bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cluster of Pseudofungemia Associated With Hospital Renovation
Adjacent to the Microbiology Laboratory
Authors: Hruszkewycz Victoria , Ruben Bruce , Hypes Catherine M. , Bostic Grace D. , Staszkiewicz Joanna , Band Jeffrey D. 
Published: September 2009

AbstractObjective:To determine the clinical significance and source of fungemia following a
cluster of positive blood cultures during a 3-day period.Design:Chart review was used to determine the clinical significance of positive
blood cultures. Microbiologic sampling of the laboratory environment was
used to determine potential sources of fungal contamination.Setting:A large, tertiary care, community teaching hospital.Patients:All patients with blood cultures positive for Aspergillus
species, Penicillium species, or both during the outbreak
period.Results:Thirteen patients, all children, were reported to have positive blood
cultures for fungus during a 3-day period in early 1990. None had
clinical features consistent with fungemia. Investigation of specimen
processing procedures revealed that microbiologic plates were not
processed-as per protocol-under the biologic hood but inadvertently were
left open to air on the work bench by laboratory technicians. Settling
plates left at the workbench, at door entry sites, and at sites of
renovation immediately adjacent to the laboratory were positive for
Aspergillus and/or Penicillium;
control plates placed elsewhere were negative. Airflow patterns suggested
spread into the microbiologic laboratory through an open door located
near the implicated workbench station and a false ceiling above the
workbench area.Conclusions:Our investigation demonstrates that faulty technique in the laboratory
coupled with a change in environmental conditions can result in
false-positive cultures and an outbreak of pseudofungemia.
Antimicrobial Therapy for Methicillin-Resistant
Staphylococcus aureus Colonization in Residents and
Staff of a Veterans Affairs Nursing Home Care Unit
Authors: Strausbaugh Larry J. , Jacobson Cleone , Sewell David L. , Potter Susan , Ward Thomas T. 
Published: September 2009

AbstractObjective:TO evaluate the effect of antimicrobial therapy on patients and staff
colonized with methicillin-resistant Staphylococcus
aureus (MRSA) in a skilled nursing facility and to assess the
role of the environment as a potential reservoir for MRSA in the nursing
home setting.Design:As part of a comprehensive program to control an MRSA outbreak in a
nursing home, patients and staff colonized with MRSA received 1 of 3
antimicrobial decolonization regimens depending upon the site and extent
of colonization. Followup cultures were performed during therapy and on
days 2, 7, 14, and 30 following the completion of therapy. Cultures of
tbe patients' inanimate environment (pajamas, sheet, and floor) were
obtained during and after therapy Antimicrobial susceptibility tests were
performed on 54 MRSA isolates obtained before and 44 MRSA isolates
recovered after therapySetting:A 120-bed Veterans Affairs nursing home care unit.Participannts:Thirty-six patients and 7 staff nurses colonized with MRSA at 1 or more
sites.Intervention:Decolonization therapy with rifampin, trimethoprim-sulfamethoxazole, and
clindamycin used alone or in various combinations for 5 or 10 days in
conjunction with other infection control measures employed to combat the
MRSA outbreak.Results:Twenty (56%) of the 36 NHCU patients were either persistently colonized
or became recolonized with MRSA during tbe 30-day followup period.
Positive cultures on day 3 during therapy frequently identified patients
who subsequently exhibited persistent or recurrent colonization. Before
therapy, 92% of MRSA isolates were susceptible to rifampin, whereas only
43% of the isolates obtained after therapy were susceptible. Sixteen
(80%) of 20 patients with persistent or recurrent colonization had
rifampin-resistant strains of MRSA isolated after therapy Twenty-three
(18%) of 125 environmental cultures obtained during and after therapy
from patients who exhibited persistent or recurrent colonization were
positive for MRSA, in contrast to 9 (8%) of 107 from patients who were
successfully decolonized.Conclusions:The decolonization component of the outbreak control program was judged
to be ineffective and potentially hazardous because colonization
persisted or recurred in more than half of the patients, and substantial
antimicrobial resistance was noted in MRSA strains isolated after therapy
Resistance, especially to rifampin, and possibly re-acquisition of MRSA
from other human or environmental sources were 2 factors that appeared to
impede the decolonization effort.
Reported Hospital Needlestick Injuries in Relation to Knowledge/Skill, Design, and Management Problems
Authors: English Judith Fay Boylan 
Published: September 2009

