bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Pharmacology of Antibiotics: Review of Imipenem
Authors: Eggleston Mark , Park Soon-young , Parker Richard H. 
Published: August 2016

AbstractImipenem, a new carbapenem ß-lactam broad-spectrum antibiotic, is highly active in vitro against most aerobic and anaerobic gram-positive and gram-negative bacteria isolated from infectious diseases of human beings. Except for enterococci and methicillin-resistant staphylococci most gram-positive cocci are inhibited by <2 μg/ml. Although the MIC-90 of methicillin-resistant staphylococci may be <4 μg/ml, these bacteria are usually resistant to imipenem by modified testing methods. The enterococcus, S. faecalis, has an MIC-90 of <8 μg/ml but bactericidal concentration may be much higher. Most Enterobacteriaceae are highly susceptible to imipenem with MIC-90 of 0.5 to 2.0 μg/ml. Proteus species are less susceptible with MICs of 4 to 8 μg/ml. Isolates of P. aeruginosa have variable susceptibility with MICs ranging from 0.25 to 16 μg/ml. Pseudomonas maltophilia and P. cepacia are usually resistant to imipenem. Except for Clostridium species, most strict anaerobes are susceptible to <1.0 μg/ml of imipenem. When combined with cilastatin (1:1 ratio), the renal elimination of the active form is increased. The serum half-life in normal renal function is about 1 hour and increases to 3.4 hours in anuria. Major adverse effects are similar to those of cephalosporins except for seizures in some patients. Colonization with fungi and drug-resistant bacteria occurs in about 5% of imipenem-treated patients. Clinical studies have demonstrated efficacy in 79% to 96% of patients treated.
Wound Infection After Cesarean Section
Authors: Pelle Hedvig , Jepsen Ole B. , Larsen Severin O. , Bo Jens , Christensen Flemming , Dreisler Anne , Jørgensen Per J. , Kirstein Annette , Kjøller Morten , Lange Aksel , Laursen Kjeld , Nickelsen Carsten N.A. , Osler Mogens , Rasmussen Helen 
Published: August 2016

AbstractA prospective multicenter study of 1,032 cesarean sections was performed to identify risk factors for postoperative wound infection. The overall rate of wound infection was 6.6% (3.8% in elective cases and 7.5% following nonelective operations), with considerable interhospital variation. Obesity was recognized as a patient-related risk factor, while risk factors inherent to the obstetric situation were duration of ruptured membranes prior to operation, fetal and labor monitoring by intrauterine devices, and omission of the use of plastic draping and redisinfection of the skin before closure. Logistic regression analysis was used to estimate the influence of these factors on the probability of wound infection. Certain risk factors associated with and overrepresented in nonelective operations would explain the increased infection rates in these, and the observed interhospital variations did not differ from the expected rates when the distribution of other risk factors was considered.
Plasmid Analysis of Simultaneous Nosocomial Outbreaks of Methicillin-ResistantStaphylococcus aureus
Authors: Kozarsky Phyllis E. , Rimland David , Terry Pamela M. , Wachsmuth Kaye 
Published: August 2016

AbstractA large outbreak of infections caused by methicillin and aminoglycoside resistantStaphylococcus aureusprovided the opportunity to evaluate mechanisms of resistance and compare the usefulness of typing systems. Between January 1979 and December 1980, 63 patients developed infections with Saureusresistant to multiple antibiotics, including methicillin and tobramycin. All isolates had an identical antibiogram and were phage type 47/54/75/77/83A. Beginning in January 1981, a superimposed outbreak caused by Saureusof the same phage type but with a resistance pattern now including gentamicin occurred. The two strains contained different aminoglycoside inactivating enzymes. The initial strain contained a single plasmid of 21.5 mDa molecular weight, whereas the subsequent strain which had acquired gentamicin resistance contained this plasmid plus a heavier one of 33 mDa. Plasmid analysis complements the analysis of antibiograms and phage types and aids in defining epidemiologic patterns of transmission.
Other Approaches to the Prevention of Aspergillosis
Authors: Speller David C.E. 
Published: August 2016

