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C Ciesielski

Publications and source records attributed to C Ciesielski.

6 recordsLinked to original sources

Lack of evidence for patient-to-patient transmission of HIV in a dental practice.

This report reviews data pertaining to the hypothesis that transmission of HIV to five patients of a Florida dentist with AIDS resulted from the patient-to-patient transfer of infectious materials through the reuse of contaminated instruments. Findings strongly suggest that patient-to-patient transmission of HIV through contaminated handpieces, prophylaxis angles or anesthetic needles or cartridges did not occur in this practice.

Anesthesia, Dental↗

Transmission of human immunodeficiency virus in a dental practice.

OBJECTIVE: To determine if patients of a dentist with the acquired immunodeficiency syndrome (AIDS) became infected with human immunodeficiency virus (HIV) during their dental care and, if so, to identify possible mechanisms of transmission. DESIGN: Retrospective epidemiologic follow-up of the dentist, his office practice, and his former patients. SETTING: The practice of a dentist with AIDS in Florida. PARTICIPANTS: A dentist with AIDS, his health care providers and employees, and former patients of the dentist, including eight HIV-infected patients. MEASUREMENTS: Identification of risks for HIV transmission (if present), degree of genetic relatedness of the viruses, and identification of infection control and other office practices. RESULTS: Five of the eight HIV-infected patients had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P greater than 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified. CONCLUSION: Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route.

Acquired Immunodeficiency Syndrome↗

Dentists, allied professionals with AIDS.

With about a million people in the United States infected with HIV, health care providers increasingly will encounter infected patients. To minimize transmission in the workplace, recommended infection control measures, including universal precautions, should be followed strictly.

Acquired Immunodeficiency Syndrome↗

Comparison of molecular methods for subtyping patients and epidemiologically linked environmental isolates of Legionella pneumophila.

We used the molecular techniques of monoclonal antibody typing, plasmid analysis, and outer membrane protein profiling to subtype 159 patients' and environmental (water distribution system) isolates of Legionella pneumophila serogroup 1 from 18 institutions. The ability of these techniques to match patients' and epidemiologically linked environmental isolates from outbreaks of Legionnaires' disease at seven institutions was also compared. Two different panels of monoclonal antibodies (I and II) identified nine subtypes (one new disease-causing subtype) and six subtypes, respectively. The Bellingham 1 subtype type was the most common among environmental isolates, and the Philadelphia 1 subtype predominated among patients' isolates from all institutions except the Veterans Administration Medical Center in Pittsburgh, Pennsylvania. The source of an isolate (patient vs. environment) and its monoclonal antibody subtype were significantly associated (P less than .01). With use of the molecular techniques tested, the subtypes of patients' isolates were identical to those of epidemiologically linked environmental isolates from the same hospital.

Antibodies, Monoclonal↗