bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concurrent Summer Influenza and Pertussis Outbreaks in a Nursing Home in Sydney, Australia
Authors: Ferson Mark J. , Morgan Keira , Robertson Peter W. , Hampson Alan W. , Carter Ian , Rawlinson William D. 
Published: April 2006

AbstractObjective:To report on the investigation of a summer outbreak of acute respiratory illness among residents of a Sydney nursing home.Design:An epidemiologic and microbiological investigation of the resident cohort at the time of the outbreak and medical record review 5 months later.Setting:A nursing home located in Sydney, Australia, during February to July 1999.Patients:The cohort of residents present in the nursing home at the time of the outbreak.Interventions:Public health interventions included recommendations regarding hygiene, cohorting of residents and staff, closure to further admissions, and prompt reporting of illness; and virologic and serologic studies of residents.Results:Of the 69 residents (mean age, 85.1 years), 35 fulfilled the case definition of acute respiratory illness. Influenza A infection was confirmed in 19 residents, and phylogenetic analysis of the resulting isolate, designated H3N2 A/Sydney/203/99, showed that it differed from strains isolated in eastern Australia during the same period. Serologic evidence of Bordetella infection was also found in 10 residents; however, stratified epidemiologic analysis pointed to influenza A as the cause of illness.Conclusions:The investigation revealed an unusual summer outbreak of influenza A concurrent with subclinical pertussis infection. Surveillance of acute respiratory illness in nursing homes throughout the year, rather than solely during epidemic periods, in combination with appropriate public health laboratory support, would allow initiation of a timely public health response to outbreaks of acute respiratory illness in this setting.
Persistent Acinetobacter baumannii? Look Inside Your Medical Equipment
Authors: Bernards A. T. , Harinck H. I. J. , Dijkshoorn L. , van der Reijden T. J. K. , van den Broek P. J. 
Published: April 2006

AbstractTwo outbreaks of multidrug-resistant Acinetobacter baumannii occurred in our hospital. The outbreak strains were eventually isolated from respiratory ventilators, an apparatus used to cool or warm patients, and four continuous veno-venous hemofiltration machines. Removing dust from the machines and replacing all dust filters brought the outbreaks to an end.
Epidemiologic Study of Nosocomial Urinary Tract Infections in Saudi Military Hospitals
Authors: Al-Helali Nabil S. , Al-Asmary Saeed M. , Abdel-Fattah Moataz M. , Al-Jabban Tawfiq M. , Al-Bamri Abdel-Latif M. 
Published: April 2006

AbstractA case-control study of patients with and without confirmed UTI was performed to identify risk factors for nosocomial UTI. Duration of hospitalization, unit of admission, history of diabetes mellitus or debilitating diseases, and duration and number of urinary catheters were independently associated with increased risk of nosocomial UTIs.
Mycobacterium simiae Outbreak Associated With a Hospital Water Supply
Authors: Conger Nicholas G. , O'Connell Robert J. , Laurel Valerie L. , Olivier Kenneth N. , Graviss Edward A. , Williams-Bouyer Natalie , Zhang Yansheng , Brown-Elliott Barbara A. , Wallace Richard J. 
Published: April 2006

AbstractObjective:Mycobacterium simiae is found primarily in the southwestern United States, Israel, and Cuba, with tap water as its suspected reservoir. Our institution saw an increase in M. simiae isolates in 2001. An investigation into possible contaminated water sources was undertaken.Design:Environmental cultures were performed from water taps in the microbiology laboratory, patient rooms, points in the flow of water to the hospital, and patients' homes. Patient and environmental M. simiae were compared by PFGE.Setting:Military treatment facility in San Antonio, Texas.Patients:All patients with cultures positive for M. simiae between January 2001 and April 2002. Medical records were reviewed.Results:M. simiae was recovered from water samples from the hospital, patients' home showers, and a well supplying the hospital. A single PFGE clone was predominant among water isolates (9 of 10) and available patient isolates (14 of 19). There was an association between exposure to hospital water and pulmonary samples positive for the clonal M. simiae strain (P = .0018). Only 3 of 22 culture-positive patients met criteria for M. simiae pulmonary disease. Of them, two had indistinguishable M. simiae strains from tap water to which they were routinely exposed.Conclusions:This represents an outbreak of M. simiae colonization with one nosocomial infection. It is only the second time that M. simiae has been recovered from hospital tap water and its first presentation in municipal water. This study raises issues about the need and feasibility of eliminating or avoiding exposure to M. simiae from tap water.
Environmental Cultures and Hospital-Acquired Legionnaires' Disease: A 5-Year Prospective Study in 20 Hospitals in Catalonia, Spain
Authors: Sabrià Miquel , Mòdol Josep M. , Garcia-Nuñez Marian , Reynaga Esteban , Pedro-Botet Maria L. , Sopena Nieves , Rey-Joly C. 
Published: April 2006

