Patient Safety

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

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

by

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

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

Vancomycin use in pediatric neurosurgery patients

by

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

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

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

by

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

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

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

by

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

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

Seasonal variation of Acinetobacter infections: 1987-1996. Nosocomial Infections Surveillance System

by

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

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

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

by

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

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

Unrecognised Mycobacterium tuberculosis bacteraemia among hospital inpatients in less developed countries

by

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

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

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

by

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

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

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

by

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

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

A pseudoepidemic of postoperative scleritis due to misdiagnosis

by

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

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

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

by

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

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

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

by

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

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

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

by

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

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

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

by

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

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

Postsurgical Candida albicans infections associated with an extrinsically contaminated intravenous anesthetic agent

by

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

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

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

by

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

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

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

by

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

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

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

by

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

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

The emergence of decreased susceptibility to vancomycin in Staphylococcus epidermidis

by

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

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

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

by

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

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

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

by

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

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

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

by

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

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

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

by

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

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

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

by

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

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

EMERGEncy ID NET: an emergency department-based emerging infections sentinel network. The EMERGEncy ID NET Study Group

by

Abstract

Acute infectious disease presentations among many at-risk patient groups (eg, uninsured, homeless, and recent immigrants) are frequently seen in emergency departments. Therefore EDs may be useful sentinel sites for infectious disease surveillance. This article describes the background, development, and implementation of EMERGE ncy ID NET, an interdisciplinary, multicenter, ED-based network for research of emerging infectious diseases.… Read more

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

Enterobacter cloacae and Pseudomonas aeruginosa polymicrobial bloodstream infections traced to extrinsic contamination of a dextrose multidose vial

by

Abstract

OBJECTIVE: To identify risk factors for polymicrobial bloodstream infections (BSIs) in neonatal intensive care unit (NICU) patients during an outbreak of BSIs.

DESIGN: During an outbreak of BSIs, we conducted a retrospective cohort study, assessed NICU infection control practices and patient exposure to NICU healthcare workers (HCWs), and obtained cultures of the environment and HCW hands.… Read more

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

Nocardia farcinica sternotomy site infections in patients following open heart surgery

by

Abstract

Although Nocardia farcinica surgical site infection outbreaks have been reported (though rarely), no source for these has been identified. From May 1992 through June 1993, 5 patients contracted N. farcinica sternotomy site infections following open heart surgery at hospital A.… Read more

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

Line-associated bloodstream infections in pediatric intensive-care-unit patients associated with a needleless device and intermittent intravenous therapy

by

Abstract

OBJECTIVES: To determine risk factors for an increase in line-associated bloodstream infections (BSIs) in three pediatric intensive-care units at one hospital that recently had changed brands of needleless access device.

DESIGN: Retrospective case-control studies; review of the units’ infection control policies and procedures for accessing and replacing components of needleless access devices.… Read more

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

Candida albicans endocarditis associated with a contaminated aortic valve allograft: implications for regulation of allograft processing

by

Abstract

A patient developed Candida albicans endocarditis and fungemia after undergoing aortic valve replacement with an allograft. The allograft had been found during tissue bank processing to be contaminated with C. albicans, but it was culture-negative for C. albicans after routine disinfection with an antifungal-containing antimicrobial solution.… Read more

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

Outbreak of sterile peritonitis among continuous cycling peritoneal dialysis patients

by

Abstract

BACKGROUND: Approximately 30,000 patients receive peritoneal dialysis in the United States. In August 1996, several dialysis centers from different states reported sterile peritonitis among CCPD patients using sterile peritoneal dialysis solution (PDS) from a single manufacturer. The manufacturer recalled 53 lots of PDS that had passed established industry guidelines and Food and Drug Administration (FDA) approved quality control tests [including endotoxin levels 1 cfu/ml.… Read more

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

Klebsiella pneumoniae bloodstream infections in neonates in a hospital in the Kingdom of Saudi Arabia

by

Abstract

OBJECTIVE: To identify risk factors for Klebsiella pneumoniae bloodstream infections (BSI) in neonates in a hospital in the Kingdom of Saudi Arabia (KSA).

