bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolation of Ureaplasma urealyticum and Mycoplasma hominis From Public Toilet Bowls
Authors: Potasman Israel , Oren Amnon , Srugo Isaac 
Published: February 2006

AbstractThe presence ofUreaplasma urealyticum, Mycoplasma hominis, andChlamydia trachomatiswas explored in 50 public restroom toilet bowls. We used culture, antigen detection, polymerase chain reaction, and survival assay. Five bowls (10%) were contaminated with at least one organism.U urealyticumwas found in four bowls,M hominisin three, andC trachomatisin one.U urealyticumsurvived on the toilet rim for up to 2 hours.
Risk of Transmission and Features of Hepatitis C After Needlestick Injuries
Authors: Hamid Saeed S. , Farooqui Badar , Rizvi Qudsia , Sultana Tarranum , Siddiqui Anwar A. 
Published: February 2006

Abstract
The rate of transmission and management of needlestick injuries from hepatitis C virus (HCV) patients to healthcare workers is still a matter of debate. We used a stringent protocol using monthly transaminase levels and polymerase chain reaction for HCV RNA to monitor 53 healthcare workers prospectively for up to 6 months following needle injuries from HCV-positive patients. Evidence of transmission of HCV was found in only 2 workers (4%) with mild asymptomatic infection, one of which resolved spontaneously. Based on our experience, we now use a less-intensive follow-up protocol. Further investigation is required to determine the most cost-effective method to monitor individuals who suffer a needlestick injury from an HCV-positive patient.
Vancomycin Use in a Hospital With Vancomycin Restriction
Authors: Roghmann Mary-Claire , Perdue Beulah E. , Polish Louis 
Published: February 2006

AbstractWe evaluated vancomycin use in a hospital with endemic vancomycin-resistant enterococci and a vancomycin restriction program. Only 68% of vancomycin was prescribed appropriately. Inappropriate use was due primarily to empirical therapy. In the patients with a microbiological diagnosis following empirical therapy, 83% (25/30) had infections due to bacteria sensitive to an appropriate antibiotic other than vancomycin. However, only 60% (15/25) of these patients had their vancomycin orders changed.
Bacterial Filters in Anesthesia: Results of 9 Years of Surveillance
Authors: Hassel Stijn van , Laveaux Margot , Leenders Marianne , Kaan Jan A. , Mintjes Joke 
Published: February 2006

Abstract
In 9 years of surveillance of postoperative lower respiratory infections, the infection rate in patients following regional anesthesia was 0.2% and 0.1% in patients following general anesthesia. No bacterial filters in the breathing circuit were used. Infected patients had risk factors such as type of surgery, American Society of Anesthesiologists class ≥2, old age, chronic obstructive pulmonary disease, or smoking habits. Infections were not clustered. This suggests that, in our setting, patient factors are most important in the development of postoperative lower respiratory infections and that the role of bacterial filters as a preventive measure is negligible.
Inactivation of Respiratory Syncytial Virus by Generic Hand Dishwashing Detergents and Antibacterial Hand Soaps
Authors: Contreras Patricia A. , Sami Iman R. , Darnell Miriam E. R. , Ottolini Martin G. , Prince Gregory A. 
Published: February 2006

AbstractIn an in-vitro test, generic liquid hand dishwashing detergents were as much as 100-fold more effective than proprietary antibacterial soaps in inactivating respiratory syncytial virus (RSV). The use of such detergents for hand washing during annual RSV epidemics, or the incorporation of their antiviral components into antibacterial soaps might be considered to limit nosocomial spread (Infect Control Hosp Epidemiol1999;20:57-58).
An Outbreak of Salmonella typhimurium at a Teaching Hospital
Authors: McCall Bradley , McCormack Joseph G. , Stafford Russell , Towner Christopher 
Published: February 2006

Abstract
An outbreak of Salmonella typhimurium infection in December 1996 affected 52 patients, relatives, and staff of a large teaching hospital in southeast Queensland. Assorted sandwiches were identified as the vehicle of transmission. This article describes the outbreak investigation and demonstrates the importance of food hygiene and timely public health interventions.
Recurrent Clostridium Difficile Disease: Epidemiology and Clinical Characteristics
Authors: McFarland Lynne V. , Surawicz Christina M. , Rubin Moshe , Fekety Robert , Elmer Gary W. , Greenberg Richard N. 
Published: February 2006

