bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brief Report Susceptibility of Filipino Nurses to the Varicella-Zoster Virus
Authors: Nassar Nabil T. , Tourna Helen C. 
Published: August 2016

AbstractFollowing an outbreak of varicella, 18% of a group of 174 young female Filipino nurses ranging in age from 20 to 25 years and working at the American University of Beirut Medical Center (AUMC) were found susceptible to the varicella-zoster virus; as compared to 3% of a matched group of 133 of their Lebanese colleagues. The level of antibody was determined by the Enzyme Linked Immunosorbent Assay (ELISA). Those susceptible were assigned duties in low-risk areas to varicella-zoster in the hospital.
Methicillin-ResistantStaphylococcus aureus:How Reliable is Laboratory Reporting?
Authors: Fleming David W. , Helgerson Steven D. , Mallery Barbara L. , Foster Laurence R. , White Mary C. 
Published: August 2016

AbstractMicrobiology laboratories in Oregon were surveyed in 1981 to determine how often methicillin-resistantStaphylococcus aureus(MRSA) was being reported to physicians in the state. Results of this survey were surprising in three respects. First, the mean percent of S.aureusisolates reported by laboratories as methicillin-resistant was 8.3%. Second, a significant inverse correlation was found between the percent of reported MRSA and laboratory size (p=0.0001). Finally, laboratories which retested initially resistant isolates reported significantly less MRSA (mean 3.3%, median 1%) than those laboratories which accepted initial results (mean 20%, median 12%) (p=0.0001). Independent testing by the Centers for Disease Control of isolates reported to be MRSA confirmed that some misideiitification was occurring. Participating laboratories were notified of our initial findings and their potentially serious clinical ramifications. Laboratories were resurveyed in 1982, and a significant decrease in the reported MRSA to a mean percentage of 3.4% was observed (p=<0.002). It is unlikely that this situation is unique to Oregon, and similar misreporting of MRSA to physicians in other areas of the country may be compromising the safe and effective treatment ofS. aureusinfections.
An Outbreak of Group A Streptococcal Bacteremia in an Intensive Care Unit
Authors: Nicolle L.E. , Hume K. , Sims H. , Rosenal T. , Sandham D. 
Published: August 2016

AbstractAdmission of a patient with group A streptococcal cellulitis and bacteremia to the intensive care unit of a tertiary care teaching hospital was followed by two subsequent cases of group A streptococcal bacteremia with pneumonia in the unit. All streptococcal isolates were the same M- and T-type. Endotracheal intubation with respiratory ventilation was a risk factor for disease acquisition. The characteristics of onset of the two nosocomially acquired cases suggested that a staff member may have been, at least transiently, a streptococcal carrier, but no such carrier was identified. No further cases occurred subsequent to a period when all patients in the unit received antibiotics effective for group A streptococcal therapy.
Category 1, 2, 3 and 4 A Procedure-Oriented Isolation System
Authors: Gilmore Donna S. , Montgomerie John Z. , Graham Irene E. 
Published: August 2016

AbstractA procedure-oriented isolation system, Category 1, 2, 3, and 4, was introduced at a 547-bed, acute and rehabilitative medical center. The system consisted of four categories of isolation which followed a numerical sequence that represented the necessary attire needed to complete the procedure. After 1 year of use, personnel compared the procedure-oriented system with the previously-used system (Strict, Respiratory, Wound and Skin, Enteric, and Limited Barrier). Personnel found the procedure-oriented system easier to understand (84%) and follow (83%). Seventy-six percent felt their isolation techniques had improved with the new system. A reduction in the cross-infection rate with methicillin-resistantStaphylococcus aureusdid coincide with the use of the new isolation system, however, no causal relationship was established. The Category 1, 2, 3, and 4 isolation system was well received by personnel and was found to be an effective alternative to the previous, more complicated system used in this setting. Further evaluation of this system in other settings would seem warranted.
Commentary: Dissemination of a Plasmid Determining Multiple Antibiotic Resistance Between Two Veterans Administration Medical Centers
Authors: Shlaes David M. , Currie-McCumber Charlotte 
Published: August 2016

