bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Synergized Glutaraldehyde-Phenate Sterilizing Solution and Concentrated Disinfectant
Authors: Leach Eddie D. 
Published: August 2016

AbstractResearch leading to the development of Sporicidin, a new (synergized glutaraldehyde-phenate) sterilant and concentrated disinfectant, is reported. Microbial evaluation and shelf life testing of the new formulation was done using AOAC tests—Use-Dilution, Sporicidal, Tuberculocidal—and the E.P.A. Virucidal Test. Full-strength Sporicidin sterilizes (is sporicidal) in 6% hours at both 20C and 25C, and disinfects in 1-2 minutes. When diluted with 15 parts of tap water, Sporicidin is tuberculocidal, virucidal, and germicidal in 10 minutes, qualifying as a hospital disinfectant that will not “yellow” the hands or skin. The shelf life of activated Sporidicin, full strength or diluted 1 in 16, is 30 days. According to the data presented, which were the basis of E.P.A. registrations, Sporicidin is: (a) the fastest glutaraldehyde sterilant at room temperature, and (b) the only glutaraldehyde product that can be diluted below 2% and still qualify as a hospital disinfectant.
Nosocomial Viral Infections: III. Guidelines for Prevention and Control of Exanthematous Viruses, Gastroenteritis Viruses, Picornaviruses, and Uncommonly Seen Viruses
Authors: Valenti William M. , Hruska Jerome F. , Menegus Marilyn A. , Freeburn Mary Jane 
Published: August 2016

AbstractThis communication is the third in a four-part series on nosocomial viral infections from the Strong Memorial Hospital. This third article discusses guidelines for prevention and control of exanthematous viruses, gastroenteritis viruses, adenoviruses and the picornaviruses other than rhinoviruses. Several uncommonly seen viruses, such as the virus of Creutzfeldt-Jakob disease and Marburg, Ebola, and Lassa fever viruses, also are reviewed briefly.
Prophylactic Antibiotics in Pediatric Orthopedic Surgery Current Practices
Authors: Faden Howard 
Published: August 2016

AbstractA limited survey of 90 orthopedic surgery programs throughout the U.S. A. was conducted to determine the use of prophylactic antibiotics in pediatric orthopedic operations. Prophylaxis was used most often in the Harrington rod procedure (80.7%); less often in hip (64.2%) and knee (44.7%) reconstructive surgery; rarely in meniscus repairs (8.0%) and in lengthening of Achilles tendǫns (2.3%). Cephalosporins (85%) were the antibiotics prescribed most frequently. The first dose was administered before surgery in 89.6% of the operations. Prophylaxis was discontinued within five days in 96% of the operations. These data provide a pattern of the use of prophylaxis in pediatric orthopedic surgery.
Nosocomial Viral Infections: IV. Guidelines for Cohort Isolation, the Communicable Disease Survey, Collection and Transport of Specimens for Virus Isolation, and Considerations for the Future
Authors: Valenti William M. , Menegus Marilyn A. 
Published: August 2016

AbstractVirus transmission within the hospital is related to trans-missibility of the virus and susceptibility of the population at risk. General guidelines for the use of cohort isolation, for the control of virus transmission in the hospital, and for the use of the communicable disease survey for pediatric patients and visitors to the hospital are outlined. We also present a brief review of how to collect and transport specimens for virus isolation to assist the infection control practitioner and the clinician, and conclude with recommendations for future investigations in the areas of virology and infection control [Infect Control 1981; 2(3):236-245.]
Clinical, Epidemiologic and Microbiologic Features of a Persistent Outbreak of Amikacin-Resistant Serratia marcescens
Authors: Arroyo Julio C. , Milligan W. Lloyd , Postic Bosko , Northey Jimmie , Parker Ellen , Bryan Charles S. 
Published: August 2016