AbstractObjective:To describe the epidemiology, diagnosis, risk factors, patient impact, and treatment strategies for recurrentClostridium difficile-associated disease (CDAD).Design:Data were collected as part of a blinded, placebo-controlled clinical trial testing a new combination treatment for recurrent CDAD. Retrospective data regarding prior CDAD episodes were collected from interviews and medical-chart review. Prospective data on the current CDAD episode, risk factors, and recurrence rates were collected during a 2-month follow-up.Settings:National referral study.Participants:Patients with recurrent CDAD.Interventions:Treatment with a 10-day course of low-dose (500 mg/d) or high-dose (2 g/d) vancomycin or metronidazole (1 g/d).Results:Recurrent CDAD was found to have a lengthy course involving multiple episodes of diarrhea, abdominal cramping, nausea, and fever. CDAD may recur over several years despite frequent treatment with antibiotics. Recurrence rates were similar regardless of the choice or dose of antibiotic. Recurrent CDAD is not a trivial disease: patients may have multiple episodes (as many as 14), may require hospitalization, and the mean lifetime cost of direct medical care was $10,970 per patient. Fortunately, the disease does not become progressively more severe as the number of episodes increase. Two risk factors predictive for recurrent CDAD were found: increasing age and a decreased quality-of-life score at enrollment.Conclusions:Recurrent CDAD is a persistent disease that may result in prolonged hospital stays, additional medical costs, and rare serious complications.
Prevalence and Risk Factors for Nosocomial Infections in Four University Hospitals in Switzerland
Authors: Pittet Didier , Harbarth Stephan , Ruef Christian , Francioli Patrick , Sudre Philippe , Pétignat Christiane , Trampuz Andrej , Widmer Andreas 
Published: February 2006

AbstractObjective:To determine the prevalence and risk factors for nosocomial infections (NIs) in four Swiss university hospitals.Design and Setting:A 1-week period-prevalence survey conducted in May 1996 in medical, surgical, and intensive-care wards of four Swiss university hospitals (900-1,500 beds). Centers for Disease Control and Prevention definitions were used, except that asymptomatic bacteriuria was not categorized as NI. Study variables included patient demographics, primary diagnosis, comorbidities, exposure to medical and surgical risk factors, and use of antimicrobials. Risk factors for NIs were determined using logistic regression with adjustment for length of hospital stay, study center, device use, and patients' comorbidities.Results:176 NI were recorded in 156 of 1,349 screened patients (11.6%; interhospital range, 9.8%-13.5%). The most frequent NI was surgical-site infection (53; 30%), followed by urinary tract infection (39; 22%), lower respiratory tract infection (27; 15%), and bloodstream infection (23; 13%). Prevalence of NI was higher in critical-care units (25%) than in medical (9%) and surgical wards (12%). Overall, 65% of NIs were culture-proven; the leading pathogens wereEnterobacteriaceae(44; 28%),Staphylococcus aureus(20; 13%),Pseudomonas aeruginosa(17; 11%), andCandidaspecies (16; 10%). Independent risk factors for NI were central venous catheter (CVC) use (odds ratio [OR], 3.35; 95% confidence interval [CI95], 2.91-3.80), admission to intensive care (OR, 1.75; CI95, 1.30-2.21), emergency admission (OR, 1.57; CI95, 1.15-2.00), impaired functional status (Karnofsky index 1-4: OR, 2.56; CI95, 1.95-3.17), and McCabe classification of ultimately fatal (OR, 2.50; CI95, 2.04-2.96) or rapidly fatal (OR 2.25; CI95,1.52-2.98) underlying condition.Conclusions:According to the results of this survey, NIs are frequent in Swiss university hospitals. This investigation confirms the importance of CVCs as a major risk factor for NI. Patient comorbidities must be taken into account to adjust for case mix in any study comparing interhospital or intrahospital infection rates.
Methicillin-Resistant Staphylococcus Aureus and Antimicrobial Use in Belgian Hospitals
Authors: Crowcroft Natasha S. , Ronveaux Olivier , Monnet Dominique L. , Mertens Raf 
Published: February 2006

Abstract

Objective:
To investigate relationships between the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and the use of different classes of antimicrobials in Belgian hospitals.

