bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental Contamination Due to Methicillin-Resistant Staphylococcus aureus: Possible Infection Control Implications
Authors: Boyce John M. , Potter-Bynoe Gail , Chenevert Claire , King Thomas 
Published: March 2006

AbstractObjective:To study the possible role of contaminated environmental surfaces as a reservoir of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals.Design:A prospective culture survey of inanimate objects in the rooms of patients with MRSA.Setting:A 200-bed university-affiliated teaching hospital.Patients:Thirty-eight consecutive patients colonized or infected with MRSA. Patients represented endemic MRSA cases.Results:Ninety-six (27%) of 350 surfaces sampled in the rooms of affected patients were contaminated with MRSA. When patients had MRSA in a wound or urine, 36% of surfaces were contaminated. In contrast, when MRSA was isolated from other body sites, only 6% of surfaces were contaminated (odds ratio, 8.8; 95% confidence interval, 3.725.5; Pく.0001). Environmental contamination occurred in the rooms of 73% of infected patients and 69% of colonized patients. Frequently contaminated objects included the floor, bed linens, the patient's gown, overbed tables, and blood pressure cuffs. Sixty-five percent of nurses who had performed morning patient-care activities on patients with MRSA in a wound or urine contaminated their nursing uniforms or gowns with MRSA. Forty-two percent of personnel who had no direct contact with such patients, but had touched contaminated surfaces, contaminated their gloves with MRSA.Conclusions:We concluded that inanimate surfaces near affected patients commonly become contaminated with MRSA and that the frequency of contamination is affected by the body site at which patients are colonized or infected. That personnel may contaminate their gloves (or possibly their hands) by touching such surfaces suggests that contaminated environmental surfaces may serve as a reservoir of MRSA in hospitals.
Acquisition of Methicillin-Resistant Staphylococcus aureus in a Large Intensive Care Unit
Authors: Marshall Caroline , Harrington Glenys , Wolfe Rory , Fairley Christopher K. , Wesselingh Steve , Spelman Denis 
Published: March 2006

AbstractObjectives:To determine the prevalence of MRSA colonization on admission to the ICU and the incidence of MRSA colonization in the ICU.Design:Prospective cohort study.Setting:University hospital.Participants:Patients admitted to the ICU in 2000-2001.Methods:Patients were screened for MRSA with nose, throat, groin, and axilla swabs on admission and discharge. MRSA acquisition was defined as a negative admission screen and a positive discharge screen. Risk factors analyzed included previous wards/current unit, gender, age, and length of stay prior to and in the ICU. Univariate and multivariate analyses were performed using logistic regression.Results:Of screened patients, 6.8% were MRSA colonized on admission to the ICU. Some patients (11.4%) became newly colonized during their stay in the ICU. Factors that remained significant in the multivariate analysis of MRSA colonization on admission were previous admission to various wards and length of stay prior to ICU admission of more than 3 days. In the multivariate analysis of MRSA acquisition in the ICU, being a trauma patient and length of stay in the ICU greater than 2 days remained significant. Thirty-six percent of patients had both admission and discharge swabs taken. This percentage increased in the presence of a supervisory nurse.Conclusion:Significant acquisition of MRSA occurs in the ICU of our hospital, with trauma patients at increased risk. Patients who had been on the cardiothoracic ward prior to the ICU had a lower risk of MRSA colonization on admission. Presence of a supervisory nurse improved compliance with screening.
An Outbreak of Methicillin-ResistantStaphylococcus aureusin a Neonatal Intensive Care Unit
Authors: Saiman Lisa , Cronquist Alicia , Wu Fann , Zhou Juyan , Rubenstein David , Eisner William , Kreiswirth Barry N. , Della-Latta Phyllis 
Published: March 2006

