bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Maternal-Neonatal Outbreak of Infections Due to an Unusual Group A β-Hemolytic Streptococcus
Authors: Wiesenthal Andrew M. 
Published: August 2016

AbstractAn outbreak of group A β-hemolytic streptococcal infections involving three parturients, three newborns, and a nursery RN is reported. Six of six organisms available for serotyping were M-untypable, T-11, serum opacity reaction-negative. Propagation of the outbreak may have been fostered by the common use of a single sitz bath, although the evidence to support this is weak. The outbreak was rapidly controlled via strict cohorting, appropriate treatment and isolation of cases, and the routine use of triple dye for umbilical cord care.
Influence of Ethanol With and Without Chlorhexidine on the Bacterial Colonization of the Umbilicus of Newborn Infants
Authors: Bygdeman S. , Hambraeus A , Henningsson A. , Nyström B. , Skoglund C. , Tunell R. 
Published: August 2016

AbstractThe effect of daily treatments with 70% ethanol and with 0.5% Chlorhexidine in 70% ethanol, respectively, on navel colonization in newborns has been studied in 624 infants in two maternity wards during a four-month period. Staphylococcus aureus, group B and G streptococci, E. coli and anaerobes were significantly less often isolated from newborns whose umbilical cord was treated with Chlorhexidine in ethanol than from those treated with ethanol only. Staphylococcus epidermidis and enterococci, on the other hand, were significantly more often isolated from the chlorhexidine-ethanol than from the ethanol group. More infants without colonization of the umbilicus on their fourth day of life were found in the Chlorhexidine in ethanol than in the ethanol group. The infants in the ethanol group were colonized with significantly more bacterial species than the infants in the other group. Signs of dissemination of group B and group G streptococci between babies were seen more often in the group of infants treated with ethanol than in the one treated with chlorhexidine-ethanol.
Lack of Utility of Routine Screening Tests for Early Detection of Peritonitis in Patients Requiring Intermittent Peritoneal Dialysis
Authors: Cooper Glenn L. , White Julie A. , D'Elia John A. , DeGirolami Paola C. , Arkin Charles , Kaldany Antoine , Piatt Richard 
Published: August 2016

AbstractA prospective study was undertaken to examine the clinical presentation of peritonitis in patients maintained on intermittent peritoneal dialysis and to determine the value of qualitative and quantitative dialysate cultures, gram stain, neutrophil counts, and a semiquantitative leukocyte test strip for case detection. Seven cases of peritonitis developed among 30 patients who underwent 553 dialyses. In most cases, neutrophil counts, cultures, and leukocyte test strip determinations were done within 48 hours prior to the clinical onset of peritonitis and in all instances failed to provide clues for incipient infection. Peritonitis was associated with a dialysate neutrophil count of >500/mm3 and leukocyte test strips were highly sensitive and specific for the detection of this quantity of neutrophils. A total of 16 dialysate cultures was positive in asymptomatic patients who did not have peritonitis. None of these patients subsequently developed peritonitis with the same organism. Dialysate gram stains, cultures, neutrophil counts or leukocyte test strips did not provide an early diagnosis of peritonitis and their use in the absence of symptoms is therefore not recommended.
Serratia marcescansContamination of Antiseptic Soap Containing Triclosan: Implications for Nosocomial Infection
Authors: Barry M. Anita , Craven Donald E. , Goularte Theresa A. , Lichtenberg Deborah A. 
Published: August 2016

AbstractDuring a recent investigation in our surgical intensive care unit, we found that several bottles of the antiseptic handwashing soap, OR Scrub®, were contaminated withSerratia marcescens. OR Scrub® contains 1% triclosan, lanolin, and detergents. The antimicrobial efficacy of OR Scrub® was examined in vitro using serial two-fold dilutions of soap inoculated with various concentrations of different nosocomial pathogens. The minimal bactericidal concentration (MBC) of OR Scrub® againstPseudomonas aeruginosaand several strains ofS. marcescenswas ≤1:2 By comparison, a non-antiseptic soap from the same manufacturer (Wash®) and 4% chlorhexidine (Hibiclens®) had MBCs for all strains tested of at least 1:64. Time-kill curves confirmed the findings of the initial experiments.This is the first report of extrinsic contamination of antiseptic soap containing triclosan. No infections could be attributed to the contaminated soap, but sporadic outbreaks ofSerratiahave occurred in the intensive care unit with no identifiable source. Although there have been few studies on the impact of antiseptic soap in reducing nosocomial infection, we question whether a soap with the limitations of OR Scrub® should be used in intensive care units or operating rooms.
The Cephalosporin Antibiotic Agents—I. Considered as a Group
Authors: Marsh T. Donald 
Published: August 2016