AbstractThis article describes a prolonged outbreak (January 1977 to February 1980) of amikacin-resistant Serratia marcescens (ARSM) urinary infections and the methods used for its control. Significant factors predisposing to ARSM urinary tract infection included an extended hospital stay, being in the urology ward, and undergoing urologie surgery. There had been no prior administration of amikacin or of other aminoglycosides in 20 of 27 patients with ARSM urinary tract infections. Chronically infected patients who required multiple hospitalizations represented a major reservoir for the perpetuation of the outbreak, overshadowing the importance of aminoglycoside use. Traditional control measures and even a major change in the inanimate environment were only partially effective in controlling the outbreak, but treatment of bacteriuric patients in the urology unit with “second and third generation” cephalosporins interrupted patient-to-patient transmission. No new cases of ARSM bacteriuria appeared in the urology unit in the ensuing 12 months [Infect Control 1981; 2(5):367-372.]
Observations Relating to an Inter-Hospital Outbreak of Methicillin-Resistant Staphylococcus aureus: Role of Antimicrobial Therapy in Infection Control
Authors: Ward Thomas T. , Winn Rick E. , Hartstein Alan I. , Sewell David L. 
Published: August 2016

AbstractClinical, bacteriologie, epidemiologic and hospital infection-control observations related to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus are described. The outbreak involved 66 patients at the University of Oregon Health Sciences Center (UOHSC) and its closely affiliated VA hospital, the Portland VA Medical Center (PVAMC). No environmental source of infection was identified; person-to-person transmission was most likely responsible for its spread. Surveillance cultures demonstrated nasal colonization in house staff and nursing personnel at both hospitals. Inter-hospital transfer of infection was, in all likelihood, achieved via nasal carriage by a single physician. Case-control analysis indicated a significantly increased risk (p < 0.05) of acquisition of infection related to age, number of days hospitalized, severity of underlying disease and number of invasive procedures. Prior antibiotic receipt was a significant risk factor when analyzed by univariate analysis (p < 0.01), but, in contrast to previous studies, this was not a significant risk factor (p > 0.05) when related variables were controlled by multivariate analysis. Prevention of spread of infection by routine infection control measures was less effective at PVAMC than at UOHSC. Patients at PVAMC were significantly older and had longer durations of hospitalization (p < 0.05). Antimicrobial therapy of colonized patients and personnel appeared to assist in the control of the outbreak at PVAMC. Antimicrobial therapy with topical bacitracin and oral rifampin, alone or in combination with oral trimethoprim-sulfamethoxazole, was effective in eliminating colonization with methicillin-resistant S. aureus. [Infect Control 1981; 2(6):453-459.]
Klebsiella pneumoniaePseudobacteremia Due to Cross-Contamination of A Radiometric Blood Culture Analyzer
Authors: Greenhood Gary P. , Highsmith Anita K. , Allen James R. , Causey William A. , West C. Michael , Dixon Richard E. 
Published: August 2016

AbstractBlood isolates from 13 patients in one hospital were positive forKlebsiella pneumoniaeover a two-week period. Vials of potassium chloride used in intravenous fluid admixture initially were suspected of being contaminated and thus causing the problem. However, a comparison of patients who had blood cultures positive forK. pneumoniaewith control patients who had blood cultures negative for this organism during the same period identified no common features that would explain the increase inK. pneumoniaeblood isolates. Careful evaluation of laboratory data suggested that six of the 13 culture-positive patients had probable pseudobacteremia, an explanation that would account for the increase in isolates above the endemic level of trueK. pneumoniaebacteremia in the hospital. Epidemiologic data suggested that cross-contamination of adjacent and non-adjacent blood culture vials on the radiometric blood culture analyzer was the cause of pseudobacteremia;K. pneumoniaeserotyping data supported this hypothesis. A mocktrial using the analyzer demonstrated that cross-contamination of non-adjacent vials by the sampling needles could occur. Changing the sampling needles of the analyzer daily, in accordance with the manufacturer's recommendations, prevented further episodes of pseudobacteremia from the analyzer. [Infect Control 1981; 2(6):460-465.]
Cost Effectiveness and Cost Benefit of Vaccination Against Pneumococcal Pneumonia. Implications for Clinical Practice
Authors: Willems Jane Sisk 
Published: August 2016

AbstractThe economic techniques of cost-effectiveness and cost-benefit analysis have provided useful insights into the potential advantages of vaccination against pneumococcal pneumonia. They suggest that the cost of vaccinating persons 65 years and older and perhaps younger persons with high risk conditions would be reasonable when compared with the cost of treatment for pneumococcal pneumonia. These findings, together with other considerations, may guide physicians and health care policymakers in deciding which individuals might be expected to benefit from pneumococcal vaccination.
Hospital-Based Pneumococcal Immunization: The Epidemiologic Rationale and Its Implementation
Authors: Fedson David S. 
Published: August 2016

