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  • 1
    Electronic Resource
    Electronic Resource
    Nosocomial Infections in a Neurosurgery Intensive Care Unit (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 1303-1308 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Intensive care unit; neurosurgery; nosocomial infection; surveillance.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ In order to identify overall and site-specific nosocomial infection (NI) rates in patients receiving neurosurgical intensive care therapy, a prospective study was started in February 1997 in the eight-bed neurosurgical ICU of the University Hospital of Freiburg, Germany. Case records were reviewed twice a week, all microbiology reports were reviewed and ward staff was consulted. NI were defined according to the CDC-criteria and were categorised into specific infection sites. Within 20 months, 545 patients with a total of 5,117 patient days were investigated (mean length of stay: 9.4 days). 113 NI were identified in 90 patients (72 pts. with one, 13 with two and 5 with three infections, respectively). A moderate to high overall incidence (20.7/100 pts.) and a moderate incidence density (22.1/1,000 patient days) of NI in the neurosurgical ICU could be documented; these figures are well within the range of published data. Site specific incidence rates and incidence densities were: 1 bloodstream infection per 100 patients (0.9 central line-associated BSIs per 1,000 central line-days), 9 pneumonias per 100 patients (15.1 ventilator-associated pneumonias per 1,000 ventilator-days), 7.3 urinary tract infections per 100 patients (8.5 urinary catheter-associated UTIs per 1,000 urinary catheter-days). Additionally, 1.1 cases of meningitis, 0.7 brain abscesses/ventriculitis, and 1.7 other infections (surgical site infection, bronchitis, catheter related local infection, diarrhoea) were documented per 100 patients, respectively. 14.6% of isolated pathogens were E. coli, 10.2% enterococci, 9.6% S. aureus, 6.4% CNS, 6.4% Klebsiella spp., 5% Enterobacter spp. and 5% Pseudomonas spp.. In 11 cases of NI no pathogen could be isolated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050434
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  • 2
    Electronic Resource
    Electronic Resource
    Biodegradability of Cefotiam, Ciprofloxacin, Meropenem, Penicillin G, and Sulfamethoxazole and Inhibition of Waste Water Bacteria (1999)
    Springer
    Archives of environmental contamination and toxicology 37 (1999), S. 158-163 
    Details
    ISSN: 1432-0703
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering , Medicine
    Notes: Abstract. Most antibiotics are metabolized only incompletely by patients after administration and enter the municipal sewage with the patients' excretions. Little is known about their biodegradability in aquatic environments and their role with respect to growing bacterial resistance. Therefore, the biodegradability of some clinically important antibiotic drugs as a very first step of an environmental risk assessment was investigated with the OECD closed bottle test (CBT). To assess toxicity of the test compounds against aquatic bacteria (1) a growth inhibition test (GIT) with Pseudomonas putida was conducted; (2) a toxicity control was used in the CBT; and (3) the colony-forming units (CFUs) were monitored in the test vessels. Theoretical concentrations of the test substances in hospital effluents were calculated and compared with minimum inhibitory concentrations for susceptible pathogenic bacteria. None of the test compounds met the criteria for ready biodegradability. Only penicillin G was biodegradable to some degree (27%), even when the test was prolonged from 28 to 40 days (35%). The inhibition concentrations measured in the GIT were in the same range or lower than the 50% minimum inhibitory concentrations (MIC50) known for susceptible pathogenic bacteria. CFU monitoring revealed high toxicity for sulfamethoxazole, whereas ciprofloxacin had a weak but significant effect; only for meropenem a weak but significant effect was measured in the toxicity control of the CBT. MIC50 published for susceptible pathogenic bacteria were for all compounds in the same range as the concentrations expected for hospital effluents. Therefore, antibiotic drugs emitted into municipal sewage may affect the biological process in sewage treatment plants (STPs), and they may persist in the aquatic environment and contribute to the increasing resistance of pathogenic bacteria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002449900501
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  • 3
    Electronic Resource
    Electronic Resource
    Influence of architectural design on nosocomial infections in intensive care units—a prospective 2-year analysis (1989)
    Springer
    Intensive care medicine 15 (1989), S. 179-183 
    Details
    ISSN: 1432-1238
    Keywords: Intensive care units ; Nosocomial infections ; Architectural design
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nosocomial infection rates in an old intensive care ward constructed in 1924 were compared with those in a new one constructed in 1986. The nosocomial infection rate in the old unit was 34.2% and that in the new unit 31.9%, with an average of 33%. The most frequent infections were: pneumonia, urinary tract infection, septicaemia and wound infection. After transfer of the intensive care unit (ICU) the incidence and profile of nosocomial infections remained the same. These findings suggest that the influence of architectural design has little impact on the incidence of nosocomial infections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01058570
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  • 4
    Electronic Resource
    Electronic Resource
    Useful and useless hygienic techniques in intensive care units (1985)
    Springer
    Intensive care medicine 11 (1985), S. 280-283 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00273536
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  • 5
    Electronic Resource
    Electronic Resource