Disseminated aspergillosis in the compromised host is an important and intractable problem in Great Britain, having a general incidence, when post-mortem data are included, approaching that quoted for the United States. It emerges as a most important cause of death in units where prolonged granulocytopenia accompanies treatment.Rhame has presented a persuasive account of the environmental origin of aspergillus infection and the possibility of its control by environmental measures. This is an important issue for those involved in the planning of new units, for the use of protective isolation is under criticism as failing to provide significant benefit, and even general provision of filtered air to the unit may be beyond the budget allowed. We have to consider the minimum necessary measures to reduce the risk. Providing HEPA-filtered air to the unit may not be sufficient in itself; British heart transplant patients have died of aspergillosis (A. fumigatus), in some cases initiated soon after surgery, despite nursing in rooms with filtered ventilation (Newsom SWB, personal communication); and respiratory ventilators have been suspected as one source within such a unit. We also have to consider other approaches to the problem. Is there an endogenous element in the production of aspergillosis? Is there any prospect of successful chemoprophylaxis?
Group B Streptococcus
Authors: Easmon Charles S.F. 
Published: August 2016

Over the past 25 years group B streptococci have become established as one of the main bacterial pathogens of the neonate in Western Europe and the United States. The attack rate of 0.25/1,000 live births found by Mayon White in Great Britain1 appears typical of many European countries. However, in some centers in the United States attack rates can be over 10 times higher.Two types of neonatal group B streptococcus (GBS) diseases exist, “early” and “late” onset. Early onset disease usually presents within the first few days of life. Often the most serious infections are present at birth or seen within a few hours. Early onset disease presents with pneumonia, respiratory distress and shock. Bacteremia is normally present and meningitis may occur. Mortality is high (50% to 75%). The portal of entry is probably the respiratory tract. Infants normally acquire the infecting organism from their mothers. Heavy maternal and infant colonization, prolonged rupture of membranes, prematurity, and obstetric complications are all risk factors.Delayed onset disease, as its name suggests, presents after the first week of life, primarily with bacteremia and meningitis. Mortality is much lower than for the early onset form, but still appreciable for a bacterial infection (14% to 18%). Its epidemiology is uncertain.
A Study on the Incidence of Postoperative Infections and Surgical Sepsis in a University Hospital
Authors: Ortona Luigi , Federico Giovanni , Fantoni Massimo , Pallavicini Federico , Ricci Francesco , Antinori Andrea 
Published: August 2016

AbstractReported are the results of a study on the incidence of nosocomial surgical infections in ten wards of the university hospital A. Gemelli, Rome. One thousand, five hundred five patients were studied and the overall incidence of surgical infections was 8.7%. Factors that influenced infection rates included age, immunosuppressive diseases, and immunosuppressive therapy. We assessed the inutility of antibiotic prophylaxis in clean operations and its usefulness in clean operations with insertion of prostheses or other devices. The importance of the duration of preoperative hospitalization and of the length of the operation were also noted. The most frequent etiological agents proved to be Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. The average hospital stay for patients with surgical infection was more than double that of patients with no infection (25.7 days v 11.7 days).
“The Coccus-Conscious” or “The Conscious Careful”
Authors: Brown Albert F. , Otterman Joan L. 
Published: August 2016

Staphylococcus aureus continues to be a resilient and persistent problem for hospital infection control programs. Now methicillin-resistant S. aureus (MRSA) is emerging as an even more formidable foe, bringing with it controversies in laboratory reporting, treatment, and isolation strategies.History suggests that the best solution to the hospital bacteria problem may well lie in the realm of spirit more than material methods. So, in the manner of Dickens' Christmas Carol fantasy, let us travel with three spirits— the Spirit of Conscience Past, the Spirit of Conscience Present, and the Spirit of Conscience to Come.
Impact of a Rigid, Puncture Resistant Container System Upon Needlestick Injuries
Authors: Ribner Bruce S. , Landry Martha N. , Gholson Gail L. , Linden Lisa A. 
Published: August 2016