Design:
Using Pearson correlation coefficients, the number of new nosocomial MRSA-colonized or -infected patients in the second half of 1994 and the first half of 1995 reported by the national MRSA surveillance program was compared with use of various antimicrobial classes as reported by the National Institute for Sickness and Disability Insurance. Relationships between different classes of antimicrobials were evaluated in a correlation matrix. MRSA incidence, antimicrobial use, and potential confounding factors were included in a multiple linear regression analysis.

Setting:
50 hospitals in Belgium.

Results:
The use of a number of different classes of antimicrobials was interrelated. In the multivariate analysis, the incidence of nosocomial MRSA increased with increasing use of ceftazidime and cefsulodin (P=.0003), amoxicillin with clavulanic acid (P=.02), and quinolones (P=.005). No association was found between MRSA incidence and total antimicrobial use.

Conclusions:
The relationships between antimicrobial use and MRSA are complex. Interventions aimed at promoting more rational prescribing patterns should be supported by adequate experimental and epidemiological evidence. Advice for preventing and controlling MRSA has focused mainly on hygienic measures and precautions to avoid cross-transmission; the role of relieving antimicrobial pressure needs to be clarified.
Risk Factors for Colonization or Infection Due to Methicillin-Resistant Staphylococcus Aureus in HIV-Positive Patients A Retrospective Case-Control Study
Authors: Onorato Michelle , Borucki Michael J. , Baillargeon Gwen , Paar David P. , Freeman Daniel H. , Cole C. Pat , Mayhall C. Glen 
Published: February 2006

AbstractObjective:To determine the risk factors for colonization or infection with methicillin-resistantStaphylococcus aureusin human immunodeficiency virus (HIV)-infected patients.Design:Retrospective matched-pair case-control study.Setting:Continuity clinic and inpatient HIV service of a university medical center.Population:Patients with HIV infection from the general population of eastern and coastal Texas and from the Texas Department of Criminal Justice.Data Collection:Patient charts and the AIDS Care and Clinical Research Program Database were reviewed for the following: age, race, number of admissions, total hospital days, presence of a central venous catheter, serum albumin, total white blood cell count and absolute neutrophil count, invasive or surgical procedures, any cultures positive forS aureus, and a history of opportunistic illnesses, diabetes, or dermatologie diagnoses. Data also were collected on the administration of antibiotics, antiretroviral therapy, steroids, cancer chemotherapy, and subcutaneous medications.Results:In the univariate analysis, the presence of a central venous catheter, an underlying dermatologie disease, lower serum albumin, prior steroid therapy, and prior antibiotic therapy, particularly antistaphylococcal therapy or multiple courses of antibiotics, were associated with increased risk for colonization or infection with methicillin-resistantS aureus. Multivariate analysis yielded a model that included presence of a central venous catheter, underlying dermatologie disease, broad-spectrum antibiotic exposure, and number of hospital days as independent risk factors for colonization or infection with methicillin-resistantS aureus.Conclusions:In our HIV-infected patient population, prior hospitalization, exposure to broad-spectrum antibiotics, presence of a central venous catheter, and dermatologie disease were risk factors for acquisition of methicillin-resistantS aureus
A Nosocomial Outbreak of Malaria Associated With Contaminated Catheters and Contrast Medium of a Computed Tomographic Scanner
Authors: Chen Kow-Tong , Chen Chein-Jen , Chang Po-Ya , Morse Dale L. 
Published: February 2006

AbstractObjective:To identify the risk factors associated with an unexpected outbreak of malaria that occurred among seven patients in a general teaching hospital in Taipei in October 1995.Design:A three-stage case-control study was conducted to identify risk factors.Patients:We identified all 7 patients who were diagnosed as malaria cases and 69 controls from those undergoing computed tomography (CT) examination.Methods:Malaria was diagnosed by demonstrating the presence ofPlasmodium falciparumon either thick or thin blood smears. Clinical characteristics and exposure information were collected from medical records and patient interviews.Results:The index case was infected by malaria when he visited Nigeria in early September and was diagnosed when he was hospitalized in hospital A in October. Among 10 patients examined with the Imatron scanner after the index case, all 6 who were injected with contrast medium were infected, but none of 4 examined without contrast medium were infected (P=.005).Conclusions:This nosocomial outbreak of malaria was most likely due to transmission via a contaminated catheter and contrast medium used for CT scanning. Use of disposable catheters may avoid such nosocomial outbreaks in the future.
Rubella Immunity in a Cohort of Pregnant Women
Authors: McElhaney Robert D. , Ringer Marilyn , DeHart Del J. , Vasilenko Peter 
Published: February 2006

