bluuebunny/crossref_metadata_2025_split huggingface dataset:
A National Survey of Surgical Antibiotic Prophylaxis in Turkey
Authors: Hosoglu Salih , Sunbul Mustafa , Erol Serpil , Altindis Mustafa , Caylan Rahmet , Demirdag Kutbettin , Ucmak Hasan , Mendes Havva , Geyik Mehmet Faruk , Turgut Huseyin , Gundes Sibel , Doyuk Elif Kartal , Aldemir Mustafa , Dokucu Ali ihsan 
Published: March 2006

AbstractObjective:To assess the quality of antibiotic prophylaxis for clean and clean-contaminated elective surgical procedures.Design:A cross-sectional, country-wide survey.Setting:Thirty-six hospitals in 12 cities in Turkey.Participants:Four hundred thirty-nine surgeons from 6 different specialties who performed selected procedures of interest.Methods:A random sample of surgeons from different hospitals was selected. A standardized data collection form was used to record the type of procedure, the names, doses, timing of the first doses, and duration of antibiotics, important decisive factors, and problems in the management of prophylactic antibiotic use for surgical procedures.Results:Fifty-five percent of surgeons addressed completed the survey. For clean-contaminated procedures, 6% of surgeons did not use antibiotic prophylaxis, whereas 88% used more than a single dose. Inappropriate antibiotics were chosen for 32% of procedures. In 39% of procedures, the first dose of antibiotics was not administered during induction of anesthesia. Duration of prophylaxis was longer than 24 hours in 80% and longer than 48 hours in 46% of all procedures. Only 112 surgeons (26%) were using definitely appropriate prophylaxis in all ways. Multivariate analysis revealed that surgeons in university hospitals (OR, 2.353; CI95, 1.426–3.884; P = .001) and general surgeons (OR, 4.986; CI95, 2.890–8.604; P < .001) used antibiotic prophylaxis more appropriately. Patients not covered by health insurance (OR, 0.417; CI95, 0.225–0.772; P < .001) were associated with inappropriate prophylaxis.Conclusion:Given the high frequency of antibiotics prescribed for surgical prophylaxis in Turkey, adherence to surgical prophylaxis guidelines is urgently needed.
Antimicrobial Activity of Glucoprotamin: A Clinical Study of a New Disinfectant for Instruments
Authors: Widmer Andreas F. , Frei Reno 
Published: March 2006

AbstractObjective:To determine the in vitro efficacy of glucoprotamin for the disinfection of instruments.Design:Prospective observational study.Setting:University women's hospital.Methods:Instruments were immersed in saline solution after use, and glucoprotamin was added to a concentration of 1.5% before soaking for 60 minutes. Biocidal activity was determined by the difference in colony-forming units (CFU) on instruments before and after disinfection.Results:One hundred thirty-seven instruments were collected during 10 days and exposed to a 1.5% dilution of glucoprotamin without prior washing. Bioburden before disinfection ranged from 2 × 105to 7.1 × 107CFU per instrument. Average bacterial killing was 5.98 log10CFU ± 0.48 under aerobic conditions and 6.75 log10CFU ± 0.54 under anaerobic conditions, despite the presence of large amounts of proteins on instruments that were frequently bloody. No vegetative bacteria were isolated in any sample after disinfection.Conclusion:This clinical study confirmed excellent in vitro efficacy of glucoprotamin without prior removal of proteins and debris.
Effectiveness of Gentamicin-Impregnated Cement in the Prevention of Deep Wound Infection After Primary Total Knee Arthroplasty
Authors: Eveillard Matthieu , Mertl Patrice , Tramier Blaise , Eb François 
Published: March 2006

AbstractEffectiveness of gentamicin-impregnated cement in preventing deep wound infection after total knee arthroplasty (TKA) was estimated using data from prospective surveillance. In multivariate analysis, the protective effect of gentamicin-impregnated cement on the development of infection was close to the limit of significance. Gentamicin-impregnated cement may prevent TKA infections.
Light-Activated Antimicrobial Coating for the Continuous Disinfection of Surfaces
Authors: Wilson Michael 
Published: March 2006

