bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Laboratory Studies of NosocomialStaphylococcus aureusResistant to Methicillin and Aminoglycosides
Authors: Bock Bonnie V. , Pasiecznik Karen , Meyer Richard D. 
Published: August 2016

AbstractA methicillin/aminoglycoside-resistant strain ofStaphylococcus aureus(MARS) was likely introduced by transfer of a patient from another hospital. Over the next year, 20 other patients were colonized or infected with MARS of the same phage type, although antibiograms varied. Affected patients usually had serious underlying disease and were in intensive care units. Vancomycin therapy was frequently delayed and MARS may have contributed to the death of some patients. The mode of spread was not definitively delineated, but two nurses were found to be colonized. Institution of isolation procedures was difficult, but the problem gradually waned.Susceptibility testing showed vancomycin to be the most active agent. Synergy studies showed no consistent effect of combining methicillin with an aminoglycoside. This experience illustrates the problem of MARS spread between hospitals and wards, the need for institution of effective control measures, and consideration of early empiric use of vancomycin.
Reliability of Disc Diffusion Susceptibility Testing
Authors: Murray Patrick R. , Zeitinger Jacquelyn R. , Krogstad Donald J. 
Published: August 2016

AbstractWe retested 2,181 bacteria-antibiotic combinations with the Kirby-Bauer disc-diffusion technique and found interpretive changes with 120 (5.5%). Most changes (101 of 120) were single steps (i.e. from R to I, I to R or S, or S to I). Of the 19 remaining, 10 of them were from R to Sand nine from S to R. These changes were significantly more frequent for combinations with zone diameters clustered near interpretive breakpoints (within 2mm) than for other combinations, and there was a linear relationship between decreased reproducibility and increased clustering near interpretive breakpoints.Based on an analysis of all susceptibility testing results performed in 1978, combinations most commonly clustered near interpretive breakpoints included: Ampicillin with Klebsiella pneumoniae; erythromycin with enterococci; chloramphenicol with Serratia marcescens; gentamicin with Pseudomonas aeruginosa and enterocci; and tetracycline with Enterobacter spp., Escherichia coli, and K. pneumoniae.
An Efficacy Evaluation of a Synergized Glutaraldehyde-Phenate Solution in Disinfecting Respiratory Therapy Equipment Contaminated During Patient Use
Authors: Townsend Timothy R. , Wee Siok-Bi , Koblin Beryl 
Published: August 2016

AbstractReusable, corrugated, expiratory limb ventilator tubing that had been in use for 24 hours, were randomly allocated to one of three groups: no treatment (N=36); detergent wash (N = 83); or a detergent wash followed by a 10 minute immersion in a 1:16 dilution of synergized glutaraldehyde-phenate solution which was reused for 30 days. (Between 10 and 22 tubes were tested in each five day interval during this 30-day period.) Tubes were quantitatively and qualitatively cultured. There were significant differences in both the percent of contaminated tubes (no treatment = 92%, detergent wash = 72%, glutaraldehyde-phenate = 0 to 20%) and numbers of microorganisms per tube (no treatment = 3.2 × 106, detergent wash = 1.3 x 104, glutaraldehyde-phenate = 0 to 182) between groups. There was no apparent decrease in glutaraldehyde-phenate's efficacy throughout the 30-day reuse period, and in the final five days of the reuse period it was completely effective.
Transient and Resident Microflora of Burn Unit Personnel and Its Influence on Burn Wound Sepsis
Authors: Heggers John P. , Robson Martin C. , Ko Francis , Cook JoDell , Landa Stuart J.F. 
Published: August 2016