This review of the cephalosporin antibiotic family will appear in three parts. The first part will provide general information on the cephalosporins as a class, highlighting the history, chemistry, pharmacokinetics, toxicity, and the segregation of these agents into “generations.” The second segment will discuss the antimicrobial spectra of activity of the first- and second-generation agents, while the last article will focus on the third-generation and investigational cephalosporins under evaluation.Despite a confusing, and somewhat overwhelming array of cephalosporin antimicrobial agents presently available to the clinician, more are on the way. Since 1962 and the introduction of cephalothin, the first agent in this family, there has been a constant parade of new cephalosporins from various pharmaceutical manufacturers. Drug manufacturers are attempting to develop a more effective drug with attractive pharmacokinetic features and less toxicity by modifying the basic cephalosporin molecule.
Peritonitis From Automated Peritoneal Dialysis
Authors: Hamory Bruce H. , Neviakias James M. , Pearson Steven K. 
Published: August 2016

AbstractThree consecutive patients undergoing automated peritoneal dialysis developed peritonitis with a nonfermenting gram-negative rod. The same organism was recovered from the dialysate produced by the machine and from its tap water supply. This is the first such outbreak in which the causative organism was also recovered from the tap water supply to the machine. The organism persisted in the machine following standard 3% formaldehyde disinfection, but was eradicated by 10% formaldehyde disinfection.
Wound Infection After Simple Suture at the Emergency Ward
Authors: Alkan Michael , Gefen Ziva , Golcman Louis 
Published: August 2016

AbstractOf 386 consecutive patients whose wounds were sutured at the emergency ward of the Soroka Medical Center, 228 returned for a follow-up visit during which pus was observed in 40 sutured wounds. Most of the patients were males, 50% lived in the city, and 13% were Beduin. Fifty percent of the wounds were dressed prior to admission. All wounds were rinsed prior to suture, 78% in a cetrimide-chlorhexidine HC1 solution and in 71% an irrigation with a povidone-iodine solution was performed. The physicians who performed the procedure were graded by their medical experience; 43% of the sutures were performed by interns, 32% by junior residents, 19% by senior residents and 6% by a specialist. Silk thread was the most commonly used suture material (79%). Wounds were classified according to size, depth and state of the margins of the wound. It was noted whether an excision was performed and the type of treatment that was prescribed after the procedure. None of the above-mentioned criteria identified a group as high-risk. Experienced physicians sutured the more serious wounds, but their infection rate did not differ significantly from other physicians.
Nosocomial Mycobacterial Pseudoinfection in a Georgia Hospital
Authors: Goodman Richard A. , Smith J. David , Kubica George P. , Dougherty Ellen M. , Sikes R. Keith 
Published: August 2016

AbstractNosocomial pseudoepidemics may be detected when clustering of pseudoinfections occur or when artificial clusters of real infection are observed. Nontuberculous mycobacteria were reportedly isolated from specimens obtained from seven patients at one hospital from October 1980 to January 1981. Because the patients' clinical illnesses were not uniformly consistent with mycobacterial disease, we hypothesized that pseudoinfections had occurred and searched for a common source of contamination. The investigation suggested that specimen contamination was associated with one microbiology laboratory technician: 6 of 22 (27%) specimens processed by that person were positive compared with 1 of 103 (1%) specimens processed by the other five technicians. However, a specific mechanism of contamination was not identified. Nosocomial pseudoepidemics associated with false infections should be suspected and investigated when clinical features and laboratory findings do not agree.
Should Routine Throat Cultures Be Done in Hospital Personnel Complaining of a Sore Throat?
Authors: Watanakunakorn Chatrchai 
Published: August 2016