AbstractObjectives:To investigate reported needlestick injuries in hospital workers from an adult learner theory perspective: identifying safe needle device knowledge and practice, and flaws in needle designs and management practices surrounding such problems.Design:Exploratory descriptive study of reported needlestick injuries from hollow needled devices in a hospital. Injured healthcare workers were counseled via hospital protocol, then a survey was filled out containing no identifiers of individual or institution.Setting:Seventeen Metropolitan Washington, DC, area hospitals.Participants:All workers reporting needlestick injuries during February 1-28, 1990.Results:Seventy-two injuries were reported; there were no multiple injuries to any individual. Thirty-three (45.8%) were to registered nurses (RNs)-more than any other group of workers. Recapping accounted for a higher percentage than any other activity (10 sticks, 14.1%). Of workers incurring recapping injuries, 3 identified a knowledge of a one-handed spearing technique and did not practice it; 4 neither knew nor practiced it. Eighteen (25.0%) were to “down-stream” housekeepers and aides who did not use such devices in their practice. Disposable needle/syringes caused 49.3% of injuries; hypodermic needles on intravenous lines caused 16.9%. Of the needlesticks, 60.6% were after use and before disposal, 4.2% occurred as the worker was putting an item into a needlebox, and 9.9% occurred from needles protruding from inappropriate bags. Many injuries occurred in the first 2 hours of work after being off the previous day, on Sunday, and on MondayConclusions:Of nurses and medical technologists reporting knowledge of a spearing recapping technique, 97.3% suffered injury via other methods. This strongly suggests that knowledge leads to different action. Safer needled devices and needle-free systems would make a safer workplace. Further study is indicated to identify if and why the first two hours after returning to work on Sunday or Monday are risky for needlestick injuries. Management practices must ensure compliance to safe practice both by employees and related medical staff.
A Five-Year Study of Needlestick Injuries: Significant Reduction Associated With Communication, Education, and Convenient Placement of Sharps Containers
Authors: Haiduven Donna J. , DeMaio Tammy M. , Stevens David A. 
Published: September 2009

AbstractObjective:To decrease the numbers of needlesticks among healthcare workers.Design:All reported needlestick injuries at Santa Clara Valley Medical Center, San Jose, California, were reviewed, analyzed, and tabulated by the infection control department yearly from 1986 to 1990.Setting:A 588-bed county teaching hospital in San Jose, California, affiliated with Stanford University.Participants:All employees of Santa Clara Valley Medical Center who reported needlestick injuries on injury report forms.Interventions:From April to December 1987, more needle disposal containers were added to as many patient care areas and as close to the area of use as possible. Results of 1986, 1988, 1989, and 1990 analyses were communicated yearly to all personnel, extensive educational programs were conducted in 1987 and 1988, and educational efforts continued in 1989 and 1990.Results:In 1986, there were 259 needlestick injuries at our institution, 22% (32) from recapping. After needle disposal containers were added to all patient care areas, needlestick injuries for 1988 totalled 143, a 45% decrease in the total needlestick injuries and a 53% decrease in recapping injuries. Communication of results to all areas of the hospital and educational activities were started in 1987 and continued through the next 3 years. In 1989, there were 135 needlestick injuries, a decrease of 6% from 1988; recapping injuries decreased 40% from 1988. In 1990, there were 104 needlestick injuries, a 23% decrease since 1989, and a 33% decrease in recapping injuries. The total number of needlestick injuries from 1986 to 1990 decreased by 60%, and those injuries from recapping decreased by 81% to 89%.Conclusions:We have continued to monitor needlestick injuries, communicate findings to all personnel, and include needlestick prevention in educational programs. We contend that more convenient placement of needle disposal containers, communication of tidings, and education do decrease needlestick injuries in healthcare workers.
A Cluster of Severe Postoperative Bleeding Following Open Heart Surgery
Authors: Villarino Margarita E. , Gordon Steven M. , Valdon Carol , Potts Diana , Fish Kevin , Uyeda Charles , McCarthy Patrick M. , Bland Lee A. , Anderson Roger L. , Jarvis William R. 
Published: September 2009