AbstractThe exogenous contamination of a thermally injured patient by contact with the health care team has been a major concern of all burn units. Since the University of Chicago Burn Center routinely monitors each burn injury for sepsis by quantitative bacteriology and recently examined the microbial population present on the hands of the health care team, it was felt that these combined data would shed some pertinent information on exogenous burn wound sepsis.Twenty-nine patients with clinical burn wound sepsis and a bacterial level of >105 bacteria/gram of tissue were studied. These patients yielded a variety of microorganisms with P. aeruginosa and Staphylococcus aureus being predominant, followed in incidence by Candida albicans. The resident and transient microflora isolated from each member of the health care team treating the specific individual concerned did not correlate with the causative agent of burn wound sepsis. The most frequent isolate from the staff personnel was Staphylococcus epidermidis followed by Micrococcus species.Though colonization of the thermally injured individual has been reported, these data strongly suggest that colonization is primarily one of an endogenous source rather than that of an exogenous one.
Recommended Precautions for Patients with Legionnaires' Disease
Authors: Jarvis William R. 
Published: August 2016

AbstractAs diagnostic techniques for the identification of Legionella species have become readily available, recognition of the pneumonic form of Legionellosis has increased. In particular, cases of hospital-acquiredLegionella pneumophilaare being identified and this has led to concern over possible person-to-person transmission. In most epidemiologic investigations where a source has been identified, water has been implicated. Person-to-person transmission has not been convincingly documented. Therefore, we discourage expensive or inconvenient special precautions for patients hospitalized with Legionnaires' Disease. Rather, we recommend that such patients be placed in secretion precautions until effective antimicrobial therapy has eradicated the organism.
Nosocomial Spread of Clostridium Difficile
Authors: Savage Alice M. , Alford Robert H. 
Published: August 2016

AbstractEnvironmental transmission of Clostridium difficile, the causative agent of antibiotic-associated pseudomembranous colitis (PMC), has been supported by animal studies and implicated in spread of C. difficile among leukemic children receiving non-absorbable antibiotics. We report antibiotic-associated C. difficile-related colitis in two adults who shared a commode chair during hospitalization.
Topics in Clinical Microbiology
Authors: Stratton Charles W. , Verrall Rosemary 
Published: August 2016

Serratia marcescenshas an interesting and many-faceted history. The presence of the red pigmented organism on starchy food products long had been noted and was thought to be blood; its presence on consecrated wafers was thought to be the blood of Christ. It was not until 1819 that Bizio, a pharmacist, demonstrated that a microorganism was responsible for the red pigment. He named this microorganismSerratia marcescens;Serratiain honor of Serafino Serrati, an Italian physicist who invented the steamboat andmarcescensfrom the Latin, “to decay.”Because of the pigment production and becauseSerratia marcescenswas believed to be a benign, saprophytic organism, it was used widely as a biological marker from 1906 to 1968. This use has been controversial in regard to experiments conducted by the US Army involving biological warfare techniques. In addition, the recognition in the 1950s of the ability of this organism to cause nosocomial infections has curtailed its use as a biological marker.Serratia marcescensis now recognized as a cause of serious infections in man. It has been implicated in practically every kind of infection and is a particularly serious problem with nosocomial infections.
Storage of Human Breast Milk
Authors: Larson Elaine , Zuill Ramona , Zier Vicki , Berg Barbara 
Published: August 2016

AbstractThe bacteriologic content of expressed breast milk was studied in 30 mothers at the time of expression and after 24 and 48 hours of refrigeration. There were no significant differences in colony counts between the three time intervals. All samples contained Staphylococcus epidermidis. In addition, eight other species were found, including four which were gram-negative. All samples contained <106 colonies/ml, and there were no significant differences in mean colony counts between samples expressed at home and at the hospital. We conclude that it is bacteriologically safe to refrigerate expressed breast milk for up to 48 hours.
Morganella morganii:Epidemiology of Bacteremic Disease
Authors: McDermott Carolyn , Mylotte Joseph M. 
Published: August 2016

