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Biomedical subjects

P J Hyams

Publications and source records attributed to P J Hyams.

14 recordsLinked to original sources
PubMed1984

Herpes zoster causing varicella (chickenpox) in hospital employees: cost of a casual attitude.

Varicella is a benign exanthematous disease of childhood, with adult infection usually occurring in the immunocompromised patient. Hospital employees may be exposed to the varicella virus through contact with patients having either varicella or herpes zoster. Two nurses developed varicella 11 and 15 days after contact with a patient with disseminated herpes zoster. Twenty-five susceptible employees were excluded from work. The cost to the hospital for this paid leave was $10,941. Additional nurses were hired to staff the 189 uncovered supplementary nursing shifts; the accrued cost was $8,093. Ninety patients were exposed. There were no secondary cases in either employees or patients. Nosocomial varicella in hospital employees can be both costly to the hospital and disruptive of patient care. Measures to prevent such an occurrence are discussed.

Chickenpox↗
PubMed1984

Susceptibility to varicella virus of certain adults in the southeastern United States.

The serologic status of 76 adults was determined to evaluate their immunity to the varicella virus. Previous reports indicate that 92% to 98% of the adult population develop this immunity. Our experience with nosocomial varicella infection in two hospital employees suggested that more adults in this subtropical region may be susceptible to varicella infection. Three (7.1%) adults with a definite history of varicella had a positive indirect fluorescent antibody (IFA) test. Twenty-eight (72%) of 39 employees without a history had a positive serology, a rate lower than previously reported (p less than 0.002). Twenty-nine (85%) of 34 other adults and 60 (79%) of the 76 adults tested had positive tests; these rates are also lower than reported (p = 0.003 and less than 0.001, respectively). These data indicate that some adult groups may be more susceptible to varicella infection and suggest that knowledge of immunity should be an important health concern in some hospitals.

Adult↗
PubMed1980

Fungal infection of the brain: an increasing threat.

A 79-year-old, diabetic man with an ear infection had a temporal lobe abscess from which Aspergillus fumigatus was cultured. He died despite treatment with amphotericin and rifampin, removal of the abscesss, and left mastoidectomy. Because of the ever-increasing number of elderly debilitated patients, the frequency of mild diabetes in the aged, the prevalent use of steroids, antibiotics, cytotoxics and immunosuppressives, and the ubiquity of the organism, Aspergillus infections of the brain have and will become more frequent.

Aged↗
PubMed1979

Consortium upgrades 12 hospitals' infection control programs.

A consortium's infection control nurse and physician epidemiologists boost the member hospitals' infection control efforts through onsite rounds, establishment of group standards, reports on each hospitals' performance, ongoing education, medicolegal assistance, monitoring of use of isolation evaluation of infection control products, and other activities.

Consultants↗
PubMed1977

The overuse of single patient isolation in hospitals.

Single patient isolation of adults to prevent spread of infection was studied in five high occupancy community hospitals. The acceptable standard was a guideline for isolation in hospitals, published by the Center for Disease Control (CDC). Overusage of single patient isolation was found to vary between 4% and 96% of physician's isolation orders. Diagnoses of viral hepatitis, surgical wound infections, skin infections and respiratory infections accounted for the majority of overisolated patients. When infection control personnel rather than attending physicians determined the type and duration of isolation, a decrease in overisolation and a saving of patient (or third party payer) charges could be demonstrated. Reduction in overisolation does not bring about savings for hospitals unless bed occupancy is high and few single rooms are available. No evidence of cross-infection was observed in one hospital as a result of implementation of the CDC guidelines.

Costs and Cost Analysis↗
PubMed1975

Staphylococcal bacteremia and hexachlorophene bathing. Epidemic in a newborn nursery.

An outbreak of staphylococcal bacteremia in healthy, full-term neonates occurred in the newborn nursery at a large county hospital not employing prophylactic hexachlorophene bathing. Seven infants had staphylococcal bacteremia and one had omphalitis. Two of the three isolates obtained for phage typing were type 86, and the other was 3c/71. Staphylococcal colonization rate in the nursery was 64% when the outbreak was recognized; 86% of these isolates were type 86. No predominant phage type was isolated from nursery personnel. The outbreak followed a six-month preliminary study that showed a rise in staphylococcal colonization rate from 2.2% with hexachlorophene bathing to 67% with a nonhexachlorophene-containing preparation. In a community survey of infants born during the two months prior to the epidemic, seven of eight babies with lesions were infected with Staphylococcus aureus type 86.

Axilla↗
PubMed1974

Synergy between cephalosporin and aminoglycoside antibiotics against Providencia and Proteus.

Clinical isolates of Providencia and Proteus with relative aminoglycoside resistance were tested for susceptibility to combinations of gentamicin or tobramycin with cephalothin or cefazolin. The minimal bactericidal concentration of aminoglycoside for one-third of the strains was reduced by fourfold or more in the presence of one-fourth of the minimal bactericidal concentration of either cephalosporin. This effect was achieved by clinically attainable concentrations of cephalothin or cefazolin.

Aminoglycosides↗
PubMed1973

In vitro bactericidal effectiveness of four aminoglycoside antibiotics.

The antibacterial activity of four aminoglycoside antibiotics (gentamicin, Sch 13706, tobramycin, and sisomicin) was tested against eight gram-negative and three gram-positive species. A total of 323 strains were studied by the broth dilution technique. Tobramycin and sisomicin had greater bacteriostatic and bactericidal activity against Pseudomonas strains than did gentamicin and Sch 13706. Of the four antibiotics, sisomicin was most active against Klebsiella, Enterobacter, Escherichia coli, indole-negative and -positive Proteus, and Streptococcus pyogenes. Gentamicin was most effective against Serratia. A fourfold or greater difference existed frequently between the minimal inhibitory and bactericidal concentrations of all antibiotics against Enterobacter and Serratia. This difference was greatest with tobramycin. Staphylococcus aureus was highly susceptible, Providencia relatively resistant, and enterococcus uniformly resistant to the antibiotics studied. Agar diffusion susceptibility testing with gentamicin and tobramycin showed that organisms susceptible to less than 6.2 mug/ml usually yielded zones 17 to 26 mm in diameters. Zones of 15 to 16 mm represented intermediate susceptibility which varied with the organism and antibiotic. Several Serratia strains required 6.2 to 12.5 mug of gentamicin/ml or 25 to 50 mug of tobramycin/ml for bactericidal activity despite minimal inhibitory concentrations of 0.09 to 3.1 mug/ml and zone sizes greater than 13 and 17 mm, respectively. Studies with Enterobacter and tobramycin yielded similar results.

Aminoglycosides↗