bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two Epidemics of Pseudobacteremia Due to Staphylococcus aureus and Aerococcus viridans
Authors: Spivack Martin L. , Shannon Robert , Natsios George A. , Wood Jan 
Published: August 2016

AbstractTwo epidemics of pseudobacteremia are reported. The first, due to Staphyloccus aureus, was caused by a physician who had active staphylococcal skin infection and nasal colonization. Because the blood culture system in use at the time was open, and used screw cap bottles, we assume that the physician contaminated the bottles at the time of inoculation. The second outbreak, caused by Aerococcus viridans, was traced to contamination of the blood culture bottle tops as they were received from the manufacturer. We assume that there was inadequate disinfection of the bottle tops by the physicians prior to their use.
Recurrent Meningococcal Meningitis Caused by Poly Groups X-W135: Importance of Chemoprophylaxis
Authors: Jacobs Richard F. , Yamauchi Terry 
Published: August 2016

AbstractPresented is a case report and literature review of the causes of recurrent meningococcal meningitis. After all factors were analyzed, the cause of reinfection in this child was postulated to be ineffective chemoprophylaxis of close contacts following the initial episode. The efficacy of chemoprophylaxis in household members and close contacts in meningococcal disease, although not demonstrated in controlled trials, has been recommended since 1974 by the Meningococcal Disease Surveillance Group. Considering known carriage rates, reports of secondary infections in close contacts, reinfection in the same person, and a high case fatality ratio, chemoprophylaxis in such cases seems justified [Infect Control 1981; 2(4):312-4.]
Excessive Levels of Gram-Negative Bacteria in Hemodialysis Machines Because of Inadequate Cleaning Guidelines
Authors: Gurevich Inge , Williams Fay , Cunha Burke A. 
Published: August 2016

AbstractThe possibility of sepsis or pyrogenic reaction increases in hemodialysis patients as coliform or other gram-negative counts in the dialysis water reach levels ≥ 1000 colonies/ml. After the introduction of Cobe Century II dialysis machines (Cobe, Lakewood, Colorado), routine testing of dialysis water samples revealed gram-negative bacteria in concentrations up to 45,000 colonies/ml. An epidemiologic investigation was performed to determine the source of the bacterial contamination. The amounts of disinfectant solution were increased, but bacterial counts remained unacceptably high. A study of the fluid path within the machines revealed that part of that path was not reached at all by the disinfectant. In addition, the disinfectant was automatically and improperly diluted. Therefore, increased bacterial counts could not be reduced satisfactorily by using the manufacturer's disinfection guidelines.
Rubella Immunization of Hospital Personnel: A Debate
Authors: Evans Martin E. , Schaffner William 
Published: August 2016

In recent months several advisory groups have issued recommendations urging hospitals to undertake comprehensive rubella control programs. The primary impetus for these suggestions has been the recognition that, despite a declining rubella incidence in the general population, pregnant women still are being exposed to this infection in hospitals.In 1979 the Vanderbilt University Hospital initiated a limited rubella control program, encompassing new and current employees working in “traditional” high-risk areas of the hospital: obstetrics (wards and clinics), labor and delivery, nursery, pediatrics (wards and clinics), and the emergency department. Medical and nursing students also were included. All persons were tested serologically and immunization was offered to susceptibles, but was not required (except for students and house officers). The Infection Control Committee and hospital administration readily approved this program.
Q Fever Control Measures: Recommendations for Research Facilities Using Sheep
Authors: Bernard Kenneth W. , Parham Gregory L. , Winkler William G. , Helmick Charles G. 
Published: August 2016

AbstractQ fever (Query Fever) is a zoonosis caused by the rickettsiaCoxiella burnetii.Domestic ungulates such as sheep, cattle, and goats serve as the reservoir of infection for humans and shed the desiccation-resistant organism in urine, feces, milk, and especially in birth products. In humans the illness is generally mild; however, Q fever hepatitis is often seen and Q fever endocarditis is an uncommon, but frequently fatal complication. Q fever long has been recognized as an occupational hazard among persons working with animals or animal products, and in laboratories working withC. burnetii.Recently, Q fever outbreaks have occurred in medical research facilities using sheep as research animals. Recommendations are presented for reducing the risk of exposure to Q fever in persons not working with sheep in research facilities that use sheep. In addition, recommendations are presented for reducing the risk of infection in persons who work with sheep in research facilities.
Nosocomial Ultraviolet Keratoconjunctivitis
Authors: Sensakovic John W. , Smith Leon G. 
Published: August 2016

