bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vancomycin Use in a University Medical Center: Effect of a Vancomycin Continuation Form
Authors: Evans Martin E. , Millheim Eric T. , Rapp Robert P. 
Published: February 2006

Objective:To examine the impact of a new policy to ensure appropriate use of vancomycin in a 461-bed tertiary-care hospital.Design:We instituted a policy that allowed physicians to prescribe vancomycin but that required them to complete a vancomycin continuation form and document that use conformed to Hospital Infection Control Practices Advisory Committee (HICPAC) guidelines if they wished to continue the drug beyond 72 hours. Vancomycin was stopped automatically at 72 hours if use was not consistent with guidelines, if an infectious diseases consultant did not approve the drug, or if the form was not completed. A pharmacist and infectious diseases specialist monitored use of vancomycin prospectively and interacted with prescribers when indicated. Educational efforts were limited to printing the HICPAC guidelines on the form and providing information about the policy in a newsletter. Patterns of prescribing and the economic impact of the form were evaluated over a 6-month period.Results:Only 29% to 48% of vancomycin orders initially met HICPAC guidelines, but 77% to 96% of use was appropriate after 72 hours when the form was used. Inappropriate surgical prophylaxis, empirical therapy of intensive-care unit and transplant patients, and therapy for inadequately documented coagulase-negative staphylococcal infections remained problems. Vancomycin use fell from a mean of 136 (±52) g/1,000 patient days in the 12 months before the form to 78 (±22) g/1,000 patient days in the 9 months after institution of the form (P<.05). Net vancomycin acquisition costs and costs of ordering vancomycin serum levels fell by $357 and $19 per 1,000 patient days, respectively (P<.05). This represented annualized saving of approximately $47,000 in drug and monitoring costs. No adverse patient outcomes were seen as a result of the program.Conclusions:A vancomycin continuation form can decrease inappropriate vancomycin use and may save money. Additional educational efforts may be required to increase compliance with HICPAC guidelines during initial prescribing.
Treatment of aLegionella pneumophila-Colonized Water Distribution System Using Copper-Silver Ionization and Continuous Chlorination
Authors: Biurrun Amaya , Caballero Luis , Pelaz Carmen , León Elena , Gago Alberto 
Published: February 2006

AbstractThe detection in April 1997 of a case of nosocomial legionellosis in our hospital led to the discovery that both our hot- and cold-water circuits were heavily colonized withLegionella pneumophila. Conventional methods for eradication of the organisms were unsuccessful, so a copper-silver (Cu-Ag) ionization system and a continuous chlorination system were installed. Five months later, the number of colonized sites decreased from an initial 58.3% to 16.7%.
Evaluation of a Disinfection Procedure for Hysteroscopes Contaminated by Hepatitis C Virus
Authors: Sartor Catherine , Charrel Remi Nicolas , Lamballerie Xavier de , Sambuc Roland , Micco Philippe De , Boubli Leon 
Published: February 2006

AbstractWe assessed the ability of a standard disinfection procedure to eliminate hepatitis C virus (HCV) from the air-water channel of hysteroscopes. The residual HCV RNA remaining after the disinfection procedure was measured by polymerase chain reaction. When correctly applied to hysteroscopes, the standard disinfection procedure was sufficient to eliminate the risk of HCV transmission.
Perioperative Antibiotic Prophylaxis in Spanish Hospitals: Results of a Questionnaire Survey
Authors: Codina Carles , Trilla Antoni , Riera Nuria , Tuset Montserrat , Carne Xavier , Ribas Josep , Asenjo Miguel-Angel ,   Hospital Pharmacy Antimicrobial Prophylaxis Study Group
Published: February 2006

AbstractA questionnaire survey was sent to a random sample of the Spanish network of National Health System public acute-care hospitals. Of responding institutions (representing 25% of Spanish hospital beds), nearly 75% had active surveillance programs for the prevention and control of surgical-site infections (SSIs), but only 20% performed postdischarge surveillance. Overall, perioperative antibiotic prophylaxis (PAP) was used in 84% of all surgical procedures. For 77% of procedures, there were written guidelines for the choice and use of PAR Cefazolin was the most commonly used antibiotic (38%). Duration of PAP was shorter than 24 hours in 75% of procedures, and only a single dose was given in 52% of procedures. PAP was commonly used in breast (52%) and inguinal hernia repair (69%) procedures, as well as in laparoscopic abdominal surgery (86%). In summary, the use of PAP in Spanish hospitals is adequate, but improvements can be made in the frequency of prolonged PAP and in the use of broad-spectrum antibiotics. Surveillance systems for SSI, including postdischarge follow-up, also should be improved.
A Randomized Trial of 72- Versus 24-Hour Intravenous Tubing Set Changes in Newborns Receiving Lipid Therapy
Authors: Matlow Anne G. , Kitai Ian , Kirpalani Haresh , Chapman Nicola H. , Corey Mary , Perlman Max , Pencharz Paul , Jewell Sue , Phillips-Gordon Cindy , Summerbell Richard , Ford-Jones E. Lee 
Published: February 2006