AbstractThe ability of a photosensitizer-containing cellulose acetate film to kill bacteria was evaluated. Substantial kills were achieved following irradiation of the film with white light for up to 24 hours. Applying a photosensitizer-containing coating to surfaces could reduce the environmental load of pathogens, thus helping to prevent infectious disease transmission.
A Survey of Latent Tuberculosis Infection Among Laboratory Healthcare Workers in New York City
Authors: Garber Elizabeth , Gabriel Pablo San , Lambert Lauren , Saiman Lisa 
Published: March 2006

AbstractObjective:To determine the prevalence of positive tuberculin skin tests (TSTs), incidence of TST conversion, risk factors for positive TSTs, and history of active TB among HCWs in microbiology laboratories in New York City.Design:Two-year survey from May 1999 to June 2001.Setting:Nineteen microbiology laboratories.Results:During the first year, interviews were conducted with 345 laboratory HCWs (mean, 18 HCWs per site; range, 2 to 51) to assess the prevalence of positive TSTs, but 3 (1%) could not recall their result and were excluded from further analyses. The mean age of the remaining 342 HCWs was 48 years; 68% (n = 233) were female, 54% (n = 183) received bacille Calmette-Guérin (BCG) vaccination, and 71% (n = 244) were foreign born. The prevalence of a positive TST was 57% (n = 196), but only 20% (n = 39) of the HCWs received isoniazid. The incidence of TST conversion in the second year of the study was 1% (1 of 108). Multivariate analysis identified age (odds ratio [OR] per year, 1.05; 95% confidence interval [CI95], 1.02–1.08), foreign birth (OR, 3.80; CI95, 1.98–7.28), BCG immunization (OR, 4.89; CI95, 2.72–8.80), and employment in a mycobacteriology laboratory (OR, 2.14; CI95, 1.25–3.68) as risk factors for a positive TST. Only one HCW had been treated for active TB.Conclusions:The prevalence of positive TSTs was high among laboratory HCWs, but the TST conversion rate was low. Higher rates of treatment for latent TB infection are desirable.
Prevalence of Tuberculin Skin Test Positivity and Conversions Among Healthcare Workers in New York City During 1994 to 2001
Authors: Cook Sharlette , Maw Khin Lay , Munsiff Sonal S. , Fujiwara Paula I. , Frieden Thomas R. 
Published: March 2006

AbstractObjective:To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees.Design:Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1,1994, to December 31, 2001.Participants:HCWs in high-risk and low-risk settings for occupational TB exposure.Results:Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR 5.7; CI95, 1.7–19.2;P< .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95,1.7–5.8;P< .001); OCME HCWs (OR 4.7; CI95, 2.3–9.4;P< .001), those of Asian ethnicity (OR 4.3; CI95,1.4–13.5;P< .01), and older HCWs (OR, 1.0; CI95,1.0–1.1;p< .05) were at a higher risk for conversion.Conclusions:Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.
Costs of Implementing and Maintaining a Tuberculin Skin Test Program in Hospitals and Health Departments
Authors: Lambert Lauren , Rajbhandary Sameer , Qualls Noreen , Budnick Lawrence , Catanzaro Antonino , Cook Sharlette , Daniels-Cuevas Linda , Garber Elizabeth , Reves Randall 
Published: March 2006

AbstractObjective:To determine (1) the annual costs of implementing and maintaining tuberculin skin test (TST) programs at participating study sites, (2) the cost of the TST program per healthcare worker (HCW), and (3) the outcomes of the TST programs, including the proportion of HCWs with a documented TST conversion and the proportion who accepted and completed treatment for latent TB infection, before and after the implementation of staffTRAK-TB software (Centers for Disease Control and Prevention, Atlanta, GA).Design:Cost analysis in which costs for salaries, training, supplies, radiography, and data analysis were collected for two 12-month periods (before and after the implementation of staffTRAK-TB).Setting:Four hospitals (two university and two city) and two health departments (one small county and one big city).Results:The annual cost of implementing and maintaining a TST program ranged from $66,564 to $332,728 for hospitals and $92,886 to $291,248 for health departments. The cost of the TST program per HCW ranged from $41 to $362 for hospitals and $176 to $264 for health departments.Conclusions:Costs associated with implementing and maintaining a TST program varied widely among the participating study sites, both before and after the implementation of staffTRAK-TB. Compliance with the TB infection control guidelines of the Centers for Disease Control and Prevention may require a substantial investment in personnel time, effort, and commitment.
Potential Nosocomial Exposure toMycobacterium tuberculosisFrom a Bronchoscope
Authors: Larson Janet L. , Lambert Lauren , Stricof Rachel L. , Driscoll Jeffrey , McGarry Michael A. , Ridzon Renée 
Published: March 2006

