bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infections in Organ Transplant Recipients
Authors: Garibaldi Richard A. 
Published: August 2016

AbstractSince the introduction and widespread performance of transplant surgery in the 1950s and 1960s, infectious complications have been a major cause of morbidity and mortality. The risks of infection are directly related to the potency and duration of immunosuppressive therapies, organ-donor selection, surgical techniques, and postoperative exposures to invasive procedures or treatments.Despite impressive advancements to decrease the risks of infection, between 40% and 80% of renal transplant patients become infected within the first two or three postoperative years. Infections that occur during the first month following transplantation are often caused by common nosocomial pathogens and are secondary to invasive procedures or therapies. Infections that occur between one and six months post-surgery are often caused by opportunistic pathogens. Symptomatic and subclinical cytomegalovirus (CMV) infections are common during this time and may contribute to a further impairment of host defenses. Late infections involve both opportunistic and conventional pathogens; opportunistic infections occur in patients with poor transplant function who require high levels of immunosuppression and conventional infections occur in patients who require little immunosuppression.During the past two decades, there has been a significant decrease in deaths from infectious complications among renal transplant recipients. Further reductions in morbidity and mortality will occur with the development of more specific approaches for immunosuppressive therapy, new strategies to prevent CMV infections and methods to eliminate sources of nosocomial infections.
Rationale and Testing of Degerming Procedures
Authors: Reber Hans 
Published: August 2016

AbstractThe rationale of degerming procedures is the elimination of undesirable microorganisms from sites serving as potential starting points for the transmission of infections, eg, secretions, excretions, and vehicles. The significance of transmission of infection is well-established for some sites, such as the hands, but debatable for others such as surfaces. No general agreement exists on the efficacy of the different procedures used to prevent hospital infections. Since frequently multiple factors intervene and the final effect is due to the interaction of several preventative measures, it is very difficult to ascertain the efficacy of any given procedure. However, to prevent the formation of germ depots outside the organism is a classical postulate of hygiene not yet invalidated.Rationale and testing of degerming procedures are closely linked. From tests one expects an answer, if and to what extent a degerming procedure fulfills the requirement fixed by the rationale.It is essential to distinguish between the degerming agent as the active principle and the degerming procedure, which is comprised of additional factors in the application.
Training of Personnel for Infection Control
Authors: Crow Sue 
Published: August 2016

AbstractThe overall objectives for implementing an infection control program are to make hospital personnel aware of nosocomial infections and to educate these persons in their role in decreasing the risk of these infections. The infection control practitioner (ICP) implements these objectives by performing surveillance to determine problem areas and by developing policies and procedures that prevent and control nosocomial infections. Appropriate qualities for an ICP include initiative, leadership, communication skills, commitment, and charisma. Expertise in patient care practices, aseptic principles, sterilization practices, education, research, epidemiology, microbiology, infectious diseases, and psychology are acquired skills.Local, state, and national organizations, as well as universities, are responsible for ICP training. In the US the Centers for Disease Control have established a training program for the beginning ICP and the Association of Practitioners in Infection Control (APIC) has developed a study guide for developing infection control skills. The ultimate responsibility for education is an individual obligation, however. Certification of the ICP would insure a minimum level of knowledge, thereby standardizing and upgrading the practice of infection control.
Three Clusters of Bacillus Pseudobacteremia Related to a Radiometric Blood Culture Analyzer
Authors: Gurevich Inge , Tafuro Patricia , Krystofiak Sharon P. , Kalter Robert D. , Cunha Burke A. 
Published: August 2016

