bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term–Care Facilities: Results of a Consensus Conference
Authors: Loeb Mark , Bentley David W. , Bradley Suzanne , Crossley Kent , Garibaldi Richard , Gantz Nelson , McGeer Allison , Muder Robert R. , Mylotte Joseph , Nicolle Lindsay E. , Nurse Brenda , Paton Shirley , Simor Andrew E. , Smith Philip , Strausbaugh Larry 
Published: February 2006

AbstractEstablishing a clinical diagnosis of infection in residents of long-term–care facilities (LTCFs) is difficult. As a result, deciding when to initiate antibiotics can be particularly challenging. This article describes the establishment of minimum criteria for the initiation of antibiotics in residents of LTCFs. Experts in this area were invited to participate in a consensus conference. Using a modified delphi approach, a questionnaire and selected relevant articles were sent to participants who were asked to rank individual signs and symptoms with respect to their relative importance. Using the results of the weighting by participants, a modification of the nominal group process was used to achieve consensus. Criteria for initiating antibiotics for skin and soft-tissue infections, respiratory infections, urinary infections, and fever where the focus of infection is unknown were developed.
New-Onset Rhinitis Symptoms Among Hospitalized Patients: Are Flowers a Culprit?
Authors: Manian Farrin A. 
Published: February 2006

Abstract
New-onset rhinitis symptoms following admission to the hospital were reported by 12.7% of surveyed patients. Presence of flower arrangements in the proximity of patients' beds was highly associated with the development of new rhinitis (odds ratio, 9.7; 95% confidence interval, 4.3-21.7), or what may be more aptly referred to as “florocomial” rhinitis.
A Blinded Comparison of Three Laboratory Protocols for the Identification of Patients Colonized With Methicillin-Resistant Staphylococcus aureus
Authors: Gardam Michael , Brunton James , Willey Barbara , McGeer Allison , Low Donald , Conly John 
Published: February 2006

AbstractObjective:To compare three laboratory screening protocols for the detection of methicillin-resistantStaphylococcus aureus(MRSA) from surveillance specimens (mannitol-salt agar containing 2 μg/mL of oxacillin [MSA-2], mannitol-salt agar containing 4 μg/mL of oxacillin [MSA-4], and a broth-containing protocol as recommended by the American Society for Microbiology [M-ASM]).Design:Blinded comparative laboratory study and cost analysis.Setting:University-affiliated microbiology laboratory.Methods:Outcome measurements included rate of detection of MRSA-positive specimens and patients, turnaround time, and media and technologist costs. All MRSA culture swabs obtained from any patient site from November 1998 to April 1999 were included.Results:The M-ASM protocol detected between 19.1% and 32.0% more MRSA-positive specimens and between 13.3% and 23.3% more MRSA-positive patients per surveillance event than the MSA-4 and MSA-2 protocols, respectively. There was no difference in positive-culture reporting time between the M-ASM and MSA-4 protocols. The broth-containing protocol was 2- to 2.5-fold more expensive than the simpler protocols, taking into account media and laboratory personnel costs.Conclusions:It remains to be determined whether it is cost beneficial for a hospital to adopt the M-ASM, as the potential cost of MRSA transmission from unidentified MRSA-colonized patients is unknown. A broth-containing protocol should be considered the gold standard in future studies examining newer MRSA screening protocols.
Blood Products: A Significant Risk Factor for Long-Term Catheter-Related Bloodstream Infections in Cancer Patients
Authors: Hanna Hend A. , Raad Issam 
Published: February 2006

Abstract
Data obtained from a previous prospective randomized study in cancer patients conducted at our institution were analyzed to investigate risk factors for catheter-related (CR) bloodstream infections (BSIs). Our recent analysis showed that the administration of blood products through central venous catheters was a risk factor for CR BSI, whereas thrombocytopenia during catheterization may have provided protection against CR BSI, as did central venous catheter insertion under maximal sterile barrier precautions.
Urinary Tract Infections in Long-Term–Care Facilities
Authors: Nicolle Lindsay E. ,   SHEA Long-Term–Care Committee
Published: February 2006

