally transmitted hepatitis B virus infections
19. IIIA 22 2 2 1 IIA 2 2 2 IIIA 2 2 3 IIIA 2 2 4 IIIB 2 2 5 EVERETT VERA BIE TF FV OBD amp RIO FEF AMET S Tew Fic IIB 2 3 2 3 1 QIB 2 3 2 7 A 2 3 3 2 IIIA 24 2 4 1 2 IB 3 1
20. 2 2 1 s IA 2 2 1 2 IA 23 3 2 5 5 A 2 4 24 1A 2 5 4 S CIB 3 3 1 CIB 3 2 IIIB 3 3 IIIA 4 4 1
21. ICMT IIIB 2 5 ICT 8 IA 3 3 1 ICT gt 10 IB 4 4 ICT 11 IVA 42 ICT
22. 7 CIA 1 4 1 IIB 2 2 1 2 2 2 3 2 4 2 5 BCR TREC RUE EEDTUSIBGWCBS ak N95 IIIA D lt D AIA IVA IVA 51 N95 IVA 2 6 MDR TB XDR TB IVA 2 7
23. CIA 4 1 4 3 IITB 5 5 1 5 1 1 IIIA 5 1 1 1 CIA 5 1 2 IIIA 5 1 3 AIA 5 1 4 AIB 5 1 5 IIIA 5 1 6
24. 427 IB 6 4 TITB 6 5 AIA 6 6 IITB 6 7 Rik 32 IA 6 8 TPN 28 IIIA 6 9 3934 IITA 6 9 1 995 IA 7 7 3 99 IVA 7 2
25. CA 070413ver 3 0 18 H18 11 HAICS t PR
26. IITB 5 2 5 2 1 IIIA 5 2 2 5 2 2 1 IIIA 5 2 2 2 IIIA FETP 5 5 2 2 3 4 CIB 5 3 5 3 1
27. IVA a 2 2 2 3 2 4 IIIA QIIIA 101975 IIIA 2 IIIA 2 4 1 26 IIIA 3 1 3 2 3 3 3 4 3 5 3 6 3 7 ARSIZ fH C ERKIN RA TD DIES S 2 4 19 1619 21 2627 CITA 3 1 1 MIA 3 1 2 471 2852 IA 1 13 16 19 21 33 34 TIIA
28. 4 IA 5 3 i A 6 1 IIB 1 2 3 A 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 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 Le
29. Y P 1 15 15 X 1 12 1 69 1 1 5 6 10 11 2 17 2 1
30. IVA 6 IVA 6 1 6 2 6 3 6 4 6 5 6 6 6 7 6 8 6 9 8 O 11
31. c Sackett Chest 1989 95 2S 4S IV 1 IV 2 RCT IC RCT IIIA 1 I RCT meta analysis II RCT
32. 1 4 6 1 4 7 7 IA 1 5 1 IVA 1 5 2 1 IVA IIIA 1 6 1 1 6 2
33. IVA 43 IVA 5 18 Jl 5 2 IVA 5 1 1 5 1 2 1 miele 5 1 3 1 5 1 3 1 5 1 3 2 5 1 4 I
34. IIIA 1 3 1 3 1 N95 N95 AZ CIA 1 4 1 4 1 IIA 1 4 2 IIA 1 4 3 IIA 2 241 A CIA 2 2 2 2 1 IIIA 2 2 2 5 IA 2 2 3 1 m
35. 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 80 10 IIB 2 1 4 1 2 5 IIIA 2 1 4 1 2 6 IIB JIIA 2 1 4 2 1
36. IIIA 2 3 2 3 1 Im 7 IA 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 CITA 3 2 3 1 m IIA 3 3 3 3 1 A 3 4 3 4 1
37. IB IIIB 1 1 IB 1 1 IIIA IA 17 IIIA 1 0007mm IB 1 1 4 IA 1 1 P IB 0 196 1 000ppm 1 IVA
38. CIB 3 5 HCV ALT HCV RNA 7 IIA 18 3 4 HCV RNA 3 IIIA 4 HIV 4 1 HIV HTIV CIA 42 HIV HIV 1 IIIA 43 HIV 1 HIV 4 IA 4 3 1 72 CIA 44 1 3 6 1 14 IIB 5 5
39. CIA 4 2 AIA 5 51 8 9 IB 5 2 1 T B 5 3 1 IB 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 pdf ar mdroGuideline2006 pdf Brinsley K Srinivasan A Sinkowitz Cochran R et al Implementation of the Campaign to Prevent Antimicrobial Resistance in Healthcare Settings 12 Steps to Prevent Antimicrobial Resistance Among Hospitalized Adults experiences from 3 insti tutions Am J Infect Control 2005 33 53 54 Classen DC Evans RS Pestotnik SL et al The timing of prophylactic administration of antibiotics and the risk of surgical wound infection New Engl J Med 1992 326 281 286 5 Antimicrobial prophylaxis for
40. IB 1 22 2 7 IIIB 1 22 2 8 IIB 1 23 1 23 1 39 1 23 1 1 AIB 1 23 1 2 AIA 1 23 1 3 IIIA 1 23 1 4
