bluuebunny/crossref_metadata_2025_split huggingface dataset:
Update on AIDS
Authors: Valenti William M. 
Published: August 2016

Recent advances in our knowledge of the Acquired Immune Deficiency Syndrome (AIDS) could have a major impact on practitioners in both infection control and employee health. The discovery that a retrovirus, the human T-cell leukemia virus (HTLV-III) is the cause of AIDS could be used to help health care workers better understand this disease. Those of us who are trying to provide our employees with up-to-date information on AIDS should use this new information to help employees understand the nature of the disease, its transmissibility and non-transmissibility. Now that the disease can be linked to a specific agent, employees may find AIDS to be much less mysterious. The retrovirus link is a major step forward in understanding this disease and may eventually lead to more effective treatment and possibly a vaccine. Our knowledge continues to evolve in much the same way as our understanding of Legionnaires' Disease and Toxic Shock Syndrome.The Acquired Immune Deficiency Syndrome (AIDS) was discussed extensively at recent infectious diseases meetings in Washington, D.C. The results of original research conducted by investigators at the National Institutes of Health (NIH), Centers for Disease Control (CDC), Pasteur Institute in Paris, and medical centers throughout the world were presented at the meetings. A number of issues have been clarified and the pieces of the puzzle are starting to come together.
EnterobacterMediastinitis Following Cardiac Surgery
Authors: Palmer Darwin L. , Kuritsky Joel N. , Lapham Sandra C. , King Rosalie M. , Akl Bechara F. 
Published: August 2016

AbstractEight cases of sternal/mediastinal infection due to Enterobacter species were seen in postoperative cardiac patients during 1980 to 1981. The attack rate was 14.5% (8/55), compared to 3.7% (2/54) for an identical period in 1979 to 1980 (p<0.05). Cases varied in severity from fulminant, acute bacteremic infections (one death) to less severe wound infection. Late complications or recurrences were not seen. There was a hospital-wide increase, relative to all other gram-negative bacillary isolates, inEnterobacterlaboratory isolations, but no increased rate of infection in any other specific surgical condition.No personnel, materials, or techniques were associated with the outbreak, and all but two environmental cultures were negative. Case-control analysis suggested that surgical complications and prophylactic cephalosporins were associated with infection. Prospectively, an additional 85 cardiac surgery patients had increasedEnterobacterskin/wound colonization following perioperative prophylaxis with cephalosporin antibiotics. After introduction of barrier isolation and restriction of contacts no further mediastinitis occurred in 100 subsequent cardiac surgery patients. This study indicates thatEnterobactermay be major pathogens causing post-cardiac-surgery infection not prevented by cephalosporin prophylaxis.
Prevention and Control of Tuberculosis
Authors: Valenti William M. 
Published: August 2016

One activity of most employee health programs is a tuberculosis control program. No two programs will be exactly the same since many of the components of this program are controversial. Each should be tailored to the needs of the individual health care facility. In general, there are two components of a program for tuberculin skin testing of employees:1. Skin testing prior to exposure.2. Skin testing after exposure.
An Outbreak of Invasive Aspergillosis Among Allogeneic Bone Marrow Transplants: A Case-Control Study
Authors: Rotstein Coleman , Cummings K. Michael , Tidings John , Killion Kathleen , Powell Eileen , Gustafson Tracy L. , Higby Donald 
Published: August 2016

AbstractBetween April 1982 and March 1983,10 of 26 (38.4%) allogeneic bone marrow transplant recipients housed on a newly opened bone marrow transplant unit developed invasive aspergillosis. By contrast, between September 1977 and March 1982, only 3 of 46 (6%) transplant recipients developed invasive aspergillosis. A case-control study to identify host factors related toAspergillusinfection found that aspergillosis was more common in patients with chronic myelogenous leukemia and aplastic anemia, older patients, patients having cytomegalovirus disease, patients who experienced prolonged granulocytopenia, patients conditioned with ara-C (100-200 mg/day), and patients who received longer duration of antimicrobial therapy. A series of logistic regression analyses revealed that underlying disease was the single best predictor ofAspergillusinfection. This study demonstrates that underlying disease is an important risk factor for aspergillosis and that special measures may be warranted when transplanting certain patients.
Bubbling Humidifiers Produce Microaerosols Which Can Carry Bacteria
Authors: Rhame Frank S. , Streifel Andrew , McComb Carter , Boyle Mike 
Published: August 2016

