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Robert A Weinstein - One of the best experts on this subject based on the ideXlab platform.
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chlorhexidine gluconate to cleanse patients in a medical intensive care unit the effectiveness of source control to reduce the bioburden of vancomycin resistant enterococci
JAMA Internal Medicine, 2006Co-Authors: Michael O Vernon, Mary K Hayden, William E Trick, Robert Hayes, Donald Blom, Robert A WeinsteinAbstract:BACKGROUND: Historically, methods of interrupting pathogen transmission have focused on improving health care workers' adherence to recommended infection control practices. An adjunctive approach may be to use source control (eg, to decontaminate patients' skin). METHODS: We performed a prospective sequential-group single-arm clinical trial in a teaching hospital's medical intensive care unit from October 2002 to December 2003. We bathed or cleansed 1787 patients and assessed them for acquisition of vancomycin-resistant enterococci (VRE). We performed a nested study of 86 patients with VRE Colonization and obtained culture specimens from 758 environmental surfaces and 529 health care workers' hands. All patients were cleansed daily with the procedure specific to the study period as follows: period 1, soap and water baths; period 2, cleansing with cloths saturated with 2% chlorhexidine gluconate; and period 3, cloth cleansing without chlorhexidine. We measured Colonization of patient skin by VRE, health care worker hand or environmental surface contamination by VRE, and patient acquisition of VRE rectal Colonization. RESULTS: Compared with soap and water baths, cleansing patients with chlorhexidine-saturated cloths resulted in 2.5 log(10) less colonies of VRE on patients' skin and less VRE contamination of health care workers' hands (risk ratio [RR], 0.6; 95% confidence interval [CI], 0.4-0.8) and environmental surfaces (RR, 0.3; 95% CI, 0.2-0.5). The incidence of VRE acquisition decreased from 26 Colonizations per 1000 patient-days to 9 per 1000 patient-days (RR, 0.4; 95% CI, 0.1-0.9). For all measures, effectiveness of cleansing with nonmedicated cloths was similar to that of soap and water baths. CONCLUSION: Cleansing patients with chlorhexidine-saturated cloths is a simple, effective strategy to reduce VRE contamination of patients' skin, the environment, and health care workers' hands and to decrease patient acquisition of VRE.
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the role of Colonization pressure in the spread of vancomycin resistant enterococci an important infection control variable
JAMA Internal Medicine, 1998Co-Authors: Marc J M Bonten, Mary K Hayden, Sarah Slaughter, Anton W Ambergen, Jean Van Voorhis, Catherine Nathan, Robert A WeinsteinAbstract:Objective The spread of nosocomial multiresistant microorganisms is affected by compliance with infection control measures and antibiotic use. We hypothesized that "Colonization pressure" (ie, the proportion of other patients colonized) also is an important variable. We studied the effect of Colonization pressure, compliance with infection control measures, antibiotic use, and other previously identified risk factors on acquisition of Colonization with vancomycin-resistant enterococci (VRE). Methods Rectal Colonization was studied daily for 19 weeks in 181 consecutive patients who were admitted to a single medical intensive care unit. A statistical model was created using a Cox proportional hazards regression model including length of stay in the medical intensive care unit until acquisition of VRE, Colonization pressure, personnel compliance with infection control measures (hand washing and glove use), APACHE (Acute Physiology and Chronic Health Evaluation) II scores, and the proportion of days that a patient received vancomycin or third-generation cephalosporins, sucralfate, and enteral feeding. Results With survival until Colonization with VRE as the end point, Colonization pressure was the most important variable affecting acquisition of VRE (hazard ratio [HR], 1.032; 95% confidence interval [CI], 1.012-1.052;P=.002). In addition, enteral feeding was associated with acquisition of VRE (HR, 1.009; 95% CI, 1.000-1.017;P=.05), and there was a trend toward association of third-generation cephalosporin use with acquisition (HR, 1.007; 95% CI, 0.999-1.015;P=.11). The effects of enteral feeding and third-generation cephalosporin use were more important when Colonization pressure was less than 50%. Once Colonization pressure was 50% or higher, these other variables hardly affected acquisition of VRE. Conclusions Acquisition of VRE was affected by Colonization pressure, the use of antibiotics, and the use of enteral feeding. However, once Colonization pressure was high, it became the major variable affecting acquisition of VRE.
