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1.
J Pediatr ; 161(5): 814-8, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22694859

ABSTRACT

OBJECTIVE: To determine the frequency and effects of nosocomial respiratory viral infections (RVIs) in premature neonates, including those who may be asymptomatic. STUDY DESIGN: We performed a year-long surveillance for RVIs in infants <33 weeks gestational age admitted to 2 Syracuse neonatal intensive care units. Infants were enrolled within 3 days of neonatal intensive care unit admission and were sampled for RVIs until discharge using a multiplex polymerase chain reaction assay capable of detecting 17 different respiratory viruses or subtypes. RESULTS: Twenty-six of 50 prematurely born infants (52%) tested positive for a respiratory virus at least once during their birth hospitalization. Testing positive for a respiratory virus was significantly associated with longer length of stay (70 days vs 35 days, P = .002) and prolonged ventilatory support (51 vs 13 days, P = .002). Infants who tested positive for a respiratory virus during their birth hospitalization had more than twice the rate of developing bronchopulmonary dysplasia (P < .05). CONCLUSION: Nosocomial RVIs were frequent in our study population, despite the absence of clinical indicators of illness. Length of hospital stay was significantly longer and a diagnosis of bronchopulmonary dysplasia was more common in infants who had respiratory viruses detected.


Subject(s)
Intensive Care, Neonatal/methods , Respiratory Tract Infections/diagnosis , Virus Diseases/diagnosis , Female , Gestational Age , Hospitalization , Humans , Infant, Newborn , Infant, Premature , Intensive Care Units, Neonatal , Male , Methicillin-Resistant Staphylococcus aureus/metabolism , Polymerase Chain Reaction/methods , Prospective Studies , Respiration, Artificial , Respiratory Syncytial Viruses/metabolism , Respiratory Tract Infections/virology , Respirovirus/metabolism
2.
Am J Infect Control ; 40(9): 893-5, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22421076

ABSTRACT

Information about hand hygiene and fecal hand contamination among the general public is limited. Hands are an important vector in transmission of various pathogenic bacteria. We found high (31%) prevalence of fecal hand contamination among healthy adults engaged in hiking.


Subject(s)
Bacteria/isolation & purification , Bacterial Infections/epidemiology , Carrier State/epidemiology , Feces/microbiology , Hand/microbiology , Adult , Hand Hygiene , Humans , Prevalence , Sports , Wilderness
5.
J Pediatr ; 156(2): 322-3, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20105642

ABSTRACT

An infant had a subdural empyema caused by the rare Salmonella species enterica subspecies houtenae (IV) serotype 44:z4,z23:- after only indirect exposure to exotic reptiles in her foster home. Infants recovering from preexisting subdural hematoma are at risk for development of empyema.


Subject(s)
Disease Reservoirs , Empyema/microbiology , Hematoma, Subdural, Chronic/microbiology , Lizards/microbiology , Salmonella Infections/etiology , Salmonella enterica , Animals , Australia , Empyema/pathology , Empyema/surgery , Female , Foster Home Care , Hematoma, Subdural, Chronic/pathology , Hematoma, Subdural, Chronic/surgery , Humans , Iguanas/microbiology , Infant , Magnetic Resonance Imaging , New York , Salmonella Infections/pathology , Salmonella Infections/surgery
6.
Anesth Analg ; 109(2): 479-83, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19608822

ABSTRACT

BACKGROUND: Laryngoscope blades are often cleaned between cases according to well-defined protocols. However, despite evidence that laryngoscope handles could be a source of nosocomial infection, neither our institution nor the American Society of Anesthesiologists has any specific guidelines for handle disinfection. We hypothesized that laryngoscope handles may be sufficiently contaminated with bacteria and viruses to justify the implementation of new handle-cleaning protocols. METHODS: Sixty laryngoscope handles from the adult operating rooms were sampled with premoistened sterile swabs. Collection was performed between cases, in operating rooms hosting a broad variety of subspecialty procedures, after the room and equipment had been thoroughly cleaned for the subsequent case. Samples from 40 handles were sent for aerobic bacterial culture, and antimicrobial susceptibility testing was performed for significant isolates. Samples from 20 handles were examined for viral contamination using a polymerase chain reaction assay that detects 17 respiratory viruses. RESULTS: Of the 40 samples sent for culture, 30 (75%) were positive for bacterial contamination. Of these positive cultures, 25 (62.5%) yielded coagulase-negative staphylococci, seven (17.5%) Bacillusspp. not anthracis, three (7.5%) alpha-hemolytic Streptococcusspp., and one each (2.5%) of Enterococcusspp., Staphylococcus aureus(S. aureus), and Corynebacteriumspp. No vancomycin-resistant enterococci, methicillin-resistant S. aureus, or Gram-negative rods were detected. All viral tests were negative. CONCLUSION: We found a high incidence of bacterial contamination of laryngoscope handles despite low-level disinfection. However, no vancomycin-resistant enterococci, methicillin-resistant S. aureus, Gram-negative rods, or respiratory viruses were detected. Our results support adoption of guidelines that include, at a minimum, mandatory low-level disinfection of laryngoscope handles after each patient use.


