bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protein metabolism in leg muscle following an endotoxin injection in healthy volunteers
Authors: Vesali Rokhsareh F. , Cibicek Norbert , Jakobsson Towe , Klaude Maria , Wernerman Jan , Rooyackers Olav 
Published: September 2009

The human endotoxin model has been used to study the early phase of sepsis. The aim of the present study was to assess leg muscle protein kinetics after an endotoxin challenge given to healthy human volunteers. Six healthy male subjects were studied in the post-absorptive state before and during 4 h following an intravenous endotoxin bolus (4 ng/kg of body weight). Primed continuous infusion of [2H5]phenylalanine and [2H3]3-methylhistidine in combination with sampling from the radial artery, femoral vein and muscle tissue were used to assess leg muscle protein kinetics. Both two- and three-compartment models were used to calculate protein kinetics. In addition 26S proteasome activity and protein ubiquitination were assessed. An increase in the net release of phenylalanine from the leg following the endotoxin challenge was observed; however, this phenylalanine originates from the free intracellular pool and not from protein. Net protein balance was unchanged, whereas both protein synthesis and breakdown were decreased. Degradation rates of contractile proteins were not affected by endotoxin, as indicated by an unchanged rate of appearance of 3-methylhistidine from leg muscle. In addition, proteasome activity and protein ubiquitination were unaffected by endotoxaemia. In conclusion, intravenous endotoxin administration to healthy volunteers resulted in an increased release of free phenylalanine from skeletal muscle, whereas protein balance was unaffected. Both protein synthesis and breakdown were decreased to a similar extent.
Microbial Flora on the Hands of Health Care Personnel: Differences in Composition and Antibacterial Resistance
Authors: Horn William A. , Larson Elaine L. , McGinley Kenneth J. , Leyden James J. 
Published: September 2009

AbstractThe composition and antibiotic sensitivity pattern of bacteria recovered from the hands of nurses and physicians in two service units of a major teaching hospital were compared with those found in a control population. Significant differences in the composition of bacteria were found in dermatology and oncology unit personnel. Staphylococcus aureus was recovered from 31% of dermatology nurses and 37% of dermatology physicians compared with 20% of oncology nurses, 15% of oncology physicians, and 17% of controls. Oncology personnel had a significantly higher carriage of gramnegative bacteria, yeasts, and multiple antibiotic-resistant, aerobic coryneforms (group JK bacteria). Both dermatology and oncology nursing personnel were colonized by organisms resistant to multiple antibiotics. Methicillin resistance was found in 26% and 66% of the staphylococci recovered from dermatology and oncology nurses respectively. Flora from physicians on the two units had sensitivity patterns similar to controls.
Nosocomial Transmission of HIV in Africa: What Tribute Is Paid to Contaminated Blood Transfusions and Medical Injections?
Authors: Lepage Philippe , Van de Perre Philippe 
Published: September 2009

AbstractWe reviewed the published data on the possible impact of medical injections and blood transfusions on the spread of human immunodeficiency virus (HIV) in Africa. We also compared these results to our experience in Rwanda, central Africa. The importance of medical injections in the epidemic of HIV infection seems to differ from one area to another. The excess of injections experienced by HIV seropositive subjects in Zaire could be secondary to the parenteral treatment of early HIV-related illness or to the treatment of sexually transmitted diseases, rather than being the cause of HIV infection, as suggested by Rwandese studies. In contrast, blood transfusions have been shown to represent an important source of nosocomial HIV infection in many African countries. Effective and relatively inexpensive measures to diminish the iatrogenic spread of HIV infection in developing countries are summarized.
Association of Malnutrition with Nosocomial Infection
Authors: Gorse Geoffrey J. , Messner Roberta L. , Stephens Nancy D. 
Published: September 2009

