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Full web cam xp crackTraining programs to decrease community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection: a systematic review.
In the United States, up to 22% of hospitalizations are attributed to methicillin-resistant Staphylococcus aureus (MRSA) infection. We reviewed the evidence for training programs and interventions in the home to reduce MRSA infections. We searched MEDLINE and EMBASE databases from 1980 to 2011 and the Cochrane Library from January 2012 to March 2012. The search identified 1,073 abstracts, of which 34 were relevant to our topic. The evidence for success of training programs or interventions was determined using criteria such as study design, study quality, and outcomes. Twenty-five of 34 articles were controlled or quasi-controlled trials (9 from the United States). The studies included in this review focused on training hospitals, emergency medicine residencies, pharmacy, nursing, and public health departments. Seventeen (68%) of the studies reported a decrease in infection rates and one (4%) reported no change in infection rates. Sixteen (64%) of the studies reported a decrease in the number of MRSA strains. Six (24%) reported no change in MRSA infection rates. Three studies (12%) were community-based interventions. Five studies (20%) were delivered at more than one site. Eleven studies (44%) showed a decrease in the number of MRSA cases in the community. Thirty-one studies (91%) were determined to be high quality and three (9%) to be low quality. Eight studies (27%) were rated as moderate quality and five (18%) as high quality. The evidence for the effectiveness of training programs to decrease infection rates is weak, but the evidence for some specific training programs is good. This may be due to selection bias, the strong and consistent messages that are sent by hospitals to improve infection control, or the strong hospitals that are used in this study. Further research is needed to determine the effectiveness of these types of training programs.
The efficiency of the DGL, however, is largely affected by the cavity loss, which will be discussed in the following section.
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