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Status of infection surveillance and control programs in the United States, 1992-1996. Association for Professionals in Infection Control and Epidemiology, Inc

Abstract

BACKGROUND: Nosocomial infections have been recognized as a source of morbidity and mortality throughout the world for several decades. In the United States, an estimated 2.1 million nosocomial infections occur annually in acute care hospitals alone. Infection surveillance and control programs (ISCPs) play a vital role in addressing this problem, but no national studies have described the status and composition of these programs since the 1970s.… Read more

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The Internet: a practical example of the use of new technology in the assessment of vancomycin use in pediatrics. The Pediatric Prevention Network

Abstract

BACKGROUND: The rapid emergence of both new infections and new technologies has revolutionized health care during the past 50 years. Increased use of the Internet has enabled health care professionals to educate, interact, and collaborate throughout the world in ways never before possible.… Read more

Illustration(s) pertain to the topic addressed in this publication, not the specific research or data presented in the publication

Pyrogenic reactions associated with single daily dosing of intravenous gentamicin

Abstract

OBJECTIVE: To identify risk factors associated with an unexpected outbreak of pyrogenic reactions (PR) following intravenous gentamicin.

DESIGN: We conducted two cohort studies. PRs were defined as chills, rigors, or shaking within 3 hours after initiating the gentamicin infusion during the preepidemic (December 1, 1997-January 15, 1998) or epidemic (May 1-June 15, 1998) periods.… Read more

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Reality check: how should we control antimicrobial use? Current practices and controversies

Abstract

The infectious diseases community shares a wide consensus about the need for control of antimicrobial use. However, current practices toward this goal remain controversial. This “Reality Check” session assessed attendees of the 4th Decennial Conference regarding their knowledge and practices about control of antimicrobial use in hospitals.… Read more

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Program overview: the reality check sessions at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections

Abstract

The 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections provided a unique forum to assess opinions regarding current infection control controversies. The “Reality Check” sessions were a special portion of the conference where attendees expressed their opinions on these issues and heard varying viewpoints from noted experts.… Read more

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Should we routinely use mupirocin to prevent staphylococcal infections?

Abstract

Routine use of mupirocin to prevent staphylococcal infections is controversial. We assessed attitudes and practices of healthcare professionals attending the Fourth Decennial International Conference on Nosocomial and Healthcare-Associated Infections regarding mupirocin prophylaxis. Eighty percent of participants did not use mupirocin routinely.… Read more

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Effects of HIV-1 peptides on T-cell receptor variable beta chain families

Abstract

Superantigens (SAGs) selectively stimulate expansion and then deletion of specific T cell antigen receptor (TCR) variable beta chain (Vbeta) families. We investigated six synthetically produced HIV-1-related peptides for evidence of SAG activity: three derived all or in part from the transmembrane gp41 protein and three from the genetic sequence of the tRNA binding region.… Read more

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An epidemic of corneal destruction caused by plasma gas sterilization. The Toxic Cell Destruction Syndrome Investigative Team

Abstract

BACKGROUND: Toxic endothelial cell destruction (TECD) syndrome after intraocular ophthalmic surgery is rare and can result from exposure to a variety of toxins. During January 8 to 14, 1998, 6 patients developed TECD with corneal edema associated with unreactive or dilated pupils at Hospital A.… Read more

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Physician preferences for educational media

Abstract

BACKGROUND: Although educational media have expanded in variety, information on physicians’ preferences for types of educational media remains limited.

METHOD: An assessment form was distributed to 14 medical societies evaluating their members’ medical education media preferences and society antimicrobial-resistance educational offerings.… Read more

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Comparison of BACTEC MYCO/F LYTIC and WAMPOLE ISOLATOR 10 (lysis-centrifugation) systems for detection of bacteremia, mycobacteremia, and fungemia in a developing country

Abstract

In less-developed countries, studies of bloodstream infections (BSI) have been hindered because of the difficulty and costs of culturing blood for bacteria, mycobacteria, and fungi. During two study periods (study period I [1997] and study period II [1998]), we cultured blood from patients in Malawi by using the BACTEC MYCO/F LYTIC (MFL), ISOLATOR 10 (Isolator), Septi-Chek AFB (SC-AFB), and Septi-Chek bacterial (SC-B) systems.… Read more

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Risk factors for acquisition of vancomycin-resistant enterococci among patients on a renal ward during a community hospital outbreak

Abstract

BACKGROUND: During an outbreak of vancomycin-resistant enterococcal (VRE) infection and colonization at a community hospital in Indianapolis, Indiana, we performed a case-control study of patients on the hospital’s renal unit to determine risk factors for acquisition of VRE among this potentially high-risk patient population.… Read more