AbstractObjective:To describe the epidemiologic and molecular investigations that successfully contained an outbreak of methicillin-resistantStaphylococcus aureus(MRSA) in a neonatal intensive care unit (NICU).Design:Isolates of MRSA were typed by pulsed-field gel electrophoresis (PFGE) and S.aureusprotein A(spa).Setting:A level III-IV, 45-bed NICU located in a children's hospital within a medical center.Patients:Incident cases had MRSA isolated from clinical cultures (eg, blood) or surveillance cultures (ie, anterior nares).Interventions:Infected and colonized infants were placed on contact precautions, cohorted, and treated with mupirocin. Surveillance cultures were performed for healthcare workers (HCWs). Colonized HCWs were treated with topical mupirocin and hexachlorophene showers.Results:From January to March 2001, the outbreak strain of MRSA PFGE clone B, was harbored by 13 infants. Three (1.3%) of 235 HCWs were colonized with MRSA. Two HCWs, who rotated between the adult and the pediatric facility, harbored clone C. One HCW, who exclusively worked in the children's hospital, was colonized with clone B. From January 1999 to November 2000, 22 patients hospitalized in the adult facility were infected or colonized with clone B.Spatyping and PFGE yielded concordant results. PFGE clone B was identified asspatype 16, associated with outbreaks in Brazil and Hungary.Conclusions:A possible route of MRSA transmission was elucidated by molecular typing. MRSA appears to have been transferred from our adult facility to our pediatric facility by a rotating HCW.Spatyping allowed comparison of our institution's MRSA strains with previously characterized outbreak clones.
Mupirocin-Resistant, Methicillin-ResistantStaphylococcus aureus: Does Mupirocin Remain Effective?
Authors: Walker Elaine S. , Vasquez Jose E. , Dula Roy , Bullock Hollie , Sarubbi Felix A. 
Published: March 2006

AbstractObjective:To determine the efficacy of mupirocin ointment in reducing nasal colonization with mupirocin-susceptible, methicillin-resistantStaphylococcus aureus(MS MRSA) as well as mupirocin-resistant MRSA (MR MRSA).Design:Prospective evaluation in which patients colonized with MRSA were treated twice daily with 2% topical mupirocin ointment for 5 days.Setting:James H. Quillen Veterans' Affairs Medical Center.Patients:Forty hospitalized patients with two anterior nares cultures positive for MRSA within a 7-day period.Methods:Treated patients had post-treatment cultures at day 3 and weeks 1,2, and 4. Isolates underwent mupirocin-susceptibility testing and DNA typing. MRSA clearance and type turnover were assessed for isolates that were mupirocin-susceptible, low-level (LL) MR MRSA and high-level (HL) MR MRSA.Results:Post-treatment nares cultures on day 3 were negative for 78.5%, 80%, and 27.7% of patients with MS MRSA, LL-MR MRSA, and HL-MR MRSA, respectively. Sustained culture negativity at 1 to 4 weeks was more common in the MS MRSA group (91%) than in the LL-MR MRSA group (25%) or the HL-MR MRSA group (25%). Positive post-treatment cultures usually showed the same DNA pattern relative to baseline. Plasmid curing of 18 HL-MR MRSA resulted in 15 MS MRSA and 3 LL-MR MRSA.Conclusions:Mupirocin was effective in eradicating MS MRSA, but strains of MR MRSA often persisted after treatment. This appeared to reflect treatment failure rather than exogenous recolonization. MR MRSA is now more prevalent and it is appropriate to sample MRSA populations for mupirocin susceptibility prior to incorporating mupirocin into infection control programs.
A 17-Month Evaluation of a Chlorine Dioxide Water Treatment System to Control Legionella Species in a Hospital Water Supply
Authors: Srinivasan Arjun , Bova Gregory , Ross Tracy , Mackie Karen , Paquette Nicholas , Merz William , Perl Trish M. 
Published: March 2006

AbstractObjective:To assess the safety and efficacy of a chlorine dioxide water treatment system in controlling Legionella in a hospital water supply.Design:For 17 months following installation of the system, we performed regular water cultures throughout the building, assessed chlorine dioxide and chlorite levels, and monitored metal corrosion.Results:Sites that grew Legionella species decreased from 41% at baseline to 4% (P = .001). L. anisa was the only species recovered and it was found in samples of both hot and cold water. Levels of chlorine dioxide and chlorite were below Environmental Protection Agency (EPA) limits for these chemicals in potable water. Further, enhanced carbon filtration effectively removed the chemicals, even at chlorine dioxide levels of more than twice what was used to treat the water. After 9 months, corrosion of copper test strips exposed to the chlorine dioxide was not higher than that of control strips. During the evaluation period, there were no cases of nosocomial Legionella in the building with the system, whereas there was one case in another building.Conclusions:Our results indicate that operation of a chlorine dioxide system effectively removed Legionella species from a hospital water supply. Furthermore, we found that the system was safe, as levels of chlorine dioxide and chlorite were below EPA limits. The system did not appear to cause increased corrosion of copper pipes. Our results indicate that chlorine dioxide may hold promise as a solution to the problem of Legionella contamination of hospital water supplies.
Shutting Down Operating Theater Ventilation When the Theater Is Not in Use: Infection Control and Environmental Aspects
Authors: Dettenkofer Markus , Scherrer M. , Hoch V. , Glaser H. , Schwarzer G. , Zentner J. , Daschner F. D. 
Published: March 2006