Objective:To compare the microbial contamination rate of infusate in the intravenous tubing of newborns receiving lipid therapy, replacing the intravenous delivery system at 72-hour versus 24-hour intervals.Design:Infants requiring intravenous lipid therapy were randomly assigned to have intravenous sets changed on a 72- or a 24-hour schedule, in a 3:1 ratio, in order to compare the infusate contamination rates in an equivalent number of tubing sets.Setting:A 35-bed, teaching, referral, neonatal intensive-care unit (NICU).Participants:All neonates admitted to the NICU for whom intravenous lipid was ordered.Methods:Patients were randomized in pharmacy, on receipt of the order for intravenous lipid therapy, to either 72- or 24-hour administration set changes, and followed until 1 week after discontinuation of lipids or discharge from the NICU. Microbial contamination of the infusate was assessed in both groups at the time of administration set changes. Contamination rates were analyzed separately for the lipid and amino acid-glucose tubing sets. Patient charts were reviewed for clinical and epidemiological data, including birth weight, gestational age, gender, age at start of lipid therapy, duration of parenteral nutrition, and type of intravenous access.Results:During the study period, 1,101 and 1,112 sets were sampled in the 72- and 24-hour groups, respectively. Microbial contamination rates were higher in die 72-hour group than the 24-hour group for lipid infusions (39/1,101 [3.54%] vs 15/1,112 [1.35%];P=.001) and for amino acid infusions (12/1,093 [1.10%] vs 4/1,103 [0.36%];P=.076). Logistic regression analysis controlling for birth weight, gestational age, and type of venous access showed that only the tubing change interval was significanfly associated with lipid set contaminations (odds ratio, 2.69;P=.0013). The rate of blood cultures ordered was higher in die 72-versus the 24-hour group (6.11 vs 4.99 per 100 patient days of total parenteral nutrition;P=.017), and a higher proportion of infants randomized to the 72-hour group died (8% vs 4%;P=.05), although the excess deaths could not clearly be attributed to bacteremia.Conclusion:Microbial contamination of infusion sets is significantiy more frequent with 72- than witii 24-hour set changes in neonates receiving lipid solutions. This may be associated with an increased mortality rate.
Influenza Vaccination in Long-Term–Care Facilities: Structuring Programs for Success
Authors: McArthur Margaret A. , Simor Andrew E. , Campbell Beverly , McGeer Allison 
Published: February 2006

Objectives:To determine which influenza vaccination program characteristics were associated with high resident vaccination rates in Canadian long-term–care facilities (LTCFs).Design:A cross-sectional survey consisting of a mailed questionnaire conducted in spring 1991.Participants:All 1,520 Canadian LTCFs for the elderly with at least 25 beds.Results:The mean overall influenza vaccination rate in the 1,270 (84%) responding facilities was 79%. In multivariate analysis, the variables significantly associated with increased vaccination rates were: a single nonphysician staff person organizing the program, having more program aspects covered by written policies, the offering of vaccine to all residents, a policy of obtaining consent on admission that was durable for future years rather than repeating consent annually, and automatically administering vaccine to residents whose guardians could not be contacted for consent. Any encouragement to staff to be vaccinated had a significant impact on staff vaccination rates.Conclusion:Well-organized influenza vaccination programs increase the influenza vaccination rates of residents in Canadian LTCFs. Facilities need to develop resident vaccination programs further and to focus on vaccinating staff.
Efficacy of Prevention by High-Efficiency Particulate Air Filtration or Laminar Airflow Against Aspergillus Airborne Contamination During Hospital Renovation
Authors: Cornet Muriel , Levy Vincent , Fleury Laurent , Lortholary Jacques , Barquins Sandrine , Coureul Marie-Hélène , Deliere Elisabeth , Zittoun Robert , Brücker Gilles , Bouvet Anne 
Published: February 2006