AbstractA series of five successive cases of ultraviolet-induced erythroderma and keratoconjunctivitis, occurring over a one-month period and related to exposure to an improperly installed ultraviolet light are described. Although in this series, as well as others reviewed, the effects appeared self-limited, significant associated morbidity was observed.
Wound Infection: A Review of Diagnosis and Treatment
Authors: Simmons Richard L. 
Published: August 2016

AbstractSurgical wounds can become infected by a variety of organisms, leading to a variety of clinical courses. In this article, several types of infections, therapies, prognoses and prophylaxes.are discussed. Skin and subcutaneous tissues infect with a range of gram-positive and gram-negative aerobic and anerobic bacteria. Gangrenous infections, whether necrotizing fasciitis or bacterial synergistic gangrene, can be devastating or fatal. Gangrenous infection in the muscle is also discussed, and various treatments outlined. The intention is to familiarize readers with the predisposing conditions, clinical manifestations and therapeutic alternatives for these surgical infections.
An Evaluation of Autopsy Review as a Technique for Infection Control: A Procedure of Questionable Value
Authors: Crossley Kent , Johnson Janice , Mudge Rebecca , Crossley Laura 
Published: August 2016

AbstractReview of necropsy reports for evidence of undiagnosed antemortem infection is included by the Joint Commission on Accreditation of Hospitals as an element of an effective hospital infection control program. We reviewed records of 155 patients autopsied at St. Paul-Ramsey Medical Center between January 1, 1980 and March 31, 1981. In 13 patients (8%), there was a discrepancy between documentation of infection during the patient's hospitalization and at autopsy. However, in none of these cases was this information useful in our infection control program. We doubt the effectiveness of necropsy review as a tool for nosocomial infection control.
The Short- and Long-term Effects of a Handbook on Antimicrobial Prescribing Patterns of Hospital Physicians
Authors: D'Eramo James Earl , DuPont Herbert L. , Preston Gary A. , Smolensky Michael H. , Roht Lewis H. 
Published: August 2016

AbstractThis study evaluates the effect of a specially designed, physician-oriented handbook of antimicrobial use on the prescribing patterns of a group of 50 doctors at a university hospital. Data were evaluated over a period of one-and-one-half years, before and after the distribution of the handbook. For the purposes of this study, antimicrobial therapy was classified: 1) inappropriate if it violated one of a number of recognized principles of antimicrobial therapy, 2) appropriate if it agreed with specific recommendations or alternatives given in the distributed reference handbook, and 3) acceptable if it was neither inappropriate nor appropriate as defined by the handbook. An initial survey of antimicrobial prescribing patterns was made. Five months later the handbook was distributed. A two-week orientation program, consisting of the distribution and promotion of the problem-oriented, pocket-sized handbook of appropriate antimicrobial therapy, was conducted. The handbook, which was developed by the authors and reviewed and approved by a panel of infectious disease specialists, presented guidelines for appropriate and efficacious usage of antimicrobial agents as most currently accepted in common clinical infections. Subsequent surveys were then conducted two weeks, three months, and six months after distribution of the handbook. A statistically significant difference (p <0.01) in antimicrobial prescribing patterns was noted between the survey conducted two weeks after the introduction of the handbook and the other surveys. In this survey, while therapy classified inappropriate decreased from 45% to 28%, therapy considered appropriate as recommended increased from 33% to 53%. The findings of this study demonstrated that the introduction and promotion of the handbook decreased abuse and increased proper use of antimicrobial therapy, although the effect is sustainable for only a short duration—no longer than three months. These results indicate the need for a vigorous, updated program to achieve and maintain current appropriate antibiotic therapy in clinical medicine.
Risk Factors for Post-operative Wound Infection in Cardiac Surgery Patients
Authors: Simchen Elisheva , Shapiro Mervyn , Marin Gideon , Sacks Theodore , Michel Jacques 
Published: August 2016

