bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of NosocomialStenotrophomonas MaltophiliaCross-Infection in a Neonatology Unit Analyzed by Three Molecular Typing Methods
Authors: de Viedma Darío García , Marín Mercedes , Cercenado Emilia , Alonso Roberto , Rodríguez-Créixems Marta , Bouza Emilio 
Published: February 2006

AbstractObjective:To characterize the epidemiological relationships amongStenotrophomonas maltophiliaisolates in the neonatology unit of our institution over a 4-month period in which an increased number of isolates was observed.Setting:The neonatology ward in a 2,000-bed university hospital in Madrid, Spain.Design:A retrospective molecular epidemiological analysis using three different typing methods, arbitrarily primed polymerase chain reaction (PCR), pulsed-field gel electrophoresis, and enterobacterial repetitive intergenic consensus-PCR, was performed with 11 isolates obtained from seven neonates over a 4-month period. Presumed unrelated isolates also were included as controls. A similarity dendrogram was obtained, to analyze the genetic relatedness among the isolates.Results:All isolates from the neonates, except one, showed a remarkably high homology among their typing patterns for the three methods assayed and clustered in the relatedness dendrogram at 96% similarity. The unrelated strains selected as controls were unclustered. The index case was considered to be a newborn who had anS maltophiliaisolate from a culture drawn on the day of admission to the neonatology unit and which was included in the clustered similarity group.Conclusions:Such a high genetic similarity among the isolates, together with the presence of an index case who had been colonized or infected byS maltophiliabefore arrival at our institution, constitutes the first evidence of nosocomial cross-transmission of this microorganism.
The Emergence of Decreased Susceptibility to Vancomycin in Staphylococcus epidermidis
Authors: Garrett Denise O. , Jochimsen Elise , Murfitt Kate , Hill Bertha , McAllister Sigrid , Nelson Pat , Spera Richard V. , Sall Richard K. , Tenover Fred C. , Johnston Judy , Zimmer Barbara , Jarvis William R. 
Published: February 2006

AbstractBackground:Coagulase-negative staphylococci (CNS) are the major cause of nosocomial bloodstream infection. Emergence of vancomycin resistance among CNS is a serious public health concern, because CNS usually are multidrug-resistant, and glycopeptide antibiotics, among which only vancomycin is available in the United States, are the only remaining effective therapy. In this report, we describe the first bloodstream infection in the United States associated with aStaphylococcus epidermidisstrain with decreased susceptibility to vancomycin.Methods:We reviewed the hospital's microbiology records for all CNS strains, reviewed the patient's medical and laboratory records, and obtained all available CNS isolates with decreased susceptibility to vancomycin. Blood cultures were processed and CNS isolates identified by using standard methods; antimicrobial susceptibility was determined by using minimum inhibitory concentration (MIC) and disk-diffusion methods. Nares cultures were obtained from exposed healthcare workers (HCWs) to identify possible colonization by CNS with decreased susceptibility to vancomycin.Results:The bloodstream infection by anS epidermidisstrain with decreased susceptibility to vancomycin occurred in a 49-year-old woman with carcinoma. She had two blood cultures positive for CNS; both isolates wereS epidermidis. Although susceptible to vancomycin by the disk-diffusion method (16-17 mm), the isolates were intermediate by MIC (8-6 μg/mL). The patient had received an extended course of vancomycin therapy; she died of her underlying disease. No HCW was colonized by CNS with decreased susceptibility to vancomycin.Conclusions:This is the first report in the United States of bloodstream infection dueto S epidermidiswith decreased susceptibility to vancomycin. Contact precautions likely played a role in preventing nosocomial transmission of this strain, and disk-diffusion methods may be inadequate to detect CNS with decreased susceptibility to vancomycin.
Surgical-Site Complications Associated With a Morphine Nerve Paste Used for Postoperative Pain Control After Laminectomy
Authors: Kramer Michael H. , Mangram Alicia J. , Pearson Michele L. , Jarvis William R. 
Published: February 2006