AbstractObjective:To investigate a cluster of postoperative bleeding following open heart surgery.Design:A cohort and case/control study.Setting:Palo Alto Veterans Administration Medical Center, Palo Alto, California.Participants:Six (21.4%) of 28 patients undergoing open heart surgery who developed severe, nonsurgical, postoperative bleeding from July 1 through August 30, 1988 (outbreak period). All case-patients had chest tube drainage of > 1000 ml within 4 hours of surgery but did not have identifiable bleeding vessel(s) on exploration.Results:Upon comparison of the pre-outbreak (January 1986 through June 1988) and the outbreak period, a significant increase was found in the incidence of postoperative nonsurgical bleeding (5/440 versus 6/28, p = .0006), but not of postoperative surgical bleeding (8/440 versus 0/28, p = 1 .0). Of all patients undergoing open heart surgery during the outbreak period, case patients were found to be older (67.8 versus 60.6, p= .02) and to have received a larger volume of hetastarch (HES), a synthetic colloidal plasma-volume expander (mean = 19.4 ml/kg versus 14.1 ml/kg, p= .02).Conclusions:We conclude that the use of large volumes of HES during surgery in the elderly open heart surgery patient may increase the risk for severe, nonsurgical postoperative bleeding, probably caused by alterations of the coagulation system. As the incidence of open heart surgery increases among the elderly, surgeons and anesthesiologists should be alert to possible adverse reactions from exposures not associated with adverse reactions in younger patients.
Predictive Value of Blood Cultures
Authors: Stratton Charles W. , Lorian Victor , Amaral Leonard 
Published: September 2009

The rising incidence of immunocompromised-patient infections caused by bacteria that are normally nonvirulent and indigenous to normal flora has focused attention on the contamination rate of blood cultures. This contamination is usually a consequence of the mode of collection or processing within the laboratory.The contamination rates of blood cultures usually are reported to a hospital's quality assurance component and to the medical staff. In addition, the identification of organisms isolated from blood cultures is reported to the physician, regardless of whether the organism isolated is a contaminant or the infectious agent. Consequently, reporting positive blood cultures that reflect contamination in certain cases may trigger some physicians to initiate prompt antibacterial therapy. The contamination rate of the blood culture has, therefore, a serious impact on medical consequences as well as on resource use.
The Agenda for Change Development of the Joint Commission Infection Control Indicators
Authors: Kazlauskas Kristina L. , Nadzam Deborah M. 
Published: September 2009

The Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) implemented the Agenda for Change initiative in 1986 as a major research and development effort. The focus of the initiative is the continuous assessment and improvement of patient outcomes. Measurement of the delivery of care may be assessed both through patient outcomes and related processes of care. The Agenda for Change shifts the emphasis of evaluation from an organization's capability to provide good care to its actual performance.The specific objectives of the Agenda for Change include: redirection of the Joint Commission standards, improvement in the survey process, and establishment of performance monitoring capabilities.There are several major aspects in the establishment of a performance monitoring system. First, performance measures need to be developed and tested for reliability and validity. Second, a mechanism needs to be established for both the Joint Commission and the healthcare organization to support data collection, analysis, and feedback. Third, a national database needs to be established that incorporates standards compliance and performance data. It is intended that the information generated by the performance data base will contribute to the continuous improvement in patient care delivery by stimulating healthcare organizations to analyze and improve processes affecting patient outcome.
Human Immunodeficiency Virus Testing Experience and Hepatitis B Vaccination and Testing Status of Healthcare Workers in South Carolina: Implications for Compliance With US Public Health Service Guidelines
Authors: Lettau Ludwig A. , Blackhurst Dawn W. , Steed Connie 
Published: September 2009