Objective:To evaluate efficacy of laminar airflow facilities plus high-efficiency particulate air (HEPA) filtration and HEPA filtration alone in preventing environmentalAspergilluscontamination during hospital renovation. To show the usefulness of environmental surveillance to facilitate protection of patients at risk for invasive pulmonary aspergillosis.Design:Prospective sampling of air and surfaces forAspergillusconidia during 2-year period.Setting:A hematological department adjacent to building renovation at a university hospital.Results:1,047 air samples and 1,178 surface samples were collected from January 1996 to December 1997. Significantly more air samples were positive forAspergillusspecies during the period of building renovation than during the periods before and after renovation in a unit without a protected air supply adjacent to the building work area (51.5% vs 31.7%; odds ratio [OR], 2.3; 95% confidence interval [CI95, 1.4-3.7;P<.001). A major increase in the frequency of positive air samples was also found in another adjacent unit that was protected with HEPA filtration alone (from 1.8% to 47.5%; OR, 48.9; CI95,12-229;P<10-7). In addition, in this unit, the mean count ofAspergillusconidia in positive air samples increased significantly during construction (4 colony-forming units [CFU]/m3to 24.7 CFU/m3;P=.04) and the proportion of positive surface samples showed a significant increase during renovation (from 0.4% to 9.7%; OR, 28.3; CI95, 3.4-623;P=104). However, none of 142 air samples collected during renovation in the area protected with laminar airflow plus HEPA filtration showedAspergillusconidia. In a unit distant from the building renovation site, the results of air and surface samples were not affected by renovation.Conclusion:This study showed a strong association between building renovation and an increase in environmentalAspergilluscontamination. Results confirmed the high efficacy of laminar airflow plus HEPA filtration and a high air-change rate. Although filtration with HEPA was effective during normal conditions, it alone was unable to prevent the rise ofAspergilluscontamination related to building renovation. This study emphasized the necessity of an environmental survey of airborne contamination related to construction, to facilitate prevention of nosocomial aspergillosis outbreaks. A standardized protocol for aerobiological surveillance is needed.
Controlling Varicella in the Healthcare Setting: Barriers to Varicella Vaccination Among Healthcare Workers
Authors: Qureshi Mahmooda , Gordon Steven M. , Yen-Lieberman Belinda , Litaker David G. 
Published: February 2006

AbstractWe surveyed healthcare workers to determine factors that may influence acceptance of varicella-zoster virus vaccine. Of 2,801 workers tested, 90 were susceptible to varicella; of workers offered vaccination, 68% accepted. Workers providing direct patient care were 3.7-fold more likely than other workers to accept VZV vaccination (P=.04).
A Pseudoepidemic of Postoperative Scleritis Due to Misdiagnosis
Authors: Burwen Dale R. , Margo Curtis E. , McNeil Michael M. , Brown June M. , Tapelband Gerda , Jenkins Robert B. , Jarvis William R. 
Published: February 2006

AbstractObjective:To describe a pseudoepidemic of infectious scleritis following eye surgery.Methods:Retrospective cohort study with selected procedural and laboratory investigations.Results:Twenty-one patients with postoperative scleritis were identified during a 2-month outbreak. Neither an infectious etiology nor a causative pre-, intra-, or postoperative exposure was found. The clinical findings, when carefully reviewed, were consistent with poor surgical-wound closure.Conclusions:The art of clinical diagnosis involves the subjective interpretation of clinical history, physical findings, and laboratory results. A repeated error in the interpretation of clinical findings can simulate an outbreak of disease. Clinicians may be reluctant to concede misdiagnosis
Breakthrough Varicella Infection in a Healthcare Worker Despite Immunity After Varicella Vaccination
Authors: Wurtz Rebecca , Check Irene J. 
Published: February 2006

AbstractAlthough varicella vaccination is recommended for varicella-susceptible healthcare workers (HCWs), breakthrough infection after vaccination is not unusual, especially following household exposures. We report breakthrough varicella in a vaccinated HCW and review the data on breakthrough infection and concerns for the healthcare setting.
A Decade of Prevalence Surveys in a Tertiary-Care Center: Trends in Nosocomial Infection Rates, Device Utilization, and Patient Acuity
Authors: Weinstein Jeffrey W. , Mazon Dorothy , Pantelick Elizabeth , Reagan-Cirincione Patricia , Dembry Louise M. , Hierholzer Walter J. 
Published: February 2006