DESIGN: Two case-control studies among hospitalized neonates during February 15-May 14, 1991, and a procedural and microbiological investigation.… Read more

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

Outbreak of Acinetobacter spp. bloodstream infections in a nursery associated with contaminated aerosols and air conditioners

by

Abstract

BACKGROUND: Acinetobacter spp. are multidrug-resistant bacteria that grow well in water and cause infections with unexplained, increased summer prevalence. In August, 1996, eight infants acquired Acinetobacter spp. bloodstream infection (A-BSI) while in a nursery in the Bahamas; three infants died and an investigation was initiated.… Read more

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

Disco fever: epidemic meningococcal disease in northeastern Argentina associated with disco patronage

by

Abstract

Neisseria meningitidis is a leading cause of adult meningitis worldwide. From 5 to 14 August 1996, 8 cases of meningococcal disease occurred in Corrientes city (population 306,000) in northeastern Argentina. Those infected ranged in age from 15 to 45 years (median, 18.5).… Read more

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

Epidemiology, appropriateness, and cost of vancomycin use

by

Abstract

Pharmaceutical costs, which approach $40 billion annually, account for about 8% of health care costs. Prescription drugs represent 5% to 20% of the total hospital budget, and antimicrobials account for 20% to 50% of hospital pharmaceutical costs. At one university hospital, the percentage of patients receiving antimicrobials increased from 31.8% in 1988 to 53.1% in 1994.… Read more

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

Risk factors for early recurrent Clostridium difficile-associated diarrhea

by

Abstract

Recurrence is a common sequela of Clostridium difficile-associated diarrhea (CDD) and may increase morbidity, costs, and treatment-related antimicrobial resistance. Because recurrent CDD (RCDD) frequently occurs very soon after an initial episode, our goal was to determine the risk factors for early RCDD (occurring < or = 45 days after the initial episode). We conducted a case-control study, comparing 13 patients with early RCDD (case patients) with 46 patients who had only one CDD episode (control patients) at Centre Hospitalier Angrignon (Québec) during January 1993 through November 1994. Risk factors for early RCDD included a history of chronic renal insufficiency, a white blood cell count of > or = 15 x 10(3)/mm3, and community-acquired diarrhea with the first CDD episode.… Read more

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

Liver failure and death after exposure to microcystins at a hemodialysis center in Brazil

by

Abstract

BACKGROUND: Hemodialysis is a common but potentially hazardous procedure. From February 17 to 20, 1996, 116 of 130 patients (89 percent) at a dialysis center (dialysis center A) in Caruaru, Brazil, had visual disturbances, nausea, and vomiting associated with hemodialysis.… Read more

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

An epidemic of Malassezia pachydermatis in an intensive care nursery associated with colonization of health care workers’ pet dogs

by

Abstract

BACKGROUND: Malassezia species are lipophilic yeasts that are emerging as nosocomial pathogens, particularly in low-birth-weight neonates who receive lipid emulsions. When a cluster of patients with Malassezia pachydermatis infection was identified in an intensive care nursery, we initiated an investigation.… Read more

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

Kawasaki disease and the T-cell antigen receptor

by

Abstract

We investigated the evidence for an infectious etiology of Kawasaki disease (KD), an acute vasculitis of unknown etiology, by assessing the effects of KD on the T cell antigen receptor variable beta region families (V beta). Using 3-color flow cytometry, we studied KD patients pre- and post-intravenous gamma globulin (IVIG) therapy and at > 40 days post therapy, additionally comparing them to matched pediatric control patients (PCC) and their own healthy parents (one parent/KD child).… Read more

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

A cluster of bloodstream infections and pyrogenic reactions among hemodialysis patients traced to dialysis machine waste-handling option units

by

Abstract

From June 17 through November 15, 1995, ten episodes of Enterobacter cloacae bloodstream infection and three pyrogenic reactions occurred in patients at a hospital-based hemodialysis center. In a case-control study limited to events occurring during October 1-31, 1995, seven dialysis sessions resulting in E.… Read more

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

Use of an estimation method to derive an appropriate denominator to calculate central venous catheter-associated bloodstream infection rates

by

Abstract

An outbreak investigation was conducted to determine if an increase in bloodstream infections (BSIs) in patients with central venous catheters (CVC) had occurred. Because other methods of obtaining CVC days were not feasible, we used an estimation method based on a random 5% sample of medical records to determine the proportion of days that a CVC was present for each of three patient units.… Read more

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

Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device

by

Abstract

OBJECTIVE: To determine if an apparent increase in bloodstream infections (BSIs) in patients with central venous catheters (CVCs) was associated with the implementation of a needleless access device.

