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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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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Gamma Knife Radiosurgery of the Glomus Jugulare Tumour – Early Multicentre Experience (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 1141-1146 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Radiosurgery; gamma knife; glomus jugulare tumour.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Leksell Gamma Knife was used to treat 66 patients with glomus jugulare tumour at 6 European sites between 1992–1998. The age of the patients ranged between 18–80 years (median 54 years). Gamma Knife radiosurgery was a primary treatment in 30 patients (45.5%). Open surgery preceded radiosurgery in 24 patients (36.4%), embolisation in 14 patients (21.2%) and fractionated radiotherapy in 5 patients (7.6%). The volume of the tumour ranged 0.5–27 cm3 (median 5,7 cm3). The minimal dose to the tumour margin ranged between 10–30 Gy (median 16.5 Gy).  After radiosurgery 52 patients were followed, the follow up period was 3–70 months (median 24 months). Neurological deficit improved in 15 patients (29%) and deteriorated in 3 patients (5,8%), one transient and two persistant. Neuroradiological follow up using MRI or CT was performed in 47 patients 4–70 months (median 24 months) after radiosurgery. Tumour size decreased in 19 patients (40%) while in the remaining 28 patients (60%) no change in the tumour volume was observed. None of the tumours increased in volume during the observation period. Control angiography was performed in 6 patients. Pathological vascularisation completely disappeared in one patient, reduced in two and there was no change in the remaining three.  Radiosurgery proves to be a safe treatment for glomus jugulare tumour with no mortality and no acute morbidity. Because of its naturally slow growth rate, up to 10 years of follow up will be necessary to establish a cure rate after radiosurgery for these lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050411
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Prävention nosokomialer Harnweginfektionen Empfehlungen des Nationalen Referenzzentrums für Krankenhaushygiene (1999)
    Springer
    Intensivmedizin und Notfallmedizin 36 (1999), S. 15-26 
    Details
    ISSN: 1435-1420
    Keywords: Key words Nosocomial urinary tract infection ; prevention of catheter-associated urinary tract infections ; evidence-based guidelines ; Schlüsselwörter Nosokomiale Harnweginfektionen ; Prävention Katheterassoziierter Harnweginfektionen ; evidenzbasierte Leitlinien
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Harnweginfektionen sind mit einem Anteil von ca. 40% die häufigsten nosokomialen Infektionen und in den meisten Fällen mit transurethralen Kathetern assoziiert. Die Empfehlungen der Centers for Disease Control and Prevention (CDC, Atlanta, USA) als international wichtigste, evidenz-basierte Leitlinien zur Prävention Katheterassoziierter Harnweginfektionen wurden im Jahre 1981 veröffentlicht und seitdem nicht aktualisiert. Evidenzbasierte nationale Empfehlungen sind in Deutschland bislang nicht verfügbar. Wir haben deshalb eine systematische Literaturrecherche nach randomisierten, kontrollierten Interventionsstudien zur Prävention Katheterassoziierter Harnweginfektionen durchgeführt (Medline, Cochrane Library, Durchsicht wichtiger Standardwerke). Insgesamt wurden 50 randomisierte, kontrollierte Interventionsstudien identifiziert, welche die Einschlußkriterien erfüllten. Wesentliche neue Erkenntnisse ergaben sich in den letzten Jahren zu Alternativen von transurethralen Kathetern und zu neuen Kathetermaterialien. Von den CDC-Empfehlungen ausgehend, deren wichtigste Prinzipien immer noch Gültigkeit besitzen, wurden vom Nationalen Referenzzentrum für Krankenhaushygiene* aktualisierte Leitlinien zur Prävention Katheter-assoziierter Harnweginfektionen entwickelt.
    Notes: Summary Urinary tract infections are the most frequent nosocomial infections, accounting for about 40% of all nosocomial infections. In most cases these infections are associated with indwelling urinary catheters. The guideline from the Centers for Disease Control and Prevention (Atlanta, USA) for the prevention of catheter-associated urinary tract infections, as the most important evidence-based guideline worldwide, was published in 1981 and has not been updated so far. Evidence-based national guidelines are not available in Germany. We have, therefore, performed a literature search for randomized, controlled studies on the prevention of catheter-associated urinary tract infections (Medline, Cochrane Library, reference text books) published since 1981. Fifty studies meeting our inclusion criteria were identified. Substantial new findings have been published on alternatives to urethral catheters and new catheter materials. Based upon the CDC guideline, whose principles are still valid, updated guidelines for the prevention of catheter-associated urinary tract infections have been developed by the National Reference Center for Hospital Hygiene.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050204
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Acinetobacter species as nosocomial pathogens (1998)
    Springer
    European journal of clinical microbiology & infectious diseases 17 (1998), S. 73-77 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion In summary,Acinetobacter colonization or infection may originate from the patients' own flora under the pressure of antimicrobial selection, the hands of staff members, or contaminated equipment. Transmission ofAcinetobacter strains between patients occurs primarily via the hands of health care workers. In outbreak situations, colonized or infected patients and the inanimate environment, which can be secondarily contaminated, are the main reservoirs in the hospital setting for crosstransmission. However, colonized or infected patients seem to be the most important source of cross-contamination, as epidemic strains spread easily throughout different wards. Especially in prolonged outbreaks in which control efforts such as proper hand washing, glove changing, and restriction of antimicrobial agents are ineffective and specific sources such as contaminated equipment are not identified, the source of the epidemic strain is likely the patients' inanimate dry environment [45, 48]. In outbreak situations it is necessary that isolatedAcinetobacter strains are identified to the genomic species level and then typed before epidemiological conclusions can be drawn, becauseAcinetobacter spp. are ubiquitous organisms [3, 31].
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01682159
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Acinetobacter Species as Nosocomial Pathogens (1998)
    Springer
    European journal of clinical microbiology & infectious diseases 17 (1998), S. 73-77 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01682159
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    Paper (German National Licenses)
    Fulltext
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