[show abstract][hide abstract] ABSTRACT: Surveillance of nosocomial bloodstream infection (BSI) is recommended, but time-consuming. We explored strategies for automated surveillance.
Cohort study. We prospectively processed microbiological and administrative patient data with computerized algorithms to identify contaminated blood cultures, community-acquired BSI, and hospital-acquired BSI and used algorithms to classify the latter on the basis of whether it was a catheter-associated infection. We compared the automatic classification with an assessment (71% prospective) of clinical data.
An 850-bed university hospital.
All adult patients admitted to general surgery, internal medicine, a medical intensive care unit, or a surgical intensive care unit over 3 years.
The results of the automated surveillance were 95% concordant with those of classical surveillance based on the assessment of clinical data in distinguishing contamination, community-acquired BSI, and hospital-acquired BSI in a random sample of 100 cases of bacteremia. The two methods were 74% concordant in classifying 351 consecutive episodes of nosocomial BSI with respect to whether the BSI was catheter-associated. Prolonged episodes of BSI, mostly fungemia, that were counted multiple times and incorrect classification of BSI clinically imputable to catheter infection accounted for 81% of the misclassifications in automated surveillance. By counting episodes of fungemia only once per hospital stay and by considering all cases of coagulase-negative staphylococcal BSI to be catheter-related, we improved concordance with clinical assessment to 82%. With these adjustments, automated surveillance for detection of catheter-related BSI had a sensitivity of 78% and a specificity of 93%; for detection of other types of nosocomial BSI, the sensitivity was 98% and the specificity was 69%.
Automated strategies are convenient alternatives to manual surveillance of nosocomial BSI.
Infection Control and Hospital Epidemiology 10/2007; 28(9):1030-5. · 4.02 Impact Factor
[show abstract][hide abstract] ABSTRACT: The ARTeMeD project aims to solve problems of interactivity and real-time in teleradiology. It integrates personal multimedia facilities and patient data access in a common platform that allows radiologists to collaborate from remote sites through a suitable communication support. ARTeMeD is based on asynchronous transfer mode (ATM) network technology and an optimized manipulation of medical image material. The ARTeMeD system opens interesting perspectives in the area of collaborative teleradiology.
Journal of Digital Imaging 09/1997; 10(3 Suppl 1):116-21. · 1.10 Impact Factor
[show abstract][hide abstract] ABSTRACT: The goal of this paper is to present a multi-media telecommunication architecture based on ATM technology, which provides reliable and effective transmission of still and motion high resolution (1024x1024 up to 4096x4096, 16 or 32 bits/pixel radiological and pathological images or part of them. The peculiarities of such architecture are the following. 1) Provide Quality of Service (QoS) awareness by means of inter and intra flow synchronization mechanisms. 2) Provide mechanisms of reliable transmission of data. 3) Provide the capability of remote manipulation of a Region of Interest (RoI), defined as a portion of a still or motion picture which is represented and coded with a higher quality than the remaining part of the picture