AbstractA retrospective review of microbiology records revealed 19 documented episodes ofM. morganiibacteremia in 18 patients at a Veterans Administration hospital during a 5.5 year period. Thirteen of 19 bacteremias were related to nosocomial infections; 11 of the 13 nosocomial bacteremias occurred in surgical patients. Nine of the 13 patients with nosocomial bacteremia had received recent therapy with a beta-lactam antibiotic. The most common source of bacteremia was a postoperative wound infection (seven episodes). Only one episode was related to a urinary tract infection.Retrospective analysis showed that clusters of cases ofM. morganiibacteremia had occurred almost yearly. This finding prompted a six-month period of prospective monitoring of all cultures forM. morganiito identify human reservoirs in our institution. Sixty percent of all cultures growingM. morganiicame from urine cultures, 18% came from wound cultures, and the remaining 22% came from a variety of body fluids or tube drainage. Thirty-one percent of patients harboringM. morganiiwere on the Surgical Service.M. morganiibacteremia most commonly occurs in postoperative patients who receive beta-lactam antibiotics. From the data in this study,M. morganiiis an infrequent cause of bacteremia, and its presence in blood cultures may be an indicator of an environment conducive for an outbreak of nosocomial infection.
Contamination of Irrigation Solutions in an Operating Theatre
Authors: Andersson Britt Marie , Lidgren Lars , Schalén Claës , Steen Anita 
Published: August 2016

AbstractSterile irrigation solutions, used in open systems in a conventional orthopedic operating theatre, were examined for bacterial contamination. At the end of 13 of 21 operations (duration ≥ one hour) the solution tested displayed the growth of Staphylococcus epidermidis and/or diphtheroid rods and/or other species. It is concluded that irrigation by solutions, kept in open bowls during an operation, is a potential source of contamination.
Enterobacter Sepsis in Infants and Children Due to Contaminated Intravenous Fluids
Authors: Matsaniotis Nikos S. , Syriopoulou Vassiliki Ph. , Theodoridou Maria Ch. , Tzanetou Konstantina G. , Mostrou Glyceria I. 
Published: August 2016

AbstractSixty-three cases of nosocomial sepsis occurring from April through October 1981, in a 500-bed pediatric hospital, were traced to bacterial contamination of intravenous fluid produced by a single manufacturer. Two species of uncommon blood stream pathogens,Enterobacter cloacaeandEnterobacter agglomeranscontaminated the fluid. Infections with these organisms might have contributed to the death of four patients; two who were immunosuppressed, one who was asplenic and one premature infant. Epidemiologic and laboratory investigations identified the site of contamination to be within the screw-caps of the bottles containing the intravenous fluid. Contamination occurred during insertion of the intravenous fluid administration set into the bottle. The “epidemic” terminated when the hospital discontinued the use of infusion fluids from that manufacturer. We conclude that intravenous fluids should be examined during outbreaks of nosocomial bacteremia due to unusual pathogens.
Cost of Hepatitis B Prevention in Hospital Employees: Post-Exposure Prophylaxis
Authors: Kirkman-Liff Bradford , Dandoy Suzanne 
Published: August 2016

AbstractTo determine the cost of post-exposure prevention of hepatitis B among hospital employees, a 12-month prospective study was conducted in six Phoenix-area hospitals. Data on reported employee accidents which involved exposure to blood and any subsequent medical attention were obtained weekly. Costs were assigned to all tests, treatments, and working time lost. For 518 potential hepatitis B exposures, the mean cost per incident was $92. Costs associated specifically with preventing hepatitis accounted for 80% of the costs. When data on these incidents were applied to a model procedure for handling potential exposures to hepatitis B, the costs increased to $109 per incident. One work-related case of clinical hepatitis B cost the hospital $13,376. A determination of total hospital costs for hepatitis B should include the direct and indirect cost of each employee case of the disease, the costs of routine serologic screening of employees, and the cost of post-exposure strategies.
Recommended Precautions for Patients Undergoing Hemodialysis Who Have AIDS or Non-A, Non-B Hepatitis
Authors: Favero Martin S. 
Published: August 2016

AbstractPrecautions used for dialysis patients who have acquired immunodeficiency syndrome or non-A, non-B hepatitis are based on infection control strategies developed for the control of hepatitis B in dialysis centers. Specificially, these recommendations include identifying infected patients; isolating (except for non-A, non-B hepatitis patients) patients, and separating staff, and equipment; applying blood precautions and aseptic techniques; and using good environmental control procedures. AIDS patients can be safely dialyzed by either hemodialysis or peritoneal dialysis in hospital-based or free-standing centers, or at home without risk of AIDS transmission to other patients or to staff members, if precautions that have been developed for the control of hepatitis B infection in dialysis units are employed. Further, the type of dialysis treatment, or modality, should be based on the needs of the patient and not on a fear of risk of disease transmission.
Whirlpool Operation and the Prevention of Infection
Authors: Davis Barry J. 
Published: August 2016