AbstractThe endemic R-plasmids mediating resistance to gentamicin and multiple other antibiotics among many species of Enterobacteriaceae from the Minneapolis and Cleveland Veterans Administration Medical Centers were compared by restriction endonuclease digestion profiling and by phenotype expressed in sensitiveE. colirecipients. Southern hybridizations were also performed. Our data indicate that these plasmids demonstrate some microheterogeneity, but are very closely related. Both are self-transferable and mediate resistance to ampicillin, carbenicillin, chloramphenicol, gentamicin, tobramycin, neomycin and kanamycin. These results suggest the dissemination of a conjugal R-plasmid or of Enterobacteriaceae bearing the plasmid between two midwestern Veterans Administration Medical Centers. The most likely mechanism of transmission may be the frequent transfer of patients between midwestern Veterans Administration Medical Centers.
Infection Control Programs in Twelve North Carolina Extended Care Facilities
Authors: Price Loraine E. , Sarubbi Felix A. , Rutala William A. 
Published: August 2016

AbstractTo assess the scope of infection control programs in extended care facilities, 1-day surveys were conducted in 12 North Carolina facilities over an 8-month period using a standardized questionnaire. All 12 facilities had a designated infection control practitioner (ICP), although none had attended an infection control education course. Eleven had an Infection Control Committee of which 8 (73%) met regularly. The Director of Nurses generally (58%) was the ICP and spent about 2 hr/wk on infection control. Ten (83%) facilities conducted infection surveillance among residents but did not accurately compute nosocomial infection rates. Eleven (92%) facilities had employee health programs that included preemployment and annual tuberculosis screening. None had a comprehensive resident health program. Infection control aspects of patient care practices often varied from facility to facility. Nosocomial infection surveillance among 336 residents in 9 facilities using modified CDC criteria revealed an overall prevalence rate of 5.4%. Additional infections were suspected but not included because of limitations of laboratory data and chart documentation.
Brief Report: Inactivation of Herpesvirus on CPR Manikins Utilizing a Currently Recommended Disinfecting Procedure
Authors: Cavagnolo Robert Z. 
Published: August 2016

AbstractThe adequacy of a currently recommended protocol for disinfecting CPR manikins was investigated. Known quantities of Herpes simplex type 1 virus were applied to various sites on both adult and infant manikin heads, exposed to disinfectant under simulated classroom conditions, and then assayed for infectious virus. Results indicate that the disinfecting protocol and disinfectant are adequate for inactivating herpesvirus on CPR manikins, but that care must be exercised to ensure thorough cleaning.
Outbreak of Staphylococcal Infection in Two Hospital Nurseries Traced to a Single Nasal Carrier
Authors: Belani Anusha , Sherertz Robert J. , Sullivan Marsha L. , Russell Beverly A. , Reumen Peter D. 
Published: August 2016

AbstractIn late January and early February 1983, an outbreak of skin infections (7 of 145 infants) caused by a penicillin/erythromycin resistant strain ofStaphylococcus aureus(SA), phage type 3A/3C, occurred in our newborn nursery. A week following the first cluster of infections, another nursery outbreak due to SA with the same antibiogram occurred in a nearby community hospital (11 of 114 infants). Subsequently, a second cluster of infections with the same SA was identified at our nursery. The epidemic strain was carried in the anterior nares of a single nurse who worked at both hospital nurseries on alternate weeks. Investigation revealed that the nurse had an upper respiratory tract infection during each of these outbreaks—simulating “a cloud baby.” No further infections have occurred since this nurse was treated and her SA nasal carrier state eliminated.
Double-Bagging of Items from Isolation Rooms is Unnecesary as an Infection Control Measure: A Comparative Study of Surface Contamination with Single- and Double-Bagging
Authors: Maki Dennis G. , Alvarado Carla , Hassemer Carol 
Published: August 2016

AbstractIn many hospitals, waste materials and used linens from the rooms of patients in isolation or the clinical laboratories are routinely double-bagged to reduce contamination of the external surface of the bag that could be transmitted to hospital personnel subsequently handling them. No studies have prospectively examined the value, if any, of double-bagging. We randomly assigned waste and linens from the rooms of 42 patients in contact isolation to be transported in single bags or double bags. Shortly after a single (or double) bag had been set outside the patient's room, the surface was cultured quantitatively in two locations near the knot; over 2 months, 209 bags were cultured. Surface contamination by Staphylococcus aureus (3% to 5%), enteric gram-negative bacilli (6% to 7%), or either (9% to 12%) was infrequent and comparable in both groups; moreover, quantitative levels of contamination in the two groups were almost identical (mean, 27 and 29 colony forming units [cfu] per bag). These data suggest that there is no advantage, as regards asepsis, to double-bagging potentially contaminated items from isolation rooms or clinical laboratories as compared with using a single bag. The use of a single-bag system with a heavyduty bag, as compared with double-bagging, saved our hospital $9,400 in 1985.
Nosocomial Bloodstream Infections: Secular Trends in a Statewide Surveillance Program in Virginia
Authors: Morrison Allan J. , Freer Carol V. , Searcy Mary Ann , Landry Sandra M. , Wenzel Richard P 
Published: August 2016

