bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Surveillance for Primary Bloodstream Infections Occurring in Canadian Hemodialysis Units
Authors: Taylor Geoffrey , Gravel Denise , Johnston Lynn , Embil John , Holton Donna , Paton Shirley ,   Canadian Hospital Epidemiology Committee,   Canadian Nosocomial Infection Surveillance Program
Published: February 2006

Objective:Bloodstream infections are a major cause of morbidity and mortality in patients receiving long-term hemodialysis. We wanted to determine the incidence of hemodialysis-related bloodstream infections in Canadian centers participating in the Canadian Nosocomial Infection Surveillance Program.Methods:Prospective surveillance for hemodialysis-related bloodstream infections was performed in 11 centers during a 6-month period. Bloodstream infections were defined by published criteria. Hemodialysis denominators included the number of dialysis procedures, the number of patient-days on dialysis, and the frequencies of different types of vascular access.Results:There were 184 bloodstream infections in 133,158 dialysis procedures (1.4 per 1,000) and 316,953 patient-days (0.6 per 1,000). Hemodialysis access through arteriovenous (AV) fistulae was associated with the lowest risk for bloodstream infection (0.2 per 1,000 dialysis procedures). The relative risk for infection was 2.5 with AV graft access, 15.5 with cuffed and tunneled central venous catheter (CVC) access, and 22.5 with uncuffed CVC access (P< .001). There was marked variation among the 11 centers in the means of vascular access used for hemodialysis. Significant variation in infection rates was observed among the centers when controlling for types of access.Conclusions:There was a hierarchy of risk of hemodialysis-related bloodstream infection according to type of vascular access. There was significant variation in the type of vascular access being used among the Canadian hemodialysis centers, and also variation in access-specific infection rates between centers.
Sterilization of Heat-Resistant Instruments With Infrared Radiation
Authors: Mata-Portuguez Victor Hugo , Pérez Leonor Sánchez , Acosta-Gío Enrique 
Published: February 2006

Objective:To evaluate the lethality profile of an infrared radiation (IR) prototype sterilizer.Method:Simulated use and D value tests were conducted with Bacillus subtilis spores American Type Culture Collection–9372. A spore suspension (1.06 ± 0.03 × 106) in 5% bovine serum albumin was air dried on stainless steel instruments. IR cycles were completed and the instruments were immersed in tryptic soy broth for 120 hours at 37°C. Direct enumeration of survivors was performed to evaluate IR death. Instrument loads contained carriers laden with spores (1.06 ± 0.3 × 106). The spores were seeded on tryptic soy agar and survivors were counted after 120 hours of incubation at 37°C.Results:All instruments exposed to IR (n = 50) were culture negative. In contrast, all unprocessed instruments (n = 30) showed B. subtilis growth. The prototype's D value was 0.56, and the death rate's slope was -1.76 (r = -0.99741; P < .0001). The 10-6 sterility assurance level was reached after 8 minutes and 40 seconds of exposure, from cold start.Conclusions:IR destroys B. subtilis spores. Instrument sterilization with IR may provide another technology for infection control.
Using Surveillance Data to Direct Infection Control Efforts to Reduce Surgical-Site Infections Following Clean Abdominal Operations in Japan
Authors: Morikane Keita , Nishioka Midori , Tanimura Hisami , Noguchi Hiroe , Konishi Toshiro , Kobayashi Hiroyoshi 
Published: February 2006

AbstractWe initiated surveillance for surgical-site infections (SSIs) in a Japanese hospital using Centers for Disease Control and Prevention definitions and the approach of the National Nosocomial Infections Surveillance (NNIS) System. Patients were observed following clean and clean-contaminated abdominal operations. SSI rates were higher than those of the NNIS System, but there was a trend toward decreased SSI rates in the latter half of the study period.
Cost-Effectiveness of Perirectal Surveillance Cultures for Controlling Vancomycin-ResistantEnterococcus
Authors: Muto Carlene A. , Giannetta Eve T. , Durbin Lisa J. , Simonton Barbara M. , Farr Barry M. 
Published: February 2006