DESIGN: Retrospective cohort study using a derived CVC-days factor for estimating appropriate denominator data.… Read more

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

Respiratory distress and sudden death associated with receipt of a peripheral parenteral nutrition admixture

by

Abstract

OBJECTIVE: To detect respiratory adverse reactions potentially related to receipt of peripheral parenteral nutrition (PPN) in hospitalized patients and to determine risk factors for their occurrence.

DESIGN: Retrospective cohort study.

SETTING: Federal tertiary-care hospital.

PATIENTS: Medical and pharmacy records of all patients who received PPN from October 1992 to February 1994 were abstracted for demographics, diagnoses, medications received, indications for and formulation of PPN, and severity of illness as measured by Acute Physiology and Chronic Health Evaluation II scores.… Read more

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

Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit

by

Abstract

BACKGROUND: An investigation of a Serratia marcescens outbreak in a pediatric cardiac intensive care unit (CICU) suggested that understaffing or overcrowding might have been underlying risk factors.

OBJECTIVE: To assess the effect of fluctuations in CICU nurse staffing levels and patient census on CICU nosocomial infection rate (NIR).… Read more

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

A semiquantitative analysis of the fecal flora of patients with vancomycin-resistant enterococci: colonized patients pose an infection control risk

by

Abstract

Montecalvo MA, Shay DK, Gedris C, Petrullo C, Uman J, Rodney K, Jarvis WR, Wormser GP

Clin. Infect. Dis. 1997 Oct;25(4):929-30

PMID: 9356817… Read more

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

Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap

by

Abstract

OBJECTIVES: To determine risk factors for Serratia marcescens infection or colonization, and to identify the source of the pathogen and factors facilitating its persistence in a neonatal intensive-care unit (NICU) during an outbreak.

DESIGN: Retrospective case-control study; review of NICU infection control policies, soap use, and handwashing practices among healthcare workers (HCWs); and selected environmental cultures.… Read more

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

Immunoregulatory changes in Kawasaki disease

by

Abstract

Kawasaki disease (KD) is an acute vasculitis of unknown etiology, occurring in young children and treated with intravenous gamma globulin (IVIG) to prevent significant cardiac morbidity and mortality. We studied KD patients pre- and post-IVIG therapy and at >40 days posttherapy, additionally comparing them with matched pediatric control patients and parents.… Read more

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

Pyrogenic reactions in patients undergoing cardiac catheterization associated with contaminated glass medicine cups

by

Abstract

Pyrogenic reactions are potentially life-threatening complications caused by bacterial endotoxin. After two cardiac catheterization patients developed rigors the same day, the procedures were halted and a case control study was conducted. To identify case patients (persons with rigors < or = 3 hr after catheterization during September 25-November 9, 1995), we reviewed medical records of all cardiac catheterization patients who had a blood culture or received intravenous meperidine. Twelve case patients and 40 randomly selected control patients were identified. No specific catheter was associated with case patients, but exposure to intracoronary-nitroglycerin (NTG) was (odds ratio = 12.0; 95% confidence interval 2.2, 75.6). NTG or indocyanine green dye was poured into glass medicine cups previously washed in an enzyme cleaner and then sterilized. The cleaner, used for an entire day, had elevated levels of gram-negative bacteria (> 10(4) colony forming units/mL) and endotoxin (434 endotoxin units [EU]/mL]); the reprocessed cups had no live bacteria but had elevated endotoxin levels (median 2,250 EU).… Read more

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

Staphylococcus aureus bloodstream infections among patients undergoing electroconvulsive therapy traced to breaks in infection control and possible extrinsic contamination by propofol

by

Abstract

Infectious complications associated with electroconvulsive therapy (ECT) are extremely unusual. When five of nine patients undergoing ECT at one facility on June 20, 1996 developed Staphylococcus aureus bloodstream infection (BSI), an investigation was initiated. A retrospective cohort study, a procedure review, and observational and microbiologic studies were performed.… Read more