    Exogenous or endogenous reservoirs of nosocomialPseudomonas aeruginosa andStaphylococcus aureus infections in a surgical intensive care unit (1993)
    Springer
    Intensive care medicine 19 (1993), S. 161-165 
    Details
    ISSN: 1432-1238
    Keywords: Nosocomial infections ; Intensive care unit ; Staphylococcus aureus ; Pseudomonas aeruginosa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective A 4 month prospective study was performed to assess the incidence and routes of endogenous or exogenous colonization and nosocomial infection caused byStaphylococcus aureus andPseudomonas aeruginosa in surgical critically ill patients. Design A total of 4634 specimens ware obtained. Patient's nasal, scalp, and rectal swabs as well as tracheal secretion (TS) were cultured every second day beginning on the day of admission. Nasal swabs and hand cultures of the personnel as well as cultures from gowns were also taken. all isolates ofS. aureus were phage typed and 116 of these isolates were also plasmid typed.P. aeruginosa isolates were sero-and pyocin typed. Resistance patterns were determined in all isolates. Setting The suty was carried out in the surgical intensive care unit (SICU) of an teaching hospital. Patients During the study period each patient (a total of 153 patients) admitted to the SICU entered the study. Results P. aeruginosa andS. aureus colonisation rate on admission were 5% and 36.5% respectively. Only 10 patients (6.5%) were colonized withP. aeruginosa during hospitalization, and only 7 patients (4.5%) acquiredS. aureus in the surgical intensive care unit (SICU). The most common primary colonisation site ofP. aeruginosa was the rectum, whereasS. aureus was predominantly found in nasal cultures. Horizontal transmission ofS. aureus occured in only 2 patients. Conclusion The study suggests that colonisation withP. aeruginosa andS. aureus occurs from endogenous rather than from exogenous sources and that the endogenous acquisition of both bacteria play a more important role in development of nosocomial infections than the exogenous route of transmission.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01720533
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  • 6
    Electronic Resource
    Electronic Resource
    Role of Acinetobacter for Biodegradability of Quaternary Ammonium Compounds (2000)
    Springer
    Bulletin of environmental contamination and toxicology 64 (2000), S. 764-770 
    Details
    ISSN: 1432-0800
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering , Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001280000069
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  • 7
    Electronic Resource
    Electronic Resource
    Combination effect of mezlocillin plus metronidazole against enterococci, klebsiella pneumoniae, escherichia coli, pseudomonas aeruginosa and indole-positive proteus strains (1982)
    Springer
    Infection 10 (1982), S. 105-105 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01816736
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  • 8
    Electronic Resource
    Electronic Resource
    Comment (1987)
    Springer
    Infection 15 (1987), S. 433-433 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01647223
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  • 9
    Electronic Resource
    Electronic Resource
    Concentrations of roxithromycin (RU 28965) in serum and in sinus mucosa (1988)
    Springer
    Infection 16 (1988), S. 250-250 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01650767
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  • 10
    Electronic Resource
    Electronic Resource
    Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria (1991)
    Springer
    Infection 19 (1991), S. 186-189 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Mittels der Checker-board-Agar-Dilutionstechnik wurden Cefepime und SCE-2787, zwei neue parenterale Cephalosporine sowie die Kombinationswirkung dieser Substanzen mit den Aminoglykosiden Tobramycin und Gentamicin gegen klinisch wichtige gramnegative Erreger untersucht. Cefepim zeigte eine ausgezeichneteIn-vitro-Wirksamkeit gegenüberKlebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens andProteus vulgaris, wobei die MHK90-Werte zwischen 0,03 und 0,125 mg/l lagen; eine gute bis mäßige Aktivität zeigte die Substanz gegenAcinetobacter anitratus, Pseudomonas aeruginosa undPseudomonas cepacia (MHK90-Werte zwischen 4 und 16 mg/l). SCE-2787 wies eine ausgezeichnete Aktivität gegenCitrobacter spp. (MHK90 0,125 mg/l) und eine sehr gute Aktivität gegenA. anitratus, P. aeruginosa undP. vulgaris auf (MHK90-Werte 1–2 mg/l),Pseudomonas maltophilia wurde allerdings von therapeutisch erreichbaren Konzentrationen nicht gehemmt (MHK90 64 mg/l). Bei 14–28% der Stämme wurde ein synergistischer Effekt der SCE-2787-Aminoglycosid-Kombination und in 8,6% der Stämme eine synergistische Wirkung der Cefepim-Gentamicin-Kombination beobachtet. Eine antagonistische Wirkung konnte bei keiner der untersuchten Kombinationen festgestellt werden.
    Notes: Summary Thein vitro activity of cefepime and SCE-2787, two new parenteral cephalosporins, and the combination effect with tobramycin and gentamicin against nosocomial gram-negative rods was studied using checker-board agar dilution technique. Cefepime showed excellentin-vitro activity againstKlebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens andProteus vulgaris (MIC90 0.03–0.125 mg/l) and good to moderate activity againstAcinetobacter anitratus, Pseudomonas aeruginosa andPseudomonas cepacia (MIC90 4–16 mg/l). SCE-2787 had an excellent activity againstCitrobacter spp. (MIC90 0.125 mg/l) and a very good activity againstA. anitratus, P. aeruginosa andP. vulgaris (MIC90 1–2 mg/l).Pseudomonas maltophilia was not inhibited at therapeutically achievable concentrations (MIC90 64 mg/l). On average, 14–28% of the strains were inhibited by synergistic SCE-2787 aminoglycoside-combinations, whereas only 8.6% were inhibited by a synergistic effect of the combination with cefepime and gentamicin. No antagonism occurred with any of the combinations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01643250
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