41. 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 5 Pierce AK Sanford JP Thomas GD Leonard JS Long term evaluation of deconatimnation of inhalation therapy equipment and the occurrence of necrotizing pneumonia N Engl J Med 1970 292 528 531 Deryfuss D Djedaini K Weber P Brun P Lanore JJ Rahmani J Boussougant Y Coste F Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change Am Rev Respir Dis 1991 143 738 43 7 Hess D Burns E Romagnoli D Kacmarek RM Weekly ventilator circuit changes a strategy to reduce costs without affect ing pne
42. 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 IVA 2 2 2 2 1 4 VB 2 2 0 IIIB
43. IIA L6 1 6 1 17 CA 1 7 1 7 1 CIA 1 8 1 8 1 0 5 10 IA 1 9 1 9 1 3 0 5 10 21 CIA 1 10 1 10 1 JA 1 11 1 11 1 3 CITA 1 11 2
44. VA 3 1 3 1 60 70C 10 0 025 250ppm 3 1 3 2 60C 5 2 3 4 3 1 4 IIIA 3 1 5 80C 10 0 025 250ppm KERRE 30 C 5 7 IVA 7 IVA MIA IIIB S CIB 4 1 4 2 4 3 4 4 4 5
45. 1 19 1 24 IIIA 1 20 1 20 1 IIIA 1 21 1 21 1 IVA 1 22 1 22 1 1 22 1 1 ILLA 1 22 1 2 CIA 1 22 2 1 22 2 1 IIIA 1 22 2 2 IIIA 1 22 2 3 CIA 1 22 2 4 AIB 1 22 2 5 IIIB 1 22 2 6
46. 5 4 1 5 4 2 5 4 3 5 4 4 5 4 5 5 4 6 5 4 7 5 4 8 IIIA IA 1 1 JIIA 1 1 IIB IIIB 0 1 0 1 0 05 IIIA IIA IB Kel AIA 25 5 5 2 i59
47. IV RCT Randomized Controlled Trial 2 A B C d e bench study 2 3
48. 200ppm 9 IA 7 71 CIA 7 2 IA 73 Burkholderia cepacia IB 8 81 157
49. 2 3 IIO 5 32 AIA 6 6 1 AIA 6 2 56 6 2 1 IIIA 6 2 2 CIA 7 7 1 CIA 8 8 1 CIA 82
50. IA 1 0 IVA 1 3 HBV HCV HIV IIIA 1 4 1 CIB 1 5 QIIA 1 6 IIIA 1 7 IIIA 1 8 EPINet IIIB 2 B 2 1 B 1 CIA 2 2 HBs HBs 25414 CIA 2 3 WAS HB
51. O IB 2 2 1 2 1 1 RTH Ready To Hang 145 IIB 2 1 2 HBSS OMS efie RSAC SAAR IB 2 1 8 IIIB 2 1 4 8 T IIIB 2 2 2 2 1 8 RTH 24 L2 IIA 2 2 2 2 3 CIB 2 2 3 428 TITB 2 2 4 CIB 3
52. 1 IA 3 2 8 IA 4 1 1A 4 2 IIIA 43 SARS IIIB 5 1 80C 10 IA 52 o IA 5 3 IA 5 4 AIB 5 5 AIB
53. 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 units Am J Epidemiol 1990 Oct 132 4 723 33 Jereb JA Burwen DR Dooley SW Haas WH Crawford JT Geiter LJ Edmond MB Dowling JN Shapiro R Pasculle AW et al Nosocomial outbreak of tuberculosis in a renal transplant unit application of a new technique for restriction fragment length polymorphism analysis of Mycobacterium tuberculosis isolates J Infect Dis 1993 Nov 168 5 1219 24 57
54. 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 12 IIA 1 1 5 VRE 1 16 IB MRSA 1 2 1 MRSA MRSA T IIB 1 2 2 MRSA 12 IA Ali ERIS MDRP 1 3 1 SAUTER MEE ORRE ICU 024 ITA 1 3 2
55. 79 IVA 7 3 IVA 7 3 1 IVA 7 3 2 26 Z IVA 7 8 8 TVA 74 TVA 7 5 TVA 7 6 IVA 7 7
56. 1VA 1 6 4m2 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 Sula 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 3 2 5 3 3 IB IIIB CNB O IB
57. CIA 1 23 2 1 23 2 1 78 ITA 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 CII 1 24 1 3 IIIA 1 24 1 4 0 IIIA 1 24 2 1 25 2 1 1 IB 1
58. 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 J Clin Pract 2001 55 145 PEG PEG CED 2006 pp13 19 Benya R Langer S Mobarhan S Flexible nasogastric feeding tube tip malposition immediately after placement JPEN 14 108 109 1990 Bankier AA Wiesmayr MN Henk C et al Radiographic detection of intrabronchial malpositions of nasogastric tubes and subsequent complications in intensive care unit patients Intensive Care Med 23 406 410 1990 National Patient Safety Agency 2005 NPSA issues new safety
