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M A Bilkert-Mooiman

Publications and source records attributed to M A Bilkert-Mooiman.

11 recordsLinked to original sources
PubMed1999

[A cluster of patients with puerperal fever in Gouda; a reiteration of the lesson by Semmelweis].

OBJECTIVE: Description of a cluster of 6 patients who developed a puerperal infection with group A haemolytic streptococci (Streptococcus pyogenes, GAS) out of 10 patients who delivered during a 2-day period in the hospital in Gouda, the Netherlands, and of the epidemiological and microbiological search for the source. DESIGN: Descriptive. METHOD: After the report on the fourth patient the suspicion of a hospital infection arose. Hospital staff, family members and environment were screened for GAS. All isolated GAS were serotyped and genotyped. Epidemiological data, like time of admission, delivery and discharge, used delivery room and maternity unit ward, were recorded. All regional midwives and general practitioners were informed and asked to be alert for puerperal endometritis in patients after hospital deliveries. RESULTS: All 6 patients and 2 health care workers proved to have an identical type of GAS. The environmental cultures were negative. By analysing the epidemiological data the most probable cause of this cluster was found to be one health care worker. After stressing the importance of good hand disinfection no additional cases were seen.

Adult↗
PubMed1999

[Cold tap water as a source of fatal nosocomial pneumonia due to Legionella pneumophila in a rehabilitation center].

OBJECTIVE: Report of the technical, microbiological and epidemiological investigation following 2 cases of fatal Legionella pneumonia. DESIGN: Descriptive. METHOD: Faced with 2 nosocomial cases in a rehabilitation centre in the South of Limburg, the Netherlands, the water supply was investigated. Water temperatures from different taps were measured. Legionella cultures were made from respiratory patients' specimens, water samples and smears from all mixing taps (used in showers), samples from hot and cold water taps from the infected ward and from the five other wards. The strains were typed by serotyping and polymerase chain reaction. RESULTS: The circulating cold water sometimes warmed up to 40 degrees C (within the Legionella growth range). From the sputum of the 2 male patients with rheumatoid arthritis who died of Legionella pneumonia the same Legionella pneumophila (serotype I) was cultured as from the water supply. Of the showers on the contaminated ward 19% (12/63) were positive for Legionella as were 59% (35/59) of the cold water taps. Cultures from the hot water supply were negative just like control cultures from five other wards and swabs from showerheads and hoses. The cold water tubes ran next to the hot water tubes and the central heating system in the same shaft. On the infected ward patients were absent during the weekends. As one of the subsequent measures, the cold water pipes were relocated to another shaft. CONCLUSION: The combination of an elevated cold water temperature caused by heating along a distance by nearby hot water and heating piping and the regular stasis of water during the weekends when the ward was closed, most probably stimulated the multiplication of Legionella in the water supply. In order to minimize contamination of cold water its temperature must be kept below 20 degrees C. Surveillance of intramural water systems is necessary to prevent nosocomial infections.

Cold Temperature↗
PubMed1994

[Methicillin-resistant Staphylococcus aureus in repatriates from the Faro airplane crash, 1992].

OBJECTIVE: To review the suitability of the guidelines of the Working Group Infection Prevention (WIP) and the Medical Inspectorate of Health with regard to possible methicillin-resistant Staphylococcus aureus (MRSA) contamination. SETTING: Medical Inspectorate of Health. DESIGN: Retrospective analysis. METHODS: For 95 repatriates from the Faro air crash, a questionnaire was filled out by medical microbiologists and attending specialists in Dutch hospitals (response rate: 100%). Classification for MRSA risk category was done in accordance with the guidelines of the Medical Inspectorate of Health. Surveillance data of the National Institute of Public Health and Environmental Protection were consulted. RESULTS: Colonisation with MRSA occurred in 8 out of the 59 patients in the high-risk group (hospitalisation > 24 h in Portugal or invasive procedures). No MRSA was found in the low-risk group (all other repatriates). The MRSA-positive patients had burns at least. Infection was detected in three patients on admission, in five patients later (after 6-27 days of hospitalisation), after 1-9 negative cultures. Probably all patients had been contaminated with MRSA in Portugal. In two Dutch hospitals secondary contamination was observed. CONCLUSION: The WIP guidelines on MRSA control proved to be sufficient with exception of the inventory cultures and the isolation measures notably for patients with covered wounds. The MRSA risk classification of patients according to the guidelines of the Medical Inspectorate of Health proved adequate.

Accidents, Aviation↗
PubMed1992

[An outbreak of mostly extrapulmonary tuberculosis in a family practice].

An outbreak of mainly extrapulmonary tuberculosis (TB) in a group of about 550 patients with rheumatoid arthritis (RA) is described. These patients had been attending the practice of a former general practitioner who treated cases of rheumatoid arthritis with phenylbutazone and steroids. The number of diagnosed TB cases was 55. Six cases had a contagious lung localisation. The possible sources of the outbreak were analysed. Both a visit on a same day as a sputum positive patient (chi 2-trend: 20.4; p < 0.001) and the administration of steroids (odds ratio (OR): 36.2; 95% confidence interval (CI): 8.8-313) were independent risk factors. There also appeared to be a relationship between TB and RA (OR: 4.4; 95%-BI: 2.2-9.1). Exogenous re(infection) and endogenous reactivation are possible causes of this outbreak.

Adrenal Cortex Hormones↗
PubMed1992

[AIDS epidemiology in The Netherlands in persons infected through heterosexual contact].

Ten years after the start of the AIDS epidemic in the Netherlands the proportion of persons infected by heterosexual contacts among the total of AIDS cases diagnosed is small (7.4%). Up to December 1991 the cumulative totals of females and males in the Netherlands reported with the diagnosis and infected by heterosexual contact were 55 and 93, respectively. Of the 55 heterosexual females, 69% had the Dutch nationality, of the 93 heterosexual males, 67%. Considerable proportions of the numbers of AIDS patients in this group (males 47%, females 45%) were diagnosed in the four largest cities (Amsterdam, Rotterdam, The Hague and Utrecht). The remaining cases of AIDS diagnosed in this group were scattered throughout the country. Among heterosexual females a gradual increase of the number of AIDS cases diagnosed was observed since 1985. In the males there was no clear trend in the number of diagnoses since 1984. Of the 55 females, 19 originated from an area endemic for AIDS or had had sexual contacts with a person from such a region (34.6%). Among the 93 males this number was 29 (31.2%). Nineteen of the 55 females (34.6%) were known to have sexual contact with a person from the known risk groups. The same held true of 12 males (12.9%). Of the remaining 17 females (30.9%) and 52 males (55.9%) it was only known that they were heterosexual without further risk factors or risk contacts.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Reported patients with infectious diseases in 1990].

The number of cases of infectious diseases notified in 1990 in accordance with the Infectious Diseases Control and Disease Cause Act are given. Of each A, B and C disease the figures are given separately. The most significant changes as compared with the previous years are discussed.

Communicable Diseases↗
PubMed1990

[AIDS 1982-1989].

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Meningococcal disease in the winter season 1988-1989].

We describe the 304 cases of meningococcal disease notified from week 45 of 1988 and up to week 21 of 1989, and compare these data with those for 1966, the year of the last epidemic in The Netherlands. During the epidemic the interval between the first day of illness and the moment of reporting shortened.

Adolescent↗