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Biomedical subjects

M B McGuckin

Publications and source records attributed to M B McGuckin.

13 recordsLinked to original sources
PubMed1983

Relationship between demographic variables, nonformal education, and the infection control practitioner's knowledge of surveillance.

Since methods used for surveillance have not been standardized, infection control practitioners choose a method based on peer-teaching, on-the-job training, or nonformal education programs. However, results of a previous study showed that 63% of ICPs were unsatisfied with their method of surveillance but did not know how to proceed with an alternative method. The purpose of this descriptive developmental study was to investigate the relationship between surveillance knowledge and the demographic profiles of ICPs and evaluate how this knowledge was affected by a nonformal education process (seminar). Results showed that the surveillance knowledge of ICPs was significantly (p less than 0.05) related to the hospital type and size in which they worked, their educational preparation, the years spent in infection control, the CDC course they took, and the development of an infection control program. The nonformal education process showed a significant (p less than 0.05) increase in surveillance knowledge. In summary, five demographic variables were found to be related to the surveillance knowledge of ICPs, and this knowledge was significantly increased by a nonformal educational process.

Analysis of Variance↗
PubMed1982

An outbreak of Achromobacter xylosoxidans related to diagnostic tracer procedures.

In December, 1978, an investigation was undertaken to determine the source of infection in five patients in one hospital with hospital-associated bacteremia due to Achromobacter xylosoxidans. Review of their records showed that each had a diagnostic tracer procedure preceding the bacteremia and that no other procedures were common to all. Further investigation revealed that patients from three other hospitals were studied using diagnostic tracer materials from the index hospital. Five patients with confirmed A. xylosoxidans bacteremia and four suspected cases were identified in these hospitals, and all had a scan before the bacteremia was detected. No other A. xylosoxidans isolates were identified in any of the hospitals in the preceding two years. Although not confirmed, the source appeared to be stored non-bacteriostatic saline. Effective control measures included a sterility testing program and use of pre-packaged single dose vials of saline. Diagnostic tracer studies should be added to the list of procedures known to cause hospital-acquired bacteremias.

Aged↗
PubMed1981

Hydrotherapy: an outbreak of Pseudomonas aeruginosa wound infections related to Hubbard tank treatments.

During a 2-week period, Pseudomonas aeruginosa wound infections developed in 11 patients, 10 of whom had had hydrotherapy in Hubbard tanks before isolation of the organism from their wounds. All 10 patients had clinical evidence of disease including a temperature of greater than 100.4F, purulent wound drainage and positive culture for P. aeruginosa. These 10 patients comprised almost 60% of all patients who had received hydrotherapy during these 2 weeks. The index case had extensive cellulitis of the leg and positive wound cultures for P. aeruginosa throughout the epidemic period. Investigation revealed that the outbreak had begun coincident with the discontinuation of the use of sodium hypochlorite as a tank disinfectant and had stopped when its use had been resumed. The temporal association between the start and end of the epidemic and the use of sodium hypochlorite indicates that this agent may prevent cross-contamination and infection among patients receiving hydrotherapy.

Cross Infection↗
PubMed1981

Endocarditis caused by Neisseria mucosa in a patient with a prosthetic heart valve.

A forty year old man was admitted with suspected subacute bacterial endocarditis. Neisseria mucosa was isolated in pure culture. Initial antibiotic therapy included penicillin and gentamicin. After onset of allergic symptoms, penicillin was discontinued and vancomycin therapy instituted. Gentamicin therapy was discontinued after the serum creatinine began to rise. Minimum inhibitory concentration indicated that N mucosa was resistant to vancomycin. After allergy testing proved negative, intravenous penicillin therapy was reinstituted and continued until discharge, at which time the patient was to continue on oral penicillin for six months.

Adult↗
PubMed1980

Significance of bacteriuria with presumed non-pathogenic organisms.

The results of 2,793 clean catch midstream specimens submitted to the microbiology laboratory were examined to determine if the isolation of reputed non-pathogens such as Lactobacillus, Staphylococcus epidermidis. Micrococcus and diphtheroids represented poor collection technique, contaminant growth by failure to plate or refrigerate quickly or actual urinary tract infection. Eight per cent of the inpatient cultures and 18 per cent of the outpatient cultures had more than 10(5) colony-forming units per ml. of these non-pathogens. Of the outpatient cultures with more than 10(5) colony-forming units per ml. of non-pathogens 44 per cent had symptoms of urinary tract infection and more than 10 white blood cells per high power field in the urinary sediment, compared to 3 per cent of inpatients. In a prospective analysis of an outpatient population a second clean catch midstream specimen was collected within 2 hours of the first specimen with careful attention to sterile collection technique. Of 15 cases of significant bacteriuria with non-pathogens in the first specimen only 1 had significant bacteriuria with the same organism in the second specimen. In contrast, in the inpatient population 7 of 11 cases with pathogen significant bacteriuria in the first specimen had significant bacteriuria in the second specimen. These findings suggest that most episodes involving isolation of non-pathogens in greater than 10(5) colony-forming units per ml. from urine represent poor techniques of specimen collection rather than urinary tract infection.

