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Biomedical subjects

C Pierson

Publications and source records attributed to C Pierson.

32 records · Page 2Linked to original sources
PubMed1995

Successful interviewing and selection strategies for patient-centered care delivery.

St. Jude Medical Center, a Sisters of St. Joseph Health System Corporation in Fullerton California, in their efforts at work redesign, realized that the success of a patient-centered care delivery system largely depended upon successful selection of the most suitable team members. The interviewing and selection process used at St. Jude Medical Center includes a structured interview process with integration of both situational and behavioral styles in conjunction with objective rating scales and values driven questions. A common thread woven into the hiring criteria for all levels of personnel in the patient-centered care delivery model was creativity, adaptability, interpersonal skills and compatibility of values. Additionally, the clinical competence of the caregiver within the scope of practice/responsibility was essential for their expanded role. Management and leadership abilities for the managers are also addressed in the interview and selection process to provide the best team members for the overall success of the patient-care redesign.

Humans↗
PubMed1990

The antimicrobial susceptibility patterns of the Bacteroides fragilis group in the United States, 1987.

A nationwide survey to monitor the susceptibility of the Bacteroides fragilis group, which began in 1981, was continued during 1987. In addition to the eleven drugs evaluated in 1986, sulbactam, a potent beta-lactamase inhibitor, was tested alone and in combination with ampicillin and cefoperazone. Imipenem, ampicillin/sulbactam, cefoperazone/sulbactam, and ticarcillin/clavulanic acid were the most active newer drugs tested, with less than 1% resistance rates. Chloramphenicol, metronidazole and clindamycin also had excellent activity with resistance rates of 0%, 0%, and 3% respectively. Resistance rates to cefoxitin remained stable at 8%. Ceftizoxime and cefotetan had resistance rates of 26% and 29%, respectively. Rates of resistance varied among different institutions and between the various species.

Anti-Bacterial Agents↗
PubMed1990

Comparative activities of newer beta-lactam agents against members of the Bacteroides fragilis group.

A nationwide susceptibility survey of 557 isolates of the Bacteroides fragilis group was continued in 1986. The most active beta-lactam drugs were imipenem and ticarcillin-clavulanic acid, which had 0.2 and 1.7% resistance, respectively. The rank order of activity of beta-lactam drugs was imipenem, ticarcillin-clavulanic acid, cefoxitin, piperacillin, moxalactam, ceftizoxime, cefotetan, cefotaxime, cefoperazone, and ceftazadime.

Anti-Bacterial Agents↗
PubMed1989

An outbreak of Mycobacterium terrae in clinical specimens associated with a hospital potable water supply.

We investigated an increase in the number of patient specimens yielding Mycobacterium terrae in 1986, isolation of M. terrae was associated with specimens obtained from inpatients at our new hospital, but not with specimens referred from other hospitals [37(+)/144 inpatient specimens versus 2(+)/26 referred specimens, p less than 0.05]. By October 31, 1987, we had identified 163 positive specimens from 131 patients. All M. terrae were isolated from specimens obtained from non-sterile sites, i.e., respiratory, gastrointestinal, or urine. No clinical disease related to M. terrae occurred. Review of procedures and cultures of solutions used in the Microbiology Laboratory suggested the source of M. terrae was not in the Microbiology Laboratory. An analysis of case location showed an association with hospital tier (p less than 0.05), a pattern matching the design of the potable water system of the hospital. M. terrae was cultured from multiple outlets of this system. There appeared to be multiple modes of transmission of M. terrae from this reservoir. Control measures included avoidance of water sources during specimen collection and hyperchlorination of the potable water system. These measures appeared to result in the disappearance of M. terrae from subsequent clinical specimens. We believe this to be the first report defining the epidemiologic aspects of M. terrae contaminating clinical specimens.

Bronchi↗
PubMed1988

Susceptibility of the Bacteroides fragilis group in the United States: analysis by site of isolation.

An ongoing survey of the susceptibility of the Bacteroides fragilis group of bacteria was continued at New England Medical Center in 1984 and 1985. A total of 1,229 strains were obtained from eight centers in the United States. These results were compared with those for 1,847 isolates tested in 1981 through 1983. The most active beta-lactam drugs were imipenem and ticarcillin-clavulanic acid (Timentin), which had a less than 1% resistance rate. No metronidazole- or chloramphenicol-resistant isolates were found during the 5 years of the study. Isolates obtained from blood, perinatal, and bone sites of infection were more resistant to a variety of antimicrobial agents. Susceptibility patterns of the members of the B. fragilis group varied at the eight hospitals and among species. These data indicate the need for determining the susceptibility patterns for the B. fragilis group of organisms at each hospital.