AbstractIt is widely held that bubbling humidifiers do not produce microaerosols, although prior studies have resulted in conflicting evidence. We have studied this phenomenon in a clean room using an airborne particle counter and samplers for airborne bacteria. At gas flow rates between 10 and 80 L/min, a Cascade 1 humidifier produced between 460 and 999 water droplets/L humidified gas. Total water volume aerosolized was approximately 10-8ml/L humidified gas. Seventy-three percent of the particles had diameters between 1 and 5 microns. With the reservoir containing 6.4 × 106P. aeruginosa/ml, it produced between 2 and 9P. aeruginosa/Lhumidified gas. Most of the bacteria were in particles of a size likely to be deposited in the lung. This bacterial carryover was between 20 and 150 times the amount predicted by multiplication of the water volume aerosolized times the concentration of bacteria in the humidifier reservoir. An Air Life humidifier produced fewer particles which were also of a size likely to be deposited in the lung and, when the reservoir containedP. aeruginosa, it aerosolized bacteria. Wick-type humidifiers did not produce detectable aerosol or bacterial carry-over. Although the clinical significance of these findings has not been established, they provide a rationale for the CDC recommendations for procedures designed to keep bubbling humidifier reservoir water uncontaminated.
The Risks of Transmission of the HTLV-III and Hepatitis B Virus in the Hospital
Authors: Shanson David 
Published: August 2016

In the hospital, both HTLV-III and hepatitis B virus are most likely to spread via infected blood or contaminated blood products. A summary of the main factors affecting spread of these viruses and some observations made at the author's hospital in central London, will be discussed here.AIDS was first recognized in Britain in 1981 and up to August 1985 there were 206 confirmed cases of AIDS with 114 deaths. The majority of patients with AIDS have been male homosexuals and less than 15% of the cases occurred outside of London. By August 1985 over 10,000 cases of AIDS had been reported in the US and it is clear by comparison that the current epidemic in Britain is in its early stages. Only a minority of London homosexuals have been infected. It is possible that an aggressive public health campaign could slow the course of the epidemic. Measures needed would include an increase in education, publicity, facilities for HTLV-III antibody tests, trained social workers and counseling on a massive scale. In the meantime the number of hospitalized patients with known HTLV-III infections has increased considerably during the last 2 years in certain hospitals in London (Figure 1). Approximately 33% of homosexuals attending sexually transmitted diseases (STD) clinics in London have serological evidence of HTLV-III infection. A few hospitals in central London have seen most of the patients with known HTLV-III or hepatitis B infections mainly because of the concentrations of homosexuals, drug addicts or other “risk groups” in the local catchment areas of these hospitals. A small number of hospitals in London and elsewhere in Britain have special hemophiliac centers and currently these centers have generally noted that more than 50% of their hemophiliac patients already have serological evidence of HTLV-III infection. Recent reports have documented the rate of increase of HTLV-III infections in British hemophiliac patients. During the last few years in London less than 10% of male homosexuals known to have HTLV-III infection and less than 1% of infected hemophiliac patients have developed AIDS.
Effect of Long-term Storage on Sterile Status of Devices in Surgical Packs
Authors: Klapes N. Ariene , Greene Velvl W. , Langholz Ann C. , Hunstiger Cindy 
Published: August 2016

AbstractWe investigated the effect of the following on the sterile integrity of surgical packs: four wrapping materials (two-ply reusable, nonbarrier wovens, both new and previously used; disposable, barrier nonwovens; and polypropylene peel pouches), dustcovers, two storage locations, and storage times ranging from 2 to 50 weeks. Two hundred sixty-three packs containing stainless steel coupons were prepared, wrapped, sterilized, and stored. Half of the packs were dustcovered prior to storage. At monthly intervals for a year, packs of each type were opened in a laminar flow hood, and the coupons inoculated into trypticase soy broth. The coupon contamination probabilities were 0.019 for reusable, woven packs; 0.017 for disposable, nonwoven packs; and 0.016 for peel pouches. These differences were not significant. The probability of finding a contaminated coupon in any pack after 50 weeks was 0.018. No trend toward increased probability of contamination over time was observed for any of the pack types studied.
The Importance of Surveillance Stool Cultures During Periods of Severe Neutropenia
Authors: Wells Carol L. , Ferrieri Patricia , Weisdorf Daniel J. , Rhame Frank S. 
Published: August 2016