AbstractObjective:To identify risk factors that might explain a sudden increase in the rate of surgical-site complications following laminectomy.Design:Retrospective cohort study.Patients and Setting:Patients who underwent laminectomy at a 120-bed hospital from August 1 through October 15, 1996 (the epidemic period). A case-patient was defined as a patient with postoperative surgical-site complications (surgical-site drainage, edema, or swelling) requiring surgical debridement.Results:Of the 148 patients who underwent a laminectomy during the epidemic period, 17 (11%) met our case definition. The rate of postoperative surgical debridement was 7.6-fold higher during the epidemic period than the preceding 19-month period (17/148 vs 15/995,P&lt;.001). Development of surgical-site complications was associated with intraoperative receipt of morphine nerve paste (relative risk [RR], 11;P&lt;.001), preoperative shaving by nurses rather than surgeons (RR, 6.6;P=.006), procedures done by a certain surgeon (RR, 3.1;P=.022), or receipt of iodine rather than povidone-iodine for preoperative skin antisepsis (RR, 5.1;P=.002). In multivariate analysis, only receipt of morphine nerve paste remained as a risk factor (RR, 18;P=.011). The paste was used to control postoperative pain and was applied directly to exposed dura and surrounding tissues. At the time of surgical debridement (median, 24 days postsurgery), the original surgical sites showed residual paste and a lack of healing. Ten of 16 cultures from surgical sites were positive; all but three grew skin commensals. Histological examination of surgical specimens showed a foreign-body reaction, but no marked acute inflammation.Conclusions:The intraoperative use of morphine nerve paste may delay wound healing and increase postoperative morbidity. When new products are introduced, standardized protocols should be developed for their use, and systematic surveillance should be done to monitor for potential adverse outcomes.
Evaluation of the SENIC Risk Index in a Spanish University Hospital
Authors: Valls Victoria , Díez Manuel , Ena Javier , Gutiérrez Alberto , Gómez-Herruz Peña , Martín Antonio , Gónzalez-Palacios Rosario , Granell Javier 
Published: February 2006

AbstractObjective:To assess the performance of the Study of the Efficacy of Nosocomial Infection Control (SENIC) risk index for the evaluation of the risk of surgical-site infection (SSI) in a country other than the United States, having a different health system.Setting:350-bed university hospital in Spain belonging to the National Health System (Insalud).Design:Observational cohort study of 1,019 patients who underwent consecutive surgery from January to December 1992. Surgical-infection risk factors assessed by the traditional wound-classification system (clean, clean-contaminated, contaminated, and dirty-infected wound) and by the SENIC risk index (length of intervention more than 2 hours, more than three discharge diagnoses, abdominal surgery, and contaminated or dirty-infected wound) were compared by forward logistic regression.Results:The SENIC risk index showed a greater ability to predict SSI than the traditional wound-classification system. The study carried out in our institution reproduced the estimators provided by the SENIC study in the United States. The SENIC risk index provided a stepwise increase in SSI rates, according to the number of factors present, for every traditional wound-classification group. In the case of clean wounds, the incidence of surgical infection (per 100 interventions) increased (1.5, 2.4, 5.3, and 50;P&lt;.001) for patients having from zero to three risk factors of the SENIC risk index.Conclusions:This study shows that the SENIC risk index results are reproducible, and the index can be used to compare rates of wound infection across countries with different health systems than the United States.
Evaluation of a Handwashing Intervention to Reduce Respiratory Illness Rates in Senior Day-Care Centers
Authors: Falsey Ann R. , Criddle Mary M. , Kolassa John E. , McCann Robert M. , Brower Christine A. , Hall William J. 
Published: February 2006

AbstractTo decrease respiratory infections in senior day care, staff were educated on viral transmission and the value of hand washing. Fanny packs with alcohol foam supplemented hand washing and were alternated monthly between centers. Infection rates were unchanged with alcohol foam use. The intervention year's infection rate was significantly lower than the previous 3 years, suggesting a benefit of education.
Regional Dissemination and Control of Epidemic Methicillin-Resistant Staphylococcus aureus
Authors: Nicolle Lindsay E. , Dyck Brenda , Thompson Genevieve , Roman Susan , Kabani Amin , Plourde Pierre , Fast Margaret , Embil John ,   Manitoba Chapter of CHICA-Canada
Published: February 2006

