A probable hypothesis to explain this unexpected result is that, in our ICU, a rigid surveillance policy of central venous catheters was undertaken, including strict asepsis during insertion, careful medication, and early removal as soon as possible (median 3 days).
Commensurate with the strict specificity for the Asp insertion over similar amino acids, the insertion does not cause disordering of the structure, but rather induces localized flexibility in the β2c−β2d loop.
As most contaminants come from patients' skin, obtaining blood cultures after skin disinfection and under strict sterile precautions during CVC insertion might reduce contamination rates.
Note that, in this work where we aim to find out the conserved blocks of genes that reflect the ancestral gene order, we required strict gene adjacency, forbidding any insertion in a synteny block of a gene which would be unique to one of the pairs of compared genomes.
Quality-trimmed reads (discussed earlier) from each of the three species were mapped to the reference using CLC Genomics Workbench v5 with strict settings (mismatch cost = 3; insertion cost = 3; deletion cost = 3; similarity fraction = 0.95; length fraction = 0.9).
Physicians and nurses were aware of the dangers of CLA-BSIs and educated on the expectation for strict adherence to sterile techniques for insertion and access of central lines.
Thus, it is important to notice that duration of catheter use is not a risk factor only under the strict assumption that the site of insertion is evaluated at least once a day and the catheter is immediately removed if there are any signs of local redness, swelling or pain at the insertion site.
Although acupuncture is commonly practised in Singapore, there are no strict guidelines regarding skin decontamination before needle insertion, and there is no specific research on this topic.
In either case, strict aseptic technique must be maintained during insertion.
Catheter insertion should be performed with strict adherence to infection-control policies, including maximal sterile barrier precautions and chlorhexidine 2% skin antisepsis [ 105, 108, 109].