AbstractDisease outbreaks involving public whirlpools have been reported frequently since their use has become popular in recent years. Because public whirlpools are often used by persons who have only transient contact, infections resulting from their use are difficult to identify, and published reports probably represent only a small portion of a larger public health problem. Most published outbreaks have reportedPseudomonas aeruginosacontamination of the whirlpool as a result of failure to operate the pool according to recommended practices. Maintaining the microbiologic quality of whirlpool water and preventing infection absolutely require regular operation and maintenance, including monitoring and record keeping by qualified personnel.
Readers' Forum: Public Health Implications Regarding the Epidemiology and Microbiology of Public Whirlpools
Authors: Castle Stuart P. 
Published: August 2016

AbstractHigh temperature bathing in hot tubs, spas and whirlpools poses four potential public health concerns: injury/death, disease transmission, possible teratogenic effects, and congestive heart failure or dysrhythmias for individuals with cardiac problems. Health departments need criteria before initiating environmental and epidemiologic investigations. These criteria must include severity of the disease and number of individuals possibly exposed. In addition, public health officials are obligated to define the magnitude of the problem, inform affected individuals and institute appropriate control measures. Optional information should be collected during an environmental and epidemiologic investigation to clarify the mechanisms of disease transmission and design control measures. The public health response to improving hot water bathing safety and sanitation should be directed at primary prevention. Educational efforts would be directed toward whirlpool operators, users and the medical community. Included should be a review of regulations addressing the construction and operation of public spas and whirlpools.
Cost Containment in Infection Control: Is Cost Effective Ordering of Microbiology Tests for Infection Control Possible?
Authors: Isenberg Henry D. 
Published: August 2016

Prospective payment fever is an all pervasive affliction that will spare no segment of the health care field. The implied rigidity of these regulations will probably not accommodate arguments that infection control efforts are cost-effective in the long run. It shall force all who labor in this field to exercise judicious restraint in the use of institutional resources. Microbiological analyses provide the most factual information lor infection control efforts. However, recent graduates of medical and nursing schools are the victims of the de-emphasis of bread-and-butter microbiology in their curricula. They lack the ability to request only clinically relevant examinations and do not appreciate the implications of microbiological results with respect to the patient and the health of the hospital or the community at large.Cost-effective ordering of microbiological and related patient examinations must, therefore, be based on an educational effort that indoctrinates responsible personnel in the appropriateness of requests based on clinical judgment and laboratory instructions. The DRG-induced change in the basic philosophy of patient care demands that microbiologists must become involved in the clinical use of the information they generate, ie, in the relevance of laboratory data to the care of patients. This interaction must benefit the laboratory scientist, for he or she can now insist that important patient information accompany each specimen.
A Prospective Study of Postoperative Fever in a General Surgery Department
Authors: Galicier C. , Richet Herve 
Published: August 2016

AbstractDuring a 4-month period, 693 patients undergoing surgical procedures were prospectively studied to investigate the etiology of postoperative fever (≥38°C during 48 hours or more). The overall rate of fever was similar for the three categories of surgical procedures studied (14%, 13.4% and 13.1% respectively after clean, clean contaminated and contaminated surgical procedures). No cause of fever was found in 5%, 2.7% and 1.7% of patients who underwent clean, clean contaminated and contaminated surgical procedures. Several episodes of fever were observed for 12 patients after clean surgery; for 11 of them this was due to infection. The mean interval between febrile episodes was 4.7 days. After clean wound surgery, fever documented as infectious began significantly later (2.7 vs 1.6 days) and lasted significantly longer (5.4 vs 3.5 days) than fever for which no source was determined. Only half of the infections were associated with fever.
Hospital Experience with Varicella-Zoster Virus
Authors: Krasinski Keith , Holzman Robert S. , LaCouture Rita , Florman Alfred 
Published: August 2016