AbstractObjective:To assess the previous human immunodeficiency virus (HIV) testing experience and the hepatitis B (HB) vaccination and testing status of healthcare workers potentially involved in invasive surgical procedures.Design:Anonymous questionnaire survey.Setting:Tertiary care and community-teaching medical center and affiliated healthcare facilities in Greenville County, South Carolina.Participants:Physicians (including residents in training), dentists, nurses and surgical technicians working in the operating room and labor/delivery areas.Results:Of 506 responding physicians and dentists (65% of the sample), 60% previously had had a test for HIV, and 72% had received HB vaccine. Testing had occurred most often because of a requirement by an insurance company or because of blood donation. Eighty percent of tested respondents had their most recent test within 2 years of the time of the survey (August 1991). Of 145 responding nurses and surgical technicians (73% of the sample), 26% had had a test for HIV and 77% had received HB vaccine.Conclusions:The majority of surgeons and dentists in Greenville County, South Carolina, already have been tested for HIV for a variety of reasons and thus are aware of their HIV infection status, at least as of the time of the most recent test. The majority of local healthcare workers who are potentially involved with invasive surgical procedures have received HB vaccine. Programs developed in response to recent US Public Health Service guidelines should take HIV testing of healthcare workers for any reason into consideration and should emphasize HB vaccination and testing for vaccine-induced HB immunity
Impact of a Shielded Safety Syringe on Needlestick Injuries Among Healthcare Workers
Authors: Younger Barbara , Hunt Ella H. , Robinson Cecil , McLemore Cheryl , Hickey Sherri 
Published: September 2009

AbstractObjectives:Evaluate the impact of a shielded 3 cc safety syringe on needlestick injuries among healthcare workers.Design:Surveillance study.Setting:Three medical centers.Results:The total number of needlesticks from all sources rose from 134 during the baseline period to 140 during the study phase. However, the overall rate of needlesticks involving 3 cc syringes decreased from 14/100,000 inventory units to 2/100,000, and the frequency declined substantially at each of the participating medical centers.Conclusions:These results suggest that shielded syringes and related technology may offer potential for reducing the risk of needlestick injuries among hospital and other healthcare employees. This study should be viewed as a preliminary effort to assess the potential of shielded-syringe technology for reducing the risk of needlestick injuries among healthcare workers. The results are encouraging, but more clinical experience with this new device and longer follow up are essential to provide the data necessary for a definitive assessment of efficacy.
Wound Infection Rates in Clean Surgery: A Potentially Misleading Risk Classification
Authors: Ferraz Edmundo Machado , Bacelar Tercio Souto , Aguiar Jose Lamartine de Andrade , Ferraz Alvaro Antonio Bandeira , Pagnossin Gilberto , Batista Jose Edmilson Mazza 
Published: September 2009

AbstractObjectives:To evaluate the incidence of wound infection in inguinal hernioplasties, incisional hernioplasties, splenectomies, and splenectomies performed in patients with hepatosplenic schistomiasis, and to examine the relationship of surgical wound infection to antibiotic use, patient age, length of stay in the hospital prior to surgery, and the duration of the operation.Design:Retrospective surveillance study.Results:One thousand five hundred forty-two clean operations were analyzed. Comparing response (wound infection) and explanatory variables (age, length of hospital stay, duration of surgery, antibiotics, and surgery type), we found that age, use of antibiotics, and type of surgery were statistically significant, while length of hospital stay and duration of surgery were not significant.Conclusions:From these results, we can predict that the probability of wound infection in surgical patients considering these significant variables is lower for patients ages 14 to 30 years and higher for patients ages 31 to 60 years and lower for patients with prophylactic antibiotic use (up to 72 hours of use) and higher for patients with prolonged use (more than 72 hours); and lower for patients undergoing inguinal heria, followed in ascending order by nonschistosomotic patients undergoing splenectomy in schistosomotic patients.
Rapid Inactivation of Infectious Pathogens by Chlorhexidine-Coated Gloves
Authors: Modak Shanta , Sampath Lester , Miller Harvey S.S. , Millman Irving 
Published: September 2009

