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Biomedical subjects

F Daschner

Publications and source records attributed to F Daschner.

At least 19 recordsLinked to original sources

In vitro susceptibility of methicillin-resistant Staphylococcus aureus and slime-producing and non-slime-producing coagulase-negative staphylococci to fusidic acid.

The in vitro susceptibility of 100 oxacillin-resistant Staphylococcus aureus and 100 oxacillin-resistant coagulase-negative staphylococci (CNS; 50 slime-negative and 50 slime-positive strains) was determined by agar dilution technique, with and without the addition of 50% human serum. All strains tested were highly sensitive to fusidic acid. S. aureus and CNS showed MIC50 values of 0.125 and 0.25 mg/l, respectively. MICs of all strains increased significantly in the presence of 50% human serum. Only minor differences were noted between the MICs of slime-producing and slime-deficient CNS.

Coagulase

[Hygienic and economic significance of sewer drainage in hospitals. Architectural changes in the guidelines of the Federal Health Office].

The hygienic importance of barrier zoning in hospitals has been evaluated on the basis of the relevant international literature between 1970 and 1989. There have been only a very few pertinent publications and in none has there been any pointer which would support the hypothesis of barriers having an infection-preventing effect. Using four University Hospitals in Baden-Würtemberg as paradigms, a model was prepared for calculating what space and cost savings were possible, if a simpler system could be installed, instead of the one demanded under federal regulations and already planned for the four hospitals. It was found that it would save a realizable area of 319,5 m2 at a potential cost saving of DM 1,138,335. By dispensing with hygienically not justifiable building work at the planning stage of new hospitals considerable greater costs could be avoided.

Cross Infection

[Prolongation of hospital stay by nosocomial pneumonia and wound infection].

From June 1988 to September 1989, a prospective survey comprising a total of 1183 patients in a university hospital was carried out to ascertain the additional length of stay in intensive care units because of nosocomial pneumonia associated with artificial ventilation (418 patients, 296 men, 122 women, mean age 48.8 +/- 21 years, ventilated for more than 24 h) or by postoperative wound infections (765 patients, 501 men, 264 women, mean age 60 +/- 11 years, after operations on the large bowel, heart or biliary tract). Each patient with a nosocomial infection was matched against a variable number of control patients (for cases of pneumonia a maximum of 6, for wound infections a maximum of 10) without nosocomial infection. Pneumonia developed in 100 (23.9%) of artificially ventilated patients, and 46 of these patients together with 101 controls were entered into the matching procedure. 24 patients with pneumonia had to be excluded from analysis because no controls could be found for them, and also 30 patients who died while in the intensive care unit. 49 (6.4%) of the surgical patients contracted postoperative wound infections. 43 of them, together with 210 controls, were entered into the matching procedure. Among patients with pneumonia the average additional duration of stay was 11.5 days, and among patients with post-operative wound infections it was 13.9 days. The results confirm that nosocomial infections contribute substantially to prolongation of hospital stay and hence to the costs.

Adult

Unnecessary and ecological cost of hospital infection.

Hospital infection control can be accomplished with less pollution to the environment, nevertheless retaining the same standard of hygiene. Waste reduction also means cost reduction. Some examples of avoidable ecological costs are unnecessary nursing techniques, unnecessary gowning and disinfection procedures, unnecessary packing material and disposables.

Communicable Disease Control

[The effect of Federal Public Health Service guidelines on air, surface and floor germ count in a general surgery and an orthopedic operating room].

In a prospective study the environmental contamination in an old and a new operating theatre was investigated. The old operating rooms were constructed in 1936 whereas the new rooms were built in 1986. The study was conducted in surgical and orthopedic surgical operating rooms. There was a slight increase in floor as well as in surface contamination in the new operating rooms. On the other hand there was a slight decrease in the airborne microorganisms in the orthopedic surgery and nearly identical colony counts in the general surgery operating rooms. All the differences were statistically not significant. The spectrum of microorganisms and the occurrence of Staphylococcus aureus in the old and the new operating rooms showed no difference.

Air Microbiology

[Selective intestinal decontamination--yes or no?].

Various studies have shown that as a result of selective decontamination of the digestive tract, the incidence of pneumonia in artificial ventilation caused by gram-negative bacteria is reduced; however, a few studies have pointed out that, at the same time, the rate of pneumonia caused by gram-positive bacteria is increased. Most investigators agree that mortality cannot be reduced. A few studies have demonstrated that simultaneous administration of cefotaxime is not necessary. Various recent reports indicate that under certain conditions selective decontamination of the digestive tract undoubtedly leads to the development of resistance to gram-negative bacteria and in particular, to oxacillin-resistant staphylococci, S. epidermidis, and enterococci. Multicenter, randomized, and prospective double-blind studies will have to investigate and establish definitively which antibiotics have to be applied in which patients in order to reduce the rate of pneumonia as well as mortality. In addition, these studies will have to determine the microbiological and hospital hygiene measures necessary to avoid the risk of resistance or colonization developing by certain agents. As long as this is not the case, broad, non-selective use of SDD is not justified, especially in intensive care units.

Anti-Bacterial Agents