AbstractUrinary tract infection (UTI) is the most common bacterial infection occurring in residents of long-term–care facilities. It is a frequent reason for antimicrobial administration, but antimicrobial use for treating UTIs is often inappropriate. Achieving optimal management of UTI in this population is problematic because of the very high prevalence of bacteriuria, evidence that the treatment of asymptomatic bacteriuria is not beneficial, and the clinical and microbiological imprecision in diagnosing symptomatic UTI. This position paper has been developed, using available evidence, to assist facilities and healthcare professionals in managing this common problem.
Bacterial Contamination Associated With Electronic Faucets: A New Risk for Healthcare Facilities
Authors: Hargreaves James , Shireley Larry , Hansen Shannon , Bren Virginia , Fillipi Gordon , Lacher Craig , Esslinger Virginia , Watne Terry 
Published: February 2006

AbstractObjective:To investigate the safety of the hospital water supply following a major flood.Design:Surveillance was conducted of the hospital water supply as it entered the hospital and at randomly selected water faucets throughout the facility.Setting:A newly constructed surgical critical-care unit in a 265-bed community hospital that had to be evacuated and was out of operation for 6 weeks following a major flood of the city.Methods:Random water samples throughout the facility were analyzed for heterotrophic plate counts (HPCs), chlorine, and coliforms utilizing standard methods.Results:Water samples entering the hospital met appropriate standards, indicating the city water distribution system was not contaminated. Of 169 faucets tested, 13 (22%) of 59 electronic faucets exceeded the HPC threshold, and 12 (11%) of 110 manual faucets exceeded the HPC threshold (P<.14). A comparison of two brands of electronic faucets with manual faucets and with each other revealed that the HPC threshold was exceeded by 11 (32%) of 34 brand A faucets as compared to 12 (11%) of 110 manual faucets (P<.006). The HPC threshold was exceeded by 2 (8%) of 25 brand B faucets compared to 12 (11%) of 110 manual faucets (P<.94). Contamination rates of brand A and brand B faucets differed significantly (P<.003). Similar testing 2 months after hyperchlorination of the water supply indicated that the HPC threshold was exceeded by 16 (52%) of 31 brand A faucets compared to 10 (9.%) of 110 manual faucets (P<.0000003) and by 2 (18%) of 25 brand B faucets compared to 10 (9%) of 110 manual faucets (P=1.0).Conclusions:A certain brand of electronic water faucet used in the hospital was associated with unacceptable levels of microbial growth in water and was a continuing source of bacteria potentially hazardous to patients.
Methicillin-ResistantStaphylococcus aureusin Two Tertiary-Care Centers in Jeddah, Saudi Arabia
Authors: Madani Tariq A. , Al-Abdullah Nabeela A. , Al-Sanousi Ali A. , Ghabrah Tawfik M. , Afandi Shadia Z. , Bajunid Huda A. 
Published: February 2006

AbstractObjective:To review clinical experience with methicillin-resistantStaphylococcus aureus(MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.Design:Retrospective review for the year 1998.Setting:Two tertiary-care hospitals.Methods:Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.Results:Of 673S aureusisolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.Conclusions:The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.
Management of an Outbreak of Vancomycin-Resistant Enterococci in the Medical Intensive Care Unit of a Cancer Center
Authors: Hanna Hend , Umphrey Jan , Tarrand Jeffrey , Mendoza Michelle , Raad Issam 
Published: February 2006