Subject(s)
Cross Infection/microbiology , Decontamination/standards , Laryngoscopes/microbiology , Adult , Aged , Cross Infection/prevention & control , Culture Media , Enterococcus/drug effects , Female , Gram-Positive Rods/drug effects , Guidelines as Topic , Humans , Laryngoscopes/standards , Male , Methicillin-Resistant Staphylococcus aureus/drug effects , Middle Aged , Reverse Transcriptase Polymerase Chain Reaction , Vancomycin Resistance , Viruses/chemistry , Young Adult
7.
J Clin Microbiol ; 47(5): 1607-8, 2009 May.
Article in English | MEDLINE | ID: mdl-19297589

ABSTRACT

We report a case of a previously healthy 38-year-old male with acute prostatitis and concurrent Pseudomonas aeruginosa urosepsis. Pulsed-field gel electrophoresis analysis confirmed that the source of the organism was the patient's newly purchased hot tub, which was filled with water from a stream.


Subject(s)
Prostatitis/microbiology , Pseudomonas Infections/diagnosis , Pseudomonas aeruginosa/isolation & purification , Urinary Tract Infections/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Humans , Male , Prostatitis/drug therapy , Pseudomonas Infections/drug therapy , Pseudomonas Infections/microbiology , Sexual Behavior , Urinary Tract Infections/drug therapy
8.
Clin Pediatr (Phila) ; 47(4): 397-9, 2008 May.
Article in English | MEDLINE | ID: mdl-18424563

ABSTRACT

Pinworm infection is a very common diagnosis in young children that is not always confirmed through laboratory evaluation before empiric therapy is prescribed. This article describes a toddler who was treated several times for pinworms because small white worms were seen in her perianal area. Laboratory analysis of parasite material found in her diaper later confirmed a diagnosis of dipylidiasis. Because the signs of dipylidiasis and pinworm infection overlap and the treatments for these parasitic infections are different, the laboratory should clinically confirm suspected persistent or recurrent pinworms.


Subject(s)
Cestoda/isolation & purification , Cestode Infections/diagnosis , Enterobiasis/diagnosis , Enterobius/isolation & purification , Animals , Antinematodal Agents/therapeutic use , Cestoda/drug effects , Cestode Infections/drug therapy , Cestode Infections/parasitology , Child, Preschool , Diagnosis, Differential , Enterobiasis/drug therapy , Enterobiasis/parasitology , Enterobius/drug effects , Female , Humans , Mebendazole/therapeutic use , Secondary Prevention
9.
Clin Infect Dis ; 45(9): 1120-31, 2007 Nov 01.
Article in English | MEDLINE | ID: mdl-17918073

ABSTRACT

BACKGROUND: Recently, epidemiological and clinical data have revealed important changes with regard to clinical adenovirus infection, including alterations in antigenic presentation, geographical distribution, and virulence of the virus. METHODS: In an effort to better understand the epidemiology of clinical adenovirus infection in the United States, we adopted a new molecular adenovirus typing technique to study clinical adenovirus isolates collected from 22 medical facilities over a 25-month period during 2004-2006. A hexon gene sequence typing method was used to characterize 2237 clinical adenovirus-positive specimens, comparing their sequences with those of the 51 currently recognized prototype human adenovirus strains. In a blinded comparison, this method performed well and was much faster than the classic serologic typing method. RESULTS: Among civilians, the most prevalent adenovirus types were types 3 (prevalence, 34.6%), 2 (24.3%), 1 (17.7%), and 5 (5.3%). Among military trainees, the most prevalent types were types 4 (prevalence, 92.8%), 3 (2.6%), and 21 (2.4%). CONCLUSIONS: For both populations, we observed a statistically significant increasing trend of adenovirus type 21 detection over time. Among adenovirus isolates recovered from specimens from civilians, 50% were associated with hospitalization, 19.6% with a chronic disease condition, 11% with a bone marrow or solid organ transplantation, 7.4% with intensive care unit stay, and 4.2% with a cancer diagnosis. Multivariable risk factor modeling for adenovirus disease severity found that age <7 years (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4-7.4), chronic disease (OR, 3.6; 95% CI, 2.6-5.1), recent transplantation (OR, 2.7; 95% CI, 1.3-5.2), and adenovirus type 5 (OR, 2.7; 95% CI, 1.5-4.7) or type 21 infection (OR, 7.6; 95% CI, 2.6-22.3) increased the risk of severe disease.


