Central line-associated bloodstream infections (CLABSIs) are important hospital-acquired infections that are related to increased mortality in cardiac intensive care units (CICUs). To determine the risk factors for CLABSIs, a case-control study was conducted in the CICU of our hospital. Emergency surgery (odds ratio: 9.6, 95% confidence interval: 1.633-56.926) was the strongest risk factor comparing the case group (n=11) to the control group (n=22). In addition, the indwelling period was significantly longer in the case group than in the control group (median 9 days versus 7 days, p=0.004). An intervention for the insertion of central lines was then started, with 1) thorough use of chlorhexidine-impregnated dressings (also known as chlorhexidine patches, CHG patches) in the insertion of central lines before emergency surgery, and 2) exchange of the central line 7 days after emergency surgery. After the intervention, the CLABSI incidence rate decreased from 6.8 to 0.8/1,000 device-days. These data suggest the usefulness of CHG patches and the importance of the early exchange of central lines in the CICU in patients following emergency surgery.Full article

Baloxavir marboxil (BXM) is a novel anti-influenza agent that developed in Japan and inhibit the cap endonuclease specifically, and suggested the more clinical effectiveness in influenza. BXM reduces viral shedding more than do neuraminidase inhibitors (NAIs), and its clinical efficacy is equivalent to that of NAIs but is superior to that of NAIs in the case of type B influenza. BXM does not demonstrate any issues with safety, and treatment with BXM reduces the incidences of complicating sinusitis and bronchitis. Prophylactic administration of BXM inhibits intrafamilial transmission of influenza although low susceptible viruses with a PA/I38X substitution are isolated with a certain frequency following administration of BXM. Finally, In influenza treatment for patients aged 12−19 years and for adult outpatients, BXM can be used with the same recommendation level as oseltamivir.Full article