AbstractTo study the association of malnutrition with nosocomial infection in a general medical and surgical inpatient population, we retrospectively compared 45 patients with nosocomial infection to 45 uninfected control patients, matched using several nonnutritional variables known to predispose to nosocomial infection. Univariate and multivariate analyses were done. Poor nutritional score (derived from serum albumin, total lymphocyte count, and unintentional body weight loss), unintentional body weight loss, low serum albumin level at both time of admission and the first nosocomial infection, and worsening in the nutritional score and serum albumin from admission to the first nosocomial infection were associated with the development of nosocomial infection. Nutritional factors were more abnormal in subgroups of patients with nosocomial pneumonia, urinary tract infection, wound infection, and bacteremia than in controls. The findings suggest that further study of correlations between nutritional factors and nosocomial infections is needed.
Incidence of Nosocomial Aspergillosis in Patients with Leukemia Over a Twenty-Year Period
Authors: Klimowski Linda L. , Rotstein Coleman , Cummings K. Michael 
Published: September 2009

AbstractThe incidence of invasive nosocomial aspergillosis was studied in leukemia patients at an oncology center from 1964 to 1983. A total of 97 cases of aspergillosis occurred in 1,866 patients, yielding an overall case rate of 5.2 cases per 100 patients and an incidence rate of 9.1 per 10,000 patient days. The highest incidence rate was in patients with chronic myelogenous leukemia (13.7 cases per 10,000 patient days), followed by patients with acute myelogenous leukemia (10.6 cases per 10,000 patient days). Subdividing patients after 1978 into those receiving bone marrow transplantation and those who did not demonstrated the predisposition of transplant recipients to aspergillosis. The rates of aspergillosis among those patients who did not receive a bone marrow transplant were highest for patients with acute myelogenous leukemia. Increases in the annual rates of aspergillosis over time coincided with the level of internal renovation activity and major construction projects upwind of patient care facilities.
Indications for Alcohol or Bland Soap in Removal of Aerobic Gram-Negative Skin Bacteria: Assessment by a Novel Method
Authors: Eckert Debra G. , Ehrenkranz N. Joel , Alfonso Blanca C. 
Published: September 2009

AbstractA patient contact model was devised for health care workers (HCWs) to define heavy hand contamination with aerobic gram-negative bacilli (AGNB) that requires alcohol for complete removal. In patients, AGNB quantitation was per ml cup scrub fluid; in HCWs, per ml glove juice. Following 15-second contact, two Proteeae groin carriers yielding ≥ 4 log10 AGNB (high burden) transmitted ≥ 3 log10 in 67% of 24 tests of six HCWs, and ≤ 2 log10 in 29%. Two carriers yielding ≤ 3 log10 (low burden) transmitted ≥ 3 log10 in 8% and ≤ 2 log10 in 38%. At ≤ 2 log10 HCW acquisitions, soap eliminated all AGNB in six of seven tests; alcohol in nine of nine (p > 0.05). At ≥ 3 log10 acquisitions, soap eliminated all AGNB in three of 10; alcohol in eight of eight (p = 0.009). Contact with densely colonized patient skin may cause heavy AGNB contamination of HCWs' hands that generally necessitates alcohol for complete removal.
Improved Perioperative Antibiotic Use and Reduced Surgical Wound Infections Through Use of Computer Decision Analysis
Authors: Larsen Robert A. , Evans R. Scott , Burke John P. , Pestotnik Stanley L. , Gardner Reed M. , Classen David C. 
Published: September 2009

AbstractA prospective study was performed over a two-year period to determine whether computer-generated reminders of perioperative antibiotic use could improve prescribing habits and reduce postoperative wound infections. During the first year, baseline patterns of antibiotic use and postoperative infection rates were established. During the second year, computer-generated reminders regarding perioperative antibiotic use were placed in the patient's medical record prior to surgery and patterns of antibiotic use and postoperative wound infections monitored.Hospitalized patients undergoing non-emergency surgery from June to November 1985 (3,263 patients), and from June to November 1986 (3,568) were monitored with respect to indications for perioperative antibiotic use, timing of antibiotic use and postoperative infectious complications. Perioperative antibiotic use was considered advisable for 1,621 (50%) patients in the 1985 sample and for 1,830 (51%) patients in the 1986 sample. Among these patients, antibiotics were given within two hours before the surgical incision in 638 (40%) of the 1985 sample and 1,070 (58%) of the 1986 sample (p<0.001). Overall, postoperative wound infections were detected in 28 (1.8%) of 1,621 patients in 1985 compared with 16 (0.9%) of 1,830 such patients in 1986 (p<0.03).We conclude that computer-generated reminders of perioperative antibiotic use improved prescribing habits with a concurrent decline in postoperative wound infections.
Mechanisms of Methicillin Resistance in Staphylcoccus aureus and Methods for Laboratory Detection
Authors: Jorgensen James H. 
Published: September 2009