AbstractThe correlation of fecal gram-negative bacilli (GNB), neutropenia, and bacteremia was studied in 45 bone marrow transplant recipients. Weekly stool cultures were prospectively monitored for GNB resistant to routine prophylactic and empiric antimicrobial agents. Seven cases of GNB bacteremia occurred in 45 patients described as follows. Twenty-three patients had no fecal or blood GNB. Fifteen patients had fecal GNB and no blood GNB; three of these latter patients had ≤50/mm3 circulating white blood cells (WBC) at the time of isolation of fecal GNB but two of the three were concurrently receiving appropriate empiric antibiotics. Two patients had blood GNB but no fecal GNB: one patient had a trimethoprim/sulfamethoxazole (TMP-SMZ)-sensitive isolate that would not be detectable in the feces by our methodology and one patient had feces analyzed only after the bacteremic event. Five patients had fecal GNB and blood GNB: one of these patients did not have a fecal sample analyzed prior to bacteremia but the remaining four patients had the same species/antibiogram of GNB isolated from the feces two to three days prior to the detection of bacteremia. Thus, the fecal GNB could have been used to predict the antibiogram of the subsequent blood GNB. In addition, all four of these latter bacteremic patients had ≤50/mm3 circulating WBC at the time of documented fecal GNB. Thus, bone marrow transplant recipients with fecal GNB coupled with severe neutropenia (≤50/mm3 circulating WBC) were more likely to develop bacteremia (P<0.02) than were those with fecal GNB and ≤50/mm3 circulating WBC.
Staphylococcus aureusMediastinitis: Prognostic Usefulness of an Early Medicosurgical Therapy
Authors: Voiriot Pascal , Marcoux J. André , Duperval Raymond , Teijeira Javier 
Published: August 2016

AbstractSix cases of acuteStaphylococcus aureusmediastinitis after median sternotomy were reported. Five resulted from an asymptomatic disseminator of 5aureuspresent in the operating room. Each case was characterized by an acute bacteremic phase, occurring after a mean interval of 8.2 ± 1.7 days after the surgical procedure; within 24 to 36 hours all patients had a temperature above 39°C, toxic appearance, and marked leukocytosis. Pericicatricial inflammation was moderate, instability of the sternum was present in only two patients, and chest roentgenogram was not helpful in making an early diagnosis. No risk factor for mediasinitis in connection with the perioperative or postoperative periods was noted in cases compared with a control group of 103 patients. All strains ofS aureuswere susceptible in vitro to the antibiotic regimen used in prophylaxis. All patients underwent early surgical reopening of the mediastinum within 47 ± 15 hours after the first sign of acute mediastinitis. Mediastinal debridement and continuous irrigation-suction with dilute povidone-iodine solution were associated with intravenous antistaphylococcal therapy for a period of four to six weeks. All patients survived and no recurrence was observed, a finding we think due to early diagnosis and aggressive medicosurgical therapy.
Staphylococcus aureusColonization and Infection After Discharge from a Term Newborn Nursery
Authors: Wang Elaine E.L. , Elder Diane , Mishkel Norma 
Published: August 2016

AbstractDuring a 6-month period, term infants underwent nasal and umbilical swabbing within 96 hours of delivery and again at 1 to 18 (mean 3.8) weeks after discharge. Swabs were inoculated onto horse blood agar and allS aureusisolates were phage typed. Two hundred three infants were enrolled and follow-up was obtained for 181 (89%). Thirty-two of 181 (17.6%) were initially colonized, of whom 12 (37.5%) were colonized on follow-up. Thirty-two of 181 became colonized subsequent to hospital discharge. No single phage type predominated. Twenty-five patients were diagnosed to have clinical illness—omphalitis (11), conjunctivitis (10), and pustulosis (5). Six of these were colonized with 5 aureus initially, although organisms of the same phage type were not recovered from cultures obtained at the time of clinical illness. There was no significant difference in the rate of infections in colonized (19%) versus noncolonized (12%) infants. In five patients whereS aureuswas recovered at the time of symptoms, all organisms were acquired subsequent to discharge. We conclude that nursery colonization withS aureusdid not lead to clinical illness, and clinical illnesse s previously ascribed toS aureusfrequently occur in the absence of these bacteria.
A Hepatitis B Vaccination Program in a Community Teaching Hospital
Authors: Tong Myron J. , Howard Ann M. , Schatz Gary C. , Kane Mark A. , Roskamp Deborah A. , Co Ruth L. , Boone Cissy 
Published: August 2016