AbstractIn a 750-bed community-teaching hospital with 3,200 employees, throat cultures were routinely done in hospital personnel complaining of a sore throat. During a 3-month period, 323 employees had throat cultures; only 20 (6.2%) of these throat cultures grew group A streptococcus. The prevalence of positive throat cultures was similarly low in employees (6.2%) and adult patients (7.3%). There was no evidence that employees either had higher prevalence of group A streptococcal pharyngitis or that they spread the infection to patients. It is concluded that routine throat cultures are not warranted in employees complaining of a sore throat, and that throat cultures should be done only selectively in hospital personnel with a high probability of group A streptococcal pharyngitis.
Prolonged Hospital Epidemic of Salmonellosis: Use of Trimethoprim-Sulfamethoxazole for Control
Authors: Linnemann Calvin C. , Cannon Constance G. , Staneck Joseph L. , McNeely Bonnie L. 
Published: August 2016

AbstractThe occurrence of a foodborne outbreak of Salmonella drypool, an uncommon serotype, led to the recognition of hospital-acquired cases occurring over a 5-year period. In late 1981, a catered luncheon resulted in an epidemic of S. drypool, and in retrospect, cases were found to have been occurring in hospital patients from 1977 until 1981. Over the next 4 months, patients, employees, and 50% of the kitchen workers became infected, despite repeated culture surveys of the staff and removal of all infected workers. Food and environmental cultures failed to reveal the source of infection, but infected workers were observed to have multiple negative cultures over several months and then to become positive again. Closing of the kitchen for 2 weeks failed to stop the epidemic. Finally, all kitchen employees, both infected and uninfected, were treated with trimethoprim-sulfamethoxazole for 2 weeks. After treatment, no new kitchen workers became infected, although two workers who had had positive cultures earlier in the epidemic began to excrete S. drypool again, and the epidemic ended.
Evaluation of H2O2 Prophylaxis of Bacteriuria in Patients with Long-Term Indwelling Foley Catheters: A Randomized Controlled Study
Authors: Sweet Donna E. , Goodpasture Hewitt C. , Holl Katherine , Smart Sharon , Alexander Holly , Hedari Ahmad 
Published: August 2016

AbstractSince the long-term catheterized patient is at significant risk of urinary tract infection, and the catheter drainage bags of these patients are at significant risk of becoming reservoirs for nosocomial pathogens, we carried out a randomized, controlled study to determine the efficacy of intermittent drainage bag instillation of hydrogen peroxide (H2O2) in patients requiring indwelling Foley catheters for 5 days or more. Herein we report the effects of this technique on the rates of catheter and bag bacteriuria, the duration to positive culture, the temporal relationships observed, and the spectrum of organisms recovered. Bag source bacteriuria was found with the same frequency in both control and H2O2 groups. H2O2 did reduce contamination of the drainage bag but did not reduce catheter-associated bacteriuria or frequency of symptomatic urinary tract infection. Furthermore, H2O2 did not reduce the frequency of bag contamination with most of the common nosocomial urinary pathogens.
Evidence for the Non-Infectious Etiology of Early Postoperative Fever
Authors: Garibaldi Richard A. , Brodine Susan , Matsumiya Sego , Coleman Miki 
Published: August 2016

AbstractIn a prospective study of infections in 871 general surgery patients, we identified 81 patients who developed unexplained postoperative fevers. The majority of these episodes (72%) occurred early (within the first 48 hours) following surgery. Patients who developed early, unexplained fevers differed significantly from patients who developed documented postoperative infections. Patients with unexplained fevers were younger, had less severe underlying disease and underwent less extensive surgeries than patients who subsequently developed infections. In these respects, they were more similar to non-infected, non-febrile patients.We concluded that episodes of early, unexplained postoperative fever occur frequently in a wide range of general surgery patients. Most of these episodes are non-infectious in origin. Patients with early postoperative fevers should be evaluated to identify any obvious sources of infection. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Unexplained fevers will resolve in time without specific therapeutic interventions.
Nosocomial Fungal Infection During Hospital Renovation
Authors: Krasinski Keith , Holzman Robert S. , Hanna Bruce , Greco M. Alba , Graff Michael , Bhogal Madhu 
Published: August 2016