AbstractThree distinctly different mechanisms of methicillin resistance have been described in Staphylococcus aureus. The best-documented and probably most important mechanism is production of a unique, low affinity penicillin-binding protein, PBP 2a Strains possessing PBP 2a are resistant to methicillin, oxacillin, and probably all other currently available b-lactam antibiotics. Two additional mechanisms of reduced susceptibility to methicillin have been described. Borderline resistance (BORSA) to the semi-synthetic penicillins has been attributed to the hyperproduction of normal staphylococcal b-lactamase. A third mechanism has recently been advanced that describes an intermediate level of resistance to methicillin due to production of modified, normal PBPs with reduced affinity for b-lactams (MODSA). Little is known regarding the prevalence or clinical significance of the BORSA and MODSA strains. The most reliable in vitro susceptibility test methods for detecting MRSA (strains possessing PBP 2,) include the microdilution minimum inhibitory concentration (MIC) test (with 2% NaCl supplemented broth), the oxacillin agar screen plate test (incorporating 6 ug/ml oxacillin in 4% NaCl supplemented agar), and the National Committee for Clinical Laboratory Standards (NCCLS) disk diffusion test with oxacillin. All three methods use direct inoculum preparation and incubation of tests at 35°C for a full 24 hours.
Methicillin-Resistant Staphylococcus aureus in Extended-Care Facilities: Experiences in a Veterans Affairs Nursing Home and a Review of the Literature
Authors: Strausbaugh Larry J. , Jacobson Cleone , Sewell David L. , Potter Susan , Ward Thomas T. 
Published: September 2009

AbstractObjectives:To delineate the spread of methicillin-resistant Staphylococcus aureus (MRSA) in a nursing home care unit (NHCU), determine its consequences, and discuss this experience in the context of reports fi-om other nursing homes.Design:Observational and descriptive; routine and special surveillance for MRSA, including a facility-wide prevalence survey; characterization of MRSA isolates by disk diffusion and agar diluation susceptibility studies and restriction enzyme analysis of plasmid (REAP) DNA.Setting and Patients:A 120-bed skilled nursing facility that is an integral part of the Veterans' Affairs Medical Center (VAMC), Portland, Oregon. The patients are predominantly elderly men with severe underlying diseases and functional impairments.Results:An asymptomatic carrier brought MRSA into the NHCU in December 1987. During the next 15 months, 24 additional MRSA cases were detected. A prevalence survey conducted in March 1989 indicated that 39 (34%) of the 114 patients and 8 (7%) of the 117 employees were colonized or infected with MRSA. All strains were resistant to ciprofloxacin. REAP DNA indicated that 37 of 41 strains recovered in the March survey had identical patterns. Although 16 episodes of MRSA infection occurred in NHCU residents during 1988 through 1989, the outbreak had little effect on overall patterns of infectious morbidity and mortality in the facility. The outbreak, however, did result in an increased MRSA caseload at the medical center's acute-care division.Conclusions:During the last three years, MRSA colonization and infection have become common in the NHCU at the Portland VAMC; this experience parallels that reported by several nursing homes in other parts of the country.
Should We Vigorously Try to Contain and Control Methicillin-Resistant Staphylococcus aureus?
Authors: Boyce John M. 
Published: September 2009

AbstractObjective:To review practices currently used to control transmission of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals, determine the frequency of their use, and discuss the indications for implementing such measures.Design:A questionnaire survey to determine how commonly selected control practices are used, and a literature review of the efficacy of control practices.Participants:Two hundred fifty-six of 360 hospital-based members fo the Society for Hospital Epidemiology of America, Inc. (SHEA) completed the survey questionnaire.Result:Many different combinations of surveillance and control measures are used by hospitals with MRSA. Nine percent of hospitals stated that no special measures were used to control MRSA. The efficacy of commonly used control measures has not been established by controlled trials.Conclusions:Implementing control measures is warranted when MRSA causes a high incidence of serious nosocomial infections, and is desirable when MRSA has been newly introduced into a hospital or into an intensive care unit, or when MRSA accounts for more than 10% of nosocomial staphylococcal isolates. While the value of some practices is well established, measures such as routinely attempting to eradicate carriage of MRSA by colonized patients and personnel require further evaluation.
The Decline of Methicillin Resistance Among Danish Staphylococcus Aureus Strains
Authors: Rosdahl Vibeke Thamdrup , Knudsen Anna Marie 
Published: September 2009