AbstractNeedlestick injuries in a 720-bed tertiary care hospital were analyzed before and after the introduction of a rigid, puncture resistant, needle disposal system. Following implementation of the system, disposal-related injuries decreased from 0.9 per 100 full-time equivalent employees/year to 0.3 per 100 full-time equivalent employees/year (p <.005). However, needlesticks associated with procedures (2.2 vs. 4.4 per 100 full-time equivalent employees/year, p <.0005), and those resulting from loose needles (0.5 vs. 1.9 per 100 full-time equivalent employees/year, p <.0005), increased. Injuries occurring during needle recapping or the carrying of needles were not significantly altered. Total needlestick injuries increased from 6.0 to 8.7 per 100 full-time equivalent employees/year (p <.0005).We concluded that a rigid, puncture resistant, needle disposal system can reduce disposal-related needlestick injuries, but must also be perceived as convenient to impact substantially upon needlesticks associated with other activities.
Surveillance Objectives: Descriptive Epidemiology
Authors: Rhame Frank S. 
Published: August 2016

This paper addresses the problems associated with defining and classifying events as nosocomial infections, discusses the methods by which rates of nosocomial infection are calculated and their rationales, and presents some specific rates useful in nosocomial epidemiology. Previously unpublished data demonstrate important differences between antibiotic susceptibility tallies produced by clinical laboratories and similar tallies derived from nosocomial infection surveillance data.Conversion of real world events into categorical data presents formidable difficulties. Surveillance personnel must classify a given series of clinical events as 0,1, or more infections and make a determination as to whether each infection is nosocomial or community acquired. High-quality research studies to validate these efforts should compare the sensitivity and specificity of methods used to some “gold standard.” The gold standard is usually a review of medical records or patients by an infectious diseases physician. But even the standard is flawed. In clinical practice this flaw presents less of a problem because therapy for infectious diseases is generally quite safe and may be instituted when the probability of infection is 10%, 5%, or even lower. For surveillance purposes a higher standard is required, which is particularly important when surveillance information is used to provide feedback data to physicians who understandably bridle at overestimates of infection rates in their patients. The overestimation of infections based on weak evidence under-cuts feedback efforts.
Lessons Learned from Implementing Clostridium difficile-Focused Antibiotic Stewardship Interventions
Authors: Ostrowsky B. , Ruiz R. , Brown S. , Chung P. , Koppelman E. , van Deusen Lukas C. , Guo Y. , Jalon H. , Sumer Z. , Araujo C. , Sirtalan I. , Brown C. , Riska P. , Currie B. 
Published: August 2016

Objective.To determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates.Design.A multicenter before-and-after intervention comparative study.Setting/Participants.Ten medical centers in the greater New York region. Intervention group comprised of 6 facilities with early antimicrobial stewardship programs (ASPs). The 4 facilities without ASPs made up the nonintervention group.Interventions/Methods.Intervention facilities identified target antibiotics using case-control studies and implemented ASP-based strategies to control their use. Pre- and postintervention hospital-onset CDI rates and antibiotic consumption were compared for a 20-month period from June 2010 to January 2012. Antibiotic usage was compared using defined daily dose, days of therapy, and number of courses prescribed. Comparisons used bivariate and regression techniques.Results.Intervention facilities identified piperacillin/tazobactam, fluoroquinolones, or cefepime (odds ratio, 2.0-9.8 in CDI case patients compared with those without CDI) as intervention targets and selected several interventions (all included a component of audit and feedback). Varying degrees of success were observed in reducing antibiotic consumption over time. Total target antibiotic use significantly decreased (P < .05) when measured by days of therapy and number of courses but not by defined daily dose. Intravenous moxifloxacin and oral ciprofloxacin use showed significant reduction when measured by defined daily dose and days of therapy (P ≤ .01). Number of courses with all forms of these antibiotics was reduced (P ≤ .005). Intervention hospitals reported fewer hospital-onset CDI cases (2.8 rate point difference) compared with nonintervention hospitals; however, we were unable to show statistically significant decreases in aggregate hospital-onset CDI either between intervention and nonintervention groups or within the intervention group over time.Conclusions.Although decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, many valuable lessons (including implementation strategies and antibiotic consumption measures) were learned. The findings can inform potential policy decisions regarding incorporating control of CDI and ASP as healthcare quality measures.
Manual Methods Are Suboptimal Compared With Automated Methods for Cleaning of Single-Use Biopsy Forceps
Authors: Alfa M. J. , Nemes R. , Olson N. , Mulaire A. 
Published: August 2016