Robert L Norton - One of the best experts on this subject based on the ideXlab platform.
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vagrancy and Colonization of st thomas and st john u s virgin islands by adelaide s warblers setophaga adelaidae
The Journal of Caribbean Ornithology, 2016Co-Authors: Richard R Veit, Lucinda C Zawadzki, Lisa L Manne, Pearl Cales, Danielle Fibikar, Shannon R Curley, Elizabeth Dluhos, Robert L NortonAbstract:We identified and photographed five Adelaide’s Warblers ( Setophaga adelaidae ) in the Lameshur Bay area on the southeastern corner of St. John, U.S. Virgin Islands, during January 2015, and found eight birds in the same area during January 2016. Adelaide’s Warblers, endemic to Puerto Rico and Vieques Island, the latter 67 km to the southwest of St. John, were first recorded in the U.S. Virgin Islands in 2012–2013 on both St. Thomas and St. John. We suggest that vagrancy of Adelaide’s Warblers to the U.S. Virgin Islands, against prevailing easterly trade winds, may represent in real time the island Colonization process of some passerine birds in the West Indies. En enero de 2015, identificamos y fotografiamos a cinco individuos de Reinita Mariposera ( Setophaga adelaidae ) en el area de la Bahia Lameshur, en el extremo sudeste de San Juan, Islas Virgenes estadounidenses. Tambien encontramos ocho individuos en la misma zona en enero de 2016. Reinita Mariposera, endemica de las islas de Puerto Rico y Vieques y cuyo punto mas cercano a San Juan dista 67 km, fue registrada por primera vez en las Islas Virgenes estadounidenses en 2012–2013 en ambas islas: Santo Tomas y San Juan. Sugerimos que la divagancia de Reinita Mariposera en las Islas Virgenes estadounidenses en contra de los vientos alisios predominantes del este pueden representar, en tiempo real, el proceso de colonizacion de una isla por parte de especies paseriformes en el Caribe Insular. Nous avons identifie et photographie cinq Parulines d’Adelaide (Setophaga adelaidae) dans la region de Lameshur Bay au sud-est de St-John (Iles Vierges americaines), en janvier 2015, et nous avons trouve huit individus dans la meme region en janvier 2016. La Paruline d’Adelaide, espece endemique des iles de Porto Rico et de Vieques - cette derniere etant situee a 67 km au sud-ouest de St-John - a ete mentionnee a St-Thomas et St-John (Iles Vierges americaines) pour la premiere fois en 2012–2013. Nous estimons que l’erratisme de la Paruline d’Adelaide aux Iles Vierges americaines, contre les alizes dominants de secteur est, pourrait illustrer en temps reel le processus de colonisation des Antilles par les passereaux.
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Vagrancy and Colonization of St. Thomas and St. John, U.S. Virgin Islands, by Adelaide’s Warblers ( Setophaga adelaidae )
The Journal of Caribbean Ornithology, 2016Co-Authors: Richard R Veit, Lucinda C Zawadzki, Lisa L Manne, Pearl Cales, Danielle Fibikar, Shannon R Curley, Elizabeth Dluhos, Robert L NortonAbstract:We identified and photographed five Adelaide’s Warblers ( Setophaga adelaidae ) in the Lameshur Bay area on the southeastern corner of St. John, U.S. Virgin Islands, during January 2015, and found eight birds in the same area during January 2016. Adelaide’s Warblers, endemic to Puerto Rico and Vieques Island, the latter 67 km to the southwest of St. John, were first recorded in the U.S. Virgin Islands in 2012–2013 on both St. Thomas and St. John. We suggest that vagrancy of Adelaide’s Warblers to the U.S. Virgin Islands, against prevailing easterly trade winds, may represent in real time the island Colonization process of some passerine birds in the West Indies. En enero de 2015, identificamos y fotografiamos a cinco individuos de Reinita Mariposera ( Setophaga adelaidae ) en el area de la Bahia Lameshur, en el extremo sudeste de San Juan, Islas Virgenes estadounidenses. Tambien encontramos ocho individuos en la misma zona en enero de 2016. Reinita