AbstractObjective:In hospital operating rooms (ORs), specially conditioned air is supplied to protect patients from airborne agents that may cause infections. This study investigated whether it is hygienically safe to shut down the air supply at night if measures are taken to ensure a timely restart before surgery is performed.Design:Experimental study.Setting:Neurosurgical OR of a German university hospital.Methods:The ventilation system was switched off and restarted after 10 hours. Particles suspended in the air near the operating table were counted, OR temperature was measured, and settle plates were exposed and incubated.Results:In 13 investigations, a median of 1.3 × 104 particles 0.5 μm/m3 or greater (range, 5.8 × 103 to 1.1 × 105) were documented immediately after restart in the morning. After 10 minutes and subsequently, no test showed a particle count exceeding the threshold limit of 1.0 × 104 particles 0.5 μm/m3 or greater recommended by the German Society of Hygiene and Microbiology. Only a few colony-forming units (CFU) were detected per settle plate (median, 0 CFU/60 cm2; range, 0 to 8) and OR temperatures quickly reached normal levels.Conclusions:Shutting down OR ventilation during off-duty periods does not appear to result in an unacceptably high particle count or microbial contamination of the OR air shortly after the system is restarted. Because substantial energy and cost savings are likely, this should be considered in hygienically safe heating, ventilation, and air conditioning systems. However, normal ventilation should be established at least 30 minutes before surgical activity.
Antianaerobic Antibiotic Therapy Promotes Overgrowth of Antibiotic-Resistant, Gram-Negative Bacilli and Vancomycin-Resistant Enterococci in the Stool of Colonized Patients
Authors: Bhalla Anita , Pultz Nicole J. , Ray Amy J. , Hoyen Claudia K. , Eckstein Elizabeth C. , Donskey Curtis J. 
Published: March 2006

AbstractBackground and Objective:Antianaerobic antibiotic therapy promotes persistent high-density growth of vancomycin-resistant enterococci (VRE) in the stool of colonized patients. We tested the hypothesis that antibiotic regimens with potent antianaerobic activity promote overgrowth of coexisting antibiotic-resistant, gram-negative bacilli in the stool of VRE-colonized patients.Design:Eight-month prospective study examining the effect of antibiotic therapy on the stool density of gram-negative bacilli resistant to ceftazidime, ciprofloxacin, or piperacillin/tazobactam.Setting:A Department of Veterans Affairs medical center including an acute care hospital and nursing home.Patients:All VRE-colonized patients with at least 3 stool samples available for analysis.Results:One-hundred forty stool samples were obtained from 37 study patients. Forty-nine (61%) of 80 stool samples obtained during therapy with an antianaerobic regimen were positive for an antibiotic-resistant, gram-negative bacillus, whereas only 14 (23%) of 60 samples obtained 4 or more weeks after completion of such therapy were positive (P< .001). Twenty-four (65%) of the 37 patients had one or more stool cultures positive for a gram-negative bacillus resistant to ciprofloxacin, ceftazidime, or piperacillin/tazobactam. The density of these organisms was higher during therapy with antianaerobic regimens than in the absence of such therapy for at least 2 weeks (mean ± standard deviation, 5.6 ± 1.4 and 3.9 ± 0.71 log10organisms/g;P< .001).Conclusion:Limiting the use of antianaerobic antibiotics in VRE-colonized patients may reduce the density of colonization with coexisting antibiotic-resistant, gram-negative bacilli.
Nasal and Hand Carriage ofStaphylococcus aureusin Staff at a Department for Thoracic and Cardiovascular Surgery: Endogenous or Exogenous Source?
Authors: Tammelin Ann , Klötz Fia , Hambræus Anna , Ståhle Elisabeth , Ransjö Ulrika 
Published: March 2006