Background:Several hospitals opting not to use active surveillance cultures to identify carriers of vancomycin-resistantEnterococcus(VRE) have reported that adoption of other parts of the Centers for Disease Control and Prevention guideline for controlling VRE has had little to no impact. Because use of surveillance cultures and contact isolation controlled a large outbreak at this hospital, their costs were estimated for comparison with the excess costs of VRE bacteremias occurring at a higher rate at a hospital not employing these measures.Setting:Two university hospitals.Methods:Inpatients deemed high risk for VRE acquisition at this hospital underwent weekly perirectal surveillance cultures. Estimated costs of cultures and resulting isolation during a 2-year period were compared with the estimated excess costs of more frequent VRE bacteremias at another hospital of similar size and complexity not using surveillance cultures to control spread throughout the hospital.Results:Of 54,052 patients admitted, 10,400 had perirectal swabs taken. Cultures and isolation cost an estimated $253,099. VRE culture positivity was limited to 193 (0.38%) and VRE bacteremia to 1 (0.002%) as compared with 29 bacteremias at the comparison hospital. The estimated attributable cost of VRE bacteremia at the comparison hospital of $761,320 exceeded the cost of the control program at this hospital by threefold.Conclusions:The excess costs of VRE bacteremia may justify the costs of preventive measures. The costs of VRE infections at other body sites, of deaths from untreatable infections, and of dissemination of genes for vancomycin resistance also help to justify the costs of implementing an effective control program.
Is Methicillin-Resistant Staphylococcus Aureus More Contagious than Methicillin-Susceptible S. Aureus in a Surgical Intensive Care Unit?
Authors: Vriens Menno R. , Fluit Ad C. , Troelstra Annet , Verhoef Jan , Werken Chris van der 
Published: February 2006

Background and Objective:In the Netherlands, the prevalence of methicillin resistance among Staphylococcus aureus isolates has been kept to less than 1% by using active screening programs and isolation. At the University Medical Center Utrecht (UMCU), an active screening program for methicillin-resistant S. aureus (MRSA) in the surgical intensive care unit (ICU) was implemented in 1986. Between 1992 and 2001, only 6 patients with MRSA were admitted to the surgical ICU. However, 4 of these 6 strains were able to spread to 23 other patients and 15 healthcare workers (HCWs). We were surprised by the epidemic behavior of these strains and wondered whether this was exceptional for S. aureus or whether methicillin-susceptible S. aureus (MSSA) was also spreading in the ICU.Design:A 2-month, prospective, observational study to investigate the incidence and spread of MSSA in the surgical ICU of UMCU and historical data collected during a 10-year period regarding MRSA.Setting:A 10-bed surgical ICU in a 1,042-bed teaching hospital.Results:Weekly swabs revealed the presence of MSSA in 11 (24%) of 45 patients and 16 (22%) of 72 HCWs. Of all 4,105 patient–HCW contacts, there were only 21 episodes in which both the patient and the HCW were found to carry MSSA. With the use of pulsed-field gel electrophoresis, no identical strains could be identified.Conclusion:In our surgical ICU, MRSA seems to spread more easily than MSSA, probably because of selection under antibiotic pressure or a still unknown intrinsic factor within MRSA.
An Epidemiologic Survey of Methicillin-ResistantStaphylococcus Aureusby Combined Use ofMec-HVR Genotyping and Toxin Genotyping in a University Hospital in Japan
Authors: Nishi Junichiro , Yoshinaga Masao , Miyanohara Hiroaki , Kawahara Motoshi , Kawabata Masaharu , Motoya Toshiro , Owaki Tetsuhiro , Oiso Shigeru , Kawakami Masayuki , Kamewari Shigeko , Koyama Yumiko , Wakimoto Naoko , Tokuda Koichi , Manago Kunihiro , Maruyama Ikuro 
Published: February 2006