Mariposera, endemica de las islas de Puerto Rico y Vieques y cuyo punto mas cercano a San Juan dista 67 km, fue registrada por primera vez en las Islas Virgenes estadounidenses en 2012–2013 en ambas islas: Santo Tomas y San Juan. Sugerimos que la divagancia de Reinita Mariposera en las Islas Virgenes estadounidenses en contra de los vientos alisios predominantes del este pueden representar, en tiempo real, el proceso de colonizacion de una isla por parte de especies paseriformes en el Caribe Insular. Nous avons identifie et photographie cinq Parulines d’Adelaide (Setophaga adelaidae) dans la region de Lameshur Bay au sud-est de St-John (Iles Vierges americaines), en janvier 2015, et nous avons trouve huit individus dans la meme region en janvier 2016. La Paruline d’Adelaide, espece endemique des iles de Porto Rico et de Vieques - cette derniere etant situee a 67 km au sud-ouest de St-John - a ete mentionnee a St-Thomas et St-John (Iles Vierges americaines) pour la premiere fois en 2012–2013. Nous estimons que l’erratisme de la Paruline d’Adelaide aux Iles Vierges americaines, contre les alizes dominants de secteur est, pourrait illustrer en temps reel le processus de colonisation des Antilles par les passereaux.
Patrick S. Ramsey - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of group B Streptococcus Colonization in subsequent pregnancies of group B Streptococcus-colonized versus noncolonized women.
American Journal of Perinatology, 2012Co-Authors: Sarah M. Page-ramsey, Sara K. Johnstone, Patrick S. RamseyAbstract:Objective To determine whether group B Streptococcus (GBS)-colonized pregnant women have an increased prevalence of GBS Colonization in subsequent pregnancies. Study Design This retrospective cohort study compared the prevalence of GBS Colonization in initial and subsequent pregnancies of 158 women with two or more deliveries at a Midwest institution since the initiation of universal screening for GBS. Results The GBS Colonization rate in index pregnancies was 20%. Colonization rate in subsequent pregnancies for initially GBS-colonized women was 42% compared with 19% for women who were not colonized with GBS in the index pregnancy (p = 0.009). The relative risk for GBS-colonized women to be GBS-colonized in subsequent pregnancies was 2.2 (confidence interval = 1.3 to 3.8). Conclusion Previous GBS Colonization is a risk factor for GBS Colonization in subsequent pregnancies. Consideration of intrapartum chemoprophylaxis in women with a history of GBS Colonization, assuming current Colonization status is unknown, warrants further investigation.
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Prevalence of group B Streptococcus Colonization in subsequent pregnancies of group B Streptococcus-colonized versus noncolonized women.
American journal of perinatology, 2012Co-Authors: Sarah M. Page-ramsey, Sara K. Johnstone, Patrick S. RamseyAbstract:To determine whether group B Streptococcus (GBS)-colonized pregnant women have an increased prevalence of GBS Colonization in subsequent pregnancies. This retrospective cohort study compared the prevalence of GBS Colonization in initial and subsequent pregnancies of 158 women with two or more deliveries at a Midwest institution since the initiation of universal screening for GBS. The GBS Colonization rate in index pregnancies was 20%. Colonization rate in subsequent pregnancies for initially GBS-colonized women was 42% compared with 19% for women who were not colonized with GBS in the index pregnancy (p = 0.009). The relative risk for GBS-colonized women to be GBS-colonized in subsequent pregnancies was 2.2 (confidence interval = 1.3 to 3.8). Previous GBS Colonization is a risk factor for GBS Colonization in subsequent pregnancies. Consideration of intrapartum chemoprophylaxis in women with a history of GBS Colonization, assuming current Colonization status is unknown, warrants further investigation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
