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Vancomycin use in pediatric neurosurgery patients

Abstract

OBJECTIVE: The objective of this article is to describe a pediatric neurosurgery patient population receiving vancomycin and examine the indications for and appropriateness of vancomycin use.

METHODS: A cross-sectional study was performed on the pediatric neurosurgery patients at Egleston Children’s Hospital who received vancomycin from January 1 through December 31, 1996.… Read more

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Reply

Abstract

Kuehnert MJ, Jarvis WR

Clin. Infect. Dis. 1999 Nov;29(5):1358

PMID: 10525009

Reply was last modified: November 1st, 1999 by Kuehnert MJ, Jarvis WR… Read more
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Seasonal variation of Acinetobacter infections: 1987-1996. Nosocomial Infections Surveillance System

Abstract

To determine whether nosocomial infections due to Acinetobacter species have increased over the past 10 years and whether infections continue to have a pronounced seasonal variation, we analyzed infections reported by hospitals in the National Nosocomial Infections Surveillance System that performed adult and pediatric intensive care unit surveillance from 1987 through 1996.… Read more

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A multistate nosocomial outbreak of Ralstonia pickettii colonization associated with an intrinsically contaminated respiratory care solution

Abstract

From 1 February through 30 April 1998, 4 hospitals reported a total of 34 patients colonized with Ralstonia pickettii. All but 1 had been exposed to 0.9% saline solution manufactured by 1 company (Modudose; Kendall, Mainsfield, MA), which was used during endotracheal suctioning.… Read more

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An outbreak of gram-negative bacteremia in hemodialysis patients traced to hemodialysis machine waste drain ports

Abstract

OBJECTIVE: To investigate an outbreak of gram-negative bacteremias at a hemodialysis center (December 1, 1996-January 31, 1997).

DESIGN: Retrospective cohort study. Reviewed infection control practices and maintenance and disinfection procedures for the water system and dialysis machines. Performed cultures of the water and dialysis machines, including the waste-handling option (WHO), a drain port designed to dispose of saline used to flush the dialyzer before patient use.… Read more

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Satellite videoconferencing for healthcare workers: audience characteristics and the importance of continuing education credits

Abstract

To assess the opinions of healthcare workers (HCWs) about a satellite videoconference as a means of earning continuing education credit, a telephone survey was conducted in September 1998, 1 month after a live interactive satellite videoconference on antimicrobial use and resistance.… Read more

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Proficiency in detecting vancomycin resistance in enterococci among clinical laboratories in Santiago, Chile

Abstract

Labarca JA, McDonald LC, Pinto ME, Palavecino E, González P, Cona E, Fernández A, Giglio MS, Jarvis WR

Emerging Infect. Dis. 1999 Nov-Dec;5(6):839-40

PMID: 10603228

Proficiency in detecting vancomycin resistance in enterococci among clinical laboratories in Santiago, Chile was last modified: November 1st, 1999 by Labarca JA, McDonald LC, Pinto ME, Palavecino E, González P, Cona E, Fernández A, Giglio MS, Jarvis WR… Read more
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Unrecognised Mycobacterium tuberculosis bacteraemia among hospital inpatients in less developed countries

Abstract

BACKGROUND: Nosocomial transmission of Mycobacterium tuberculosis is a global public-health concern. Although early clinical recognition of M. tuberculosis in hospital inpatients is critical for effective infection control, such recognition may be difficult in patients with HIV infection. To find out whether M.… Read more

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Association between mucositis severity and vancomycin-resistant enterococcal bloodstream infection in hospitalized cancer patients

Abstract

OBJECTIVE: To determine the role of mucositis severity in the development of vancomycin-resistant enterococcal (VRE) bloodstream infection (BSI).

SETTING: A tertiary-care university medical center.

PARTICIPANTS: Hematology-oncology-unit inpatients.