Objective.Most reusable biopsy forceps and all of the currently available single-use biopsy forceps do not have a port that allows fluid flow down the inner tubular shaft of the device. Reusable biopsy forceps are widely used and reprocessed in healthcare facilities, and single-use biopsy forceps are reprocessed either in-house (eg, in Canada and Japan) or by third-party reprocessors (eg, in the United States). The objective of this study was to determine the cleaning efficacy of automated narrow-lumen sonic irrigation cleaning, sonication-only cleaning, and manual cleaning for biopsy forceps.Design.A simulated-use study was performed by inoculating the inner channel of single-use biopsy forceps with artificial test soil containing both Enterococcus faecalis and Geobacillus stearothermophilus at concentrations of 106 colony-forming units per milliliter. The cleaning methods evaluated were manual cleaning, sonication-only cleaning, and “retroflush” cleaning by an automated narrow-lumen irrigator. Bioburden and organic soil reduction after washing was evaluated. Forceps used in biopsies of patients were also tested to determine the worst-case soiling levels.Results.Only retroflush irrigation cleaning could effectively remove material from within the shaft portion of the biopsy forceps: it achieved an average reduction of more than 95% in levels of protein, hemoglobin, carbohydrate, and endotoxin. However, even this method of cleaning was not totally effective, as only a 2 log10 reduction in bioburden could be achieved, and there were low residual levels of hemoglobin and carbohydrate.Conclusion.The data from this evaluation indicate that manual and sonication-only cleaning methods for biopsy forceps were totally ineffective in removing material from within the biopsy forceps. Even the use of retroflush cleaning was not totally effective. These findings suggest that in-hospital reprocessing of biopsy forceps with currently available equipment and cleaning methods is suboptimal.
Seroprevalence Survey of Varicella, Measles, Rubella, and Hepatitis A and B Viruses in a Multinational Healthcare Workforce in Saudi Arabia
Authors: Almuneef M. A. , Memish Z. A. , Balkhy H. H. , Otaibi B. , Helmi M. 
Published: August 2016

Objective.To determine the prevalence of the vaccine-preventable diseases caused by varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce.Design.Prospective cohort study.Setting.A 750-bed tertiary care center located in Riyadh, Saudi Arabia.Methods.In compliance with hospital policy, newly recruited healthcare workers (HCWs) were enrolled in the study from September 2001 to March 2005. Serum samples were collected from all HCWs during the initial hiring process and tested for IgG antibodies against each of the 5 viral agents. Nonimmune HCWs were subsequently vaccinated at the earliest opportunity.Results.A total of 4,006 newly hired (international and local) employees were included in the study. All underwent serologic testing for IgG antibodies against varicella, measles, rubella, hepatitis A, and hepatitis B viruses. Of the total, 63% were female and 37% were male. Middle Eastern employees comprised 47% of the total, followed by employees from the Far East (35%), the West (10%), and Africa (8%). Forty-two percent were nurses, 27% were in administration, 18% were medical technicians, and 13% were physicians. Among the 4,006 newly hired HCWs, 14% had negative IgG antibody test results for varicella virus, 13% for measles virus, 10% for rubella virus, 33% for hepatitis A virus, and 43% for hepatitis B virus. More women than men were susceptible to hepatitis A (40% vs. 24%; P< .001), whereas more men were susceptible to hepatitis B (55% vs. 35%; P< .001). Varicella susceptibility was more common among HCWs from the Far East (19%), whereas susceptibility to measles, rubella, hepatitis A, and hepatitis B was highest among HCWs from the Middle East. Both relative youth and male sex were associated with lack of antibodies against hepatitis B virus and rubella virus. In contrast, female sex and younger age were associated with lack of antibodies against hepatitis A virus (P< .001).Conclusion.Seroprevalence surveys of vaccine-preventable diseases among HCWs, although labor intensive, are invaluable in caring for a multinational workforce.
Queensland Literature
Authors: Buckridge Patrick 
Published: August 2016