AbstractObjective:To determine whether environmental cultures for Legionella increase the index of suspicion for legionnaires' disease (LD).Design:Five-year prospective study.Setting:Twenty hospitals in Catalonia, Spain.Methods:From 1994 to 1996, the potable water systems of 20 hospitals in Catalonia were tested for Legionella, Cases of hospital-acquired LD and availability of an “in-house” Legionella test in the previous 4 years were assessed. After the hospitals were informed of the results of their water cultures, a prospective 5-year-study was conducted focusing on the detection of new cases of nosocomial legionellosis and the availability and use of Legionella testing.Results:Before environmental cultures were started, only one hospital had conducted active surveillance of hospital-acquired pneumonia and used Legionella tests including Legionella urinary antigen in all pneumonia cases. Only one other hospital had used the latter test at all. In six hospitals, Legionella tests had been completely unavailable. Cases of nosocomial LD had been diagnosed in the previous 4 years in only two hospitals. During prospective surveillance, 12 hospitals (60%) used Legionella urinary antigen testing in house and 11 (55%) found cases of nosocomial legionellosis, representing 64.7% (11 of 17) of those with positive water cultures. Hospitals with negative water cultures did not find nosocomial LD.Conclusions:The environmental study increased the index of suspicion for nosocomial LD. The number of cases of nosocomial LD increased significantly during the prospective follow-up period, and most hospitals began using the Legionella urinary antigen test in their laboratories.
Tuberculosis Prevention and Control in Long-Term–Care Facilities for Older Adults
Authors: Thrupp Lauri , Bradley Suzanne , Smith Philip , Simor Andrew , Gantz Nelson , Crossley Kent , Loeb Mark , Strausbaugh Larry , Nicolle Lindsay ,   SHEA Long-Term-Care Committee
Published: April 2006

AbstractIn the United States, older adults comprise 22% of cases of tuberculous disease but only 12% of the population. Most cases of tuberculosis (TB) occur in community dwellers, but attack rates are highest among frail residents of long-term–care facilities. The detection and treatment of latent TB infection and TB disease can pose special challenges in older adults. Rapid recognition of possible disease, diagnosis, and implementation of airborne precautions are essential to prevent spread. It is the intent of this evidence-based guideline to assist healthcare providers in the prevention and control of TB, specifically in skilled nursing facilities for the elderly.
Limitations of Forehead Infrared Body Temperature Detection for Fever Screening for Severe Acute Respiratory Syndrome
Authors: Liu Chuan-Chuan , Chang Ray-E , Chang Wen-Cheng 
Published: April 2006

AbstractWe investigated alternative measurement methodology for infrared body thermometry to increase accuracy for outdoor fever screening during the 2003 SARS epidemic. Our results indicate that the auditory meatus temperature is a superior alternative compared with the forehead body surface temperature due to its close approximation to the tympanic temperature.
Factors Affecting Perceived Risk of Contracting Severe Acute Respiratory Syndrome Among Academic Physicians
Authors: Grace Sherry L. , Hershenfield Karen , Robertson Emma , Stewart Donna E. 
Published: April 2006