AbstractNosocomial fungal pulmonary infections (Zygomycetes, Aspergillussp.) developed in two premature infants in a special care unit (SCU) adjacent to an area of renovation. Inspection showed that inadequate barriers permitted the passage of airborne particles between the two areas, and cultures confirmed a significantly higher (p≤0.05) density of mold spores in the SCU (0.88 cfu per hour per settling plate) compared to a construction-free comparison area (0.22 cfu per hour per settling plate). The major source of mold was the dust above the hospital's false ceiling. In another construction area, impervious barriers were shown to effectively restrict the dispersal of mold. Our experience addsRhizopustoAspergillusas a possible cause of construction-related nosocomial infection. Sporadic episodes will continue to occur until the hazards of renovation are appreciated and effective preventive measures are routinely instituted.
Handwashing and Skin Physiologic and Bacteriologic Aspects
Authors: Larson Elaine 
Published: August 2016

AbstractHandwashing practices are often based on tradition and belief. To develop sound rationale for handwashing practices, the physiologic and bacteriologic effects of handwashing must be examined. The purposes of this article are to review the three major microenvironments of the skin with their bacterial flora, to discuss physiologic and bacteriologic characteristics of the skin with particular reference to handwashing, and to describe current handwashing recommendations and practices.
A Rubella Outbreak Among Dental Students Description of the Outbreak and Analysis of Control Measures
Authors: Storch Gregory A. , Gruber Carol , Benz Bette , Beaudoin Janine , Hayes Joyce 
Published: August 2016

AbstractFrom February to April 1982, rubella was diagnosed in 17 Washington University dental students. The affected students represented 4.8% of all dental students and 21% of susceptible students. Because a high likelihood of rubella transmission was perceived, three adjacent university hospitals undertook an emergency program to ensure immunity to rubella in all personnel. The program reached 84.6% of all target personnel, but only 36% of physicians (p<0.001). We estimated that the program increased the level of rubella immunity from 92.2% to 98.1%, at a total cost of $140,274 of which $29,990 was in excess of ordinary expenditures. Our experience indicates that schools training health professionals face the possibility of rubella outbreaks unless they ensure rubella immunity in all students. The experience also supports the value of ongoing programs to ensure rubella immunity in hospital personnel. Without such programs, hospitals may be forced to undertake emergency programs that are likely to be disruptive and expensive and may have relatively little immediate measurable impact.
The Relationship Between Intravenous Fluid Contamination and the Frequency of Tubing Replacement
Authors: Josephson Adele , Gombert Myles E. , Sierra Marcelino F. , Karanfil Lynne V. , Tansino Gary F. 
Published: August 2016

AbstractMedical patients receiving IV therapy were randomly assigned to one of two IV tubing change groups. One group had a 48-hour tubing change and the other had no tubing change for the remainder of the cannula placement. A daily IV fluid specimen was processed microbiologically. To complete the study, a minimum of 3 continuous days of therapy and three fluid specimens was required. There were two contaminated specimens, one in each tubing change group. The contamination rate in the 48-hour change group was 0.87% and 0.96% in the no change group. The rate difference of 0.09% has a 95% confidence interval (−0.035 to +0.036) which includes zero. Survival analysis also revealed no significant difference in the cumulative probability of survival, however the mean duration of continuous tubing use of 4.3 days in the no change group and 1.8 days in the 48 hour change group were significantly different (p<0.05). The cumulative probability of surviving contamination free was 0.988 in the 48-hour group and 0.987 in the no-change group. We conclude that it is safe to change IV tubing at intervals up to but not exceeding 4 days.
Infections Related to Summer Recreational Activities
Authors: Gray Beverly J. , Haley Charles E. 
Published: August 2016