AbstractIn a prospective study of 372 patients undergoing cardiac surgery, we evaluated the relative contribution of host factors and patient care variables to the risk of postoperative wound infection. Host factors studied were age, sex, country of origin, the diagnosis for which the operation was performed and, for coronary artery by-pass operations, the functional cardiac status according to modified New York Heart Association criteria. The performance of more than one operation during a single admission carried the highest risk for infection, followed by a coronary artery by-pass operation lasting for more than six hours or performed on patients 65 years or older. In patients undergoing coronary artery by-pass surgery, host factors (age and cardiac function) were associated with infections in the chest wound, while the length of the operation was found to affect the occurrence of infections at the “donor” site.
Control of Aminoglycoside Resistance by Barrier Precautions
Authors: Gaynes Robert P. , Weinstein Robert A. , Smith Judy , Carman Margaret , Kabins Sherwin A. 
Published: August 2016

AbstractThe efficacy of antibiotic resistance (barrier) precautions for control of aminoglycoside resistance was evaluated from 1978 to 1981. Despite increasing aminoglycoside use and a 13-fold increase in aminoglycoside-resistant isolates on a newly opened oncology unit, the hospital-wide frequency of aminoglycoside resistantEnterobacteriaceaeremained low, supporting the continued value of barrier precautions which were initiated in our hospital in 1974. This control enabled us to focus on exceptions to the effectiveness of barrier precautions. These were traced to environmental reservoirs, very chronic and heavily infected patients, asymptomatic carriers of Serratia, and oncology patients receiving oral non-absorbable aminoglycosides. In addition, resistance inPseudomonas aeruginosaparalleled aminoglycoside use and, as in our prior experience, continued to rise. With increasing adoption of barrier precautions by others such exceptions should be anticipated.
Mechanisms of Antibiotic Resistance and Their Dissemination of Resistance Genes in the Hospital Environment
Authors: Wiedemann Bernd 
Published: August 2016

AbstractThe dissemination of resistance determinants among bacterial populations depends on ecological and epidemiological properties as well as additional factors: 1) the mechanism of resistance or its specificity toward a certain drug, and 2) the genetic basis in relation to the mobility of the genetic material and its survival in bacteria. From two resistance mechanisms directed toward old-fashioned drugs, namely sulfonamides (Su) and streptomycin (Sin), we can deduce that a resistance mechanism is encoded by a special sort of genetic material. Thus the linked SmSu resistance mediated by a sulfonamide-resistant dihydropteroatsynthetase II and the aminoglycoside phosphotransferase APH-(3") is always located on very small pBPl-like plasmids. Such plasmids survive without selective pressure of drugs in Enterobacteriaceae in the bowel flora of humans and animals. Both resistance determinants can be mediated by a transposon which codes for the production of a dihydropteroatsynthetase I in connection with an aminoglycoside adenylyltransferase AAD-(3"). These two mechanisms are genetically linked as well. The basic structure is a transposon designated Tn2411, which belongs to a whole family of transposons, all including the basic structure; however, their genetic exchange and substitution leads to structures coding for many different enzymatic characters: ANT-(2") (Gentamicin resistance), CAT (Chlo-ramphenicol resistance), AAC-(6') (resistance to all modern aminoglycosides), TEM-1, OXA-1, OXA-2, or PSE (β-lactam resistance). Resistance to the modern (β-lactamase-stable antibiotics is mediated by mutation in the regulatory genes of chromosomally-determined (β-lactamases. A spread of these resistance mechanisms can be avoided as long as the responsible genes are not located on sufficient structures like small plasmids or efficient transposons.
Infections in Compromised Hosts An Overview
Authors: Schaffner William 
Published: August 2016

