American journal of infection control
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Am J Infect Control · Dec 1993
Nosocomial herpes simplex virus infection associated with oral endotracheal intubation.
To determine by culture the frequency of herpes simplex virus reactivation complicating oral endotracheal intubation. Additionally, clinical appearance and recognition of patient infection by attendant health care workers were studied. Last, evidence of any occupational acquisition of herpes simplex virus infection was sought. ⋯ Nosocomial reactivation of herpes simplex virus infection complicated oral endotracheal intubation in our patient population in approximately one half of the patients who were intubated for more than 48 hours during the first week after the procedure. Clinically, the infection was recognizable in only one half of the virus culture-positive cases. Increased awareness of this infection is needed by health care workers, patients, and families. More information is needed on optimal therapy and prevention.
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The manuscript review process is a critical part of the dissemination of new science. This article reviews the components of the process, including editorial screening, peer review, and final author review of manuscripts, and notes the persons involved in each stage of the process. The editorial review process is an evolving science, and Journal policies and procedures are revised as this science gains new insights.
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Am J Infect Control · Aug 1993
Comparative StudyNatural history of bloodstream infections in a burn patient population: the importance of candidemia.
Because of a perceived increase in Candida bloodstream infections in our burn unit, we retrospectively reviewed all the microbiologic data and the medical records of 209 patients with burns admitted during a 42-month period. Twice weekly burn wound cultures demonstrated that Candida species were the tenth most frequently isolated organisms (69/191 patients, 36%). Despite the low frequency of isolation from burn wounds, Candida species were the most common organisms found in blood cultures and urine cultures. ⋯ Patients with candidemia were more likely than patients with blood culture growth of other organisms to have burn wound cultures that grew Candida (15/16 vs 21/33, p = 0.02), larger burns (61% vs 38%, p < 0.001), and death (63% vs 27%, p = 0.02). Multivariate analysis demonstrated that the total number of blood cultures with microorganism growth and large burn size were the greatest independent risk factors for candidemia. These data demonstrate that yeasts are pathogens of major importance in patients with burns, suggesting that in patients with burns who have suspected sepsis and large burn injury or a previous bacteremia, strong consideration should be given to administration of amphotericin B initiation of empiric antibacterial therapy.
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Surgical masks are used in hospitals to reduce postoperative infection in patients. The presence of aerosols containing pathogens makes it desirable to protect the medical staff as well. ⋯ The mask that has the highest collection efficiency is not necessarily the best mask from the perspective of the filter-quality factor, which considers not only the capture efficiency but also the air resistance. Although surgical mask media may be adequate to remove bacteria exhaled or expelled by health care workers, they may not be sufficient to remove the submicrometer-size aerosols containing pathogens to which these health care workers are potentially exposed.