AbstractSARS disproportionately affects healthcare providers. A physician survey was administered within three hospitals providing care to SARS patients. Knowing a colleague who contracted SARS and previous occupational exposure to infectious agents were significantly predictive of greater perceived risk, whereas perceived effectiveness of precautions and provision of direct care were not.
Dynamics of Bacterial Hand Contamination During Routine Neonatal Care
Authors: Pessoa-Silva Carmem Lúcia , Dharan Sasi , Hugonnet Stéphane , Touveneau Sylvie , Posfay-Barbe Klara , Pfister Riccardo , Pittet Didier 
Published: April 2006

AbstractObjective:To evaluate the dynamics of bacterial contamination of healthcare workers' (HCWs) hands during neonatal care.Setting:The 20-bed neonatal unit of a large acute care teaching hospital in Geneva, Switzerland.Methods:Structured observation sessions were conducted. A sequence of care began when the HCW performed hand hygiene and ended when the activity changed or hand hygiene was performed again. Alcohol-based handrub was the standard procedure for hand hygiene. An imprint of the five fingertips of the dominant hand was obtained before and after hand hygiene and at the end of a sequence of care. Regression methods were used to model the final bacterial count according to the type and duration of care and the use of gloves.Results:One hundred forty-nine sequences of care were observed. Commensal skin flora comprised 72.4% of all culture-positive specimens (n = 360). Other microorganisms identified were Enterobacteriaceae (n = 55, 13.8%);Staphylococcus aureus(n = 10, 2.5%); and fungi (n = 7,1.8%). Skin contact, respiratory care, and diaper change were independently associated with an increased bacterial count; the use of gloves did not fully protect HCWs' hands from bacterial contamination.Conclusions:These data confirm that hands become progressively contaminated with commensal flora and potential pathogens during neonatal care, and identify activities at higher risk for hand contamination. They also reinforce the need for hand hygiene after a sequence of care, before starting a different task, and after glove removal.
Differences in Hand Hygiene Behavior Related to the Contamination Risk of Healthcare Activities in Different Groups of Healthcare Workers
Authors: Wendt Constanze , Knautz Donald , von Baum Heike 
Published: April 2006

AbstractBackground:The Fulkerson scale lists 15 typical clinical activities ranked according to their risk of hand contamination.Objective:To investigate how often healthcare workers (HCWs) apply antiseptic handrubs after each of the specified activities ranked in the Fulkerson scale.Design:Observational study.Setting:University Hospital of Heidelberg, a 1,600-bed teaching hospital.Methods:Using a structured protocol, 41 observers recorded whether HCWs rubbed their hands in 1 of 15 given situations.Results:Handrubs were used in 1,115 (52.2%) of 2,138 observations. Comparatively high rates of handrub use were observed after contact with sterile materials (39.6%) and after contact with excretions (90% to 97%). Nurses used handrubs significantly more frequently than did physicians after contact with the inanimate environment, but physicians applied handrubs significantly more frequently after contact with body secretions.Conclusions:This study showed better compliance with hand hygiene than that reported by many previous studies, but compliance was still inadequate and varied significantly by type of HCW, type of activity, and location in the hospital.
Nosocomial Pediatric Bacteremia: The Role of Intravenous Set Contamination in Developing Countries
Authors: Macías Alejandro E. , Muñoz Juan M. , Herrera Laura E. , Medina Humberto , Hernández Isabel , Alcántar Dolores , Ponce de León Samuel 
Published: April 2006

AbstractObjective:To assess the rate of bacterial contamination of intravenous administration sets at their rubber injection ports and matching infusates.Design:Cultures of injection ports and infusate during 26 visits to 4 hospitals.Setting:Four public general pediatric hospitals in Mexico City with substandard care practices.Patients:Hospitalized pediatric patients receiving intravenous solutions.Results:Overall, 176 of 251 injection ports were contaminated (70.1%; 95% confidence interval [CI95], 64.5% to 75.8%), 35 (13.9%; CI95, 9.7% to 18.2%) with gram-negative rods, primarily of the tribe Klebsielleae. Cultures of infusates were positive in 17 cases (6.8%, CI95, 3.7% to 9.9%), 5 of which grew gram-negative rods (2%; CI95, 0.6% to 4.6%). In 3 cases (1.2%), the same species with gram-negative rods was found in the infusates and on the injection ports. During one visit, 8 clustered cases of injection port contamination with a clonal Enterobacter cloacae were found; this agent was also found in the blood culture, intravenous fluid, and parenteral nutrition of one patient. Inadequate chlorination of tap water, a potential risk factor, was recorded during 22 visits (84.6%).Conclusion:These data suggest that external contamination of the intravenous administration set could play a role in infusate contamination.
Outbreak ofBurkholderia CepaciaBacteremia Traced to Contaminated Hospital Water Used for Dilution of an Alcohol Skin Antiseptic
Authors: Nasser Rana M. , Rahi Amal C. , Haddad Mona F. , Daoud Ziad , Irani-Hakime Noha , Almawi Wassim Y. 
Published: April 2006