AbstractBetween November 1996 and February 1997, 17 episodes of vancomycin-resistant enterococci (VRE) infection or colonization (9 infections, 8 colonizations), all with the same or a similar genomic DNA pattern, were identified in the medical intensive care unit (MICU) of a tertiary-care cancer hospital. The cases were genotypically traced to a patient who was admitted to the hospital in September 1996 and who, by December 1996, had four different admissions to the MICU. Multifaceted infection control measures, including decontamination of the environment and of nondisposable equipment, halted the nosocomial transmission of VRE in the MICU.
Infection Control Dogma: Top 10 Suspects
Authors: Manangan Lilia P. , Pugliese Gina , Jackson Marguerite , Lynch Patricia , Sohn Annette H. , Sinkowitz-Cochran Ronda L. , Jarvis William R. 
Published: February 2006

AbstractAs infection control evolved into an art and science through the years, many infection control practices have become infection control dogmas (principles, beliefs, ideas, or opinions). In this “Reality Check” session of the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections, we assessed participants' perceptions of prevalent infection control dogmas. The majority of participants agreed with all dogmas having evidence of efficacy, except for the dogma on the frequency of changing mechanical-ventilator tubing. In contrast, the majority of participants disagreed with dogmas not having evidence of efficacy, except for the dogma on perineal care, umbilical cord care, and reminder signs for isolation precaution. As for controversial dogmas, many of the responses were almost evenly distributed between “agree” and “disagree.” Infection control professionals were knowledgeable about evidence-based infection control practices. However, many of the respondents still believe in some of the non–evidence-based dogmas.
A Review of Single-Use and Reusable Gowns and Drapes in Health Care
Authors: Rutala William A. , Weber David J. 
Published: February 2006

AbstractGowns and drapes are used widely in healthcare facilities. Gowns have been used to minimize the risk of disease acquisition by healthcare providers, to reduce the risk of patient-to-patient transmission, and during invasive procedures to aid in maintaining a sterile field. Drapes have been used during invasive procedures to maintain the sterility of environmental surfaces, equipment, and patients. This article reviews the use of gowns and drapes in healthcare facilities, including the characteristics, costs, benefits, and barrier effectiveness of single-use and reusable products.Currently, gowns protect healthcare personnel performing invasive procedures from contact with bloodborne pathogens. Although gowns have been recommended to prevent patient-to-patient transmission in certain settings (eg, neonatal intensive care unit) and for certain patients (eg, those infected with vancomycin-resistant enterococci), scientific studies have produced mixed results of their efficacy. While appropriate use of drapes during invasive procedures is recommended widely as an aid in minimizing contamination of the operative field, the efficacy of this practice in reducing surgical-site infections has not been assessed by scientific studies.Based on an evaluation of the functional requirements, environmental impact, and economics of gowns and drapes, clear superiority of either reusable or single-use gowns and drapes cannot be demonstrated. The selection of particular gowns and drapes by individual healthcare facilities requires an assessment of the facility's requirements, available products, and costs and should be based on the desired characteristics of an ideal gown or drape as defined in this paper.
Nosocomial Rotavirus in a Pediatric Hospital
Authors: Ratner Adam J. , Neu Natalie , Jakob Kathleen , Grumet Surah , Adachi Nora , Della-Latta Phyllis , Marvel Edith , Saiman Lisa 
Published: February 2006

AbstractWe describe a nosocomial rotavirus outbreak among pediatric cardiology patients and the impact of a prospective, laboratory-based surveillance program for rotavirus in our university-affiliated, quartenary-care pediatric hospital in New York City. Improved compliance with infection control and case-finding among patients and healthcare workers halted the outbreak.
The Chronic Indwelling Catheter and Urinary Infection in Long-Term–Care Facility Residents
Authors: Smith Philip W. , Nicolle Lindsay E. 
Published: February 2006