AbstractA methicillin-resistantStaphylococcus aureus(MRSA) strain introduced into the largest tertiary-care teaching hospital in Manitoba in 1993 led to a sustained outbreak with secondary outbreaks at one community hospital, two large long-term-care facilities, and nosocomial transmission at a second teaching hospital. Control measures were consistent at each institution and were coordinated on a province-wide basis. MRSA is not currently endemic in any facility in the province.
Nosocomial Infections With Ceftazidime-Resistant Pseudomonas aeruginosa: Risk Factors and Outcome
Authors: Lee Sai-Cheong , Fung Chang-Phone , Liu Peter Yuk-Fong , Wang Tzu-Chien , See Lai-Chu , Lee Ning , Chen Shu-Chu , Shieh Wen-Bin 
Published: February 2006

AbstractProspective studies were conducted for nosocomialPseudomonas aeruginosainfections from February 1, 1994, to October 30,1995. Of 97P aeruginosaisolates from 97 patients, 35 were resistant to ceftazidime. Logistic regression revealed previous cephalosporin or piperacillin use as independent risk factors for nosocomial ceftazidime-resistantP aeruginosainfection. Pulsed-field gel electrophoresis revealed that four nosocomial ceftazidime-resistantP aeruginosainfections were caused by cross-infection, probably through medical personnel.
Survival of Mycobacteria on N95 Personal Respirators
Authors: Reponen Tiina A. , Wang Zheng , Willeke Klaus , Grinshpun Sergey A. 
Published: February 2006

AbstractObjectives:The overall aim of this study was to investigate the survival and possible growth of Mycobacterium tuberculosis simulant bacteria on respirator filters.Methods:Mycobacterium smegmatis was used as a biochemical simulant for M tuberculosis. Bacterial survival was tested on National Institute for Occupational Safety and Health-certified N95 respirators from three manufacturers. The first experiments simulated one-time respirator use and subsequent storage for 1 to 9 days under ideal conditions for the growth of mycobacteria: 37°C and 85% relative humidity. The bacteria were loaded on the respirator filters under three different nutritional conditions: in the absence of nutrients; in the presence of human saliva (simulating conditions when the respirator is worn); and in the presence of nutrient broth (for ideal growth potential). The subsequent experiments simulated respirator wear for 2 hours under medium workload conditions at a breathing rate of 56 L/min.Results:It was found that M smegmatis did not grow on the tested respirators, even when the respirators were stored at temperature, humidity, and nutrition conditions most favorable for microbial growth. However, these bacteria could survive on respirators for up to 3 days during storage. The culturability of M smegmatis was not affected by airflow that simulated the breathing rate associated with medium work-load conditions for 2 hours.Conclusions:This study shows that M tuberculosis surrogate bacteria collected on a respirator are not able to grow and are able to survive only in ideal (ie, not clinically relevant) conditions. Based on these experiments, we conclude that M tuberculosis is unlikely ever to become an infectious problem in the air again, once it is removed by a respirator.
Guideline for Prevention of Surgical Site Infection, 1999
Authors: Mangram Alicia J. , Horan Teresa C. , Pearson Michele L. , Silver Leah Christine , Jarvis William R. ,   The Hospital Infection Control Practices Advisory Committee
Published: February 2006

The “Guideline for Prevention of Surgical Site Infection, 1999” presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.Part I, “Surgical Site Infection: An Overview,” describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis.
Control of Transmission of Vancomycin-Resistant Enterococcus faecium in a Long-Term–Care Facility
Authors: Armstrong-Evans Maxine , Litt Margaret , McArthur Margaret A. , Willey Barbara , Cann Darlene , Liska Susan , Nusinowitz Sidney , Gould Richard , Blacklock Anna , Low Donald E. , McGeer Allison 
Published: February 2006