Subject(s)
Adenoviridae/classification , Adenovirus Infections, Human/epidemiology , Adenoviridae/genetics , Adenoviridae/isolation & purification , Adenovirus Infections, Human/classification , Adenovirus Infections, Human/virology , Adolescent , Adult , Child , Child, Preschool , Female , Genotype , Humans , Infant , Male , Microbiological Techniques , Middle Aged , Prevalence , Risk Factors , United States/epidemiology
10.
J Clin Microbiol ; 44(5): 1869-72, 2006 May.
Article in English | MEDLINE | ID: mdl-16672426

ABSTRACT

The Q score and Q234 systems were compared to our current protocol for interpreting wound cultures. The Q score and Q234 systems were more cost effective than our current method, with the Q234 system being considered the most useful protocol for implementation by both the laboratory and our clinicians.


Subject(s)
Microbiological Techniques , Wound Infection/diagnosis , Cost-Benefit Analysis , Epithelial Cells/pathology , Gentian Violet , Humans , Microbiological Techniques/economics , Microbiological Techniques/statistics & numerical data , Neutrophils/pathology , Phenazines , Wound Infection/microbiology , Wound Infection/pathology
11.
J Clin Microbiol ; 42(6): 2855-7, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15184491

ABSTRACT

This is the first report of infection caused by "Mycobacterium lacticola," a rapidly growing, scotochromogenic mycobacterium that was isolated from the blood of an immunosuppressed child. The organism was identified by sequence analysis of >1,400 bp of the 16S rRNA gene. The clinical relevance of this isolate, coupled with its unique 16S rRNA gene sequence, should prompt further investigation to establish this organism as a valid mycobacterial species.


Subject(s)
Bacteremia/etiology , Catheterization, Central Venous/adverse effects , Catheters, Indwelling/microbiology , Mycobacterium/isolation & purification , Base Sequence , Child, Preschool , Female , Humans , Molecular Sequence Data , Polymorphism, Restriction Fragment Length , RNA, Ribosomal, 16S/genetics
12.
J Clin Microbiol ; 40(4): 1346-51, 2002 Apr.
Article in English | MEDLINE | ID: mdl-11923355

ABSTRACT

Identification of Nocardia to the species level is useful for predicting antimicrobial susceptibility patterns and defining the pathogenicity and geographic distribution of these organisms. We sought to develop an identification method which was accurate, timely, and employed tests which would be readily available in most clinical laboratories. We evaluated the API 20C AUX yeast identification system as well as several biochemical tests and Kirby-Bauer susceptibility patterns for the identification of 75 isolates encompassing the 8 medically relevant Nocardia species. There were few biochemical reactions that were sufficiently unique for species identification; of note, N. nova were positive for arylsulfatase, N. farcinica were positive for opacification of Middlebrook 7H11 agar, and N. brasiliensis and N. pseudobrasiliensis were the only species capable of liquefying gelatin. API 20C sugar assimilation patterns were unique for N. transvalensis, N. asteroides IV, and N. brevicatena. There was overlap among the assimilation patterns for the other species. Species-specific patterns of susceptibility to gentamicin, tobramycin, amikacin, and erythromycin were obtained for N. nova, N. farcinica, and N. brevicatena, while there was overlap among the susceptibility patterns for the other isolates. No single method could identify all Nocardia isolates to the species level; therefore, a combination of methods was necessary. An algorithm utilizing antibiotic susceptibility patterns, citrate utilization, acetamide utilization, and assimilation of inositol and adonitol accurately identified all isolates. The algorithm was expanded to include infrequent drug susceptibility patterns which have been reported in the literature but which were not seen in this study.


Subject(s)
Algorithms , Bacterial Typing Techniques , Nocardia Infections/microbiology , Nocardia/classification , Anti-Bacterial Agents/pharmacology , Carbohydrate Metabolism , Humans , Microbial Sensitivity Tests , Nocardia/drug effects , Nocardia/metabolism , Species Specificity
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