Objective:To evaluate the usefulness of an assay using two polymerase chain reaction-based genotyping methods in the practical surveillance of methicillin-resistantStaphylococcus aureus(MRSA).Methods:Nosocomial infection and colonization were surveyed monthly in a university hospital in Japan for 20 months. Genotyping withmec-HVR is based on the size of themec-associated hypervariable region amplified by polymerase chain reaction. Toxin genotyping uses a multiplex polymerase chain reaction method to amplify eight staphylococcal toxin genes.Results:Eight hundred nine MRSA isolates were classified into 49 genotypes. We observed differing prevalences of genotypes for different hospital wards, and could rapidly demonstrate the similarity of genotype for outbreak isolates. The incidence of genotype D: SEC/TSST1 was significantly higher in isolates causing nosocomial infections (49.5%; 48 of 97) than in nasal isolates (31.4%; 54 of 172) (P= .004), suggesting that this genotype may represent the nosocomial strains.Conclusion:The combined use of these two genotyping methods resulted in improved discriminatory ability and should be further investigated.
Risk Factors for Methicillin-Resistant Staphylococcus Aureus Carriage in Residents of German Nursing Homes
Authors: Baum H. von , Schmidt C. , Svoboda D. , Bock-Hensley O. , Wendt Constanze 
Published: February 2006

Objectives:To determine the prevalence of and the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage in nursing home residents in the Rhine-Neckar region of southern Germany.Design:Point-prevalence survey.Setting:Forty-seven nursing homes in the region.Participants:All residents of the approached nursing homes who agreed to participate.Methods:After informed consent was obtained, all participants had their nares swabbed, some personal data collected, or both. All swabs were examined for growth of MRSA All S. aureus isolates underwent oxacillin susceptibility testing and polymerase chain reaction for demonstration of the meek gene. All MRSA isolates were typed using pulsed-field gel electrophoresis after digestion with SmaI.Results:Swabs from 3,236 nursing home residents yielded 36 MRSA strains, contributing to a prevalence rate of 1.1%. Significant risk factors for MRSA carriage in the multivariate analysis were the presence of wounds or urinary catheters, limited mobility, admission to a hospital during the preceding 3 months, or stay in a medium-size nursing home. One predominant MRSA strain could be detected in 30 of the 36 MRSA carriers.Conclusions:The prevalence of MRSA in German nursing homes is still low. These residents seemed to acquire their MRSA in the hospital and transfer it to their nursing home. Apart from well-known risk factors for the acquisition of MRSA we identified the size of the nursing home as an independent risk factor. This might be due to an increased use of antimicrobials in nursing homes of a certain size.
Outbreak of Hemodialysis Vascular Access Site Infections Related to Malfunctioning Permanent Tunneled Catheters: Making the Case for Active Infection Surveillance
Authors: Hannah Elizabeth L. , Stevenson Kurt B. , Lowder Connie A. , Adcox Michael J. , Davidson Robert L. , Mallea Michael C. , Narasimhan Nagraj , Wagnild Jon P. 
Published: February 2006

Objective:To describe an outbreak of infections with permanent cuffed hemodialysis catheters recognized through ongoing surveillance and related to a specific malfunctioning permanent catheter.Design:The outbreak was suspected from the results of prospective infection surveillance and confirmed by a retrospective cohort study using medical records for patients receiving dialysis between April 1,1999, and March 31, 2000.Setting:Integrated network of six outpatient hemodialysis facilities in southern Idaho and eastern Oregon.Patients:Outpatients receiving long-term hemodialysis.Results:During the 18 months prior to the outbreak, the overall infection rate was 4.1 infections per 1,000 dialysis sessions with a catheter rate of 8.9 per 1,000 dialysis sessions. During the 7 months of the outbreak, the overall rate increased to 5.8 per 1,000 dialysis sessions, whereas the catheter rate increased to 18.1 per 1,000 dialysis sessions. Reports of malfunctioning “Brand A” catheters prompted discontinuation of their placement. A manufacturer recall occurred in April 2000. During the 14 months after the outbreak, the overall infection rate decreased to 3.3 per 1,000 dialysis sessions and the catheter rate to 10.8 per 1,000 dialysis sessions. A 12-month retrospective cohort study recognized 96 patients with an identifiable catheter brand and 48 infections. Of these, 27 (56%) occurred in patients with Brand A catheters. The relative risk for infection when compared with other catheter brands was 1.96 (95% confidence interval, 1.32 to 2.92; P < .001).Conclusions:Ongoing infection surveillance in hemodialysis facilities can identify specific device-related outbreaks of infections and promote interventions to reduce infectious complications and promote patient safety. Surveillance for vascular access site infections is recommended as a routine activity in hemodialysis facilities.
Breakthrough Candidemia in Patients with Cancer Differs from De Novo Candidemia in Host Factors andCandidaSpecies But Not Intensity
Authors: Kontoyiannis Dimitrios P. , Reddy Bhavanandra T. , Hanna Hend , Bodey Gerald P. , Tarrand Jeffrey , Raad Issam I. 
Published: February 2006

