The epidemiology of Pseudomonas aeruginosa in oncology patients in a general hospital
Infection with the organism Pseudomonas aeruginosa among cancer patients continues to be a major source of morbidity and mortality, even in the presence of advances in antibiotic therapy. Cancer patients are now being cared for in general hospitals, which have a varied patient mix, rather than in specialized cancer-care hospitals. This commingling of cancer and general care patients adds to the risk of P. aeruginosa infections in patients who are undergoing chemotherapy, which compromises the immune system. During 1986, a study of the oncology unit of a large hospital was conducted. From July to October, all patients admitted were included, while during the last two months of the year, only patients with lymphoma, leukemia, or neutropenia (a depletion of white blood cells, which are necessary for immune response), or undergoing autologous bone marrow transplant were selected. A total of 283 patients were divided into groups on the basis of the nature of their illness. A serial surveillance program was conducted. Rectal cultures were obtained from all admissions, and throat and axillary (armpit) cultures were collected from the patients admitted in December and from those with multiple myeloma. Patient cultures were obtained within 24 hours of admission, from then on weekly and finally 24 hours prior to discharge. Environmental and personnel cultures were also obtained. Twelve percent were infected at admission, and 10 percent became infected in the hospital. Sixty-three genetically distinct strains were characterized. The four most prevalent strains represented 21 percent of the isolates. Of the 33 nosocomial (hospital-acquired) infections, 5 were transmitted from contact. Nine cases were tied to environmental strains isolated from sinks. P. aeruginosa was found to be a serious pathogen in oncology patients, especially those who were severely neutropenic. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Infectious Diseases
Multiple Antibiotic--Resistant Klebsiella and Escherichia coli in Nursing Homes
Nursing homes may be acting as a reservoir of drug-resistant bacteria. Between November 1990 and October 1992, 55 patients infected or colonized with ceftazidime-resistant E. coli, Klebsiella pneumoniae, or both were identified at a Chicago hospital. Thirty-five had been admitted from one of 8 nursing homes, and 31 had the resistant bacteria when admitted to the hospital. Most of the bacteria were resistant to ceftazidime, gentamicin, tobramycin, and trimethoprim-sulfamethoxazole. Even though seven different bacterial strains were isolated, they all had the same gene for drug resistance. A gastrostomy tube and prior antibiotic use were associated with drug-resistant bacteria.
Publication Name: JAMA, The Journal of the American Medical Association
A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit
Requiring hospital personnel to wear gowns in addition to gloves when attending to patients in intensive care units does not seem to significantly affect the spread of vancomycin-resistant infections. Ninety-three intensive care patients were cared for by hospital employees wearing both gowns and gloves and 88 were cared for with gloves only. A similar percentage of the glove-and-gown group (25.8%) and glove-only group (23.9%) developed vancomycin-resistant infections. The infections developed in an average of 7.1 days among the glove-only group and 8.0 days among the glove-and-gown group.
Publication Name: Annals of Internal Medicine
- Abstracts: An epidemiologic study of headache among adolescents and young adults. Cost of lost productive work time among US workers with depression
- Abstracts: The reliability of the medical history in the identification of patients at risk for infective endocarditis. The evidence base for the efficacy of antibiotic prophylaxis in dental practice
- Abstracts: Mitoxantrone for refractory and relapsed acute leukemia. Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia
- Abstracts: Validity of reported energy intake in obese and nonobese adolescents
- Abstracts: The role of saliva in maintaining oral homeostasis. Calculus update: prevalence, pathogenicity and prevention