Abstract
To assess the rubella immune status of a cohort of high-risk pregnant women visiting a Midwestern clinic, we retrospectively studied 50 random pregnancies per year from 1990 through 1996. Of 350 patients analyzed, 53 (15.1%) were not immune to rubella, and vaccination opportunities were missed.
Incidence of Pertussis Infection in Healthcare Workers
Authors: Wright Seth W. , Decker Michael D. , Edwards Kathryn M. 
Published: February 2006

AbstractObjective:To determine the incidence of pertussis infection in two groups of healthcare workers.Design:Retrospective cohort study.Setting:660-bed, urban, tertiary-care university hospital.Participants:106 resident physicians and 39 emergency department employees.Interventions:Antibodies to pertussis toxin and filamentous hemagglutinin were determined in fresh serum specimens and in stored sera collected 1 to 3 years previously. A 50% rise in both the pertussis toxin and filamentous hemagglutinin from the initial to the follow-up specimen was considered diagnostic of a pertussis infection.Results:Two of 106 residents had serological evidence of a pertussis infection during 151.3 subject-observation years, for an annual incidence rate of 1.3% (95% confidence interval [CI95], 0%-3.5%). Three of 39 emergency department employees had serological evidence of a pertussis infection during 81.2 subject-observation years, for an annual incidence of 3.6% (CI95,, 0%-9.6%). Of these 5 subjects, 2 had symptomatic disease.Conclusion:We found both symptomatic and asymptomatic pertussis infections in two cohorts of healthcare workers. Although the incidence rates were somewhat lower than found in other studies, they nonetheless were higher than for almost all other diseases for which we vaccinate healthcare workers. Our results would support the use of acellular pertussis vaccine in healthcare workers.
The Continuing Evolution of Methicillin-Resistant Staphylococcus aureus in Western Australia
Authors: Torvaldsen Siranda , Roberts Christine , Riley Thomas V. 
Published: February 2006

AbstractMethicillin-resistantStaphylococcus aureus(MRSA) has been notifiable in Western Australia since 1985. This article reviews the notification data from 1994 to 1997, focusing on increases in MRSA notifications and the proportion that are local strains; changes in the geographical distribution of MRSA; and changes in antibiotic-resistance patterns.
Transmission of Measles Virus in Healthcare Settings During a Communitywide Outbreak
Authors: Steingart Karen R. , Thomas Ann R. , Dykewicz Clare A. , Redd Stephen C. 
Published: February 2006

AbstractObjective:To describe the epidemiology of measles in medical settings and to evaluate the implementation and effectiveness of the 1989 Advisory Committee on Immunization Practices (ACIP) guidelines for measles immunization in healthcare workers (HCWs).Design:Confirmed cases of measles reported in Clark County, Washington, from March 14 to June 2,1996, were analyzed for characteristics of cases occurring in medical settings. A questionnaire was used to assess employee immunization (95% response rate).Setting and Participants:Reported measles cases and HCWs at community hospitals, primary-care medical facilities, a health-maintenance organization, and a multispecialty group practice.Results:Of 31 cases of measles, 8 (26%) occurred in HCWs, and 5 (16%) occurred in patients or visitors to medical facilities. Cases of measles occurred in HCWs who were not required to have proof of measles immunity as defined by the 1989 ACIP guidelines. The relative risk of measles in HCWs compared to Clark County adults was 18.6 (95% confidence interval, 7.4-45.8;P<.001).A survey of medical facilities revealed that 47% had an employee measles immunization policy; only 21% met ACIP recommendations and enforced their policies.Conclusions:HCWs were at higher risk of measles than the adult population. Transmission of measles in medical settings was related to both deficiencies in, and lack of implementation of, the ACIP guidelines.
Infusion Therapy Team and Dressing Changes of Central Venous Catheters
Authors: Abi-Said Dima , Raad Issam , Umphrey Jan , Gonzalez Virginia , Richardson Deborah , Marts Kathy , Hohn David 
Published: February 2006