AbstractObjective:To investigate the rates ofStaphylococcus aureuscarriage on the hands and in the noses of healthcare workers (HCWs) and the relatedness ofS. aureusisolates found in the two sites.Design:Point-prevalence study.Setting:Department for Thoracic and Cardiovascular Surgery at the University Hospital of Uppsala, Uppsala, Sweden.Subjects and Methods:Samples were obtained from 133 individuals, 18 men and 115 women, using imprints of each hand on blood agar and a swab from the nose.S. aureusisolates were identified by standard methods and typed by pulsed-field gel electrophoresis.Results:S. aureuswas found on the hands of 16.7% of the men and 9.6% of the women, and in the noses of 33.3% of the men and 17.4% of the women. The risk ratio forS. aureuscarriage on the hands with nasal carriage was 7.4 (95% confidence interval, 2.7 to 20.2;P< .001). Among the 14 HCWs carryingS. aureuson their hands, strain likeness to the nasal isolate was documented for 7 (50%).Conclusions:Half of the HCWs acquiredS. aureuson the hands from patients or the environment and half did so by apparent self-inoculation from the nose. Regardless of the source of contamination, good compliance with hand hygiene is needed from all HCWs to protect patients from nosocomial infections. The moderate rate ofS. aureuscarriage on hands in this setting could be the result of the routine use of alcoholic hand antisepsis.
Favorable Impact of a Multidisciplinary Antibiotic Management Program Conducted During 7 Years
Authors: Carling Philip , Fung Teresa , Killion Ann , Terrin Norma , Barza Michael 
Published: March 2006

AbstractObjective:To evaluate the impact of an interventional multidisciplinary antibiotic management program on expenditures for antibiotics and on the incidence of nosocomial infections caused by Clostridium difficile and antibiotic-resistant pathogens during 7 years.Design:Prospective study with comparison with preintervention trends.Setting:University-affiliated teaching hospital.Patients:All adult inpatients.Intervention:A multidisciplinary antibiotic management program to minimize the inappropriate use of third-generation cephalosporins was implemented in 1991. Its impact was evaluated prospectively. The incidence of nosocomial C. difficile and resistant Enterobacteriaceae infections as well as the rate of vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) were compared with those of National Nosocomial Infections Surveillance System hospitals of similar size.Results:Following implementation of the program, there was a 22% decrease in the use of parenteral broad-spectrum antibiotics (P < .0001) despite a 15% increase in acuity of patient care during the following 7 years. Concomitantly, there was a significant (P= .002) decrease in nosocomial infections caused by C. difficile and a significant (P = .02) decrease in nosocomial infections caused by resistant Enterobacteriaceae. The program also appeared to have a favorable impact on VRE rates without a sustained impact on MRSA rates.Conclusion:These results suggest that an ongoing multidisciplinary antibiotic management program may have a sustained beneficial impact on both expenditures for antibiotics and the incidence of nosocomial infection by C. difficile and resistant bacterial pathogens.
Graph-based analysis and visualization of experimental results with ONDEX
Authors: Köhler Jacob , Baumbach Jan , Taubert Jan , Specht Michael , Skusa Andre , Rüegg Alexander , Rawlings Chris , Verrier Paul , Philippi Stephan 
Published: March 2006

Abstract
Motivation: Assembling the relevant information needed to interpret the output from high-throughput, genome scale, experiments such as gene expression microarrays is challenging. Analysis reveals genes that show statistically significant changes in expression levels, but more information is needed to determine their biological relevance. The challenge is to bring these genes together with biological information distributed across hundreds of databases or buried in the scientific literature (millions of articles). Software tools are needed to automate this task which at present is labor-intensive and requires considerable informatics and biological expertise.
Results: This article describes ONDEX and how it can be applied to the task of interpreting gene expression results. ONDEX is a database system that combines the features of semantic database integration and text mining with methods for graph-based analysis. An overview of the ONDEX system is presented, concentrating on recently developed features for graph-based analysis and visualization. A case study is used to show how ONDEX can help to identify causal relationships between stress response genes and metabolic pathways from gene expression data. ONDEX also discovered functional annotations for most of the genes that emerged as significant in the microarray experiment, but were previously of unknown function.
Availability: ONDEX is freely available under the GPL License and can be downloaded from SourceForge
Contact: Jacob.Koehler@bbsrc.ac.uk
Supplementary information: Supplementary data are available at Bioinformatics online.
An International Study of Cross‐sectional Variations in Audit Fees
Authors: Chung Shifei , Narasimhan Ramesh 
Published: March 2006