P. W. M. Hermans - One of the best experts on this subject based on the ideXlab platform.
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Epidemiology of Streptococcus pneumoniae and Staphylococcus aureus Colonization in healthy Venezuelan children
European Journal of Clinical Microbiology & Infectious Diseases, 2011Co-Authors: B. Quintero, M. Araque, C. Gaast-de Jongh, F. Escalona, M. Correa, S. Morillo-puente, S. Vielma, P. W. M. HermansAbstract:Streptococcus pneumoniae and Staphylococcus aureus cause significant morbidity and mortality worldwide. We investigated both the Colonization and co-Colonization characteristics for these pathogens among 250 healthy children from 2 to 5 years of age in Merida, Venezuela, in 2007. The prevalence of S. pneumoniae Colonization, S. aureus Colonization, and S. pneumoniae – S. aureus co-Colonization was 28%, 56%, and 16%, respectively. Pneumococcal serotypes 6B (14%), 19F (12%), 23F (12%), 15 (9%), 6A (8%), 11 (8%), 23A (6%), and 34 (6%) were the most prevalent. Non-respiratory atopy was a risk factor for S. aureus Colonization ( p = 0.017). Vaccine serotypes were negatively associated with preceding respiratory infection ( p = 0.02) and with S. aureus Colonization ( p = 0.03). We observed a high prevalence of pneumococcal resistance against trimethoprim–sulfamethoxazole (40%), erythromycin (38%), and penicillin (14%). Semi-quantitative measurement of pneumococcal Colonization density showed that children with young siblings and low socioeconomic status were more densely colonized ( p = 0.02 and p = 0.02, respectively). In contrast, trimethoprim–sulfamethoxazole- and multidrug-resistant-pneumococci colonized children sparsely ( p = 0.03 and p = 0.01, respectively). Our data form an important basis to monitor the future impact of pneumococcal vaccination on bacterial Colonization, as well as to recommend a rationalized and restrictive antimicrobial use in our community.
Ben Lugtenberg - One of the best experts on this subject based on the ideXlab platform.
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root Colonization by phenazine 1 carboxamide producing bacterium pseudomonas chlororaphis pcl1391 is essential for biocontrol of tomato foot and root rot
Molecular Plant-microbe Interactions, 2000Co-Authors: Thomas F C Chinawoeng, Linda C Dekkers, Ine H M Mulders, Guido V Bloemberg, Ben LugtenbergAbstract:The phenazine-1-carboxamide-producing bacterium Pseudomonas chlororaphis PCL1391 controls tomato foot and root rot caused by Fusarium oxysporum f. sp. radicis-lycopersici. To test whether root Colonization is required for biocontrol, mutants impaired in the known Colonization traits motility, prototrophy for amino acids, or production of the site-specific recombinase, Sss/XerC were tested for their root tip Colonization and biocontrol abilities. Upon tomato seedling inoculation, Colonization mutants of strain PCL1391 were impaired in root tip Colonization in a gnotobiotic sand system and in potting soil. In addition, all mutants were impaired in their ability to control tomato foot and root rot, despite the fact that they produce wild-type levels of phenazine-1-carboxamide, the antifungal metabolite previously shown to be required for biocontrol. These results show, for what we believe to be the first time, that root Colonization plays a crucial role in biocontrol, presumably by providing a delivery syste...
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role of the o antigen of lipopolysaccharide and possible roles of growth rate and of nadh ubiquinone oxidoreductase nuo in competitive tomato root tip Colonization by pseudomonas fluorescens wcs365
Molecular Plant-microbe Interactions, 1998Co-Authors: Linda C Dekkers, Ine H M Mulders, Claartje C Phoelich, Rino A R Wentwoord, Deborah C M Glandorf, Carel A Wijffelman, Ben LugtenbergAbstract:Colonization-defective, transposon-induced mutants of the efficient root colonizer Pseudomonas fluorescens WCS365 were identified with a gnotobiotic system. Most mutants were impaired in known Colonization traits, i.e., prototrophy for amino acids, motility, and synthesis of the O-antigen of LPS (lipopolysaccharide). Mutants lacking the O-antigen of LPS were impaired in both Colonization and competitive growth whereas one mutant (PCL1205) with a shorter O-antigen chain was defective only in Colonization ability, suggesting a role for the intact O-antigen of LPS in Colonization. Eight competitive Colonization mutants that were not defective in the above-mentioned traits colonized the tomato root tip well when inoculated alone, but were defective in competitive root Colonization of tomato, radish, and wheat, indicating they contained mutations affecting host range. One of these eight mutants (PCL1201) was further characterized and contains a mutation in a gene that shows homology to the Escherichia coli nuo...