AbstractObjective:To determine whether central venous catheter (CVC) dressing changes could be performed by ward nurses rather than by the infusion therapy team (ITT) nurses without increasing the risk of catheter-related infection.Design:Retrospective cohort study using prospectively collected data. The study extended from January 1995 to June 1996.Setting:The University of Texas M.D. Anderson Cancer Center, a referral cancer center.Patients:The study group was a random sample of 483 patients who received CVC dressing changes by ward nurses during the study period. A random sample of 483 patients who received CVC dressing changes by the ITT constituted the control group.Results:The risks of catheter-related septicemia were 1.7% among cases and 1.4% among controls (risk ratio, 1.14; 95% confidence interval [CI95], 0.26-6.42;P=.70). There also were no significant differences between the two groups in the risks of catheter-related site infection (risk ratio, 0.50; CI95, 0.02-4.12;P=.25) or any catheter-related infection (risk ratio=1.00; CI95, 0.27-3.64;P=.59).Conclusions:Provided that aseptic techniques (including maximal barrier precautions during insertion) are maintained, the responsibility of CVC dressing changes could be delegated to the ward nurses without increasing the low risk of CVC-related infection, resulting in an estimated cost saving in excess of $90,000 per year.
Control of Vancomycin-Resistant Enterococci at a Community Hospital: Efficacy of Patient and Staff Cohorting
Authors: Jochimsen Elise M. , Fish Laurie , Manning Kelly , Young Sally , Singer Daniel A. , Baker Robert , Jarvis William R. 
Published: February 2006

AbstractObjective:To evaluate the efficacy of patient and staff cohorting to control vancomycin-resistant enterococci (VRE) at an Indianapolis community hospital.Design:To interrupt transmission of VRE, a VRE point-prevalence survey of hospital inpatients was conducted, and VRE-infected or -colonized patients were cohorted on a single ward with dedicated nursing staff and patient-care equipment. To assess the impact of the intervention, staff compliance with contact isolation procedures was observed, and the VRE point-prevalence survey was repeated 2 months after the cohort ward was established.Results:Following the establishment of the cohort ward, VRE prevalence among all hospitalized inpatients decreased from 8.1% to 4.7% (25 positive cultures among 310 patients compared to 13 positive cultures among 276 patients,P=.14); VRE prevalence among patients whose VRE status was unknown before cultures were obtained decreased from 5.9% to 0.8% (18 positive cultures among 303 patients compared to 2 positive cultures among 262 patients,P=.002); and observed staff-patient interactions compliant with published isolation recommendations increased (5 [22%] of 23 interactions compared to 36 [88%] of 41 interactions,P<.0001).Conclusions:Our data suggest that, in hospitals with endemic VRE or continued VRE transmission despite implementation of contact isolation measures, establishing a VRE cohort ward may be a practical and effective method to improve compliance with infection control measures and thereby to control epidemic or endemic VRE transmission.
Investigation of Suspected Nosocomial Clusters of Staphylococcus haemolyticus Infections
Authors: Perl Trish M. , Krüger Wolfgang A. , Houston Alison , Boyken Linda D. , Pfaller Michael A. , Herwaldt Loreen A. 
Published: February 2006

AbstractObjective:To determine whether typing methods can discriminate amongStaphylococcus haemolyticusisolates.Design:Molecular epidemiological evaluation of Shaemolyticusisolates obtained from patients hospitalized on a hematology service and in a surgical intensive-care unit (SICU).Setting:A large Midwestern teaching hospital.Interventions:None.Results:Over 22 days,S haemolyticuswas isolated from five patients on the hematology service. Isolates from four patients had the same unusual antibiogram and biotype. Ribotyping, restriction endonuclease digestion of plasmid DNA (REAP), and whole chromosomal DNA analysis by pulsed-field gel electrophoresis (PFGE) confirmed that these isolates were identical and different from the fifth patient's isolate and from 6 control isolates. In a second cluster, 11S haemolyticusisolates obtained from eight patients in the SICU had similar antibiograms and biotypes. By REAP and ribotype analysis, isolates from four patients were identical. However, PFGE indicated that only two of these patients shared a common strain.Conclusions:Antibiograms or biotyping may discriminate among isolates ofS haemolyticusif the results of these tests are unusual. Many clinical isolates can be differentiated by REAP analysis, ribotyping, or PFGE. However, some isolates are identical by all of these methods, suggesting that they may have been transmitted nosocomially.