AbstractObjectives:To describe the investigation and control of transmission of vancomycin-resistant enterococci (VRE) in a residential long-term-care (LTC) setting.Outbreak Investigation:A strain of vancomycin-resistantEnterococcus faeciumnot previously isolated in Ontario colonized five residents of a 254-bed LTC facility in Toronto. The index case was identified when VRE was isolated from a urine culture taken after admission to a local hospital. Screening of rectal swabs from all 235 residents identified four others who were colonized with the same strain ofE faecium.Control Measures:Colonized residents were cohorted. VRE precautions were established as follows: gown and gloves for resident contact, restriction of contact between colonized and noncolonized residents, no sharing of personal equipment, and daily double-cleaning of residents' rooms and wheelchairs.Outcome:Two colonized residents died of causes unrelated to VRE. Although bacitracin therapy (75,000 units four times a day X 14 days) failed to eradicate carriage in two of three surviving residents, both cleared their carriage within 7 weeks. Repeat rectal swabs from 224 residents (91%) 2 months after isolation precautions were discontinued and from 125 residents (51%) 9 months later identified no new cases. Total cost of investigation and control was $12,061 (Canadian).Conclusion:VRE may be transmitted in LTC facilities, and colonized LTC residents could become important VRE reservoirs. Control of VRE transmission in LTC facilities can be achieved even with limited resources.
The Mycobactericidal Efficacy of Ortho-Phthalaldehyde and the Comparative Resistances of Mycobacterium bovis, Mycobacterium terrae, and Mycobacterium chelonae
Authors: Gregory Adam W. , Schaalje G. Bruce , Smart Jonathan D. , Robison Richard A. 
Published: February 2006

AbstractObjectives:To assess the mycobactericidal efficacy of an agent relatively new to disinfection, ortho-phthalaldehyde (OPA) and to compare the resistances of threeMycobacteriumspecies.Mycobacterium bovis(strain BCG) was compared withMycobacterium chelonaeandMycobacterium terraeto investigate the feasibility of using either of the latter two species in tuberculocidal testing.M chelonae(a rapid grower) andM terrae(an intermediate grower) both grow faster and are less virulent thanM bovis(a slow grower).Design:The quantitative suspension protocol specified by the Environmental Protection Agency (EPA), the Tuberculocidal Activity Test Method (EPA test), was used throughout this study. Standard suspensions of all three species were prepared in a similar manner. Two suspensions ofM bovis,created in different laboratories, were used. These were tested against two concentrations of alkaline glutaraldehyde to provide reference data. Two concentrations of OPA were evaluated against all mycobacterial test suspensions. Four replicates of each organism-disinfectant combination were performed.Results:Results were assessed by analysis of variance.M terraewas significantly more resistant to 0.05% OPA than eitherM bovisorM chelonae.At 0.21% OPA,M terraewas slightly more susceptible than one test suspension ofM bovis,but not significantly different from the other.M chelonaewas significantly less resistant than the other species at both OPA concentrations. At their respective minimum effective concentration, OPA achieved a 6-log10 reduction ofM bovisin nearly one sixth the time required by glutaraldehyde (5.5 minutes vs 32 minutes).Conclusions:These data, along with other recent studies, lend support to the idea thatM terraemay be a suitable test organism for use in the tuberculocidal efficacy testing of disinfectants. They also confirm the relatively rapid tuberculocidal activity of OPA.
Occupational Injuries and Exposures Among Canadian Dentists: The Results of a National Survey
Authors: McCarthy Gillian M. , Koval John J. , MacDonald John K. 
Published: February 2006

AbstractObjectives:To measure the frequency of occupational exposures reported by dentists in Canada and to identify factors associated with occupational exposure.Design:A national mailed survey of a stratified random sample of 6,444 dentists with three follow-up attempts. Weighted data were analyzed usingttests, analysis of variance, and multiple logistic regression.Results:The response rate was approximately 66%. Occupational exposures, percutaneous injuries, and mucous membrane exposures in the last year were reported by 67%, 62%, and 29% of respondents, respectively. Fewer than 1% reported exposure to human immunodeficiency virus or hepatitis B virus (HBV). Respondents reported means of 1.5 mucous membrane and 3.0 percutaneous exposures per year. HBV immunization was reported by 91% of dentists, but of these 28% reported no post-immunization serology. Other reports of suboptimal compliance included use of a postexposure protocol by only 41% and HBV vaccination of all assistants or of hygienists by 74% and 77% of respondents, respectively. Factors associated with percutaneous exposure included non-use of postexposure protocol or puncture-proof containers for sharps disposal, treating ⩾20 patients per day, and male gender. Risk factors for mucous membrane exposure included non-use of eye protection or masks.Conclusion:This study provides evidence of the protective effect of puncture-proof containers, eye protection, and masks and raises concerns related to HBV post-immunization serology and postexposure protocols. To reduce risk of infection, educational interventions are required to improve compliance with Universal Precautions, with emphasis on comprehensive HBV immunization and post-immunization serology, the use of barriers, puncture-proof containers for sharps disposal, and postexposure protocols.
Agrobacterium radiobacter as a Cause of Pseudobacteremia
Authors: Rogues Anne-Marie , Sarlangue Jean , de Barbeyrac Bertille , Doerman Henri-Pierre , Helmer Catherine , Labadie Jean-Claude , Delfeau Christine , Sandler Boris , Bebear Christiane , Gachie Jean-Pierre 
Published: February 2006