AbstractDuring a ten-month period from September 1981 to July 1982 three episodes of pseudobacteremia due to Bacillus species occurred at this 550-bed institution. The first involved eight isolates, the second 11, and the third seven isolates of the organism, all with the same antibiogram.The patients involved did not exhibit clinical signs of septicemia, and in only one case was more than one specimen per patient positive when multiple blood samples were obtained. Occasional blood cultures of Bacillus species identified in between clusters revealed a different antibiogram.Extensive epidemiologic investigation of patient locations, phlebotomists, and time of cultures yielded no common source. Components involved in the transport and processing of blood cultures, including the radiometric blood culture processor, were also sampled but without recovery of the organism. After the last episode, a layer of dust was noted inside the machine, and culture of this dust grew Bacillus spp. with the same antibiogram as those found in the blood cultures. The filter from an air conditioning unit in close proximity to the machine grew several species of Bacillus.It is presumed that Bacillus spores in the dust were introduced into the blood culture bottles following the heat sterilization of the gas sampling (inoculation/removal) needles.Modification of the cover of the machine was undertaken to prevent access of dust bearing microbes to the inside of the machine. In addition, maintenance now includes regular disinfection/cleaning of the “floor” of the machine, and more frequent changes of the air conditioner filter.
AIDS—Safety Practices for Clinical and Research Laboratories
Authors: Federico John V. , Gershon Robyn R.M. 
Published: August 2016

AbstractAcquired immunodeficiency syndrome, or AIDS, is currently a significant public health problem receiving widespread interest as both cause and treatment are sought. Indications are that a transmissible agent is involved. Both clinical and research laboratories are receiving greater numbers of specimens from AIDS patients as both prevalence of the condition increases and research efforts intensify. Until such time as the causative agent is identified, prudent practice warrants that a high level of precaution be observed. The Division of Occupational and Environmental Health Services of the Yale University Health Services presents a set of safety procedures and guidelines for use by personnel of both clinical and research laboratory facilities. These exceed previously suggested containment recommendations.
Rubella in Hospital Employees
Authors: Strassburg Marc A. , Stephenson Timothy G. , Habel Laurie A. , Fannin Shirley L. 
Published: August 2016

AbstractIn early 1982, 15 hospitals in Los Angeles County reported one or more serologically confirmed rubella cases among their employees. Secondary cases occurred at eight hospitals; overall, 56 cases were identified among employees, of which 28 were serologically confirmed. Testing of 2,061 employees revealed 1,770 (86%) with detectable antibody. A survey of 83 hospitals offering obstetrical services indicated only 42% (33 of 78) had an established rubella screening policy. Based on the results of this survey, the Los Angeles County Department of Health Services published recommendations for hospital rubella screening and immunization policies.
Brief Report: Nosocomial Infection Rates in a Cancer Treatment Center
Authors: Robinson Gayle V. , Tegtmeier Bernard R. , Zaia John A. 
Published: August 2016

AbstractThis report describes the results of a prospective study of nosocomial infection in 7,714 patients hospitalized during a 24-month period at a cancer treatment center. An overall nosocomial infection rate of 9.3% was observed with site-specific infection rates of 2.6% for urinary tract, 1.9% for surgical wound, 2.2% for bacteremia and 1.9% for respiratory tract infection. Within specific patient groups, the overall nosocomial infection rates observed were: 8.2% in medical patients, 14.9% in surgical patients and 1.5% in pediatric patients. Despite the markedly elevated nosocomial infection rate in surgical patients (P < 0.001), surgical wound infection rates were not unlike those observed in general hospitals: clean—2.4%, clean contaminated—5.8%, contaminated—13.2%, and dirty—11.8%. These observations provide evidence that institutions which provide medical care predominantly for cancer patients can expect to observe higher nosocomial infection rates than general care hospitals.
Risks and Benefits of Vaccinations
Authors: Wiedermann Gerhard , Ambrosch Franz , Kollaritsch Herwig , Kundi Matthias 
Published: August 2016

Abstract Any medical intervention is expected to prevent sickness and complications of a disease rather than to induce them. This is true for therapy as well as prophylaxis. Special formulas have been developed to calculate the risks and benefits of vaccinations simply but with sufficient accuracy. The risk ratio (Q) tells how many times the risk of contracting certain complications or even death from a disease is greater in unvaccinated than in vaccinated individuals. The risk difference (D) directly expresses the number of complications or deaths that may be prevented by a certain vaccination. It is even possible to evaluate the epidemiologic trend of a disease and to calculate or estimate the point of time when the risks of disease and vaccination are just balanced, ie, when a vaccination has lost its beneficial effect. Vaccinations against measles, poliomyelitis and tick borne encephalitis in Austria are highly beneficial. BCG vaccination is still beneficial on a low level in Austria as far as protection against tuberculosis is concerned. This effect will persist for the rest of this century. The benefit of pertussis vaccination depends on the local epidemiologic situation. It has expired for non-risk groups in Austria since 1976 but continues to persist in the US.
Evaluation of Skin Antisepsis Prior to Blood Culture in Neonates
Authors: Champagne Sylvie , Fussell Susan , Scheifele David 
Published: August 2016