Unusual infections, many of which are easily preventable, may occur during the summer months as a result of travel and recreational activities. Infection Control Practitioners may be consulted for isolation recommendations, but more importantly may have opportunities to educate patients and personnel about preventive measures.During the summer months, Americans of all ages travel extensively and participate in a variety of outdoor recreational activities such as swimming, boating, camping, hiking, and gardening, which may result in exposure to unusual pathogens. Climatic factors, poor immunity to these pathogens, and lack of attention to hygiene may increase the risk for infections caused by these organisms. They may be transmitted by ingestion of contaminated food or water, contact with contaminated water, soil, or vegetation, or by insect bites. Basic preventive measures are effective against many infections related to recreational activities. Persons traveling to underdeveloped areas should consult a physician about the need for immunization or prophylactic medication.
Candidal Suppurative Peripheral Thrombophlebitis Recognition, Prevention, and Management
Authors: Walsh Thomas J. , Bustamente Carlos I. , Vlahov David , Standiford Harold C. 
Published: August 2016

AbstractCandidaspecies are seldom considered as a cause of suppurative peripheral thrombophlebitis. During a 15-month period in a 291-bed acute-care hospital, candidal suppurative peripheral thrombophlebitis developed in seven patients. All patients had fever, a tender palpable cord, andCandidaspecies isolated from resected veins and/or pus expressed at the catheter entrance site. Four patients had candidemia. None were neutropenic or recipients of corticosteroids. All had concomitant or preceding bacterial infections, and had received a median of 5 antibiotics (range 3 to 9) for at least 2 weeks. Five of seven had documented preceding candidal colonization associated with broad spectrum antibiotic therapy. Catheter sites had not been routinely rotated and local catheter site care was deficient. Risk factors of antibiotics and duration of hospitalization were fewer in patients with bacterial suppurative thrombophlebitis. Combined segmental venous resection and intravenous amphotericin B appears to be the most rational therapy for this nosocomial fungal infection.
Physiologic and Microbiologic Changes in Skin Related to Frequent Handwashing
Authors: Larson Elaine , Leyden James J. , McGinley Kenneth J. , Grove Gary L. , Talbot George H. 
Published: August 2016

AbstractHandwashing practices may be adversely influenced by the detrimental effects of handwashing on skin. A protocol was developed to assess the physiologic and microbiologic effects of frequent handwashing. Fifty-two female volunteers washed their hands 24 times per day for 5 days. Five agents were tested: water alone, non-medicated bar soap, a chlorhexidine-containing antiseptic, and two agents containing povidone-iodine (one currently available on the market and one being tested for possible marketing). Some damage to the outer membrane of skin, the stratum corneum, occurred in all groups. There were significant changes in the amount of evaporation water loss (p=.001) and in self assessments of skin condition (p=.005) from pre-to-post test for the entire group. Skin damage was also assessed by visualizing desquamating stratum corneum cells, which are shed in large aggregates when detergents injure skin. Significantly less such shedding occurred in subjects using water alone, bar soap, and the Chlorhexidine formulation (p=.02). Greater antimicrobial activity of an agent was not correlated with increased skin trauma. We have quantitated, using objective physiologic parameter, the skin damage that occurs during even a short period of frequent handwashing. We recommend that further studies using the methods described be conducted to quantitate skin damage over longer periods of time, more closely resembling handwashing practices of health care personnel.
NosocomialMycobacterium gordonaePseudoinfection From Contaminated Ice Machines
Authors: Panwalker Anand P. , Fuhse Elizabeth 
Published: August 2016

AbstractThirty-two clinical specimens submitted to the laboratory during a 12-month period from July 1980 to June 1981 were reported to be culture-positive forMycobacterium gordonae,an organism generally considered to be a slow-growing saprophyte with natural habitats which include soil and water. Only seven similar isolates had been recovered in the preceding4½year period. The discordance between clinical findings and the mycobacterial cultures suggested extrinsic contamination of the specimens. Contamination in the laboratory was believed unlikely because: 1) clinical samples obtained in an aseptic manner were never contaminated; 2) various surveillance cultures of reagents and deionized water used in the laboratory were negative; and 3) substitution of deionized water with sterile water did not control the outbreak. Extensive hospital-wide cultures of water sources implicated the use of ice and ice water from contaminated ice machines as the source of this pseudoepidemic. Cleaning of the ice machines resulted in a sharp decrease in the number ofM. gordonaeisolates. Pseudoinfection by M.gordonaefrom improperly maintained ice machines has not been reported before.