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Biomedical subjects

C Beck-Sague

Publications and source records attributed to C Beck-Sague.

8 recordsLinked to original sources
PubMed1997

Outbreak investigations.

Epidemic nosocomial infections are defined as hospital-acquired infections that represent an increase in incidence over expected rates. Epidemic-associated infections usually are clustered temporally or geographically, suggesting that the infections are from a common source or are secondary to increased person-to-person transmission. Epidemics are important, because they account for a substantial percentage of nosocomial infections. Furthermore, if infection control personnel thoroughly investigate outbreaks of nosocomial infections, they may identify new agents, reservoirs, or modes of transmission.

Cross Infection↗
PubMed1995

Pathology of the umbilical cord in congenital syphilis: analysis of 25 specimens using histochemistry and immunofluorescent antibody to Treponema pallidum.

Identification of Treponema pallidum in the placenta is important for diagnosis of congenital syphilis; however, spirochetes are difficult to observe in chorionic villi. To determine the sensitivity of umbilical cord examination for T pallidum, and the association of spirochetes with cord pathology, placentas were prospectively obtained from 25 women with untreated syphilis. The most common finding using hematoxylin-eosin staining was a normal-appearing umbilical cord (48%); necrotizing funisitis was the most frequent pathological lesion (36%). Spirochetes were detected using silver and immunofluorescent staining in 89% of cords, including 92% of histologically normal and 84% of abnormal cords. Three specimens showed subamnionic aggregates of spirochetes, consistent with amniotic fluid infection. Necrotizing funisitis was strongly associated with umbilical artery infection by spirochetes (P = .008). There was a 100% correlation between results of silver and immunofluorescent staining. The umbilical cord is a sensitive site for morphological confirmation of T pallidum; it is significant for the pathologist that spirochetes may often be detected in the absence of overt tissue inflammation or necrosis.

Antibodies, Bacterial↗
PubMed1994

Epidemic Clostridium difficile-associated diarrhea: role of second- and third-generation cephalosporins.

OBJECTIVE: To better define the role of multiple risk factors for cytotoxic Clostridium difficile-associated diarrhea. DESIGN: Case-control study. SETTING: A Veterans Affairs Medical Center. PATIENTS: Thirty-three case patients with C difficile-associated diarrhea. Two control groups were used: one group consisted of 32 patients from the same ward as the case patients, and one group consisted of 34 patients with nosocomial diarrhea and negative C difficile toxin assays. INTERVENTION: None. RESULTS: Multivariate analyses revealed that exposure to second- or third-generation cephalosporins was the most important independent risk factor, even after controlling for other antimicrobial use (odds ratio [OR] = 8.3, 95% confidence interval [CI95] = 1.4 to 48.9 compared to ward controls; OR = 9.6, CI95 = 2.1 to 44.1 compared with diarrhea controls). Persons exposed to two or more antimicrobials simultaneously were at substantially elevated risk (OR = 18.7, CI95 = 4.1 to 85.8 compared with ward controls; OR = 21.5, CI95 = 3.2 to 141.9 compared with diarrhea controls). CONCLUSION: Physicians should consider carefully the appropriateness of second- and third-generation cephalosporin use and combination antimicrobial therapy, especially during nosocomial C difficile-associated diarrhea outbreaks (Infect Control Hosp Epidemiol 1994;15:88-94).

Case-Control Studies↗
PubMed1994

Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes.

An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990. The study included 1754 residents, among whom 835 infections were identified during the study period. The most common infections were urinary tract infections (UTIs; 286, 34.2%), respiratory tract infections (RTIs; 259, 31%), and skin infections (150, 17.9%). Of the 259 residents with respiratory tract infections, 69 (27%) had pneumonia. Antimicrobials were prescribed for 646 (77%) of the infectious episodes. Residents with pneumonia were more likely to die than residents with other infections (4 of 69 versus 12 of 766; P = 0.04). Symptoms of altered body temperature (fever, hypothermia, chills) and change in mental status also were associated with an increased risk of a fatal outcome (10 of 260 versus 6 of 575; P = 0.01) and (7 of 127 versus 9 of 708; P = 0.004). This study suggests that the most common infections among NH residents are UTIs, RTIs, and skin infections. Pneumonia, symptoms of fever, and mental status changes all were associated with increased mortality. The frequency of infections among NH residents and their impact on resident outcome highlights the need for infectious disease surveillance in this population.

Aged↗
PubMed1993

A cluster of coagulase-negative staphylococcal bacteremias associated with peripheral vascular catheter colonization in a neonatal intensive care unit.

BACKGROUND: A cluster of six neonatal cases of coagulase-negative staphylococcal bacteremias occurred in a Los Angeles County neonatal intensive care unit in March 1989. METHODS: A retrospective cohort study assessed the impact of host-and delivery-related variables, length of hospitalization, duration of antibiotic treatment, performance or duration of invasive procedures, and staffing variables on risk of coagulase-negative staphylococcal bacteremia. RESULTS: Unstratified analyses yielded eight risk factors with risk ratios greater than 2. After stratification by gestational age (less than 29 weeks) and low birth weight (less than 1500 gm), frequency of blood transfusions, duration of respiratory therapy, heparin lock and central vascular line placement, and hyperalimentation remained associated with elevated risk. Two species were identified, arguing against a common source of infection. Of four cohort months with more than 15 very low birth weight infants in the neonatal intensive care unit, an elevation of coagulase-negative staphylococcus-positive blood cultures and diagnosed bacteremias occurred in only two. CONCLUSIONS: This cluster of coagulase-negative staphylococcal bacteremia was probably caused by frequent manipulation of catheters in neonates who were at heightened risk because of low birth weight and prematurity.

Bacteremia↗
PubMed1993

Infectious diseases and mortality among US nursing home residents.

Data collected in the 1985 National Nursing Home Survey were analyzed to identify risk factors for infections and mortality and to explore their relationship in US nursing homes. An infection was recorded in 166,609 (14%) discharges. Risk of pneumonia was found to be higher among bedbound patients (54.5 vs 13.1 per 100 discharges); urinary tract and other infections were most frequent among residents with indwelling catheters (6.6 vs 1.0 per 100 discharges). Residents with pneumonia were more likely than those with other infections to die (35% vs 28%), or be discharged to hospitals if alive (94% vs 66%). Thus, immobility and catheterization were associated with infections in US nursing homes, and pneumonia was found to contribute to mortality.

Adolescent↗
PubMed1987

Sexually transmitted diseases in children and adolescents.

Sexually transmitted diseases have an impact on children's health at three times in their development: during pregnancy or delivery (through maternal-neonatal transmission), during prepubertal childhood (through sexual transmission), and during adolescence (through sexual transmission). These phases must be considered distinctly by the physician, since not only the type of infection but also the management and long-term implications of the disease vary with the time period in which it was acquired.

Adolescent↗