AbstractIn our Intensive Care Nursery, coagulase-negative staphylococcus is the most frequent blood culture isolate. As skin antisepsis is critical in preventing blood culture contamination, we examined the efficacy of the chlorhexidine tincture (CH) used in our nursery for this purpose.Staphylococcus epidermidiscolonized the forearms of 88% of infants tested, in a mean density of 104 organisms/cm2. Following a 60-second application of CH (0.5% in 70% ethanol), bacterial growth from forearm skin remained abundant in 15/38 infants (39.4%). Cleansing with 70% isopropyl alcohol, followed by CH as above, left abundant residual growth in only 1/37 infants (2.7%) (P<0.001). All 136S. epidermidistested were susceptible to CH (MIC<5(μg/ml) and 14 of 15 exposed to CH 0.02% were rapidly killed (≥98% fall in viable counts within 90 sec). We conclude that two-phase antisepsis using isopropanol followed by CH is a more effective preparation for blood culture in neonates than is CH alone.
A Multivariate Analysis of Risk Factors for Acquiring Bacteriuria in Patients With Indwelling Urinary Catheters for Longer Than 24 Hours
Authors: Shapiro Mervyn , Simchen Elisheva , Izraeli Shai , Sacks Theodore G. 
Published: August 2016

AbstractData related to risk factors for catheter-acquired bacteriuria were collected prospectively on 112 patients consecutively catheterized for >24 hours at the Hadassah University Hospital. Logistic regression analysis indicated that factors independently associated (p≤0.05) with a higher risk of catheter-acquired bacteriuria were as follows: hospitalization in orthopedics or urology, ethnic origin (Arabs > Jews), insertion of a catheter after the sixth day of hospitalization, catheterization outside the operating theaters, lack of administration of systemic antibiotics, unsatisfactory catheter care, and prolonged duration (≥7 days) of catheterization before infection occurred. The risk associated with catheterization outside the operating theater could be explained by its correlate, that is, catheterization for incontinence/obstruction as opposed to output measurement. Life-table analyses demonstrated that the daily risk for acquiring bacteriuria during the first six days of catheterization was higher among patients ultimately catheterized for ≥7 days than among those ultimately catheterized for < 7 days (P<0.05).
How Frequent Are Outbreaks of Nosocomial Infection in Community Hospitals?
Authors: Haley Robert W. , Tenney James H. , Lindsey James O. , Garner Julia S. , Bennett John V. 
Published: August 2016

AbstractA statistical algorithm was used to identify potentially important clusters among nosocomial infections reported each month by 7 community hospitals. Epidemiologic review and on-site investigations distinguished outbreaks of clinical disease from factitious clusters. In 1 year, 8 outbreaks were confirmed. They involved 82 patients—approximately 2% of patients with nosocomial infections and 0.09% of all discharges. One true outbreak occurred for every 12,000 discharges—at least 1 outbreak per year for the average community hospital. Five (63%) outbreaks were recognized independently by the hospitals' infection control personnel. Four (50%) resolved spontaneously; the hospitals' own control measures were necessary in 2; and 2 resolved only after an outside investigation. Organized surveillance appears necessary to detect some outbreaks, and control measures are needed to stop many. Since, however, outbreaks account for such a small proportion of nosocomial infections, infection control programs should be sufficiently staffed and managed so that most of the effort is directed toward the surveillance and control of endemic infection problems, but with adequate resources remaining to respond to outbreaks when they occur.
Occupational Risk of Hepatitis B Infection in Hospital Workers
Authors: Hadler Stephen C. , Doto Irene L. , Maynard James E. , Smith Joseph , Clark Brian , Mosley James , Eickhoff Theodore , Himmelsbach Clifton K. , Cole William R. 
Published: August 2016