Most previous studies in the market for auditing services and modeling of audit fees have been limited to either a single country (e.g., Johnson et al. 1995) or a single region (e.g., Simon et al. 1992) or a collection across regions (Haskin & Williams 1988). The main studies to examine cross‐country audit fee models are Taylor and Simon (1999) and Wingate (1994). This study extends their previous work by building an audit fees model for 12 countries in Europe, Africa, and Asia. A more comprehensive model is tested which includes the developing stage of the country, (a variable not yet tested) and industry classifications (a variable not tested by most previous studies). Data were compiled from the annual reports published in the International Accounting and Auditing Trends, Fourth Edition (1995) over 1989–1993 by Center for International Financial Analysis and Research (CIFAR).Our results show that, on average, companies in developed countries pay higher audit fees than companies in developing countries. Companies in manufacturing industries for most of the countries studied have the lowest fees charged to them, as compared to the other four industries, presumably because auditors get more training in auditing manufacturing companies than other companies. As in previous studies, our results show that the Big 6 audit firms charge higher fees than non‐Big 6 auditors. The fee premium may be due to the need for quality‐differentiated audits in the emerging capital markets, or due to the brand name reputation enjoyed by the Big 6.
Intensive referral to 12‐Step self‐help groups and 6‐month substance use disorder outcomes
Authors: Timko Christine , DeBenedetti Anna , Billow Rachel 
Published: March 2006

ABSTRACTAims  This study implemented and evaluated procedures to help clinicians make effective referrals to 12‐Step self‐help groups.Design  Randomized controlled trial.Setting  Out‐patient substance use disorder treatment.Participants  Individuals with substance use disorders (SUDs) entering a new treatment episode (n = 345) who were assigned randomly to a standard referral‐ or an intensive referral‐to‐self‐help condition.Measurements  Self‐reports of 12‐Step group attendance and involvement and substance use at baseline and a 6‐month follow‐up.Intervention  The intensive referral intervention focused on encouraging patients to attend 12‐Step meetings by connecting them to 12‐Step volunteers.Findings  Among patients with relatively less previous 12‐Step meeting attendance, intensive referral was associated with more meeting attendance during follow‐up than was standard referral. Among all patients, compared with those who received standard referral, those who received intensive referral were more likely to be involved with 12‐Step groups during the 6‐month follow‐up (i.e. had provided service, had a spiritual awakening and currently had a sponsor). Intensive referral patients also had better alcohol and drug use outcomes at 6 months. Twelve‐Step involvement mediated part of the association between referral condition and alcohol outcomes.Conclusions  The brief intensive referral intervention was associated with improved 12‐Step group involvement and substance use outcomes even among patients with considerable previous 12‐Step group exposure and formal treatment. Future 12‐Step intensive referral procedures should focus on encouraging 12‐Step group involvement in addition to attendance to benefit patients most effectively.
The effect of red blood cells on thrombin generation
Authors: Horne McDonald K. , Cullinane Ann M. , Merryman Paula K. , Hoddeson Elizabeth K. 
Published: March 2006

SummaryWe have developed an assay of thrombin generation in clotting whole blood. Because our goal was to study patients with red blood cell diseases that are associated with thrombosis, the initial evaluation of this assay analysed the effect of the haematocrit and haemolysate on the total amount of thrombin activity generated and the maximal concentration of thrombin achieved. Both of these parameters were proportional to the haematocrit throughout a wide range of clinically relevant cell concentrations. Red cell lysate also augmented thrombin generation. Because this effect was removed by filtration of the lysate, we propose that it was related to red cell microparticles.