DESIGN: Patients with VRE BSI (case-patients) were compared with VRE-colonized (control) patients from September 1994 through August 1997.… Read more

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Reporting of vancomycin-resistant enterococci in Connecticut: implementation and validation of a state-based surveillance system

Abstract

OBJECTIVE: To assess state-based surveillance for isolation from a sterile site of vancomycin-resistant enterococci (VRE) in Connecticut.

DESIGN: Clinical laboratory reporting (passive surveillance) of VRE isolates to the Connecticut Department of Public Health (CDPH) was followed by state-initiated validation, laboratory proficiency testing, and review of hospital demographic characteristics.… Read more

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Emerging Issues in Nosocomial Fungal Infections

Abstract

Nosocomial fungal infections remain a serious cause of morbidity and mortality. As immunodeficient populations increase, the incidence of nosocomial fungal infections continues to rise. Although a wide variety of new and emerging fungi can cause nosocomial infections, Candida species remain the major etiologic agent.… Read more

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Prospective evaluation of risk factors for bloodstream infection in patients receiving home infusion therapy

Abstract

BACKGROUND: Intravenous therapy in the outpatient and home settings is commonplace for many diseases and nutritional disorders. Few data are available on the rate of and risk factors for bloodstream infection among patients receiving such therapy.

OBJECTIVE: To determine rates of and risk factors for bloodstream infection among patients receiving home infusion therapy.… Read more

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Infection-control measures reduce transmission of vancomycin-resistant enterococci in an endemic setting

Abstract

BACKGROUND: Vancomycin-resistant enterococci (VRE) are nosocomial pathogens in many U. S. hospitals.

OBJECTIVE: To determine whether enhanced infection-control strategies reduce transmission of VRE in an endemic setting.

DESIGN: Prospective cohort study.

SETTING: Adult oncology inpatient unit.

PATIENTS: 259 patients evaluated during use of enhanced infection-control strategies and 184 patients evaluated during use of standard infection-control practices.… Read more

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Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients

Abstract

During early 1997, the Siouxland District Health Department (SDHD; Sioux City, IA) reported an increased incidence of vancomycin-resistant enterococcal (VRE) isolates at area health care facilities. To determine the prevalence and risk factors for colonization with VRE strains at 32 health care facilities in the SDHD region, a prevalence survey and case-control study were performed.… Read more

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A pseudoepidemic of postoperative scleritis due to misdiagnosis

Abstract

OBJECTIVE: 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.… Read more

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Antimicrobial resistance in Staphylococcus aureus

Abstract

Recognized since 1883 as a common cause of infection, Staphylococcus aureus’ preantimicrobial-era bacteremia mortality rate was 82%. The mortality of that era threatens to return as evidence of growing vancomycin resistance undermines the utility of vancomycin therapy. Successful treatment of S.… Read more

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Lessons from recent nosocomial epidemics

Abstract

This review describes important examples of recent nosocomial infection epidemics. Current trends suggest that emerging problems in nosocomial infections include increased nosocomial epidemics in out-of-hospital settings, contamination of medical devices and products, and antimicrobial resistance. Increased attention should be focused on outbreak investigations in these areas.… Read more

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Fever and human immunodeficiency virus infection as sentinels for emerging mycobacterial and fungal bloodstream infections in hospitalized patients >/=15 years old, Bangkok

Abstract

To determine the etiology of bloodstream infections (BSIs) in hospitalized patients /=15 years old in Thailand, prospectively enrolled, consecutive febrile (/=38 degrees C) patients were admitted to one hospital during February-April 1997. After a patient history was taken and a physical examination was performed, blood was obtained for comprehensive culture and human immunodeficiency virus (HIV) testing.… Read more

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Proficiency of clinical laboratories in Spain in detecting vancomycin-resistant Enterococcus spp. The Spanish VRE Study Group

Abstract

Studies in a variety of U.S. clinical laboratories have demonstrated difficulty in detecting intermediate and low-level vancomycin-resistant enterococci (VRE). The misclassification of “at least intermediate resistant isolates” as vancomycin susceptible may have both clinical implications and a negative impact on measures to control the spread of VRE.… Read more