AbstractObjective:To investigate a possible nosocomial outbreak of tuberculosis (TB).Design:Retrospective cohort study.Setting:Community hospital.Methods:We reviewed medical records, hospital infection control measures, and potential locations of nosocomial exposure. We examined the results of acid-fast bacilli (AFB) smears, cultures, and drug susceptibility testing, and performed a DNA fingerprint analysis. We observed laboratory specimen processing procedures and bronchoscope disinfection procedures. We also reviewed bronchoscopy records.Results:In October 2000, three patients had bronchoscopy specimen cultures that were positive forMycobacterium tuberculosis.Of the three, only one had clinical signs and symptoms consistent with TB and positive AFB sputum smears. The other two did not have signs and symptoms consistent with TB and had no known exposure to individuals with infectious TB. The threeM. tuberculosisisolates had matching DNA fingerprints. No evidence of laboratory cross-contamination was identified. The three culture-positive specimens ofM. tuberculosiswere collected with the same bronchoscope within 9 days. This bronchoscope was inadequately cleaned and disinfected between patients, and the automated reprocessor used was not approved for use with the hospital bronchoscope.Conclusions:One of the bronchoscopes at this hospital was contaminated withM. tuberculosisduring bronchoscopy of an AFB-smear-positive patient. Subsequent specimen contamination likely occurred because the bronchoscope had been inadequately cleaned and disinfected. Patients who subsequently underwent bronchoscopy were also potentially exposed toM. tuberculosisfrom this bronchoscope.
Use of, Effectiveness of, and Attitudes Regarding Influenza Vaccine Among House Staff
Authors: Lester Richard T. , McGeer Allison , Tomlinson George , Detsky Allan S. 
Published: March 2006

AbstractObjective:To determine influenza vaccination rates, vaccine effectiveness, and factors influencing vaccination decisions among house staff.Design:Cross-sectional survey.Setting and Participants:All residents registered at the University of Toronto were surveyed after the 1999-2000 influenza season. Of the 1,159 questionnaires mailed, 670 (58%) could be evaluated.Results:Influenza-like illnesses were reported by 36% of house staff. The vaccination rate was 51% among respondents, being highest for community and occupational medicine and pediatric staff (77% and 75%) and lowest for psychiatry, surgery, and radiology staff (32%, 36%, and 36%). Vaccinees reported significantly fewer episodes of illness (42 vs 54 per 100 subjects; P = .03) and fewer days of illness (272 vs 374 per 100 subjects; P = .02); absenteeism was not different (63 vs 69 per 100 subjects; P = .69). Self-protection was the most common reason for vaccination. Vaccinees believed the vaccine was more effective than did non-vaccinees (P < .01). Non-vaccinees considered influenza-like symptoms the most important side effect of the vaccine. Busy schedules and inconvenience were the most common reasons for not getting vaccinated. Overall, 44% of house staff believed the influenza vaccine should be mandatory.Conclusions:Influenza-like illness was common among house staff. They tended to work through their illnesses, potentially putting patients at risk. They were motivated mostly by self-protection and did report a benefit. Despite busy schedules and an unfounded fear of getting influenza symptoms from the vaccine, many thought the vaccine should be mandatory.
Correlation Between Healthcare Workers' Knowledge of Influenza Vaccine and Vaccine Receipt
Authors: Martinello Richard A. , Jones Laura , Topal Jeffrey E. 
Published: March 2006