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When clusters occur: an illustrative example and a statistical dilemma

Abstract

Sinkowitz-Cochran RL, Cazes C, Chinn RY, Vargo JA, Jarvis WR

Am J Infect Control 2000 Aug;28(4):325-6

PMID: 10926718

When clusters occur: an illustrative example and a statistical dilemma was last modified: August 1st, 2000 by Sinkowitz-Cochran RL, Cazes C, Chinn RY, Vargo JA, Jarvis WR… Read more
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Transfusion-related sepsis due to Serratia liquefaciens in the United States

Abstract

BACKGROUND: Severe, often fatal, transfusion reactions due to bacterial contamination of blood components continue to occur. Serratia liquefaciens, an unusual human pathogen, is a recently recognized potential cause of transfusion-related sepsis.

CASE REPORTS: Five episodes of transfusion-related sepsis and endotoxic shock due to S.… Read more

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Natural T, gammadelta, and NK cells in mycobacterial, Salmonella, and human immunodeficiency virus infections

Abstract

NK cells, gammadelta T cell antigen receptor chain-positive cells, and CD3(+)CD16/56(+) (natural T [NT]) cells are involved in innate immunity and immunoregulation; however, their role in clinical infection is not well defined. Cytofluorometric analysis was used to examine peripheral blood from bacteremic, nonbacteremic, and healthy human immunodeficiency virus (HIV)-positive and -negative persons in Malawi, Africa.… Read more

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Association between implementation of CDC recommendations and ventilator-associated pneumonia at selected US hospitals

Abstract

BACKGROUND: To assess whether selected recommendations in the Centers for Disease Control and Prevention “Guideline for Prevention of Nosocomial Pneumonia” were being implemented and having an impact on the occurrence of ventilator-associated pneumonia (VAP) at US hospitals, we surveyed hospitals participating in the National Nosocomial Infections Surveillance (NNIS) system.… Read more

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Evaluation of a satellite education program on the prevention and control of antimicrobial resistance

Abstract

Sinkowitz-Cochran RL, Jarvis WR

Am J Infect Control 2000 Jun;28(3):267-8

PMID: 10840349

Evaluation of a satellite education program on the prevention and control of antimicrobial resistance was last modified: June 1st, 2000 by Sinkowitz-Cochran RL, Jarvis WR… Read more
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Acute onset of decreased vision and hearing traced to hemodialysis treatment with aged dialyzers

Abstract

CONTEXT: A recent event in which 7 patients at 1 hospital developed decreased vision and hearing, conjunctivitis, headache, and other severe neurologic symptoms 7 to 24 hours after hemodialysis drew attention to the issue of the long-term integrity of dialysis machines and materials.… Read more

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A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy

Abstract

The etiology of bloodstream infections (BSIs) in febrile (or =37.5 degrees C) adults (or =18 years old) in one Malawi hospital were determined during August and September 1997. After clinical evaluation, blood was drawn for comprehensive culture, human immunodeficiency virus (HIV) type 1 testing, and malaria smear.… Read more

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Preventing multidrug-resistant tuberculosis and errors in tuberculosis treatment around the globe

Abstract

Manangan LP, Jarvis WR

Chest 2000 Mar;117(3):620-3

PMID: 10712980

Preventing multidrug-resistant tuberculosis and errors in tuberculosis treatment around the globe was last modified: March 1st, 2000 by Manangan LP, Jarvis WR… Read more
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Outbreak of Pseudomonas aeruginosa ventriculitis among patients in a neurosurgical intensive care unit

Abstract

OBJECTIVE: To determine the cause of an outbreak of Pseudomonas aeruginosa cerebral ventriculitis among eight patients at a community hospital neurosurgical intensive care unit. All had percutaneous external ventricular catheters (EVCs) to monitor cerebrospinal fluid (CSF) pressure.

METHODS: Cohort study of all patients who had EVCs placed during the epidemic period (August 8-October 22, 1997).… Read more

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Determining the significance of coagulase-negative staphylococci isolated from blood cultures at a community hospital: a role for species and strain identification

Abstract

OBJECTIVES: To determine the degree to which species identification or strain relatedness assessment of successive blood culture isolates of coagulase-negative staphylococci (CNS) may improve the clinical diagnosis of bloodstream infection (BSI).

SETTING: 400-bed community hospital.