Objectives:To evaluate the risk factors associated with breakthrough candidemia in patients with cancer and to compare them with those of de novo candidemia in this patient population. DESIGN: Retrospective case series of 120 episodes of candidemia, 90 de novo and 30 breakthrough candidemias.Setting:University-affiliated, tertiary-care cancer center in Houston, Texas.Patients:All patients with cancer who acquired candidemia between January 1993 and December 1998 were included if they had non-catheter-related candidemia and information about quantitative blood cultures.Results:Although less frequent, breakthrough candidemia was seen more often in neutropenic patients with leukemia. The intensity of breakthrough candidemia was comparable to that of de novo candidemia. Most (70%) of the breakthrough candidemias were due toCandida glabrataorC. krusei.Conclusions:In breakthrough candidemia, the same risk factors seen in de novo candidemia were encountered, although more frequently.C. glabrataandC. kruseiare the leading causes of breakthrough candidemia in patients with cancer.
Effectiveness of Bacteria-Controlled Nursing Units in Preventing Cross-Colonization With Resistant Bacteria in Severely Burned Children
Authors: Weber Joan M. , Sheridan Robert L. , Schulz John T. , Tompkins Ronald G. , Ryan Colleen M. 
Published: February 2006

AbstractBacteria-controlled nursing units (BCNUs) are laminar air-flow patient isolation units. The rate of cross-colonization with resistant organisms in 66 critically ill pediatric burn patients with massive open wounds and ventilators housed in BCNUs during 5 years was examined and found to be extremely low (3.2 cases per 1,000 patient-days)
Quality of life and depression in a population of occupational hand eczema patients
Authors: Cvetkovski Rikke Skoet , Zachariae Robert , Jensen Henrik , Olsen Jørn , Johansen Jeanne Duus , Agner Tove 
Published: February 2006

Occupational hand eczema (OHE) is the most frequently recognized occupational disease in Denmark, and despite governmental attempts to reduce exposure to harmful occupational allergens, the number of new cases has remained almost unchanged since the mid‐1990s. Some studies have indicated that OHE has considerable impact on quality of life (QoL) and may lead to depression. The aims of the study were to determine risk factors for low QoL, the frequency and severity of depression among OHE patients and changes in QoL and depression after 12 months of follow up. The study population, 758 patients, comprised all new recognized cases from the Danish National Board of Industrial Injuries Registry between October 2001 and November 2002. All patients received a questionnaire to determine impairment of QoL and depressive symptoms. A similar follow‐up questionnaire was posted after 1 year. The response rate was 82% at baseline and 91% at follow up.The mean Dermatology Life Quality Index total score was 5.5 for all patients and 7.8 for severe OHE cases. Severe OHE cases and lower socioeconomic status were independently associated with low QoL. The prevalence of moderate‐to‐severe depression was 9%. Only minor changes in QoL and depressive symptoms were found after 12 months of follow up.
Lack of expression of the chondroitin sulphate proteoglycan neuron‐glial antigen 2 on candidate stem cell populations in paediatric acute myeloid leukaemia/abn(11q23) and acute lymphoblastic leukaemia/t(4;11)
Authors: Neudenberger J. , Hotfilder M. , Rosemann A. , Langebrake C. , Reinhardt D. , Pieters R. , Schrauder A. , Schrappe M. , Röttgers S. , Harbott J. , Vormoor J. 
Published: February 2006