AbstractObjective:To identify the source of an epidemic ofBurkholderia cepaciabloodstream infections during 7 years (411 episodes in 361 patients).Design:Outbreak investigation.Setting:A 250-bed university hospital in Beirut, Lebanon.Methods:Matched case-control and retrospective cohort studies, and microbiological surveillance and polymerase chain reaction–restriction fragment length ascertainment were employed. Special media and filtration techniques were used to isolate organisms from water and diluted alcohol solutions.Results:In a group of 50 randomly selected case-matched patients from 1999, the positive blood cultures were concomitant with fever in 98%, intravenous phlebitis in 44%, and recurrent bacteremia in 20%. Fever disappeared approximately 6 hours after intravenous catheter removal. Polymerase chain reaction–restriction fragment length polymorphism revealed strain homogeneity in patient, water, and alcohol isolates. Contaminated tap water had been used to dilute alcohol for skin antisepsis and for decontamination of the caps of heparin vials. Only sporadic cases directly attributable to breach of protocol were reported after single-use alcohol swabs were substituted.Conclusion:This is potentially the largest single-source nosocomial bloodstream infection outbreak ever reported, and the first report of an alcohol skin antiseptic contaminated by tap water as a source for nosocomial bacteremia.
Device-Associated Nosocomial Infection Rates in Intensive Care Units of Argentina
Authors: Rosenthal Victor Daniel , Guzmán Sandra , Crnich Christopher 
Published: April 2006

AbstractBackground:Nosocomial infections are an important public health problem in many developing countries, particularly in the intensive care unit (ICU) setting. No previous data are available on the incidence of device-associated nosocomial infections in different types of ICUs in Argentina.Methods:We performed a prospective nosocomial infection surveillance study during the first year of an infection control program in six Argentinean ICUs. Nosocomial infections were identified using the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System definitions, and site-specific nosocomial infection rates were calculated.Results:The rate of catheter-associated bloodstream infections in medical-surgical ICUs was 30.3 per 1,000 device days; it was 14.2 per 1,000 device-days in coronary care units (CCUs). The rate of ventilator-associated pneumonia in medical-surgical ICUs was 46.3 per 1,000 device-days; it was 45.5 per 1,000 device-days in CCUs. The rate of symptomatic catheter-associated urinary tract infections in medical-surgical ICUs was 18.5 per 1,000 device-days; it was 12.1 per 1,000 device-days in CCUs.Conclusion:The high rate of nosocomial infections in Argentinean ICUs found during our surveillance suggests that ongoing targeted surveillance and implementation of proven infection control strategies is needed in developing countries such as Argentina.
Cost Implications of Successful Hand Hygiene Promotion
Authors: Pittet Didier , Sax Hugo , Hugonnet Stéphane , Harbarth Stephan 
Published: April 2006

AbstractWe evaluated the costs associated with a sustained and successful campaign for hand hygiene promotion that emphasized alcohol-based handrubs. The total cost of the hand hygiene promotion corresponded to less than 1% of the costs associated with nosocomial infections. Successful hand hygiene promotion is probably cost-saving.
Unnecessary Use of Central Venous Catheters: The Need to Look Outside the Intensive Care Unit
Authors: Trick William E. , Vernon Michael O. , Welbel Sharon F. , Wisniewski Mary F. , Jernigan John A. , Weinstein Robert A. 
Published: April 2006