Much has been written recently concerning the new and growing occurrence of infections in compromised hosts. During the almost four decades since the end of World War II scientific investigation has produced extraordinary advances in diagnosis and treatment. This has resulted in two changes which have implications for this discussion. First, the classical acute community-acquired infections now are recognized quickly and treated effectively with antibiotics. Indeed, many such infections are managed quite effectively by physicians in the office or clinic and no longer require admission to the hospital. (For example, it has been years since I have seen mastoiditis or streptococcal erysipelas in my hospital consulting practice.) We have abandoned our “pneumonia ward” which once housed patients in various stages of life-threatening pneumococcal infection. Similarly, intensive immunization of our population has virtually eliminated poliomyelitis, diphtheria, tetanus, and measles; once common, these classical infectious diseases now are absent from our hospital.The second effect of medical progress has been the opportunity to offer patients with certain diseases, previously untreatable, the hope of increased survival and even cure. The list here is long and includes premature infants, children with congenital immune deficiency disorders, individuals with leukemia, lymphoma, aplastic anemia, burns, renal and other organ failure, and many others. Thus, the numbers of such patients in our hospitals have increased. These patients are at an increased risk of acquiring a complicating infection because of their underlying disease or because of our diagnostic and therapeutic interventions.
Longitudinal Analysis of Endemic Gentamicin- and Tobramycin-Resistant Gram-Negative Bacilli in a Community Hospital
Authors: Magnussen C. Richard , Jacobson Maria T. 
Published: August 2016

AbstractThe epidemiology of endemic gentamicin- and tobramycin-resistant gram-negative bacilli at a community hospital was analyzed over a one-year period three years following an original analysis at the same hospital. The frequency and distribution of resistant organisms remained stable over the time spanning the two studies. Only 2.8% of all gram-negative bacilli were resistant to gentamicin or tobramycin, and the majority of resistant isolates were non-Enterobacteriaceae. The respiratory and urinary tracts remained the body sites most prone to harbor resistant organisms. Risk analysis using a matched comparison group again revealed prior treatment with an aminoglycoside to be the only significant factor pre-disposing to acquisition of resistant gram-negative bacilli. This analysis indicates that community hospitals may not be important reservoirs of endemic aminoglycoside-resistant gram-negative bacilli, and reconfirms the observation that each hospital must define its own pattern of aminoglycoside resistance and unique risk factors.
A Prevalence Survey of Infections in a Combined Acute and Long-Term Care Hospital
Authors: Standfast Susan J. , Michelsen Phyllis B. , Baltch Aldona L. , Smith Raymond P. , Latham Ethel K. , Spellacy Ann B. , Venezia Richard A. , Andritz Mary H. 
Published: August 2016

AbstractA prevalence survey of infections among 572 acute and long-term care patients in the Albany Veterans Administration Medical Center was conducted in September 1979. Presence of infection was determined by patient examination and chart review. Urine specimens from 94% of patients were cultured. The total number of clinically significant infections was 178; 117 were nosocomial (20.5 per 100 patients). The prevalence rate of nosocomial infections was highest on the Intermediate Service (long-term medical care) followed by the Surgical and Medical Services. Sites with the highest nosocomial infection rates were urinary tract (10.7), skin and subcutaneous tissues (5.1), and surgical wounds (3.0) per 100 patients. Nosocomial infections increased with age and length of hospital stay which partially explained the higher rate on the Intermediate Service. Patients using condom drainage and Foley catheters showed similarly high rates of bacteriuria. Antimicrobial drug use was 17% for acute care patients and 4% for long-term and psychiatry patients. Excepting Providencia stuartii urinary tract infection confined to the Intermediate Service, the bacterial isolates and their antibiotic susceptibilities were similar for the acute and long-term care services.
Antibiotic Resistance in Intensive Care Unit Areas
Authors: Daschner F. , Langmaack H. , Wiedemann B. 
Published: August 2016

