PubMed Health⌕ Search

Biomedical subjects

M J Stenberg

Publications and source records attributed to M J Stenberg.

7 recordsLinked to original sources
PubMed1990

Frequent acquisition of multiple strains of methicillin-resistant Staphylococcus aureus by healthcare workers in an endemic hospital environment.

Methicillin-resistant Staphylococcus aureus (MRSA) has been an endemic nosocomial pathogen at the VA medical center (VAMC) in Providence, Rhode Island since 1981. From 1985 to 1987, more than 30% of all unique S aureus isolates were methicillin resistant. To evaluate the frequency of acquisition of MRSA isolates by healthcare workers, we compared the antimicrobial susceptibility patterns, multilocus enzyme genotypes and plasmid profiles of isolates recovered from nasal and hand cultures from VAMC nurses and house staff on rotation at the VAMC with those of clinical isolates from patients at the VAMC and four other affiliated hospitals. Fifty-six percent of ward nurses cultured (n = 112) were colonized with S aureus, of which 65% was methicillin resistant. Six isolates of MRSA were identified on the initial culturing of house staff (n = 65); 16 MRSA isolates were recovered at the end of a four-week rotation (p less than .02). Phenotypic and genotypic analyses demonstrated that numerous distinct MRSA strains were recovered in the study period. The incidence of MRSA among clinical isolates at the VAMC and affiliated institutions was remarkably constant throughout the three-year study period. Moreover, despite regularly sharing resident physicians, interns and medical students, MRSA isolates were commonly recovered at the other university-affiliated hospitals. Our study failed to reveal evidence of significant interhospital transmission of MRSA isolates by healthcare workers. While healthcare workers may contribute to the dissemination of MRSA within institutions, they appear to be less important in spreading MRSA between institutions.

DNA, Bacterial↗
PubMedDate not supplied

Postoperative pneumonia.

1. Postoperative nosocomial (hospital-associated) pneumonia is among the most serious complications of surgery. The mortality from these pneumonias is 30%, even with treatment with appropriate antibiotics. 2. The incidence of pneumonia in patients on ventilators averages 14 times that of patients not receiving mechanical ventilator support. These pneumonias are a major factor in the deaths of patients using ventilators. The design and necessary functions of ventilators contribute to bacterial colonization of the machinery, airway, and lungs. Burn patients also represent a particularly vulnerable group in relation to nosocomial pneumonia. 3. Health care workers can introduce organisms from the environment or the patient in the next bed by neglecting handwashing between patients. Some health care professionals think it is not necessary to change the gloves that protect them from bloodborne pathogens when moving between patients. Such erroneous beliefs add significantly to the patient's bacterial colonization, often with treatment-resistant organisms.

Aged↗