AbstractWe developed criteria for justifiable CVC use and evaluated CVC use in a public hospital. Unjustified CVC-days were more common for non-ICU patients compared with ICU patients. Also, insertion-site dressings were less likely to be intact on non-ICU patients. Interventions to reduce CVC-associated bloodstream infections should include non-ICU patients.
Wound Ventilation With Ultraclean Air for Prevention of Direct Airborne Contamination During Surgery
Authors: Persson Mikael , Linden Jan van der 
Published: April 2006

AbstractBackground and Objective:Despite the novelties in operating room ventilation, airborne bacteria remain an important source of surgical wound contamination. An ultraclean airflow from the ceiling downward may convey airborne particles from the surgical team into the wound, thus increasing the risk of infection. Therefore, similar ventilation from the wound upward should be considered. We investigated the effect of wound ventilation on the concentration of airborne particles in a wound model during simulated surgery.Design:Randomized experimental study simulating surgery with a wound cavity model.Setting:An operating room of a university hospital ventilated with ultraclean air directed downward.Interventions:Particles 5 um and larger were counted with and without a 5-cm deep cavity and with and with-out the insufflation of ultraclean air.Results:With the surgeon standing upright, no airborne particles could be detected in the wound model. In contrast, during simulated operations, the median number of particles per 0.1 cu ft reached 18 (25th and 75th percentiles, 12 and 22.25) in the model with a cavity and 15.5 (25th and 75th percentiles, 14 and 21.5) without. With a cavity, wound ventilation markedly reduced the median number of particles to 1 (range, 0 to 1.25; P< .001).Conclusions:To protect a surgical wound against direct airborne contamination, air should be directed away from the wound rather than toward it. This study provides supportive evidence to earlier studies that operating room ventilation with ultraclean air is imperfect during surgical activity and that wound ventilation may be a simple complement. Further clinical trials are needed.
Prevalence of Nosocomial Infections After Surgery in Greek Hospitals: Results of Two Nationwide Surveys
Authors: Gikas Achilleas , Roumbelaki Maria , Pediaditis John , Nikolaidis Pavlos , Levidiotou Stamatina , Kartali Sofia , Kioumis John , Maltezos Efstratios , Metalidis Symeon , Anevlavis Eleftherios , Haliotis George , Kolibiris Hariton , Tselentis Yiannis ,   the Hellenic Infection Control Network
Published: April 2006

AbstractObjective:To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals.Design:Two point-prevalence studies.Setting:Fourteen Greek hospitals.Patients:Those in the hospitals during two prevalence surveys undergoing surgery during their stay.Results:In the 1999 survey, 129 of 1,037 surgical patients had developed 148 NIs (14.3%). A total of 1,093 operations were registered, and 49 SSIs (4.5%) were found. In the 2000 survey, 82 of 868 surgical patients had developed 88 NIs (10.1%). A total of 902 operations were registered, and 38 SSIs were detected (4.2%). The median length of stay (LOS) for surgical patients without SSI was 10.0 days (range, 1-19 days); for patients who developed SSI it was 30 days (range, 1-52 days; P < .001). The median LOS prior to surgery for patients without SSI was 1 day (range, 0-4 days); for patients who developed SSI it was 3 days (range, 0-7.5 days; P < .001). Among 30 possible risk factors studied, wound class, LOS prior to surgery, and central venous catheterization were independent predictors of SSI. Median durations of prophylactic antibiotic therapy were 4 days (range, 1-14 days) and 6 days (range, 1-16 days) in the 1999 and 2000 surveys, respectively.Conclusion:Surgical patients in Greek hospitals suffered higher rates of SSI than did surgical patients in other developed countries while prophylactic antibiotics were used excessively.
Value of an Infection Control Practitioner in Improving Infection Control Practices at Ambulatory Sites
Authors: Zimmerman Melanie , Pur Stacy , Schmitt Barbara , Levin Stuart , Harris Alan A. , Segreti John 
Published: April 2006

AbstractLittle information exists on the state of infection control (IC) practices in ambulatory sites. In preparation for a JCAHO survey, 62 ambulatory sites were visited to monitor and improve IC practices. A dedicated IC practitioner was instrumental in improving practices at ambulatory sites and in successfully completing a JCAHO survey.