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Biomedical subjects

R E Dixon

Publications and source records attributed to R E Dixon.

At least 19 recordsLinked to original sources
PubMed1979

Changing phage typing patterns of epidemic gentamicin-resistant Staphylococcus aureus. Evidence for transmission of gentamicin resistance.

In a 10-week period, infection with gentamicin resistant Staphylococcus aureus appeared in 24 adults and infants in one hospital. Medical staff were affected first, and subsequently 16 infants in the neonatal intensive-care unit. The gentamicin-resistant staphyloccal isolates showed three distinct phage susceptibility patterns in two distinct phage groups during the early, middle, and late phases of the outbreak. Although not confirmed with in-vitro or in-vivo laboratory data, this outbreak suggests that gentamicin resistance may be transferred between different strains of Staph. aureus in vivo.

Adult↗
PubMed1979

Contamination of intravenous infusion fluid: effects of changing administration sets.

Daily change of intravenous (i.v.) infusion administration sets has been recommended by the Center for Disease Control since 1973 to reduce the risk of infusion bacteremia. To evaluate this recommendation, we undertook a prospective, randomized, controlled trial that compared the rates of i.v.-associated bacteremia, in-use i.v. fluid contamination, and phlebitis in 300 patients whose administration sets were changed every 24 h with those in 300 patients whose administration sets were changed every 48 h. No i.v.-associated bacteremia occurred. Twelve of 600 infusions (2%) had positive infusion-fluid cultures: five in one group and seven in the other. Both groups had comparable rates of phlebitis. In this study population with low rates of fluid contamination, no benefit accrued from changing the administration sets every 24 h instead of every 48 h. In hospitals with low rates of fluid contamination, the routine changing of i.v. administration sets every 48 h will result in substantial financial savings.

Candida albicans↗
PubMed1979

Guidelines for the care of patients hospitalized with viral hepatitis.

For years patients hospitalized with viral hepatitis have been placed in two categories of isolation--enteric precautions and blood precautions. This strategy was based on the inability to differentiate between hepatitis A and B and on the assumption that feces and blood from patients with either type might be infective. It is now known that patients with hepatitis A do not pose a problem of disease transmission through direct contact with blood, and although blood of patients with hepatitis B may be infective, the virus is not transmitted via feces. The enteric route is the principal mode of transmission for hepatitis A, but maximal levels of hepatitis A virus excretion occur before the onset of jaundice. Non-A, non-B hepatitis is similar epidemiologically to hepatitis B. Thus, the major thrust for caring for patients hospitalized with viral hepatitis is toward blood precautions; the same precautions used when handling feces, urine, and excretions from all other hospitalized patients are appropriate for patients admitted with a diagnosis of hepatitis A.

Bedding and Linens↗
PubMed1979

Nosocomial varicella. Part II: suggested guidelines for management.

Because of the potential severity of varicella among patients with compromised immunity in hospitals, a case of nosocomial varicella demands immediate attention. Patients with varicella should be discharged or placed in strict isolation. Other patients in the hospital should be screened for varicella exposure and susceptibility, and isolated as necessary. Exposed staff members must also be screened for susceptibility. Prompt institution of these measures should prevent or reduce transmission of nosocomial varicella.

Chickenpox↗
PubMed1978

The role of nationwide nosocomial infection surveillance in detecting epidemic bacteremia due to contaminated intravenous fluids.

Since January, 1970, the Center for Disease Control (CDC) has corridnated surveillance of nosocomial infections in a group of voluntarily cooperating hispitals in the United States. In 1970, this surveillance system failed to realize one of its major goals: detection of a nationwide epidemic of septicemia caused by contaminated intravenous products. However, retrospective review of infections reported to CDC revealed that the data received were sufficient for the outbreak to have been recognized. Beginning in July, 1970, one month after the contaminated products were first distributed and five months before the outbreak was actually detected. CDC data showed a persistent increase in the incidence of Enterobacter and Erwinia (presently designated Enterobacter agglomerans) bacteremia. Furthermore, monthly rates of cases of bacteremia caused by these organisms were higher in hospitals using the contaminated intravenous products than for hospitals not using them. Failure to detect this outbreak at the time of its occurrence was due to delays in data processing and insufficiently sophisticated data analysis. Based on this experience, CDC has modified the surveillance system to aid recognition of future outbreaks.

Cross Infection↗
PubMed1978

Effect of infections on hospital care.