AbstractFrom 5% to 10% of residents of long-term–care facilities have urinary drainage managed with chronic indwelling catheters. These residents are always bacteriuric, usually with a complex microbiological flora of two to five organisms and a biofilm on the catheter that may contribute to obstruction. Residents with chronic indwelling catheters have increased morbidity from urinary infection compared to bacteriuric residents without chronic catheters. The most effective means to prevent infection is limitation of chronic indwelling catheter use. While appropriate catheter care and infection control precautions are recommended in managing these patients, the impact of these practices on the occurrence of urinary infection or prevention of symptomatic episodes has not been evaluated. Symptomatic infection can likely be prevented by attention to catheter care, including early recognition and replacement of obstructed catheters and prevention of catheter trauma. Appropriate use of prophylactic antimicrobial therapy prior to invasive genitourinary procedures is also necessary. Asymptomatic bacteriuria should not be treated. When symptomatic episodes occur, patients should be evaluated clinically and microbiologically and treated with appropriate antimicrobial therapy. Further technological advances in catheter material and urine drainage will be needed to have a substantial impact on the frequency of urinary infection with chronic catheter use.
HACCP and Food Hygiene in Hospitals Knowledge, Attitudes, and Practices of Food-Services Staff in Calabria, Italy
Authors: Angelillo Italo F. , Viggiani Nunzia M.A. , Greco Rosa M. , Rito Daniela ,   Collaborative Group
Published: February 2006

AbstractObjectives:To determine adherence to Hazard Analysis and Critical Control Points (HACCP) methods and to evaluate knowledge, attitudes, and practices of food-services staff with regard to food hygiene in hospitals.Design:A survey.Participants:Hospital medical directors and food-services staff of 36 hospitals in Calabria, Italy.Methods:A questionnaire about hospital characteristics, food-services organization, and measures and procedures for the control and prevention of foodborne diseases was sent to medical directors; a questionnaire about demographic and practice characteristics, knowledge, attitudes, and behaviors about control and prevention of foodborne diseases was sent to food-services staff. Multiple logistic regression analysis was performed.Results:Only 54% of the 27 responding hospitals were using the HACCP system and, of those using HACCP, 79% adopted a food-hygiene–practice manual; more than one half already had developed written procedures for food storage, personal hygiene, cleaning and disinfection; one half or less performed microbiological assessment of foods and surfaces. Of the 290 food-services staff who responded, 78.8% were aware of the five leading food-borne pathogens; this knowledge was significantly higher among those with a higher educational level and those who worked in hospitals that had implemented the HACCP system. Younger staff and those who had attended continuing educational courses about food hygiene and hospital foodborne diseases had a significantly higher knowledge of safe temperatures for food storage. A positive attitude toward foodborne-diseases prevention was reported by the great majority, and it was significantly higher in older respondents and in those working in hospitals with a lower number of beds. Only 54.9% of those involved in touching or serving unwrapped raw or cooked foods routinely used gloves during this activity; this practice was significantly greater among younger respondents and in those working in hospitals using HACCP.Conclusion:Full implementation of the HACCP system and infection control policies in hospital food services is needed.
Differences in Antimicrobial Susceptibility Among Hospitals in an Integrated Health System
Authors: Lubowski Teresa J. , Woon John L. , Hogan Patricia , Hwang Ching-Chang 
Published: February 2006

AbstractWe evaluated the differences in antimicrobial susceptibility among hospitals in three different integrated healthcare systems. Each system provided antibiogram-susceptibility reports from representative hospitals. Reports were analyzed for statistically significant differences between hospitals in a given system for nine important organisms. We found numerous significant interhospital differences in antimicrobial-susceptibility patterns within health systems. For this reason, the practice of combining antibiotic-susceptibility data into a systemwide antibiogram should be discouraged.
Bloodborne Pathogen Exposures in a Developmental Center 1993–2000
Authors: Lohiya Ghan-Shyam , Tan-Figueroa Lilia , Lohiya Sonia 
Published: February 2006