AbstractPrior to offering the hepatitis B (HB) vaccine, a prescreen for hepatitis B virus (HBV) antibodies was conducted in a 565 bed hospital in Pasadena, California. Antibodies to the hepatitis B virus were detected in 14.5% of 1,745 employees tested. There was a significantly higher prevalence in those with a previous history of hepatitis, blood transfusions, exposure to nee-dlesticks, number of years in the same occupation, and in the same hospital work area. Employees of Asian extraction (33.3%) and blacks (23.1%) had a higher prevalence of antibodies to the hepatitis B virus than Hispanics (13.7%) and whites (10.2%). Anti-HBs was detected in 92.6% of 865 employees who received three doses of the hepatitis B vaccine. Only 28.6% of nonresponders receiving a fourth dose of hepatitis B vaccine produced anti-HBs. The nonresponders to the HB vaccine were older (average age 64.9 years) when compared to the responders (average age 37.5 years), and more males failed to produce anti-HBs after vaccination than females. Hepatitis B vaccination of the majority of individuals with either “low level” anti-HBs alone or anti-HBc alone did not elicit an anamnestic response after one dose of vaccine, implying that these “low level” antibodies are nonspecific and do not represent antiviral antibodies. Adverse reactions to the hepatitis B vaccine were minor and included a flulike syndrome, sore arm, and rash and swelling at the injection site. The reasons for nonparticipation were obtained from 179 individuals, and the main issue was concern about safety of the hepatitis B vaccine.
Review of the 4-Quinolones
Authors: Eggleston Mark , Park Soon-Young 
Published: August 2016

AbstractImprovements in antimicrobial activity and pharmacokinetics have moved the 4-quinolones into the forefront of antibiotic research. The 4-quinolones are analogues of nalidixic acid, and there are presently at least six agents in this group under investigation in the United States. It is difficult to generalize their clinical usefulness, since these agents exhibit different pharmacokinetic profiles, antimicrobial activity (with varied minimum inhibitory concentrations among similar organisms), and dosage regimens.The 4-quinolones are potential therapeutic alternatives for infections caused by a variety of organisms. They include: Neisseria gonorrhoeae; Pseudomonas aeruginosa; Haemophilus influenzae; Staphylococcus aureus; common enteric pathogens (salmonella, shigella, Campylobacter, etc); and intracellular bacteria (legionella, chlamydia, mycobacteria, etc).Clinical efficacy has been demonstrated in urinary tract infections, respiratory tract infections, and sexually transmitted diseases. Future studies will undoubtedly demonstrate effectiveness in numerous additional infectious processes.The purpose of this article is to compare the 4-quinolones in regards to pharmacokinetics and spectrum of activity and review the clinical studies involving these agents.
Protein Fingerprinting for the Determination of Relatedness inAcinetobacter calcoaceticussubspecies anitratus Isolated from Patients in a Surgical Intensive Care Unit
Authors: Mortensen Joel E. , LaRocco Mark T. , Steiner Bret , Ribner Bruce 
Published: August 2016