AbstractMany patients hospitalized for or dying of pneumococcal bacteremia have been discharged from a hospital with in the previous five years. In addition to age and underlying medical condition, previous hospital care, particularly for high risk conditions, is a useful marker for identifying individuals who are destined to develop serious pneumococcal infections. Relatively few patients, especially those with high risk conditions, would need to receive pneumococcal vaccine at the time of hospital discharge to prevent, within the next five years, each subsequent readmission or death from pneumococcal pneumonia. Although pneumococcal vaccine has not been widely used in the hospital setting, there are sound epidemiologic reasons to expect that organized programs for vaccine delivery in hospitals would be an effective approach to preventing many serious pneumococcal infections.
Pneumococcal Immunization: Policy Development and Implementation from the ACIP Perspective
Authors: Dull H. Bruce 
Published: August 2016

AbstractThe Advisory Committee on Immunization Practices (ACIP) of the U.S. Public Health Service is responsible for making recommendations on the use of new vaccines and periodically revising those for established vaccines. Recommendations for pneumococcal vaccine were first issued in 1978 and revised in 1981. The changes which appear in the revision reflect the continuing maturation of the Committee's judgment on the vaccine and are a good example of the process by which the ACIP develops its recommendations on national immunization practices.
An Evaluation of Daily Bacteriologic Monitoring to Identify Preventable Episodes of Catheter-Associated Urinary Tract Infection
Authors: Garibaldi Richard A. , Mooney Barbara R. , Epstein Beverly J. , Britt Michael R. 
Published: August 2016

AbstractWe evaluated the efficacy of a daily bacteriologic monitoring program for preventing symptomatic urinary tract infections (UTI) in hospitalized patients with temporary indwelling urethral catheters. We identified 99 instances in which bacteriuria was present at the time of catheter insertion among 1,140 catheterizations. Of those, 62 patients were asymptomatic and 37 patients had fever or symptoms attributable to UTI. Of the 37 symptomatic episodes, only 14 developed symptoms 24 hours or more after the first culture and might be considered potentially preventable.We also identified 76 episodes of acquired bacteriuria among 608 catheterizations that were initially non-bacteriuric in which at least two cultures were available. Of these 76 patients, 51 (67%) remained asymptomatic throughout their period of hospitalization. Of the 25 patients who developed symptomatic infections, only ten were potentially preventable.In all, only 24 symptomatic episodes among 1,140 catheterizations (2%) occurred 24 hours or more after colonization was first detected and might be considered potentially preventable. Our data suggest that routine daily bacteriologic monitoring of urine from all catheterized patients is not an efficient way to decrease the incidence of symptomatic, catheter-associated UTI.
Presumed Autoclave Failure Due to False-Positive Spore Strip Tests
Authors: Gurevich Inge , Holmes Joyce E. , Cunha Burke A. 
Published: August 2016

AbstractThe sterilizing processes in autoclaves and ethylene oxide sterilizers are challenged on a regular basis with a controlled inoculum of spores from two Bacillus species. Within a two-day period in March 1980, the seven autoclaves at this 550-bed hospital appeared to have failed in their function of killing spores on 18 out of 46 test strips. A shut-down of the autoclaves and a massive investigation failed to identify any mechanical, physical, or human failures. However, after 48 hours, it was found that the broth used as growth medium contained a contaminant, Bacillus coagulans, that resulted in broth turbidity at 55°C. Incubating an uninoculated tube of trypticase soy broth (TSB) for quality control at 55°C in addition to the usual 37°C quality check is a recommended safeguard against such occurrences.
Nosocomial Infections Decade-Specific Risk
Authors: Gross Peter A. , Rapuano Christopher , Adrignolo Anthony , Shaw Barbara 
Published: August 2016