AbstractAgrobacterium radiobacterwas isolated from 15 blood cultures collected from 15 newborns. Contamination of blood cultures was suspected because, in most cases, the babies' illnesses seemed incompatible with infection.A radiobacterwas isolated from citrated tubes used for clotting-factor studies. Review of venipuncture technique revealed that occasionally the coagulation study tubes were being inoculated before the blood-culture bottles. This investigation demonstrated how an environmental source coupled with faulty technique caused a cluster of false-positive blood cultures.
Changing Heat and Moisture Exchangers Every 48 Hours Does Not Increase the Incidence of Nosocomial Pneumonia
Authors: Daumal Françoise , Colpart Eric , Manoury Benoît , Mariani Mercedès , Daumal Marc 
Published: February 2006

Abstract
This prospective study was conducted to evaluate the risk of nosocomial pneumonia when changing heat and moisture exchangers every 48 hours in 1996 instead of every 24 hours in 1995 for patients needing continuous mechanical ventilation. Medical and surgical patients in the two periods did not differ in terms of demographic characteristics and markers of acute or underlying illnesses. The incidence density of nosocomial pneumonia was not different in the two groups. Extended heat and moisture exchanger use reduces circuit manipulation and cost.
Bacitracin Versus Mupirocin for Staphylococcus aureus Nasal Colonization
Authors: Soto Norberto E. , Vaghjimal Ashok , Stahl-Avicolli Annette , Protic John R. , Lutwick Larry I. , Chapnick Edward K. 
Published: February 2006

AbstractWe performed a randomized prospective study of 5-day treatment with topical mupirocin or bacitracin for the elimination ofStaphylococcus aureusnasal colonization in healthcare workers (HCWs). Nasal cultures were obtained from 141 HCWs, 37 (26%) of whom showed Saureus.After 72 to 96 hours of treatment, the organism was eradicated in 15 (94%) of 16 by mupirocin and in 8 (44%) of 18 by bacitracin (P=.0031). Similar efficacy was demonstrated at 30 days. Mupirocin may be more effective than bacitracin for eradication of Saureusin healthy HCWs.
Infected Pressure Ulcers in the Long-Term–Care Facility
Authors: Smith Philip W. , Black Joyce M. , Black Steven B. 
Published: February 2006

Abstract
Pressure ulcers occur with some frequency in the elderly, debilitated population in long-term–care facilities. Pressure ulcers cause morbidity and mortality and, by virtue of breaking the integumentary barrier, predispose to skin and soft-tissue infections. The latter often are deep and require lengthy medical and surgical therapy. Prevention depends on avoidance of pressure, as well as providing adequate nutrition and meticulous skin care.
Nosocomial Methicillin-Resistant and Methicillin-SusceptibleStaphylococcus AureusPrimary Bacteremia: At What Costs?
Authors: Abramson Murray A. , Sexton Daniel J. 
Published: February 2006

Objective:To determine the attributable hospital stay and costs for nosocomial methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistantS aureus(MRSA) primary bloodstream infections (BSIs).Design:Pairwise-matched (1:1) nested case-control study.Setting:University-based tertiary-care medical center.Patients:Patients admitted between December 1993 and March 1995 were eligible. Cases were defined as patients with a primary nosocomialS aureusBSI; controls were selected according to a priori matching criteria.Measurements:Length of hospital stay and total and variable direct costs of hospitalization.Results:The median hospital stay attributable to primary nosocomial MSSA BSI was 4 days, compared with 12 days for MRSA (P=.023). Attributable median total cost for MSSA primary nosocomial BSIs was $9,661 versus $27,083 for MRSA nosocomial infections (P=.043).Conclusion:Nosocomial primary BSI due toS aureussignificantly prolongs the hospital stay. Primary nosocomial BSIs due to MRSA result in an approximate threefold increase in direct cost, compared with those due to MSSA.