The idea of ‘Queensland Literature’ has a history, but a rather discontinuous one. During the present century, it has emerged sporadically at particular historical moments, rather than as a constant preoccupation, which is how the idea of an Australian literature has figured during this period. An explanation of the different profiles of national and state literary histories in the post-Federation era might begin by asking what is at stake in each case? The cultural beneficiaries of one ‘construction’ of Australian literature are different from those of other, competing constructions of Australian literature. Nationally, there are social and political identities at stake. But at the state level, for most of this century, literature seems to have been much less involved in identity politics of that kind, considerably less than one might have expected, given the ferocity of interstate rivalry in sporting and other areas.
Regionalism in Audiovisual Production
Authors: Cunningham Stuart 
Published: August 2016

A great deal has been made of the boom in audiovisual production based in southern Queensland (and to some extent in northern Queensland) in the 1990s. This follows a pattern throughout the so-called ‘revival’ period (since the early 1970s) in Australia which has seen successive moments of regional upsurge. In the 1970s, it was South Australia, under the energetic leadership of the South Australian Film Corporation, that saw many of the best feature films and several of the early historical mini-series of the early revival period made in that state (see, for example, Moran). During the early to mid-1980s, Western Australia, with the location of bold production houses such as Barron Films and strong independent documentary traditions, offered robust regional opportunities, culminating in such memorable films as Shame and Fran.
'Paradise Beach'
Authors: Malone Jacki , Schembri Peter 
Published: August 2016

According to one newspaper report, Paradise Beach was initially marketed in the US as a ‘very hip, very cool’ Australian serial about three good-looking suburban kids finding romance and adventure in an endless summer. Here, in Australia, Channel 9 did something rather similar:

PARADISE BEACH is where the perfect white sand stretches for miles; where the music is hot and the party just goes on and on. It's where teenagers from everywhere converge to cut loose, find the perfect wave, and fall hopelessly in love. And that's exactly what happens with our four young and passionate central characters and their friends.
'Beethoven by Bus'
Authors: McKay Belinda 
Published: August 2016

In the last issue of Queensland Review, it was argued that the idea of Queensland literature has a history, and that the various competing formulations of that idea have implications for Queensland identity and politics. Queensland art, likewise, has some currency as an idea, particularly as an ‘art off centre’ to borrow the title of a recent conference. It is, therefore, somewhat surprising that the idea of ‘Queensland music’ has not emerged as a useful way of constructing a cultural or political identity. ‘Music in Queensland’, suggesting an exotic and not fully acclimatized cultural form, is instead the designation used in the few — mostly unpublished — works which treat Queensland's musical history.
'The Modern Athens'
Authors: Harris Marjorie 
Published: August 2016

When the Ipswich Punch described colonial Ipswich as ‘the Modem Athens of the North’ (quoted in Deppeler-Hagan 1999: 28), it endowed the fledgling city with the image of a strong cultural background based on the traditions of Europe. However, the literary culture which existed in that period could not reflect all that the appellation might imply. Some of the town's inhabitants may have been educated in England and brought knowledge of European literature and thought to the new colony, but many were more concerned with earning a living than with cultivating their minds.