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Selected global health care activities of the Hospital Infections Program, Centers for Disease Control and Prevention

Abstract

Manangan LP, Archibald LK, Pearson ML, Duffy RE, Garrett DO, Alonso-Echanove JA, Richet HM, Parvez FM, Jarvis WR

Am J Infect Control 1999 Jun;27(3):270-4

PMID: 10358231

Selected global health care activities of the Hospital Infections Program, Centers for Disease Control and Prevention was last modified: June 1st, 1999 by Manangan LP, Archibald LK, Pearson ML, Duffy RE, Garrett DO, Alonso-Echanove JA, Richet HM, Parvez FM, Jarvis WR… Read more
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Vancomycin use in pediatric cardiothoracic surgery patients

Abstract

Shah SS, Sinkowitz-Cochran RL, Keyserling HL, Jarvis WR

Pediatr. Infect. Dis. J. 1999 Jun;18(6):558-60

PMID: 10391192

Vancomycin use in pediatric cardiothoracic surgery patients was last modified: June 1st, 1999 by Shah SS, Sinkowitz-Cochran RL, Keyserling HL, Jarvis WR… Read more
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Postsurgical Candida albicans infections associated with an extrinsically contaminated intravenous anesthetic agent

Abstract

From 16 to 30 April 1990, four of 364 (1%) postsurgical patients at one hospital developed Candida albicans fungemia or endophthalmitis. The case patients’ surgeries were clustered on two days. To identify risk factors for C. albicans infections, we conducted a cohort study comparing these 4 patients with 67 control patients who had surgeries on the same days but did not acquire C.… Read more

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Increased risk of Mycobacterium tuberculosis infection related to the occupational exposures of health care workers in Chiang Rai, Thailand

Abstract

SETTING: Chiang Rai, the northernmost province of Thailand.

OBJECTIVE: To evaluate the occupational risk for tuberculous infection of health care workers (HCWs) and the utility of tuberculin skin test (TST) in a developing country setting.

DESIGN: A cross-sectional TST survey, including a risk assessment questionnaire, of Chiang Rai Hospital HCWs.… Read more

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Trends in compliance with the guidelines for preventing the transmission of Mycobacterium tuberculosis among New Jersey hospitals, 1989 to 1996

Abstract

OBJECTIVE: To determine trends in compliance with the guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities among New Jersey hospitals from 1989 through 1996.

DESIGN: A voluntary questionnaire was sent to all 96 New Jersey hospitals in 1992.… Read more

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Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee

Abstract

EXECUTIVE SUMMARY The “Guideline for Prevention of Surgical Site Infection, 1999” presents the Centers for Disease Control and Prevention (CDC)’s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.1,2 Part I, “Surgical Site Infection: An Overview,” describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs.… Read more

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Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee

Abstract

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR

Infect Control Hosp Epidemiol 1999 Apr;20(4):250-78; quiz 279-80

PMID: 10219875

Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee was last modified: April 1st, 1999 by Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR… Read more
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Reply

Abstract

Cookson ST, Schuchat A, Jarvis WR

J. Infect. Dis. 1999 Mar;179(3):751-2

PMID: 9952477

Reply was last modified: March 1st, 1999 by Cookson ST, Schuchat A, Jarvis WR… Read more
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The emergence of decreased susceptibility to vancomycin in Staphylococcus epidermidis

Abstract

BACKGROUND: Coagulase-negative staphylococci (CNS) are the major cause of nosocomial bloodstream infection. Emergence of vancomycin resistance among CNS is a serious public health concern, because CNS usually are multidrug-resistant, and glycopeptide antibiotics, among which only vancomycin is available in the United States, are the only remaining effective therapy.… Read more

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The prevalence of colonization with vancomycin-resistant Enterococcus at a Veterans’ Affairs institution

Abstract

OBJECTIVE: To study vancomycin-resistant Enterococcus (VRE) prevalence, risk factors, and clustering among hospital inpatients.