To determine research priorities in infectious diseases, the impact of infections on hospital care in the United States is estimated from the number of infectious diseases observed in hospitals that cooperate with the Center for Disease Control in surveillance of community-acquired and nosocomial infections. Each year, over 3 million community-acquired infections require persons to be hospitalized, and over 2 million nosocomial infections are acquired. Approximately 90% of the infections treated in hospitals are bacterial. These infections account for an estimated 29 million days of acute hospital care, which is approximately 10% of the patient days in United States acute-care hospitals. The direct hospitalization costs for treating infectious diseases are estimated to be over $4.8 billion. Treatment of infectious diseases accounts for a major portion of hospital care in the United States.

Cross Infection↗
PubMed1977

The risks and prevention of Neisseria gonorrhoeae transfer in fresh ejaculate donor insemination.

The risk of transferring gonorrhea with donor insemination was investigated in this study. Thirteen semen specimens contaminated by Neisseria gonorrhoeae were placed in containers as used in donor artificial insemination (AID) and cultured serially. Since most fresh ejaculates are used rapidly, a 2-hour peroid was used as the end-point. Ten of the thirteen ejaculates were positive on initial and 2-hour delay cultures. Three were negative by both cultures. The epidemiology of gonorrhea is reviewed, and those cases of gonorrhea reported following AID are discussed. The use of frozen semen as advocated by some is compared with the use of fresh ejaculates. It is shown that fresh ejaculates, which are more practical for many physicians and have better fertilizing capacity, can be used if proper cultures are obtained at the time of insemination. It is suggested that either frozen ejaculates with negative culture or fresh ejaculates screened by smear and cultured at the time of insemination be utilized. The use of fresh semen is possible, since results of appropriate cultures could be available and treatment instituted before clinical disease occurs.

Gonorrhea↗
PubMed1977

Nosocomial infection. A continuing problem.

Bacteremia, urinary tract infection, and respiratory infection account for over 60% of all nosocomial infections. The incidence of nosocomial bacteremia is low, but about 25% of patients with Gram-negative bacteremia die from it. Many cases of nosocomial bacteremia result from contamination of intravenous (IV) infusion systems. If an underlying source of infection cannot be found in a patient with fever and an indwelling IV catheter, the infusion set should be removed immediately. Urinary tract infection is the most common nosocomial infection. It is often associated with urinary tract instrumentation and is frequently preventable. Lower respiratory tract infection is a major cause of morbidity and prolonged hospitalization; it is sometimes preventable by careful management of respiratory therapy equipment. When infection occurs, treatment should be started with large doses of broad-spectrum antibiotics until results of culture can point the way to more specific therapy. Every hospital should have an active patient surveillance system and a strong infection-control program. If a problem with nosocomial infection cannot be resolved within the hospital, the local or state health department should be contacted for assistance.

Anti-Bacterial Agents↗
PubMed1977

Control of influenza in the hospital.

Nosocomial transmission of influenza has been reported infrequently; however, patients in general hospitals are often among the most susceptible to the complications of influenza infection. Hospital-acquired influenza may occur more often than is reported, but it may be recognized because of lack of diagnostic facilities or the time required for virus isolation and identification. Based on the mode of transmission in the hospital, the established reservoirs of influenza virus, and duration of virus shedding, isolating patients with influenza may occasionally be useful but restricting visitors is probably not required. Vaccinating hospital personnel with influenza vaccine and, if influenza A is prevalent, giving amantadine hydrochloride to high-risk patients or personnel should both be considered.

Cross Infection↗
PubMed1976

Artificial insemination using homologous semen: a review of 158 cases.

One hundred fifty-eight women underwent artificial insemination with homologous semen (AIH) in an attempt to achieve conception. Only 15 (9.5%) were successful. Women with anatomical abnormalities were not excluded from the study and they were less successful than the normal women, but results were disappointing in both groups. The most frequently recorded indication for AIH was decreased density or motility of the husband's sperm, but pregnancy occurred in only 2 of the 48 cases in which sperm count was consistently less than 50 X 10(6)/ml and in only 3 of the 63 cases in which sperm motility was consistently less than 60%. When several semen analyses revealed considerable fluctuation in semen quality, the chances for impregnation by natural means appeared to be greater than the likelihood of success with AIH. The procedure does not seem to compensate for diminished count or motility, does not seem to be of particular value in cases of unexplained infertility, and appears to be indicated only in very special cases, if at all.

Adult↗