AbstractObjective:To describe the occurrence and decline of methicillin-resistant Staphylocococcus aureus in Denmark from 1966 to 1986, and to illustrate why it has been possible to retain a frequency of only 0.2% MRSA since 1984.Design:A study of antibiotic susceptibility and phage-type of 522,978 S aureus strains isolated from hospitalized patients in Denmark during the years 1960 to 1988 combined with clinical information on patients with methicillin-resistant strains during the years 1986 through 1988.Setting:All strains and information were collected at the centralized, national laboratory for S aureus phage-typing.Patients:Hospitalized patients with S aureus isolates, and especially patients with meth-icillin-resistant strains.Intervention:Antibiotic treatment.Results:The frequency of MRSA rose to 15% in the years 1967 through 1971 but decreased to 0.2% in 1984, and has remained so ever since. The increase was due mainly to the spread of a single or a few clones of the phage-type complex 83A. Occurrence of strains of these phage-types declined from 18% in 1969 to 0.6% in 1989. In 1986 through 1988, at least 48% of the MRSA strains were imported by patients from abroad. Cross-infection occurred only in two cases. High awareness and special precautions were taken when MRSA was detected.Conclusions:MRSA of a single or a few clones spread in Danish hospitals in the years 1967 through 1971. Since 1984, only 0.2% of the Danish S aureus population has been MRSA, and imported MRSA strains have been prevented from spreading. (Infect Control Hosp Epidemiol. 1991;12:83-88.)
Infection Risks Associated with Spirometry
Authors: Rutala Donna Renfrow , Rutala William A. , Weber David J. , Thomann Charlotte A. 
Published: September 2009

AbstractObjectives:Spirometry is a widely used pulmonary function test that allows measurement of forced vital capacity and time-related measures of dynamic pulmonary function. This study was designed to identify the risk of cross-transmission associated with two commonly used dry-rolling seal spirometers.Design:Using a prospective study design, we examined whether microbial contamination of spirometers occurred following use by patients with a heavily colonized or infected respiratory tract. Prior to spirometry evaluation, a patients sputum culture and equipment samples (i.e., mouthpiece, proximal tubing, piston surface) were obtained. After patient evaluation, a sterile 2 L ventilation bag and sterile tubing were used to simulate the risk of infection of subsequent patients. Simulation 1 was performed immediately after patient testing and Simulation 2, representing a second patient was conducted approximately 18 hours later.Setting:This study was conducted at the University of North Carolina Hospitals, a large university teaching facility.Patients:Fourteen patients with underlying pulmonary disease were studied.Results:Our study revealed that the mouthpieces became contaminated with the patients' oral flora and with the associated respiratory pathogen. Fourteen percent of the associated tubing after patient testing contained the respiratory pathogen. All other equipment samples (e.g., interior surfaces of the machine, Simulation 1, Simulation 2 samples) were negative for the respiratory pathogen.Conclusions:These data suggest that mouthpieces and spirometry tubing may become contaminated with microorganisms and should not be shared between patients. Since there is little or no bacterial contamination of the surfaces inside the spirometers and cross transmission is unlikely, it is unnecessary to routinely clean the interior surfaces of the spirometers. (Infect Control Hosp Epidemiol. 1991;12:89-92.)
Prevention of Radioactive Indicator and Viral Particle Transmission with an Ointment Barrier
Authors: Oz Mehmet C. , Newbold John E. , Lemole Gerald M. 
Published: September 2009