AbstractVaricella-zoster virus (VZV), one of the most common highly communicable agents of disease, stimulates aggressive infection control measures. In a 1-year period, at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric patients) and 2 hospital staff with active varicella-zoster infections served as potential sources of nosocomial infection. Six incidents of exposure to the virus that occurred without the protection of standard infection control precautions were investigated by the infection control surveillance team. One hundred fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no history of varicella-zoster infection, but only five were susceptible by serologic testing. One hundred one staff members had no history of varicella-zoster, but only 11 were susceptible by serologic testing. These exposures resulted in three secondary varicella-zoster infections, six courses of varicella-zoster immune globulin prophylaxis and furlough of 13 staff members. Epidemiologic investigation consumed approximately 356 hours of staff time, and management of exposed persons cost approximately $41,500. Prospective knowledge of the immune status of health care workers would vastly decrease the time and effort required to control hospital VZV exposures.
An Approach for Selection of Health Care Personnel Handwashing Agents
Authors: Larson Elaine , Talbot George H. 
Published: August 2016

AbstractGiven the wide range of available health care personnel handwashing agents, selection of an appropriate product may be difficult. This decision may be made on the basis of user preference, cost, or other factors unrelated to product effectiveness. Four criteria—efficacy, safety, cost, and acceptability—are appropriate for systematic evaluation of handwashing products. These criteria are applied to para-chloro-meta-xylenol (PCMX), a compound used with increasing frequency in health care personnel handwashing agents. Published data regarding the biochemical properties, efficacy, and safety of PCMX are summarized. We conclude that the substance appears to be safe and efficacious. However, the activity of PCMX is highly formula-dependent and many of the studies available in scientific literature have been conducted in Europe using a variety of testing conditions and formulations different from those currently available in the US. Clinical studies of marketed formulations are beginning to appear in the literature. Such studies will provide the data needed for adequate product evaluation.
Methicillin-ResistantS. aureusandS. epidermidisStrains: Modern Hospital Pathogens
Authors: Wenzel Richard P. 
Published: August 2016

The international recognition of the emergence of methicillin-resistantStaphylococcus aureusas major nosocomial pathogens dates to the late 1970s. The weight of evidence from many institutions suggests that transmission involves spread from patient to patient of the same or very similar strain and that effective control, if not elimination, involves isolation of infected and colonized patients.More recently, a number of reports have suggested the emergence of methicillin-resistantS. epidermidisand other coagulase-negative staphylococci as significant nosocomial pathogens. Although the organisms undoubtedly share many similarities with methicillin-resistant strains ofS. aureus, it is certain that biologic differences exist which are important for infection control.
Isolation Usage in a Pediatric Hospital
Authors: Kim Mee-Hai Marie , Mindorff Cathy , Patrick Mary Lou , Gold Ronald , Ford-Jones E. Lee 
Published: August 2016

AbstractIn a prospective 12-month study at a university-affiliated pediatric hospital, isolation usage was quantitated by ward/service, season, isolation category and type of infection (community-acquired vs nosocomial). Such information may be helpful in designing hospitals, recognizing time utilization of the pediatric infection control nurse, and defining educational and isolation needs. Hospitals with multiple bed rooms and inadequate numbers of single rooms may be unable to meet current federal isolation guidelines.The mean number of isolation days was 153 per 1000 patient days or 15.3% of bed days used. This ranged from 18.5% on the infant/toddler/preschool medical ward to 2.8% on child/teenage orthopedic surgery. Isolation requirements vary seasonally and rose to 32% in winter on one ward. Proportional frequencies of isolation category included enteric—29%, protective—28%, strict—16%, barrier (contact)—10%, multiply resistant organism (MRO)—8%, wound—5%, pregnant women (careful handwashing)—3%, blood and body fluid precautions—1%. Isolation of patients with and contacts of nosocomial infections account for 32% of isolation usage. During one third of the 365-day year, the hospital is unable to provide adequate numbers of single rooms for one to 20 patients.