AbstractTo estimate the risk of hepatitis B virus (HBV) infection among hospital workers, we measured the prevalence of HBV infection in employees in five hospitals in different parts of the country and examined the effect of occupational and non-occupational factors on HBV prevalence. Among 5,697 persons studied, serologic markers of HBV infection were found in 807 (14%). Prevalence of infection was strongly related to race (Asian > Black > White), sex (male > female) and increasing age.Risk related to health occupation, studied by examining the change in HBV prevalence with duration in occupational group, was most strongly correlated with frequency of contact with blood during work. Workers having frequent blood contact had the highest estimated infection rate (1.05 per 100 person-years) and those with moderate contact an intermediate infection rate, compared to a negligible infection rate in workers with no blood contact. Frequency of needle accidents had an independent, positive effect on HBV infection rates, while degree of patient contact had no effect. Infection risk was uniform among all hospitals for groups with frequent blood contact. Among different occupation groups, risk of HBV infection also correlated closely with degree of blood-needle contact during daily work. This study provides a general approach to assessing risk of HBV infection in hospital personnel, and indicates that risk may be most easily estimated by quantitating degree of blood-needle contact during daily work.
Resistance to Antibiotics in Clinical Isolates of Klebsiella pneumoniae
Authors: F. O'Brien Thomas , Mayer Kenneth H. , Hopkins John D. , Farrell John J. , Chao Lee , Kent Ralph L. 
Published: August 2016

AbstractThe antibiotic resistance of Klebsiella pneumoniae isolates from 12 medical centers worldwide, over a 1- to 6-year period, were tested. Clinical isolates of K. pneumoniae were resistant to ampicillin and carbenicillin. Resistance to other antibiotics was less frequent with isolates of K. pneumoniae from 5 of 6 US centers than with those from 6 centers outside the US. In nearly all of the centers, resistance to sulfamethoxazole-trimethoprim, gentamicin, tobramycin, or chloramphenicol was more frequent in isolates of K. pneumoniae than in those of Escherichia coli, while the reverse was true for resistance to tetracycline. Resistance to multiple antibiotics declined gradually in isolates of K. pneumoniae at one center, but rose abruptly again with dissemination of a new plasmid.
The Control of Infection in General Surgery: A Four-Year Prospective Study in Brazil
Authors: Ferraz Edmundo M. , Lima José F. Correa , Porfirio Lourdes , Kelner Salomão 
Published: August 2016

Infection is an inherent complication in surgery. The high cost, the morbidity and the mortality to which it gives rise require that an effort be made to reduce its incidence. The control of the rates of infection constitutes today a parameter of the quality of the service provided by a hospital. In Brazil the unstructured nature of the vast majority of hospitals makes the recording of hospital infection and any attempt to control it a difficult task.Isolated studies have appeared in the Brazilian literature such as those of Hultzler et al on data from the São Paulo University Hospital, Zanon et al2 from Ipanema Hospital, Rio de Janeiro, and Ferraz et al from the Federal University of Pernambuco Teaching Hospital. Hultzler et al reported in 1973 that the incidence of acquired infection in the patients admitted to the São Paulo University Hospital was 5.95%. The overall rate of post-operative infection in 4,746 operations performed was 6.59%, while that of wound infection was 3.08%.In 1979 Zanon et al reported a 7.5% incidence of wound infection in the Division of General Surgery at Ipanema Hospital (Rio de Janeiro).In 1980 the National Enquiry on Post-Operative Infection was organized under the auspices of the Brazilian College of Surgeons. A questionnaire was sent to 3,225 members of the College throughout the country. Of the 107 questionnaires duly completed and returned (3.31%) only 86 (2.66%) reported controlling infection, and of these, 61 (1.89%) included the outpatient department within the scope of their control of infection. Only 20 of the 107 questionnaires returned gave what were considered answers with regard to surgical wound infection.
A Randomized Study Comparing a Transparent Polyurethane Dressing to a Dry Gauze Dressing for Peripheral Intravenous Catheter Sites
Authors: Craven Donald E. , Lichtenberg Deborah A. , Kunches Laureen M. , McDonough Ann T. , Gonzalez Maria I. , Heeren Timothy C. , McCabe William R. 
Published: August 2016