AbstractObjective:To evaluate the usefulness of repeated prevalence surveys to determine trends in the rates of nosocomial infections and to detect changes in risk factors (eg, use of invasive devices) associated with nosocomial infections.Patients And Methods:Ten annual prevalence surveys were conducted by trained infection control practitioners between 1985 and 1995 for acute-care patients on the medical, surgical, pediatric, and obstetric-gynecologic services at a 900-bed, tertiary-care, teaching hospital with 750 acute-care beds. The same methods of chart review and concurrent reporting from nursing, the microbiology and clinical laboratory, and the pharmacy were used each year to collect data on the prevalence of nosocomial infections, invasive-device utilization, and abnormal laboratory indicators. Although data were collected on a single day, a period-prevalence study approach was used, because charts were reviewed for any infection data occurring within the 7 days prior to the survey.Results:The hospital census for acute-care patients, as measured by the prevalence surveys, declined sharply over the 10 years, from 673 to 575 patients (P=.02). However, the medical service census increased from 150 to 188 patients (P=.01). During the same period, there was a significant decrease in the mean length of stay, from 7.3 to 6.0 days (P=.01), and a concomitant increase in the mean diagnosis-related-group case-mix index, from 1.03 to 1.24 (P=.001). Overall, nosocomial infection rates remained unchanged over the study period (mean of 9.85 infections per 100 patients), but rates of nosocomial bloodstream infection increased from 0.0% in 1985 to 2.3% in 1995 (P=.05). Nosocomial infection rates were significantly higher on the medical and surgical services than on other services (P<.001). Utilization rates increased significantly for Foley catheters (9.0% to 16.0%, P=.002) and ventilators (5.0% to 8.0%, P=.05).Conclusions:Despite apparent increases in the severity of illness of our patients, overall rates of nosocomial infection remained stable during a decade of study. Rates of nosocomial bloodstream infection increased, in parallel with National Nosocomial Infection Surveillance System data. We found repeated prevalence surveys to be useful in following trends and rates of infection, device utilization, and abnormal laboratory values among patients at our institution. Such methodologies can be valuable and low-cost components of a comprehensive infection surveillance, prevention, and control program and other potential quality-improvement initiatives, because they enable better annual planning of departmental strategies to meet hospital needs
Prospective Evaluation of a Hospital Epidemiologist's Activities at a European Tertiary-Care Medical Center
Authors: Ruef Christian 
Published: February 2006

AbstractObjective:Assessment of the distribution of tasks and consultations provided by the hospital epidemiologist (HE) at University Hospital of Zurich (UHZ).Design:Prospective collection of data on hospital epidemiology consultations over a 3-year period (1995-1997). Time spent per consultation and activities of infection control practitioners were not recorded.Setting:A 1,040-bed tertiary-care university hospital in Zurich, Switzerland.Results:Between January 1, 1995, and December 31, 1997, the HE received 1,660 requests for consultation. Advice or action was sought in the following areas: epidemiology (27.5% of requests); quality assurance, including antibiotic utilization and technology assessment (24.8%); infection control and practice guidelines (22.5%); disinfection and sterilization (11.6%); clinical infectious diseases (13.4%). During 1997, 35% of epidemiology consults were related to methicillin-resistant Staphylococcus aureus and 5.8% to tuberculosis. Public or private hospitals not affiliated with UHZ requested 40% of all consults.Conclusions:This study shows that HEs are involved in many different activities. Only 27.5% of hospital epidemiology consultations were directly related to issues of epidemiology. Practical knowledge of the methodologies for continuous quality improvement and assessment of various new technologies is important for HEs. The results of this study may be useful in discussions between HEs and administrators about allocation of resources or issues of reimbursement.
Surveillance of Antimicrobial Prophylaxis for Surgical Procedures
Authors: Vaisbrud Victor , Raveh David , Schlesinger Yechiel , Yinnon Amos M. 
Published: February 2006