AbstractOver a 7-year period (1978-1984) the authors studied the rates of nosocomial bloodstream infections in acute-care hospitals participating in a statewide surveillance network in Virginia. A total of 4,617 hospital-acquired bloodstream infections were documented among 1,807,989 patients at risk for an overall rate of 25.5 cases per 10,000 patient admissions/discharges (annual range = 22.1 to 30.7). Compliance of reporting for Virginia hospitals averaged 58% (1 to 5 monthly reports in a study year), and 39% (≥6 monthly reports annually). Significant changes in bloodstream infection rates (cases per 10,000 patient admissions/discharges) due to specific pathogens included the following: coagulase-negative staphylococci increased from a rate of 1.3 to 4.5 (P=.0003), and those due to all gram-positive cocci increased from a rate of 7.5 to 11.4 (P=.03).Candidaspecies increased from a rate of 0.1 to 1.5 (P=.005). The data show a continuing rise of nosocomialCandidaBSI and clearly document the re-emergence of gram-positive cocci as major nosocomial bloodstream pathogens.
Brief Report: Influence of Country of Origin on Prevalence of Hepatitis B Markers Among Employees in a Small Suburban Hospital
Authors: Kiel Frank Wilson 
Published: August 2016

AbstractHepatitis risk in a small suburban hospital was evaluated by laboratory screening of all hospital employees for hepatitis immunologic markers. Excluding four U.S.-born subjects who had received hepatitis vaccination, the laboratory screening revealed 21% of those tested had some hepatitis B antigen or antibody. Positive markers were found in 46% of foreign-born compared to 10% of native-born (P<0.001). Foreign-born participants accounted for 68% of the employee population. The country of origin appeared to have a statistically significant greater importance as a determinant of hepatitis B status than occupational area in this particular hospital setting.
Nosocomial Bacteriuria: Estimating the Potential for Prevention by Closed Sterile Urinary Drainage
Authors: Burke John P. , Larsen Robert A. , Stevens Lane E. 
Published: August 2016

Urinary tract infections associated with the temporary use of indwelling bladder catheters remain a vexing problem in acute care hospitals. The appreciable morbidity and mortality from these infections are still under active investigation. Because of the large numbers of patients at risk, increased attention is also being given to the costs for prevention, detection, treatment, and follow-up of catheter-associated infections.Before the advent of commercially available systems for maintaining closed sterile urinary drainage, infection was believed to be inevitable. In the past 25 years, the successful prevention of infection in 70% to 80% of catheterized patients by aseptic methods has undoubtedly prevented thousands of deaths from gram-negative bacteremia and stimulated efforts to further reduce the infection rate.
The Sources of Pneumonia in ITU Patients
Authors: Sanderson Philip J. 
Published: August 2016

Much attention has been given to ventilators, respiratory tubing and humidifiers as sources of bacteria causing pneumonias in intensive therapy unit (ITU) patients. However, efficient decontamination and safe storage of ventilators and humidifiers between patients, with frequent changing of respiratory tubing and the use of Chlorhexidine in humidifier reservoirs, are now undertaken in most ITUs. In addition, chest aspiration, which is an important route for bacterial entry to the chest, is performed by trained ITU staff, who are well aware of this danger and wear gloves and use meticulous techniques. As a result, it can be argued that infection of the lungs in ITU patients from these sources and routes has reached an “irreducible minimum.”Unfortunately, many patients in ITUs continue to develop pneumonias. In my own experience patients yielded Pseudomonas in tracheal aspirates as frequently after the introduction of these techniques, together with the insertion of efficient bacterial filters, between the patient and the ventilator in both the inspiratory and expiratory lines, as before their adoption. What other sources and routes of infection of the lungs should be considered?
Evaluation of the Skin Disinfecting Activity and Cumulative Effect of Chlorhexidine and Triclosan Handwash Preparations on Hands Artificially Contaminated with Serratia marcescens
Authors: Bartzokas C.A. , Corkill J.E. , Makin T. 
Published: August 2016