Anti-Bacterial Agents↗
PubMed1987

Single-concentration broth microdilution test for detection of high-level aminoglycoside resistance in enterococci.

Growth in a single broth microdilution well containing gentamicin at a concentration of 500 micrograms/ml predicted high-level resistance to gentamicin (MIC, greater than or equal to 2,000 micrograms/ml) in 505 of 508 clinical isolates of enterococci. Failure to achieve synergistic killing with the combination of penicillin and an aminoglycoside was demonstrated with 100% specificity in 20 strains which showed resistance to 500 micrograms of gentamicin per ml. We recommend this procedure be adopted as a routine screening test to detect high-level aminoglycoside resistance in enterococci.

Anti-Bacterial Agents↗
PubMed1987

Collaborative clinical laboratory study of a broth-disk test for determination of bacterial susceptibility to beta-lactams in combination with amdinocillin.

Methodology for the performance of synergistic antibiotic susceptibility studies has not been standardized. We addressed this problem collaboratively with combinations of amdinocillin and select other beta-lactam antibiotics by using a simple broth-disk test compared with a microdilution approach. Each method used the same drugs singly and in combination. The broth-disk test evaluated each agent and the combinations at concentrations that reflected the breakpoints for each drug; the same ratios of beta-lactam to amdinocillin were used in doubling dilutions with the microdilution method. Initially, each participant studied the same 50 members of the family Enterobacteriaceae; each bacterium was studied on three occasions. Thereafter, 500 representatives of Enterobacteriaceae isolated recently from clinical specimens were studied. Designated strains served as controls. Reproducibility between the two approaches studied in phase 1 of the investigation indicated good agreement between the methods, ranging from 87 to 100%. Agreement between the microdilution and broth-disk tests for the 2,551 clinical isolates ranged from 86 to 95%, with slightly better correlations between combination results than with the single agents. The findings indicate that antibiotic disks used routinely in the clinical laboratory can be used in a simple elution test to determine susceptibility of organisms to beta-lactam antibiotics alone and in combination with amdinocillin.

Amdinocillin↗
PubMed1980

Chi mutation in a transposon and the orientation-dependence of Chi phenotype.

Chi, an element that stimulates recombination via the E. coli RecBC pathway, can arise by spontaneous mutation in the transposon Tn5. When in phage lambda in one orientation, the mutant transposon confers Chi+ phenotype (large plaque and a high rate of exchange near the transposon). In the other orientation, however, the transposon does not confer Chi+ phenotype. The mobility of the transposon allows us to show that the Chi+ orientation of the mutant Tn5 is the same at different locations in lambda. These include a site near gene J, one in gam at 69, one to the right of gam at 73 and several to the right of R between 95.7 and 99.5. To the right of R, the mutant transposon could be found in only one orientation, that which confers Chi+ phenotype. We speculate that the other orientation of Tn5 in that locale is lethal to lambda. The orientation-dependence of Chi+ phenotype also revealed that Tn5 flip-flops in lambda.

Bacteriophage lambda↗
PubMed1978

Effects of centrally acting drugs on serum prolactin levels in rhesus monkeys.

Prolactin (Prl) responses to anesthetics, stress of immobilization, and agents that block adrenergic receptors were determined in 13 female rhesus monkeys. The local anesthetic (lidocaine HCl) had no effect, but the general anesthetics (ketamine HCl and sodium pentobarbital) significantly increased serum Prl levels in intact animals. There was no indication of a pentobarbital-induced inhibition of Prl secretion as reported for other species. A combination of halothane anesthesia and immobilization for 30 or 60 min produced significantly greater increases in Prl levels than immobilization alone for similar periods of time. Prl responses to blockers of adrenergic receptors varied in chair-adapted ovariectomized monkeys. The increase in serum Prl concentrations produced by the beta-receptor blocker propranolol was less marked than that induced by the alpha-receptor blockers phentolamine and phenoxybenzamine. Prl elevations of the highest magnitude and longest duration were produced by haloperidol, which blocks both adrenergic and dopaminergic receptors. Pretreatment of these animals with estradiol-17beta had no effect on Prl responses to phentolamine and haloperidol. These results indicate involvement of an adrenergic neurotransmitter system in the control of Prl secretion in primates.

Anesthetics↗