AbstractThe use of protein fingerprinting for the establishment of relatedness among isolates ofAcinetobacter calcoaceticussubspeciesanitratus, isolated from patients in a surgical intensive care unit was examined. Poly-acrylamide gel electrophoresis was used to analyze the cellular proteins from whole cell lysates of 14 intensive care unitA calcoaceticussubspeciesanitratusisolates and 11 control strains. Antimicrobial susceptibilities and plasmid profiles were also determined for all isolates. All intensive care unitA calcoaceticussubspeciesanitratusisolates exhibited identical cellular protein fingerprints, no detectable plasmids, and minimum inhibitory concentrations within ±1 log2dilution of the mode value for each of the antimicrobial agents tested. The other clinical isolates demonstrated a range of antimicrobial susceptibilities, various numbers and sizes of plasmids, and distinctly different protein fingerprints. These data indicate that protein fingerprinting may be useful as an epidemiologic tool inA calcoaceticussubspeciesanitratusoutbreaks and this method deserves further study.
The Antiseptic Efficacy of Chlorxylenol-Containing vs. Chlorhexidine Gluconate-Containing Surgical Scrub Preparations
Authors: Soulsby M.E. , Barnett J.B. , Maddox S. 
Published: August 2016

AbstractThe studies described here evaluate the efficacy of the chlorxylenol-containing surgical scrub formulations against the Chlorhexidine gluconate-containing formulations using the Glove Juice Test, as recommended by the FDA's panel to develop guidelines for the study of antiseptic agents. Similar reports from the literature evaluating the relative efficacies of the iodophor-containing and the hexachlorophene-containing formulations are cited. Results fail to detect any significant differences in the efficacy of these two preparations, each significantly reducing the bacterial flora on the hands as indicated by immediate post-wash colony counts, and each demonstrating the continuing ability to significantly reduce bacterial growth with continued regular use.
Outbreak ofBurkholderia cepaciain the Adult Intensive Care Unit Traced to Contaminated Indigo-Carmine Dye
Authors: Gravel Denise , Sample Mary Lu , Ramotar Karam , Toye Baldwin , Oxley Cathy , Garber Gary 
Published: August 2016

AbstractWe report an unusual cluster ofBurkholderia cepaciain patients. Environmental cultures identified indigo-carmine dye used in enteral feeding as the reservoir. Compared with the controls, the cases were significantly more likely to have received tube feedings tinted with this dye. This outbreak was terminated with the removal of the dye from hospital inventory.
Can Hospital Discharge Diagnosis be used for Surveillance of Bacteremia? A Data Quality Study of a Danish Hospital Discharge Registry
Authors: Madsen Kreesten Meldgaard , Schønheyder Henrik Carl , Kristensen Brian , Nielsen Gunnar Lauge , Sørensen Henrik Toft 
Published: August 2016

AbstractObjective:To assess the data quality of septicemia and sepsis registration in a hospital discharge registry in the County of Northern Jutland, Denmark.Design:Comparison of data from the discharge registry of an 880-bed, public, urban hospital in the County of Northern Jutland with data from a computerized bac-teremia database at the regional department of clinical microbiology.Setting:Urban hospital with approximately 45,000 admissions per year.Patients:The study included 406 episodes of bac-teremia in the bacteremia database and 83 discharges with the diagnosis of septicemia registered in the hospital discharge registry between January 1, 1994, and December 31, 1994.Interventions:None.Results:Eighteen episodes were registered in both the hospital discharge registry and the bacteremia database. Using the bacteremia database as reference standard, the sensitivity for the diagnosis of septicemia in the hospital discharge registry was 4.4% (18/406; 95% confidence intervals [CI95, 2.4%-6.4%]). By review of hospital records, we estimated the positive predictive value of septicemia registration in the hospital discharge registry as 21.7% (18/83; CI95, 12.8%-30.5%). No blood culture had been obtained in 44.4% (36/81; CI95, 33.6%-55.3%) of the cases with a discharge diagnosis of septicemia. In 33.3% (27/81; CI95, 23.1%-43.6%), the discharge diagnosis of septicemia was given, although blood cultures were negative.Conclusions:The hospital discharge registry revealed numerous misclassifications, and the system was found not suited for surveillance of, or research in, bacteremia at present
Hartley Grattan and Australia-U.S. Connections
Authors: Fitzgerald Ross 
Published: August 2016

Fifteen years ago, on Christmas Day 1980, I wrote a list of four people whose biography, if I had the time and ability, I would like to write. They were as follows: Queensland premier and federal treasurer, E.G. (‘Red Ted’) Theodore; Australia's only Communist member of Parliament, Fred Paterson; New Zealand born Communist and author of the superb social realist novel Sugar Heaven, Jean Devanny; and that remarkable American observer of Australia, Clinton Hartley Grattan.