DESIGN: Prospective laboratory survey during which all CNS blood culture isolates obtained between mid-August 1996 and mid-February 1997 (study period) were saved and later identified to the species level; selected isolates were genotyped using pulsed-field gel electrophoresis at the Centers for Disease Control and Prevention (CDC).… Read more

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Outbreaks of infection and/or pyrogenic reactions in dialysis patients

Abstract

These dialysis-related outbreaks demonstrate the ongoing potential for infection-related morbidity and mortality among dialysis patients. Many of these outbreaks could have been prevented by adequate water treatment, proper disinfection of water systems and dialysis machines, adherence to recommended reprocessing protocols in centers reusing dialyzers, and more stringent quality control monitoring.… Read more

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Mitogen-induced modulation of CD3, CD4, and CD8

Abstract

It is not clear whether CD3 contacts CD4 or CD8 directly, nor have the regulation and interregulation of expression of these three receptor molecules been determined. We explored these issues by first stimulating human peripheral blood lymphocytes in vitro with three well-characterized T-cell receptor-directed mitogens (phytohemagglutinin [PHA], concanavalin A [ConA], and anti-CD3 monoclonal antibody [anti-CD3]) and then using multiparameter flow cytometric techniques to investigate modulation of surface (sur) and cytoplasmic (c) CD3, CD4, and CD8.… Read more

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Nosocomial tuberculosis prevention measures among two groups of US hospitals, 1992 to 1996

Abstract

OBJECTIVE: To compare trends in nosocomial tuberculosis (TB) prevention measures and health-care worker (HCW) tuberculin skin test (TST) conversion of hospitals with HIV-related Pneumocystis carinii pneumonia (PCP) patients and other US hospitals from 1992 through 1996.

DESIGN AND SETTING: Surveys in 1992 and 1996 of 38 hospitals with PCP patients in four high-HIV-incidence cities and 136 other US hospitals from the American Hospital Association membership list.… Read more

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Risk factors for radial artery harvest site infection following coronary artery bypass graft surgery

Abstract

Radial arteries increasingly are used during coronary artery bypass graft (CABG) surgery. Although risk factors for saphenous vein harvest site infection (HSI) have been reported, rates of and risk factors for radial artery HSI are not well established. We compared rates of radial artery HSI that were detected by 2 surveillance methods, regular and heightened.… Read more

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A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission?

Abstract

OBJECTIVES: To describe an outbreak of Pseudomonas aeruginosa bloodstream infection (BSI) and endotracheal tube (ETT) colonization in a neonatal intensive care unit (NICU), determine risk factors for infection, and make preventive recommendations.

DESIGN: A 15-month cohort study followed by a case-control study with an environmental survey and molecular typing of available isolates using pulsed-field gel electrophoresis.… Read more

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Epidemic transmission of human immunodeficiency virus in renal dialysis centers in Egypt

Abstract

In 1993 an epidemic of human immunodeficiency virus (HIV) infection occurred among 39 patients at 2 renal dialysis centers in Egypt. The centers, private center A (PCA) and university center A (UCA) were visited, HIV-infected patients were interviewed, seroconversion rates at UCA were calculated, and relatedness of HIV strains was determined by sequence analysis; 34 (62%) of 55 patients from UCA and 5 (42%) of 12 patients from PCA were HIV-infected.… Read more

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Modifiable risk factors associated with deep sternal site infection after coronary artery bypass grafting

Abstract

OBJECTIVE: Our objective was to identify risk factors for deep sternal site infection after coronary artery bypass grafting at a community hospital.

METHODS: We compared the prevalence of deep sternal site infection among patients having coronary artery bypass grafting during the study (January 1995-March 1998) and pre-study (January 1992-December 1994) periods.… Read more

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Enterobacter cloacae bloodstream infections traced to contaminated human albumin

Abstract

In August 1996, a patient in Kansas developed an Enterobacter cloacae bloodstream infection (BSI) shortly after receiving Albuminar, a brand of human albumin. Albuminar contamination was suspected. A case-control study of patients with primary gram-negative bacterial BSIs showed that patients with E.… Read more

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The influence of the composition of the nursing staff on primary bloodstream infection rates in a surgical intensive care unit

Abstract

OBJECTIVES: To determine the risk factors for acquisition of nosocomial primary bloodstream infections (BSIs), including the effect of nursing-staff levels, in surgical intensive care unit (SICU) patients.

DESIGN: A nested case-control study.

SETTING: A 20-bed SICU in a 1,000-bed inner-city public hospital.… Read more

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Vancomycin use in pediatric hematology-oncology patients

Abstract

Across-sectional study was performed of pediatric hematology-oncology patients who received vancomycin; use was compared to the Centers for Disease Control and Prevention (CDC) recommendations for vancomycin use. Thirty-seven patients received 308 doses of vancomycin. AR patients initially received vancomycin as empirical therapy; 100% of this use was not consistent with the CDC recommendations.… Read more