AbstractThe initial and cumulative efficacy of two antiseptic handwash preparations in eliminating Serratia marcescens from hands was evaluated on volunteers. Two antiseptics with persistent skin antibacterial activity, 4% chlorhexidine gluconate in detergent and 1.5% triclosan in natural soap, were studied in a new protocol designed according to Food and Drug Administration guidelines. After a single handwash, both preparations exhibited a degerming action statistically superior to the mechanical elimination of the marker organism that was achieved by the nonmedicated controls. Following a further nine hand recontamination sequence with 109 colony-forming units (cfu)/mL S marcescens (mean pre-disinfection baseline, log10 6.6), the efficacy of chlorhexidine and triclosan was significantly augmented: the mean log10 reduction factors were 4.15 and 3.78, respectively. In the absence of internationally accepted testing standards for antiseptic handwash products, the significance of protocol variables is discussed. The advantages to preventative microbiology of antiseptics with persistent skin antibacterial activity are highlighted.
Methicillin-resistantStaphylococcus aureusin Veterans Administration Medical Centers
Authors: Preheim Laurel C. , Rimland David , Bittner Marvin J. 
Published: August 2016

AbstractTo determine the frequency of isolation of methicillin-resistantStaphylococcus aureus(MRSA) at Veterans Administration Medical Centers, 163 hospitals were surveyed; 137 responded. Between 1975 and 1984, the number of Veterans Administration Medical Centers with known MRSA increased from 3 to 111. This increase was geographically widespread and occurred in hospitals of all sizes. In Veterans Administration Medical Centers, isolation policies for MRSA-infected patients were (% of hospitals using): strict (19%), contact (52%), site-related (28%), no isolation (1%). For patients colonized with MRSA policies were: strict (15%), contact (44%), site-related (35%), and no isolation (6%). Only 41% of Veterans Administration Medical Centers reported discharging known MRSA-colonized patients to nursing homes. Most attempts to eradicate MRSA carriage used trimethoprim-sulfamethoxazole plus rifampin with or without bacitracin ointment; success rates were low. MRSA incidence is increasing at Veterans Administration Medical Centers across the United States. Improved regimens to eliminate MRSA carriage are needed.
Community Hospital Surgeon-Specific Infection Rates
Authors: Collier Caryl , Miller Donald P , Borst Marguerite 
Published: August 2016

AbstractA one-year prospective study of surgeon-specific nosocomial infection rates was done in two community hospitals. Hospital A (93 beds) and Hospital B (158 beds) have nearly identical surgical staffs. Unified criteria for the diagnosis of infections, methods of data collection, and coding were used. Data were processed with an IBM 370 computer using Statistical Analysis System (SAS). Each surgeon received semiannual reports of 1) overall infection rate by site, 2) number of surgical wound infections by wound class and type of procedure, 3) pathogens for each deep and incisional infection, and 4) quarterly wound infection rates by wound class. Analysis of reports revealed high Class I surgical wound infection rates for both general and orthopedic surgeons. One person in each group had inordinately high infection rates. These data serve as an objective incentive to reduce surgical wound infections, identify individual problems, and suggest surgical privileges be evaluated by performance.
Inactivation of Human Immunodeficiency Virus by Betadine
Authors: Kaplan Joan C. , Crawford David C. , Durno Amy G. , Schooley Robert T. 
Published: August 2016

AbstractHuman immunodeficiency virus (HIV), the etiological agent of the acquired immunodeficiency syndrome (AIDS), was treated with either Betadine® (povidone-iodine) Solution or Betadine Surgical Scrub®. HIV inactivation was analyzed using the viral reverse transcriptase assay or by observing the cytopathic effect produced in HIV-infected, H-9, T-cell cultures. The minimum effective Betadine dose was 0.25% for complete inactivation of HIV that was treated for various time intervals (immediate vortex to ten minutes). The titer of HIV stocks used in these experiments (105 TCID50per mL) was greater than amounts generally detected in clinical specimens. Our results provide a rationale for the use of povidone-iodine as a topical antiseptic against HIV in the clinic or laboratory.
Prospective Microbiologic Surveillance in Control of Nosocomial Methicillin-ResistantStaphylococcus aureus
Authors: Walsh Thomas J. , Vlahov David , Hansen Sharon L. , Sonnenberg Edda , Khabbaz Rima , Gadacz Thomas , Standiford Harold C. 
Published: August 2016