AbstractWe studied rates of peripheral intravenous (IV) catheter tip and insertion site colonization after randomly assigning patients to transparent polyurethane (TP) dressings (N=316) or dry gauze (DG) dressings (N=421). The study was conducted during both summer and fall seasons, in a facility which lacked air conditioning. All patients had a teflon plastic catheter inserted, maintained and cultured by a member of the IV therapy team; no antibiotic or antiseptic ointments were used. Colonization rates were higher in the summer than in the fall for both catheter tips (9.0% vs 3.5%, p=0.005) and sites (21.6% vs 7.0%, p=0.001). During the summer season, the rate of catheter tip colonization with TP dressings was nearly twice that of DG dressings (12.4% vs 6.8%, p=0.04). Logistic regression analysis indicated that catheter tip colonization was associated with the summer season (odds ratio=3.0, 95% CI 1.4-6.2) and TP dressings (odds ratio=1.8, 95% CI 1.1-3.2), and that site colonization was associated with both summer (odds ratio=4.0, 95% CI 2.2-7.1) and receipt of antibiotics (odds ratio=1.9, 95% CI 1.1-3.2). Coagulase-negative staphylococci were isolated from 55.5% of the colonized catheter tips and insertion sites. The data suggest that bacterial colonization of peripheral IV catheters is increased in summer, and that use of TP dressings may increase both tip colonization and cost nearly twofold.
Pool-Associated Pseudomonas aeruginosa Dermatitis and Other Bathing-Associated Infections
Authors: Jacobson Jay A. 
Published: August 2016

AbstractThe growing popularity of heated pools, especially whirlpools and hot tubs, has been accompanied by increasingly frequent oubreaks of an illness produced by Pseudomonas aeruginosa. The illness usually includes folliculitis, pruritic skin rash, and/or otitis externa and occasionally mastitis and systemic symptoms. Although usually self-limited, rare severe cases have been described. Motel and hotel whirlpools are most often implicated as the source of outbreaks. The relative importance of pool conditions and the bacteriology of P. aeruginosa in the pathogenesis of this illness remain to be elucidated. Implementing CDC Guidelines for public spas and hot tubs seem the most reasonable way of reducing the risk of large outbreaks. Prevention of cases arising from home hot tubs or whirlpools will be very difficult and may depend on extensive public education or the development of simple, inexpensive and effective disinfection systems.
Infection Control and Employee Health: AIDS Update Part 2
Authors: Valenti William M. 
Published: August 2016

The Acquired Immune Deficiency Syndrome (AIDS) continues to perplex health care providers. As our knowledge has increased, so has the number of questions, especially those related to infection control and employee health. Since the last time AIDS was reviewed in this column, additional information has become available which elaborates on some of the infection control aspects of this disease.The human T-cell lymphotropic retrovirus (HTLV-III) appears to be the cause of AIDS. Other names used for HTLV-III are lymphadenopathy-associated virus (LAV) and AIDS-associated retrovirus. So called co-factors may be necessary to initiate disease after an individual acquires HTLV-III infection. Agents such as cytomegalovirus, the Epstein-Barr virus and multiple exposures to HTLV-III have been suggested as possible cofactors. Only a relatively small percentage of individuals who acquire HTLV-III antibody eventually develop overt disease or “full-blown AIDS.” Studies to date have shown that after 1 to 5 years of follow-up, 4% to 19% of seropositives developed AIDS.In addition, the spectrum of disease caused by HTLV-III appears to be broader than originally thought. An additional 25% of those with antibody may have developed AIDS-related diseases including neurological symptoms, fever, weight loss, diarrhea, oral candidiasis and lymphadenopathy during the follow-up period.