AbstractObjective:Influenza vaccine receipt by healthcare workers (HCWs) is important because HCWs are at risk for occupational exposure to influenza and may act as vectors in the nosocomial transmission of influenza. HCWs were surveyed to determine whether belief in commonly held influenza vaccine misconceptions was associated with influenza vaccine acceptance.Design:Cross-sectional study.Setting:A large urban teaching hospital.Method:A self-administered survey was used to assess nursing and physician staff influenza vaccine knowledge, current vaccination status, and potential reasons for vaccine declination.Results:Two hundred twelve of 215 surveys were completed. The overall influenza vaccination rate was 73%. Physician staff were significantly more likely to have been vaccinated compared with nursing staff (82% vs 62%, respectively; P = .0009). HCWs answering the 5 influenza vaccine basic knowledge questions correctly were significantly more likely to have been vaccinated than those responding incorrectly to any question (84% vs 64%, respectively; P = .002). This association was present in the nursing group where 80% of those answering the knowledge questions correctly were vaccinated, but only 49% of those answering incorrectly were vaccinated (P = .000005). However, in the physician group, there was no significant difference in the influenza vaccination rates between those answering correctly and those answering incorrectly (P = .459).Conclusion:Belief in commonly held influenza vaccine misconceptions was significantly associated with influenza vaccine declination among nursing staff and may act as a barrier to greater rates of influenza vaccination. Reasons for influenza vaccine nonreceipt may differ between nursing and physician staff.
A Preventable Outbreak of Pneumococcal Pneumonia Among Unvaccinated Nursing Home Residents in New Jersey During 2001
Authors: Tan Christina G. , Ostrawski Stanley , Bresnitz Eddy A. 
Published: March 2006

AbstractObjective:To characterize risk factors for invasive pneumococcal infection in a nursing home outbreak.Design:Outbreak investigation, case-control study.Setting:A 114-bed nursing home in New Jersey.Participants:Case-patients were nursing home residents hospitalized with febrile respiratory illness and radiographic findings consistent with pneumonia, and either sputum specimens positive for diplococci or blood cultures positive for Streptococcus pneumoniae, with illness onset during April 3-24, 2001. Control-patients were selected randomly from remaining residents without respiratory symptoms.Methods:Chart reviews were performed for case-patients and control-patients. Serotyping and susceptibility testing were performed on S. pneumoniae isolates. Long-term-care facilities (LTCFs) were surveyed to assess compliance with a state regulation mandating pneumococcal vaccination of residents 65 years and older.Results:Nine case-patients were identified, with a median age of 86 years (range, 78 to 100 years). The median age of control-patients was 86 years (range, 58 to 95 years). No case-patients versus 9 (50%) control-patients received pneumococcal vaccine before the outbreak (OR, 0; CI95, 0–0.7). Recent antibiotic use, pneumonia history, and physical functioning were not associated with illness. Illness attack rate was 16% among all unvaccinated residents versus 0 among vaccinated residents. S. pneumoniae serotype 14, included in pneumococcal vaccine, was isolated from blood cultures of 7 case-patients. Of 361 LTCFs (42%) that replied to the survey, 28 (8%) were not complying with state immunization regulations.Conclusions:This outbreak occurred in an LTCF with low vaccine coverage. Implementing standing order programs, enforcing regulations, documenting vaccinations, and providing education might increase coverage among nursing home residents.
Ventilator-Associated Pneumonia in a Multi-Hospital System Differences in Microbiology by Location
Authors: Babcock Hilary M. , Zack Jeanne E. , Garrison Teresa , Trovillion Ellen , Kollef Marin H. , Fraser Victoria J. 
Published: March 2006

AbstractObjective:To determine whether there were differences in the microbiologic etiologies of ventilator-associated pneumonia in different clinical settings.Design:Observational retrospective cohort study of microbiologic etiologies of ventilator-associated pneumonia from 1998 to 2001 in a multi-hospital system. Microbiologic results were compared between hospitals and between different intensive care units (ICUs) within hospitals.Setting:Three hospitals—one pediatric teaching hospital, one adult teaching hospital, and one community hospital— in one healthcare system in the midwestern United States.Patients:Patients at the target hospitals who developed ventilator-associated pneumonia and for whom microbiologic data were available.Results:Seven hundred fifty-three episodes of ventilator-associated pneumonia had culture data available for review. The most common organisms at all hospitals wereStaphylococcus aureus(28.4%) andPseudomonas aeruginosa(25.2%). The pediatric hospital had higher proportions ofEscherichia coli(9.5% vs 2.3%;P< .001) andKlebsiella pneumoniae(13% vs 3.1%;P< .001) than did the adult hospitals. In the pediatric hospital, the pediatric ICU had higherP. aeruginosarates than did the neonatal ICU (33.3% vs 17%;P= .01). In the adult hospitals, the surgical ICU had higherAcinetobacter baumanniirates (10.2% vs. 1.7%;P< .001) than did the other ICUs.Conclusions:Microbiologic etiologies of ventilator-associated pneumonia vary between and within hospitals. Knowledge of these differences can improve selection of initial antimicrobial regimens, which may decrease mortality.
Is Cutaneous Tuberculosis Infectious? A Case Presentation and Practical Management Plan
Authors: Hui Charles , Garg Amit X. , Pennie Ross 
Published: March 2006