AbstractObjective:Gloves containing chlorhexidine gluconate in an instant-release matrix on their inner surface (CHG gloves) were tested to determine their ability to rapidly inactivate infectious pathogens that may permeate or leak through the latex surface.Design:CHG gloves were exposed for 1 to 10 minutes to blood or media containing infectious pathogens (e.g., bacteria, fungi, parasites, and viruses) as well as to lymphocytes and macrophages that are known to be the primary carriers of human immunodeficiency virus (HIV). Inactivation of pathogens was determined either by in vitro assay or in vivo infectivity. Stressed control and CHG glove fingers were submerged in a viral pool (retrovirus or bacteriophage) and after a set time, the glove interiors were checked for presence of permeated viz-ions.Results:CHG gloves rapidly inactivate all the pathogens tested including retrovirus and hepatitis B virus (90% to 100%). In the stressed glove fingers, live virus was detected in 26% of the control group but not in any of the CHG group.Conclusions:The use of CHG gloves may reduce the risk of exposure to infectious fluidborne pathogens should the integrity of the latex barrier be compromised by overt failure or by permeation of viruses. Rapid destruction of lymphocytes and macrophages may facilitate inactivation of HIV associated with these cells. Tests have shown that CHG coating does not alter physical properties of the glove, and, furthermore, CHG gloves do not show potential for dermal irritation or sensitization.
“Through a Drinking Glass and What Was Found There”: Pseudocontamination of a Hospital's Drinking Water
Authors: Klotz Stephen A. , Normand Richard E. , Kalinsky Robert G. 
Published: September 2009

AbstractOejective:Examination of suspended macroscopic debris that was noted in hospital cafeteria drinking water over a prolonged period of time.Setting:A tertiary care hospital.Design:A retrospective description of events.Methods:Conventional medical microbiology techniques were employed to determine if contamination of drinking water had occurred.Results:Microscopic examinations of the debris showed live nematodes similar to Strongyloides stercoralis rhabditiform larvae and amoebic trophozoites. A culture of an ice container in the cafeteria yielded coliform bacteria. Hospital employees lost work because of a diarrheal illness thought to be contracted from drinking cafeteria water. Further investigation revealed that the debris contained numerous ciliated organisms, nematodes, fresh water amoebae, bacterial mats, flagellated fungi, and unidentified cysts suggesting that the debris was of a freshwater origin rather than fecal contamination. Another hospital served by a collateral city water line experienced a similar problem. The debris was observed in November when lake water in the reservoir undergoes inversion.Conclusions:Nonpathogenic freshwater microbiota probably originating from the city reservoir were the cause of pseudocontamination of hospital drinking water.
Flavimonas oryzihabitans (CDC Group Ve-2)
Authors: Chaudhry Humayun J. , Schoch Paul E. , Cunha Burke A. 
Published: September 2009

Flavimonas oryzihabitans is an uncommon organism with distinctive microbiological and biochemical features that is infrequently isolated from humans. The presence of foreign material, including indwelling intravascular catheters and artificial grafts, or various surgical procedures appear to predispose patients with underlying disease to bacteremic infection with Flavimonas. A gram-negative bacillus, F oryzihabitans is sensitive to most antibiotics except first- and second-generation cephalosporins. F oryzihabitans isolated from blood should be considered pathogenic in patients with indwelling catheters or prosthetic materials.Previously designated Pseudomonas oryzihabitans and also known as Centers for Disease Control (CDC) Group Ve-2, F oryzihabitans is an unusual gram-negative, nonfermenting, oxidase-negative bacillus that is uncommonly associated with serious illness in humans.’ First described by Dresel and Stickl in 1928 and initially assigned the name Bacterium typhiflavum because of its similarity to the typhoid bacillus, the organism has been isolated from a variety of human sources, including blood, wounds, and abscesses, and (in mixed cultures) from sputum, urine, and cervical cultures.