AbstractAlthough the elderly are thought to be at increased risk for acquiring nosocomial infections (NIs), the degree of risk has not been carefully quantified. We determined the decade-specific risks of NIs. The rate was constant at approximately 10 per 1,000 discharged patients from birth to 40 to 49 years. Thereafter the rate rose logarithmically and peaked at greater than 100 per 1,000 discharges after 70 years. Of all NIs, 64% occurred after 60 years of age. Yet, this elderly group made up only 23% of hospitalized patients. In conclusion, while the elderly comprise a small fraction of hospitalized patients, they account for the majority of nosocomial infections.
An Outbreak of Gentamicin-ResistantEnterobacter cloacaeInfections in a Pediatric Intensive Care Unit
Authors: Anderson Edwin L. , Hieber J. Patrick 
Published: August 2016

AbstractThe intensive care unit at Children's Medical Center in Dallas is a medical-surgical unit that cares for pediatric patients of all ages. In 1978 an outbreak of infections occurred that was caused by a gentamicin-resistant strain ofEnterobacter cloacae. Thirty of the 34 patients involved in the outbreak were neonates. Six patients developed bacteremia, five of them neonates. The neonates who became infected were significantly smaller (> 1500 g) and more premature (< 35 weeks) than control patients. Neonates with bacteremia had a significantly higher incidence of congenital anomalies. In a multi-specialty pediatric intensive care unit newborn infants were the group of patients at high risk for nosocomial infection.
Nursery Salmonellosis Delayed Recognition Due to Unusually Long Incubation Period
Authors: Seals Jerry E. , Parrott Patricia L. , McGowan John E. , Feldman Roger A. 
Published: August 2016

AbstractA nursery outbreak of diarrheal illness caused bySalmonella nienstedteninitially involved seven infants cared for in one nursery; secondary infection subsequently affected one infant cared for in the same nursery as well as four other infants. Recognition of the outbreak was delayed due to an unusually long incubation period. The period from last known exposure to onset of diarrhea ranged from two to 18 days, with a median of ten days. The prolonged incubation period may have resulted from a low inoculum of the organism, from a previously unknown characteristic ofSalmonella nienstedten, or may be an age-specific response. Hospital infection control personnel should be aware that nosocomial cases of salmonellosis may have a longer incubation period than has been previously recognized.
Practical Aspects for Cost Reduction in Hospital Infection Control
Authors: Daschner F.D. 
Published: August 2016

AbstractNosocomial infections consume a significant amount of the total hospital budget. This article describes some practical aspects for cost reduction in hospital infection control. Within one year total savings of 91.000 DM* could be achieved by discontinuing unnecessary disinfection procedures. Within six years 2,27 million DM could be saved by discontinuing unnecessary infection control procedures or employing cheaper methods. Of the total antibiotic costs 25% can be reduced by certain measures.
An Outbreak of Gentamicin-ResistantKlebsiella pneumoniae:Analysis of Control Measures
Authors: Saravolatz Louis D. , Arking Lucille , Pohlod Donald , Fisher Evelyn J. , Borer Robert 
Published: August 2016

AbstractIn April 1978, a strain of gentamicin-resistantKlebsiella pneumoniae(GRK) was introduced into the neonatal intensive care unit of Henry Ford Hospital. An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. All GRK were susceptible to amikacin and were capsular serotype 19. Though hand contamination of hospital personnel with GRK was documented, increased handwashing practices did not reduce colonization rates of neonates with the epidemic strain. Intestinal carriage persisted for up to ten months and could not be eradicated by administering oral colistin sulfate. Discontinuation of gentamicin and utilization of amikacin were associated with a significant reduction in colonization with GRK (p< 0.05). However, the only control measure that prevented both new cases and colonization with the epidemic strain was the utilization of a strict cohort system.
Comments on the CDC Guideline for Employee Health
Authors: Valenti William M. 
Published: August 2016

A number of resources are available to individuals who are interested in employee health and infection control. These resources can be useful to individuals whose employee health programs are just starting or to those whose programs are well-established.The most comprehensive document to date is the Employee Health Guidelines published by the Centers for Disease Control. This is perhaps the most comprehensive and thorough document published to date. It is current, reflects the state of the art in employee health, and should provide employee health and infection control practitioners with a wealth of useful information that is practical and clinically relevant.
Summary of the International Workshop National Laws and Guidelines for Control of Infections
Authors: Nyström Bertil , Reber Hans , Weuffen Wolfgang , Schaffner William 
Published: August 2016