SummaryIt has increasingly been acknowledged that only a few leukaemic cells possess the capability to renew themselves and that only these self‐renewing leukaemic stem cells are able to initiate relapses. Therefore, these leukaemic stem cells should be the target cells for therapy and for minimal residual disease (MRD) detection. Because of its presence on blasts of 11q23‐rearranged high‐risk leukaemic patients, neuron‐glial antigen 2 (NG2) is thought to be a valuable marker for detecting leukaemic stem cells. Six acute myeloid leukaemia (AML)/abn(11q23) and three acute lymphoblastic leukaemia (ALL)/t(4;11) samples were analysed by four‐colour flow cytometry for NG2 expression on primitive cell populations. Candidate leukaemic cell populations were defined by the antigen profiles CD34+CD38− in AML and CD34+CD19−CD117+ in ALL. Surprisingly, in all patients these candidate stem cell populations were shown to lack expression of NG2. Instead, a correlation between the expression of the myeloid differentiation marker CD33 and increasing levels of NG2 on maturing cells could be demonstrated. Similarly, in ALL patients CD34+CD19+ cells showed a higher expression of NG2 mRNA compared with CD34+CD19−. Thus, NG2 appears to be upregulated with differentiation and not to be expressed on primitive disease‐maintaining cells. This hampers the clinical use of NG2 as a therapeutic target and as a sensitive marker for MRD detection.
In vitro fermentation patterns and methane production as influenced by cultivar and season of harvest of Lolium perenne L.
Authors: Lovett D. K. , McGilloway D. , Bortolozzo A. , Hawkins M. , Callan J. , Flynn B. , O'Mara F. P. 
Published: February 2006

AbstractIn some European countries, the majority of annual enteric methane (CH4) emissions by ruminants occur at pasture – a direct result of the predominance of grazing within ruminant production systems. However, there are only limited data available as to the effect of perennial ryegrass cultivar and season of harvest on CH4 production. Using the in vitro gas production technique, the effect of perennial ryegrass cultivar on fermentation characteristics and CH4 production was determined (Experiment 1) and the persistence of these traits throughout the growing season for two cultivars, identified from Experiment 1 as having either a high or low methanogenic potential, was examined (Experiment 2). In Experiment 1, organic matter (OM) digestibility and cumulative total gas production profiles were unaffected by cultivar but, with regard to the kinetics of CH4 production, the asymptote value (A), cumulative CH4 yield at 72 h, and the fractional rate (μ) of CH4 production at both time of 0·5A(T)(μCH4T) and at 48 h (μCH448h) were significantly (P < 0·05) different. The amount of digested OM, as a proportion of cumulative CH4 production (DigOM/CH4) at 24 and 72 h after commencement of inoculation, revealed that the amount of substrate required to produce 1 ml of CH4 also differed significantly between cultivars (P < 0·01). In Experiment 2, regrowth number significantly modified the majority of measured samples (P < 0·01); cultivar effects were limited to the lag phase of the cumulative CH4 production curve and DigOM/CH4 at 8 h only (P < 0·05). These results suggest that differences exist between cultivars in how OM is partitioned following microbial fermentation and that these differences demonstrate persistency throughout the growing season. In the course of time it may be possible to exploit these differences through cultivar selection and plant breeding programmes, and thereby reduce enteric CH4 emissions within pastoral production systems.
Impact of shading and cutting on the demography and composition of Mimosa pudica L., a ligneous weed species of tropical grasslands
Authors: Magda D. , Duru M. , Huguenin J. , Gleizes B. 
Published: February 2006

AbstractThe aim of the study was to evaluate the potential impact of grazing on the control of Mimosa pudica, a ligneous weed species that invades grasslands in French Guiana. Three experiments were conducted in a glasshouse to test the potential impact of: (i) shading by testing different Photsynthetically Active Radiation (PAR) fluxes on seedlings and (ii) cutting of juveniles, at three stages of development, on their survival, flowering rate and nutritive value as measured by the mass:length ratio of stems and by branching processes. A significant mortality rate (0·20) was obtained only for seedlings at the cotyledon stage when the PAR flux was reduced proportionately by 0·83. Shading reduced both flowering rate and mass:length ratio of stems. For seedlings at the cotyledon stage, the flowering rate decreased from 0·85 for the control to zero for the low light treatment (0·13 of PAR flux of the control treatment). The mass:length ratio of stems of seedlings in the low light treatment was reduced to 0·20 of that of control seedlings, at the fifth‐leaf stage. Cutting treatment had no effect on mortality of juvenile plants whatever the size of the juvenile plant. The proportion of juvenile plants flowering was high for all cutting treatments. It is suggested that regular, but not continuous grazing, could maintain a dense sward to limit recruitment by seedling establishment and seed production, and maintain branched and juvenile plants with a high‐nutritive value at the seedling stage.