AbstractObjective:To determine the efficacy of a lanolin-based gel in preventing radioactive particle and viral penetration.Design:Paired, stacked filter discs were held in a stainless steel support, and the gel was applied manually to the upper surface of the upper filter. Indicator solution containing either radioactive viral particles (3H-labeled simian virus 40 or 3H-labeled woodchuck hepatitis virus) or 20 u1 or 100 u1 of 32P-labeled radioactive compounds of much lower molecular weight then were applied to the upper filter. The filter discs were separated after 30 minutes, and the lower disc was examined for radioactivity in a liquid scintillation counter.Results:Transmission of radioactive particles was statistically significantly reduced by the application of the ointment on the upper filter (from 6.7 ± 0.1 × 105 counts per minute [cpm] to 88 ± 38 cpm). Transmission of both labeled viral particles also was reduced to a similar degree.Conclusions:Application of protective ointment to the filters significantly reduces transmission of radioactive viral particles and smaller radioactive compounds through filter discs. Use of this ointment may offer similar mechanical protection against the transmission of viruses between patient and healthcare provider. (Infect Control Hosp Epidemiol. 1991;12:93-95.)
Risk Factors for Clostridium difficile Cytotoxin-Positive Diarrhea After Control for Horizontal Transmission
Authors: Zimmerman Richard Kent 
Published: September 2009

AbstractObjective:This study identifies risk factors that predispose hospitalized patients to diarrhea caused by Clostridium difficile.Design:Unlike most previous studies, this case-control study accounts for horizontal (person-to-person) transmission of this infectious organism by matching on location.Setting:An urban community hospital of 600 beds with both primary care and referred patients.Patients:Both the 36 cases and the 36 controls came from billing printouts for C difficile cytotoxin assays. Exclusion criteria included outpatient specimens and stays of 38 days or more. Controls had negative assays and were individually matched on the basis of the floor and by the general date of specimen collection.Results:Cases had a longer mean duration of antibiotic use (6.7 versus 4.1 days, p = .006). Of the other 22 factors that were evaluated for their risk of predisposing to C difficile, only clindamycin (OR = 3.50, p =.09) and third-generation cephalosporins (OR = 3.00, p = .04) showed any association. The odds ratio for third-generation cephalosporins in the absence of clindamycin was 3.50 (p = .09). Data were collected by physicians who were not blinded.Conclusions:This study found that the clindamycin and third-generation cephalosporins were risk factors for C difficile-associated diarrhea after controlling for horizontal transmission. First-generation cephalosporins were not risk factors (OR= 0.86), while sample size considerations prevented firm conclusions about second-generation cephalosporins (OR = 1.67, p = .23). Many of the previously alleged risk factors might be explained by the horizontal transmission of an infectious disease; for instance, this seems a better explanation for an outbreak on a surgery ward than does surgery itself. (Infect Control Hosp Epidemiol. 1991;12:96-100.)
Diagnostic Applications of DNA Probes
Authors: Pfaller Michael A. 
Published: September 2009

The use of recombinant DNA technology to develop specific molecular (usually DNA) probes has provided medical and veterinary diagnostic laboratories with powerful new tools to enhance the diagnosis of infectious diseases, genetic disorders, and malignancies, as well as more sensitive and specific means to accomplish such tasks as tissue typing and paternity testing. They are also useful as aids in forensic medicine (Table 1). Application of DNA probes as diagnostic reagents may allow laboratories to reduce turnaround time, broaden the spectrum of agents detected, identified and/or quantitated, and reduce costs by simplifying certain labor intensive determinations and allowing laboratories to perform other tests on-site rather than sending specimens to reference laboratories.‘-”DNA probes are single-stranded pieces of nucleic acid, labeled with a specific tracer (isotope, enzyme, or chromophore), that will hydrogen bond (hybridize) with complementary single-stranded pieces of DNA (or RNA) under the appropriate conditions of pH, temperature, and ionic strength. The stability of the double-stranded complex (hybrid) depends on the degree of complementarity between the two nucleic acid strands. Under stringent conditions (high pH and temperature, low ionic strength), the two strands of an imperfectly matched hybrid will dissociate and the perfectly matched hybrids will remain intact. The hybridization reaction is the basis for any DNA probe assay and consists of four components (Table 2): the probe; the target (the nucleic acid contained in the sample submitted for testing); the detection method, which is based on the specific label or reporter group employed; and the hybridization format.