AbstractA prospective microbiological surveillance (PMS) program was developed in a comprehensive hospital-wide effort for control of nosocomial methicillin-resistantStaphylococcus aureus(MRSA). This PMS program entailed: 1) active identification of colonized and infected patients; 2) application of a screening microbiologic system for MRSA; 3) isolation of colonized and infected patients; 4) antibiotic decolonization of MRSA; and 5) educational efforts. The PMS program was studied over three and one half years for its contribution to infection control of MRSA, early identification of nosocomial MRSA outbreaks, use of the highest yield surveillance culture sites, and cost effectiveness. Following initiation of the PMS program in December 1982, during an MRSA outbreak, the frequency of new MRSA cases declined from 14 to none by the end of a 3-month pilot study. The frequency of new MRSA cases stabilized at approximately 2 per month until October 1983, when the PMS system allowed prompt detection of a new outbreak of 11 cases. Following isolation and antibiotic decolonization, the frequency of cases again declined to 3 per month. A third outbreak in December 1985 again was promptly detected and controlled. Infection to colonization ratio decreased from a maximum of 1.5 during outbreaks to a minimum of 0.17 after outbreaks. Wounds and tracheostomy sites provided the greatest yield of detection of new cases of MRSA. During one 15-month period, 35 of the 43 new cases were detected initially at wounds and tracheostomy sites. No new MRSA cases were detected by a positive axillary or nares site alone. The estimated quarterly cost of outbreaks and infection paralleled the quarterly frequency of new MRSA cases. The cost of managing MRSA outbreaks and treating MRSA infections versus the cost of implementing the PMS program suggested that the PMS program may be cost effective. This prospective microbiological surveillance program may be applicable to other institutions for hospital-wide infection control of MRSA.
Outbreak Due to Methicillin- and Rifampin- ResistantStaphylococcus aureus:Epidemiology and Eradication of the Resistant Strain from the Hospital
Authors: Bitar Cynthia M. , Mayhall C. Glen , Lamb V. Archer , Bradshaw Thomas J. , Spadora Alice C. , Dalton Harry P. 
Published: August 2016

AbstractA methicillin- and rifampin-resistant strain ofStaphylococcus aureuswas introduced into a university hospital by interstate transfer of an infected surgical patient. An outbreak occurred, and 17 patients became infected or colonized with the epidemic strain. Reservoirs appeared to be patients who were infected or colonized with the resistantS aureusand possibly two nurses who were nasal carriers. The outbreak isolate was likely spread by contact with contaminated hands of personnel. A retrospective case-control study identified tracheostomy, debridement, and irrigation of wounds by power spray and prolonged nasogastric intubation as risk factors for acquisition of the epidemic strain. Analysis of factors by groups indicated that surgical procedures, wound care procedures and instrumentation of the respiratory tract were significantly associated with cases. The nasal carrier state was eradicated in two nurses by topical application of 5% vancomycin. The epidemic strain was eradicated from the hospital 8 months after it was introduced.
Methicillin-Resistant Staphylococcus aureus in a Nursing Home
Authors: Storch Gregory A. , Radcliff Jan L. , Meyer Patricia L. , Hinrichs James H. 
Published: August 2016

AbstractDuring a 13-month period, 25 residents of a nursing home were found to have positive cultures for methicillin-resistant Staphylococcus aureus (MRSA), including 17 with clinically significant infections. The outbreak came to attention in February 1985 when pneumonia was diagnosed in five residents during a 10-day period, and sputum cultures from all five were positive for MRSA. A survey revealed that nine (12%) of a sample of 74 residents and nine (7%) of 130 personnel had positive cultures for MRSA. Six of nine residents with MRSA detected in the culture survey had not been hospitalized for 6 or more months before the survey, suggesting acquisition of MRSA in the nursing home. Implementation of control measures was associated with a decreased occurrence but not complete elimination of new cases. MRSA in nursing homes is of concern because these institutions might serve as reservoirs for MRSA in the community. Further studies are required to define the magnitude of the problem, as well as optimal control measures.