AbstractThe incidence of nosocomial infections and antimicrobial resistance rates of nosocomial pathogens vary considerably among countries and even among intensive care units (ICUs) within one hospital. Such differences might be partly due to the selection pressure exerted by certain antibiotics, since intensive care patients are given more antimicrobials than any other group of patients. We therefore compared resistance rates of four important nosocomial pathogens (Staphylococcus aureus, E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) isolated from patients in general wards and ICUs. There were few trends toward higher resistance of ICU isolates, and most differences were found with Klebsiella pneumoniae.We also tried to relate antibiotic use in ICUs and frequency of antibiotic resistance of five selected nosocomial pathogens. The ampicillin and cephalosporin resistance of E. coli and Klebsiella pneumoniae arose along with an increase in usage of both drugs. Decreasing prescription of cotrimoxazole was not reflected by decrease in resistance of Staphylococcus aureus and Staphylococcus epidermidis. Increasing prescriptions of tetracyclines were followed by an increasing resistance of E. coli, but not of Staphylococci. The oxacillin resistance of Staphylococcus epidermidis almost paralleled the consumption, the opposite was true for Staphylococcus aureus. There seemed to be a rather close relationship between the incidence of resistant Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa strains and the quantities of gentamicin, tobramycin and azlocillin prescribed.The increase or decrease of prescriptions of certain antimicrobials increased or decreased their resistance rate to the respective drugs of only certain bacterial strains in one ICU, but not in the other. The findings in our hospital cannot necessarily be applied to other hospitals. Restriction of antimicrobial usage however decreased resistance rates in most situations.
Nosocomial Infections in a Developing Middle East Hospital
Authors: McCormack Joseph G. , Barnes Mary 
Published: August 2016

AbstractThe prevalence and pattern of nosocomial infections in a new hospital in the United Arab Emirates is presented. During an 18-month period in which there were 6,544 discharges, 379 nosocomial infections occurred in 310 patients, representing an attack rate of 4.7%. The commonest site of infection was the urinary tract which accounted for 42.2% of the total. This was followed by surgical wound infections, cutaneous infections, bloodstream infections, lower and upper respiratory infections, infected burns and gastrointestinal infections. The most common organisms were Escherichia coli (22.7% of isolates), Pseudomonas species (17.5%) and Staphylococcus aureus (16.7%). Escherichia coli was the most common cause of urinary tract infections and bacteremia; Staphylococcus aureus was the most common cause of surgical wound and cutaneous infections. There was only one Serratia marcescens infection. We observed a high incidence of Pseudomonas infections, particularly of the urinary tract, and Staphylococcal surgical wound and other cutaneous infections, but otherwise our data are similar to nosocomial infection data from US hospitals.
The Role of the Laboratory in Control of Nosocomial Infection
Authors: McGowan John E. 
Published: August 2016

AbstractNosocomial (hospital-associated) infection continues to represent a major problem for hospitals. Gram-negative aerobic bacilli continue to be identified most frequently as etiologic agents, but a number of new pathogens now are recognized to play a role. The persons responsible for infection control efforts and in charge of the clinical microbiology laboratory (frequently the same person) must cooperate closely to attack this problem. The role of the laboratory in attempts to minimize occurrence of nosocomial infection involves six aspects: 1) accurate identification of responsible organisms, 2) timely reporting of laboratory data, 3) provision of additional studies, when necessary, to establish similarity or difference of organisms, 4) provision, on occasion, of microbiologic studies of the hospital environment, 5) training of infection control personnel, and 6) participation in activities of the hospital infection control committee.
Assessment of Catheter-Associated Infection Risk with the Hickman Right Atrial Catheter
Authors: Fuchs Peter C. , Gustafson Marie E. , King James T. , Goodall Patrick T. 
Published: August 2016

AbstractOne hundred fifty Hickman right atrial catheters were inserted into 143 patients and were followed prospectively until removal. Primary indications for their use were: cancer chemotherapy (45), parenteral nutrition (35), antibiotic therapy (63), and miscellaneous (7). The overall catheter-associated infection rate was 12.0%. Since the mean duration of catheterization was 125 days, the infection/duration rate was 1.0/1,000 days of use. The risk of infection differed significantly according to the primary indication for catheterization: parenteral nutrition > antibiotic therapy > cancer chemotherapy. The increased risk of catheter-associated infection attributable to duration of catheterization was additive, and the per day risk of such infections remained constant regardless of duration. Nearly two-thirds of patients were discharged home with catheters in place, without adversely affecting infection risk.