AbstractInfection control measures for cutaneous tuberculosis in the absence of pulmonary disease are problematic. Delays in diagnosis can lead to the exposure of many individuals. This article describes a case of cutaneous tuberculosis and the subsequent contact investigation. Strategies for infection control and their practicality are discussed.
Role of Comorbidity in Mortality Related to Staphylococcus aureus Bacteremia: A Prospective Study Using the Charlson Weighted Index of Comorbidity
Authors: Lesens Olivier , Methlin Cédric , Hansmann Yves , Remy Véronique , Martinot Martin , Bergin Colm , Meyer Pierre , Christmann Daniel 
Published: March 2006

AbstractObjective:To demonstrate the effectiveness of the Charlson weighted index of comorbidity (WIC) for controlling comorbidity in prospective studies focusing on mortality in patients with Staphylococcus aureus bacteremia (SAB).Design:Cohort study.Setting:Two tertiary-care, university-affiliated hospitals in France.Patients:One hundred sixty-six inpatients 18 years or older consecutively diagnosed with SAB from May 15, 2001, to May 15, 2002.Methods:Patients were prospectively assessed and cases were followed by the infectious diseases consult service at least 3 months after effective antibiotic therapy completion. The Charlson WIC was computed and dichotomized into scores of fewer than 3 points and 3 or more points. Bacteremia source, acute complication due to SAB acquisition in the ICU, and inappropriate empiric antibiotic therapy were recorded. The endpoint was death due to SAB and overall mortality.Results:In univariate analysis, the Charlson WIC was able to predict overall mortality and S. aureus-related death. The following variables were found to be independently predictive of mortality due to SAB using the Cox model: an acute complication due to S. aureus (OR, 8.9; CI95, 4 to 19.7; P < .001), a Charlson WIC score of 3 or more (OR, 3; CI95, 1.3 to 5.5; P = .006), and age (OR, 1.04; CI95, 1.009 to 1.07; P < .01).Conclusions:Comorbidity contributes to death in patients with SAB. The Charlson WIC is a good predictor of mortality in this population and may be a useful instrument to control comorbidity in studies aiming to investigate risk factors for death due to bacteremia.
Outcomes of Hickman Catheter Salvage in Febrile Neutropenic Cancer Patients WithStaphylococcus aureusBacteremia
Authors: Kim Sung-Han , Kang Cheol-In , Kim Hong-Bin , Youn Sung-Soo , Oh Myoung-don , Kim Eui-Chong , Park Seon-Yang , Kim Byoung-Kook , Choe Kang-Won 
Published: March 2006

AbstractObjective:To evaluate the outcome of attempted Hickman catheter salvage in neutropenic cancer patients withStaphylococcus aureusbacteremia who were not using antibiotic lock therapy.Design:Retrospective cohort study.Setting:A university-affiliated, tertiary-care hospital with 1,500 beds for adult patients.Patients:All neutropenic cancer patients who had a Hickman catheter andS. aureusbacteremia (32 episodes in 29 patients) between January 1998 and March 2002.Methods:Salvage attempts were defined as cases where the Hickman catheter was not removed until we obtained the results of follow-up blood cultures performed 48 to 72 hours after starting treatment with antistaphylococcal antibiotics. Salvage was considered to be successful if the Hickman catheter was still in place 3 months later without recurrent bacteremia or death.Results:Catheter salvage was attempted in 24 (75%) of the 32 episodes. Of the salvage attempts, the success rate was 50% (12 of 24). Salvage attempts were successful in 14% (1 of 7) of the episodes with positive follow-up blood cultures, and in 65% (11 of 17) of those with negative follow-up blood cultures (P= .07). If the analysis is confined to cases with no external signs of catheter infection, salvage attempts were successful in 14% (1 of 7) of the episodes with positive follow-up blood cultures and in 80% (8 of 10) of those with negative follow-up blood cultures (P= .02).Conclusion:In neutropenic cancer patients withS. aureusbacteremia, attempted catheter salvage without antibiotic lock therapy was successful in 50% of the cases.