DESIGN: Rectal-swab prevalence culture survey conducted from February 5 to March 22, 1996.

SETTING: The Veterans’ Affairs Medical Center, Atlanta, Georgia.

PATIENTS: Hospital (medical and surgical) inpatients.… Read more

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Surgical-site complications associated with a morphine nerve paste used for postoperative pain control after laminectomy

Abstract

OBJECTIVE: To identify risk factors that might explain a sudden increase in the rate of surgical-site complications following laminectomy.

DESIGN: Retrospective cohort study.

PATIENTS AND SETTING: Patients who underwent laminectomy at a 120-bed hospital from August 1 through October 15, 1996 (the epidemic period).… Read more

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Emergence of vancomycin resistance in Staphylococcus aureus. Glycopeptide-Intermediate Staphylococcus aureus Working Group

Abstract

BACKGROUND: Since the emergence of methicillin-resistant Staphylococcus aureus, the glycopeptide vancomycin has been the only uniformly effective treatment for staphylococcal infections. In 1997, two infections due to S. aureus with reduced susceptibility to vancomycin were identified in the United States.… Read more

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Bloodstream infection associated with needleless device use and the importance of infection-control practices in the home health care setting

Abstract

The influence of infection-control practices on bloodstream infection (BSI) risk was examined in a home health care setting in which three needleless devices were used consecutively. A case-control study and a retrospective cohort study were conducted. Risk factors for BSI included lower education level, younger age, having a central venous catheter (CVC) with multiple ports, or having a tunneled CVC.… Read more

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Control of vancomycin-resistant enterococci at a community hospital: efficacy of patient and staff cohorting

Abstract

OBJECTIVE: To evaluate the efficacy of patient and staff cohorting to control vancomycin-resistant enterococci (VRE) at an Indianapolis community hospital.

DESIGN: To interrupt transmission of VRE, a VRE point-prevalence survey of hospital inpatients was conducted, and VRE-infected or -colonized patients were cohorted on a single ward with dedicated nursing staff and patient-care equipment.… Read more

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EMERGEncy ID NET: an emergency department-based emerging infections sentinel network

Abstract

Talan DA, Moran GJ, Mower WR, Newdow M, Ong S, Slutsker L, Jarvis WR, Conn LA, Pinner RW

Clin. Infect. Dis. 1999 Feb;28(2):401-2

PMID: 10064261

EMERGEncy ID NET: an emergency department-based emerging infections sentinel network was last modified: February 1st, 1999 by Talan DA, Moran GJ, Mower WR, Newdow M, Ong S, Slutsker L, Jarvis WR, Conn LA, Pinner RW… Read more
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Increased expression of CD80 and CD86 in in vitro-infected CD3+ cells producing cytoplasmic HIV type 1 p24

Abstract

Determining the effects of HIV infection on the expression of cell surface molecules has been limited by an inability to differentiate between productively infected cells and those without productive infection. We inoculated human peripheral blood mononuclear cells from healthy, human immunodeficiency virus type 1 (HIV) antibody-negative donors with HIV; noninoculated cells were also examined.… Read more

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Proficiency of clinical laboratories in and near Monterrey, Mexico, to detect vancomycin-resistant enterococci

Abstract

Early detection of vancomycin-resistant enterococci is important for preventing its spread among hospitalized patients. We surveyed the ability of eight hospital laboratories in and near Monterrey, Mexico, to detect vancomycin resistance in Enterococcus spp. and found that although laboratories can reliably detect high-level vancomycin resistance, many have difficulty detecting low-level resistance.… Read more

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Immune determinants of organism and outcome in febrile hospitalized Thai patients with bloodstream infections

Abstract

Opportunistic infections (OI) and the human immunodeficiency virus (HIV) cause significant morbidity and mortality in developing countries. Immune cell and cytokine profiles may be related to the type and course of OI and to the OI-HIV interaction. Examining cell-specific cytokine production ex vivo has only recently become feasible.… Read more