59. 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 IIIB 3 1 2 SOC C 10 7 IVA 3 1 3
60. 1 1 IVA 6 6 ICT 19 CIB 7 7 1 ICT PIR HERL tngin A IVA 7 2 VB 7 8 ICT IVA 7 4 ICT IIIA 7 5 1ICT
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62. 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 IIIA 2 2 IIIA 2 3 ICI gt IIIB 2 4 ICT CD ACN
63. 47 i 51 Vidi qe soin m UE E 55 Evidence based Clinical Practice Guideline 18 a b Medline PubMed Cochrane Library Best Evidence Evidence Based Medicine ACP Journal Club 2
64. PRSP MRSA MDRP H5N1 3 3 1 IVA 3 1 1 AVA 23 12 IVA 4 4 1 VO 42
65. IIA 9 3 IA 9 4 IVA 9 5 CITA X hetp law e gov go jp htmldata S23 S23HO205 html htp www mhlw go jp topics 2006703 dl tp0314 1b01 pdf http jcqhc orjp html index htm ICD http wwwricd umin jp http www nurse orjp senmon kansen index html http wwwJjshp orjp index htm http www jscm org icmt index html
66. 1 1 AIA 1 2 IIA 1 3 CIA 1 4 AUR HE CSS S IIIA 1 5 IIIA 2 2 1 AIA CIITA 2 1 1 2 12 2 1 3 2 1 4 CIA 3 IIIA 2 1 4 1 2 1 4 2 2 1 4 3
67. IVA 51 CIA 5 2 QA 20C 0 2 0 4mg L ppm 60C 55 71 IVA 53 G O AIA f 61 ER
68. 4 IVA 43 ICT 7 IVA f 5 5 1 ICT 1 IB 6 6 1 ICT 1 1 7 IVA 6 2 ICT CIB 6 3 ICT 1 1 IVA 6 4 ICT VA 6 5 ICT
69. 6 1 QIIA 37 6 2 IIIB 6 3 1 IIA 6 4 3 IO 6 5 JIIA 6 6 IIIA 6 7 P IIIA 6 8 IIIA 6 9 IIIA 6 10 6 IIIA 7 7 1 IIIA 7 2 IIIB 8
70. 0201004 gt 24 1 25 1 29 1 3 15 2 4 7 9 7 15 GERE 5 4E 2 H 15 14 7 18 93 18 3 6 0306002 8 22 1 1 23 35 1 5 1 61 1 1 581 9 593 594 598 614 6 625 1 1 1 1 VA 1 2
71. 3 HBs HBs HBs HB 3 5 IIIA 2 4 HB 3 HBs HBs HB 3 IIA 2 5 2 D HB HBs HBs 7 IIA 2 6 D HBs HBs AST GOT ALT GPT Ze 1 3 6 1 CIB 2 7 HBV IIIB 3 C 3 1 D HCV AST GOT ALT GPT 1 3 6 1 9 IB 3 2 _
72. 8 UO 82 15 IA 8 3 IIIB 9 9 1 H gt IA 9 2 pH 7 CIB 9 3 Ho Foy A IA 10 10 1 30 45 7 IA 10 2 IIB 11 11 1 IIA 12 12 1
73. IIIA 32 gt 4 IA 3 3 IIIA 3 4 CITA 3 5 1 IITA 3 6 IIIA 3 7 IA 30 3 8 IIIA 3 9 IIIA 3 10 IB 41 IIIA 5 1 TTA 5 2
74. ARE SARS E A Q B
75. IIA 1 12 1 12 1 CIB 1 13 1 13 1 LA 38 1 14 1 14 1 2 77 ITA 1 15 1 15 1 78 IB 1 16 1 16 1 7 IIA 1 17 1 17 1 ICU 3032 IIA 1 17 2 IA 1 18 1 18 1 GIA 1 18 2 1 2 7 TIB 1 19
76. IIIA VA 1 2 1 I IA 1 2 2 CIA 9 A 1 IIIA 1 4 1 1 4 2 1 4 3 1 4 4 1 4 5
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78. 20 1 1 1 7 CIA 1 2 2002 CDC Campaign to Prevent Antimicrobial Resistance in Healthcare Settings www cdc gov drugresistance healthcare 12 4 12 6 IIA 12 Step 5 Step6 Step 7 Step 8 Step 9 Step 10
79. IIA 2 21 IA A O O 3 31 IVA 3 2 IIIA 4 4 1 JIIA 4 1 1 IIIA 4 1 2 IIIB 413
80. IIIA 2 2 1 4 IIIA 2 2 2 IIIA 2 2 3 4 IIIA 3 3 1 0 55 2 0 3 IIIA 32 IIIB 4 41 IIIA 5 5 1 5 IVA 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 1
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83. SEX ToS CER BOEKIEDZIU T Z7r4A Z WR VAD eR QTA 5 5 3 1 1 b AP RAE 5 5 4 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 IIIA 5 6 5 AIA 6 6 1 797 CIA 6 2 IA 63
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