Bacteria↗
PubMed1979

Disposable humidifiers in a recovery room--a microbiological evaluation.

Humidification, unlike nebulization, does not produce water droplets in the process of producing desiccated gases, and therefore is considered low risk in terms of potential infection sources. However, direct inoculation of bacteria into these units has been shown to produce contaminated effluents. Therefore, the present study was designed to determine if the airborne route of contamination was a potential source of bacterial inoculum for these units and to determine the maximum number of days units remained free of bacterial contamination. Disposable humidifiers were placed in both high and low volume patient areas of the recovery room. Units were used on multiple patients with only the cannula replaced between patients. Our results showed that these units do have the potential for becoming inoculated through the airborne route, but did not produce contaminated effluents greater than background air. Units remained sterile during the entire time in use in both high and low volume areas. In conclusion, our data suggests that each institution should evaluate the usage of disposable humidifiers based on patient parameters and environment rather than manufacturer's guidelines.

Air Microbiology↗
PubMed1979

Storage of microtiter plates for antimicrobial susceptibility tests.

Microdilution susceptibility tests are being performed routinely and in increasing numbers in many clinical laboratories. Microtiter plates for these assays are usually prepared in large batches and stored frozen until needed. Studies were performed to investigate the stability at -20C and at -70C of ampicillin, carbenicillin, ticarcillin, gentamicin, tobramycin, amikacin, chloramphenicol, and cephalothin, using Enterobacter aerogenes, Proteus mirabilis, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella as test organisms. The stability at -20C and -70C of clindamycin, vancomycin, cephalothin, cefazolin, oxacillin, methicillin, nafcillin, and penicillin was analyzed using Staphylococcus eureus, Staphylococcus epidermidis, Enterococcus, and alpha Streptococcus as the test organisms. No significant deterioration of any of the antibiotics was noted after ten weeks of storage at -70C, as detected by minimum inhibitory concentration determinations. No significant differences were noted at -20C for clindamycin, chloramphenicol, vancomycin, cefazolin, cephalothin, gentamicin, tobramycin, and amikacin. By ten weeks' storage at -20C, significant deterioration of carbenicillin, ticarcillin, ampicillin, penicillin, methicillin, oxacillin, and nafcillin was observed.

Anti-Bacterial Agents↗
PubMedDate not supplied

Surveillance in a surgical intensive care unit: patient and environment.

Microbiologic surveillance of both the patients and the ambient environment of a surgical intensive care unit allowed us to relate the incidence of nosocomial respiratory tract infection to levels of airborne bacteria. Over the study period respiratory tract nosocomial infection rates varied from 0.7% to 17.0%, and nonrespiratory infection rates varied from 1.0% to 25.0%. Airborne bacteria counts during that time varied from 1.0 +/- 0.8 S.E. CFU/ft3 to 96.0 +/- 6.8 S.E. CFU/ft3. There was a reasonably close correlation between airborne bacteria levels and the incidence of nosocomial pneumonia (r = 0.81, p less than 0.05). Furthermore, there was a close correlation between a specific organism nosocomial infection rate and the number of colonies of that organism present in the air (r = 0.88, p less than 0.05). In contrast, there was no significant relationship between airborne bacteria counts and nonrespiratory attack rates (r = 0.60, p less than 0.05). If the bacteria traveled from the air to the patients, there appear to be at least three possible explanations for this significant relationship: (1) direct inoculation of the airway by the airborne bacteria; (2) inoculation of the airway by direct contact, which is related to the degree of "cleanliness" of the environment; and (3) an increased incidence of contaminated respiratory equipment and airway inoculation because of high counts of airborne bacteria. It is also possible that high bacterial air counts represent contamination of the air from patients with respiratory infections. Regardless of the pathway(s), surveillance of the ambient environment may prove to be a useful epidemiologic tool in the study and control of nosocomial respiratory tract infections in certain high-risk patient care areas.

Air Microbiology↗