AbstractIn a developmental center, 257 potential bloodborne pathogen exposures (119 bites, 91 scratches, 30 sharps injuries, 17 mucosal breaks) occurred during 8 years (13,187 employee-years and 6,980 resident-years). Of the residents, 9% were hepatitis B virus (HBV) surface antigen carriers. Serological follow-up of exposed, susceptible employees and residents identified no transmission of HBV, hepatitis C virus (HCV), or human immunodeficiency (HIV) virus. This outcome has been due primarily to hepatitis B immunization and low prevalences of HCV or HIV infections among the subjects. Proper follow-up of all potential exposures is crucial to identify transmission promptly, allay anxiety, and prevent unwarranted workmen's compensation claims. Measures are suggested to reduce exposure further.
Infrequent Isolation of MultiresistantAcinetobacter baumanniiFrom the Staff Tending a Colonized Patient With Severe Burns
Authors: Paavilainen Teemu , Alanen Markku , Mäkelä Mika , Routamaa Marianne , Järvinen Helinä , Huovinen Pentti , Kotilainen Pirkko 
Published: February 2006

AbstractA patient with severe burns who was colonized by multiresistantAcinetobacter baumanniiwas cared for in contact isolation by staff intensively trained on hospital hygiene. Of the 1,907 post-exposure cultures from the staff and 425 environmental samples, only 0.7% and 4%, respectively, yielded this microorganism. These data show that strict hygienic measures may limit staff colonization and contamination of the environment byA baumannii.
The Effects of Contamination on Biological Monitoring
Authors: Kleinegger Cynthia L. , Yeager Dennis L. , Huling Judith K. , Drake David R. 
Published: February 2006

AbstractWe investigated the frequency and patterns of biological-monitoring–test contamination and the effect of contamination on the growth of test organisms. Overall, the contamination rate was 0.81%, but the rate of contamination varied significantly by sterilization method. Contamination did not appear to inhibit growth of test organisms.
An Episodic Outbreak of Genetically RelatedBurkholdebja cepaciaAmong Non-Cystic Fibrosis Patients at a University Hospital
Authors: Siddiqui Anwer H. , Mulligan Maury E. , Mahenthiralingam Eshwar , Hebden Joan , Brewrink Jeanine , Qaiyumi Sadaf , Johnson Judith A. , LiPuma John J. 
Published: February 2006

AbstractObjective:To investigate an outbreak ofBurkholderia cepacia.Design:Observational study and chart review.Patients:Adult non-cystic fibrosis (CF) patients.Setting:Intensive care units (ICUs) at a university-affiliated teaching hospital.Methods:As part of the epidemiological investigation, we conducted a chart review and collected environmental samples. A review of work schedules of healthcare workers also was performed. We usedB cepaciaselective agar for preliminary screening for all isolates, which subsequently were confirmed as members of theB cepaciacomplex by polyphasic analysis employing conventional biochemical reactions and genus- and species-specific polymerase chain reaction assays. Pulsed-field gel electrophoresis, randomly amplified polymorphic DNA typing, and automated ribotyping were used to genotype the isolates. As part of the intervention, contact isolation precautions were initiated for all patients identified as having had a culture positive forB cepacia.Results:Between September 1997 and September 1999,B cepaciawas isolated from 31 adult patients without CF in ICUs at a university-affiliated teaching hospital. Based on geographic clustering and genotypic analysis, three distinct clusters were observed involving 20 patients. Isolates from 17 of these patients were available for testing and were found to be of the same strain (outbreak strain). Further taxonomic analysis indicated that the outbreak strain wasB cepaciacomplex genomovar III. Twelve (71%) of the 17 patients were judged to be infected, and 5 (29%) were colonized with this strain. Six of 200 environmental cultures from multiple sources in the hospital's ICUs yieldedB cepacia.Two of these isolates, both recovered from rooms of colonized patients, were the same genotype as the outbreak strain recovered from patients.Conclusion:Despite an extensive investigation, the source of theB cepaciaclone involved in this outbreak remains unknown. The spatial and temporal pattern of cases suggests that cross-transmission of a genetically related strain contributed to clustering among patients. The initiation of contact isolation may have limited the extent of this transmission. Additional studies are needed to elucidate better the epidemiology of nosocomialB cepaciainfection among non-CF adult patients.