AbstractObjective:To assess the practice of antimicrobial prophylaxis for surgical procedures in eight surgical departments in a 550-bed teaching hospital.Methods:A list of all major procedures performed in our hospital, with recommendations for prophylaxis based upon the literature, has been distributed since 1993 and is updated periodically. The practice of surgical prophylaxis between January 1 and March 31,1996, was examined by assessing four variables: (1) Did the particular procedure justify prophylaxis, and was it provided? (2) Was timing optimal, ie, within 1 hour prior to surgery? (3) Was the appropriate antimicrobial selected? (4) Was duration optimal, ie, ≤24 hours?Results:During the study period, 2,117 operations were performed, of which 1,631 (77%) were reviewed. Sixty-six percent were clean surgery, 28% clean-contaminated, and 6% contaminated; 72% of procedures were elective, 28% emergencies. Of 1,631 operations requiring prophylaxis, 1,142 (70%) received it, 489 (30%) did not. Of 1,631 patients, 1,392 (85%) received appropriate care: 929 (67%) appropriately received prophylaxis, and 463 (33%) appropriately did not receive prophylaxis. Of 955 patients who received prophylaxis, 26 (3%) did so inappropriately. Of 1,142 patients who should have received prophylaxis, 213 (19%) did not receive it. Female gender, clean surgery, elective operations, and infrequently performed procedures were all significant indicators of inappropriately withheld prophylaxis (P<.001). In addition, the rate of appropriately provided prophylaxis varied between departments from 71% to 97% (P<.001). Assessment of the 929 procedures for which prophylaxis was justified and given revealed that 100% of patients received it on time, the choice of antimicrobial was appropriate in 95% of cases, and duration was ≤24 hours in 91%.Conclusions:Audits of surgical prophylaxis are expected to detect different errors in different institutions. Conducting audits of surgical prophylaxis probably should be part of the routine activity of infection control teams. Feeding the information back to surgeons could improve adherence to recommended guidelines and might contribute to reduced wound infection rates.
Infection and Antimicrobial Use in Laparoscopic Cholecystectomy
Authors: McGuckin Maryanne , Shea Judy A. , Schwartz J. Sanford 
Published: February 2006

AbstractRetrospective chart review of 1,702 patients undergoing laparoscopic cholecystectomy (LC) revealed an overall infection rate of 2.3% and a surgical-site infection rate of 0.4%. Preoperative antimicrobial prophylaxis was received by 79% of patients, but only 33% of these received the agent within 1 hour or less prior to surgery. These facts suggest that antimicrobial prophylaxis may not be necessary for low-risk LC patients.
Hospital Gangrene: The Scourge of Surgeons in the Past
Authors: Cohen Jack 
Published: February 2006

AbstractBefore the days of antisepsis, the infection rate on surgical wards was very high. Mortality from common operations such as limb amputations could run from 40% to 60%, mostly from infection. Hospital gangrene, a type of necrotizing infection, occurred frequently. It would spread rapidly, and the helpless surgeon could do nothing to stop it. The patient would be in agony for many days before death mercifully intervened.
Predicting interactions in protein networks by completing defective cliques
Authors: Yu Haiyuan , Paccanaro Alberto , Trifonov Valery , Gerstein Mark 
Published: February 2006

Abstract
Datasets obtained by large-scale, high-throughput methods for detecting protein–protein interactions typically suffer from a relatively high level of noise. We describe a novel method for improving the quality of these datasets by predicting missed protein–protein interactions, using only the topology of the protein interaction network observed by the large-scale experiment. The central idea of the method is to search the protein interaction network for defective cliques (nearly complete complexes of pairwise interacting proteins), and predict the interactions that complete them. We formulate an algorithm for applying this method to large-scale networks, and show that in practice it is efficient and has good predictive performance. More information can be found on our website
Contact: Mark.Gerstein@yale.edu
Supplementary information: Supplementary Materials are available at Bioinformatics online.
affylmGUI: a graphical user interface for linear modeling of single channel microarray data
Authors: Wettenhall James M. , Simpson Ken M. , Satterley Keith , Smyth Gordon K. 
Published: February 2006

Abstract
Summary: affylmGUI is a graphical user interface (GUI) to an integrated workflow for Affymetrix microarray data. The user is able to proceed from raw data (CEL files) to QC and pre-processing, and eventually to analysis of differential expression using linear models with empirical Bayes smoothing. Output of the analysis (tables and figures) can be exported to an HTML report. The GUI provides user-friendly access to state-of-the-art methods embodied in the Bioconductor software repository.
Availability: affylmGUI is an R package freely available from . It requires R version 1.9.0 or later and tcl/tk 8.3 or later and has been successfully tested on Windows 2000, Windows XP, Linux (RedHat and Fedora distributions) and Mac OS/X with X11. Further documentation is available at
Contact: keith@wehi.edu.au