By way of introduction, Dr. Nyström described the hospital system in Sweden which is organized in a pyramidal fashion within each county. The largest hospital in each county contains a Department of Clinical Microbiology and the organization of hospital infection control activities follows this county structure.An infection control unit is located within the clinical microbiology laboratory of the major county hospital. The head of the unit, the hospital epidemiologist, is usually a specialist in clinical microbiology with medical training. The epidemiologist has an infection control committee consisting of clinicians of various specialties, especially surgeons. There are usually two infection control nurses per county (now approximately 1 nurse/3000 beds with an eventual goal of 1 nurse/1000 to 1500 beds). The nurses advise the ward staff in all the county hospitals. There are only some 50 infection control nurses in Sweden; financial restrictions curtail the development of infection control activities.
Serratia MarcescensMeningitis Associated With a Contaminated Benzalkonium Chloride Solution
Authors: Sautter Robert L. , Mattman L.H. , Legaspi Ruben C. 
Published: August 2016

AbstractSerratia marcescensis recognized as an important and potentially hazardous nosocomial pathogen. The organism has been implicated here as the first reported case ofS. marcescensmeningitis associated with skin disinfection. A quaternary ammonium compound (QAC—Benzalkonium Chloride), was used to sterilize the skin prior to injection in a physician's office. Epidemiological studies were initiated. Six spray bottles containing disinfectant, the opened stock bottle of QAC, and an unopened bottle of disinfectant were all cultured.S. marcescenswas noted growing in the spray bottles as well as in the opened stock bottle. Anti-biograms of the patient and epidemiological isolates are essentially the same. It is our contention as well as that of the Centers for Disease Control that an appropriate skin disinfectant such as Tincture of Chlorhexidine, Iodophors, or Tincture of Iodine should be used, and that physicians performing surgical techniques in the office be aware of the potential hazard of contamination. The consequences of nosocomial infection with resistant organisms warrant every precaution by health care professionals.
Analysis of Hospital Infection Surveillance Data
Authors: Birnbaum David 
Published: August 2016

AbstractHow often infection rates should be calculated and how large a change is required for “significance” are pertinent questions in nosocomial infection surveillance programs. A method is presented which establishes outbreak threshold infection frequencies. Comparison is direct and immediate: computation of rates or use of electronic data processing is not required. We have validated this method, using computer systems, by comparing the distributions of mean weekly incidence and prevalence statistics for each ward by nosocomial infection site in an acute care general hospital against both our theoretical outbreak threshold limits and the distribution of proven infection outbreaks. Sensitive and specific distinction between random variation or sporadic cross-infection and true persisting outbreaks requiring intervention is obtained. This approach provides a simple and timely alternative to intuitive after-the-fact interpretation of infection patterns which is applicable to infection surveillance and cost-effective infection control in hospitals of all sizes.
Multiple-Dose Vials: Persistence of Bacterial Contaminants and Infection Control Implications
Authors: Longfield Robert N. , Smith L. Patrick , Longfield Jenice N. , Coberly Jacqueline , Cruess David 
Published: August 2016

AbstractDue to sporadic infections attributed to contaminated multiple-dose medication vials (MDV), some authorities have suggested discarding all MDV within 24 hours. We inoculated 11 commonly used medications with suspensions of 10 bacterial species previously associated with contaminated parenteral solutions and determined microbial persistence at both room and refrigerator temperature. At 22°C, atropine, curare, folic acid, NPH insulin and triamcinolone did not allow microbial persistence beyond 4 hours. Lidocaine and heparin were sterile by 24 hours. Regular insulin, immune serum globulin, and myochrysine allowed persistence for up to 7 days. At 4°C, bacterial persistence was significantly prolonged for all medications including those MDV requiring refrigeration. No organisms proliferated; however,F. meningosepticumandP. maltophiliawere particularly persistent at both temperatures. The risk of persistent MDV contamination appears to be dependent upon specific pharmaceutical, microbe and storage temperature interactions. Recommendations for the refrigeration of MDV medications may require reevaluation on a product-by-product basis.