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Volume 13 - October 1992

Contents

Page 2 of 14

Letters to the Editor

Departments

  • Body Substance Isolation

  • Inge Gurevich
  • Published online by Cambridge University Press:
    21 June 2016, p. 191
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  • Nosocomial Infection and Pseudoinfection From Contaminated Endoscopes Could Have Been Avoided

  • F.D. Daschner
  • Published online by Cambridge University Press:
    21 June 2016, p. 254
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  • Statistics and Meaningful Infection Rates

  • David Birnbaum
  • Published online by Cambridge University Press:
    21 June 2016, p. 134
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  • To the Editor

  • J. De Jong
  • Published online by Cambridge University Press:
    21 June 2016, p. 693
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  • The authors reply

  • Robert P. Gaynes
  • Published online by Cambridge University Press:
    21 June 2016, pp. 134-135
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  • Medical Waste

  • Nathan L. Belkin
  • Published online by Cambridge University Press:
    21 June 2016, pp. 75-76
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  • Hepatitis C Virus Antibodies in Patients on Hemodialysis

  • G. San Miguel, J. Crespo, S. Echevarria, A. D'Francisco, P. Gomez Ullate, F. Pons Romero
  • Published online by Cambridge University Press:
    21 June 2016, pp. 254-256
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  • The author replies

  • N. Joel Ehrenkranz
  • Published online by Cambridge University Press:
    21 June 2016, pp. 453-454
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  • The authors reply

  • Marguerite M. Jackson, Patricia Lynch
  • Published online by Cambridge University Press:
    21 June 2016, pp. 191-192
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Letters to the Editors

Departments

  • MRSA in Long-Term Care Facilities

  • Harry J. Silver
  • Published online by Cambridge University Press:
    21 June 2016, p. 571
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Proceedings of the First International Consensus Conference on the Clinical Investigation of Ventilator-Associated Pneumonia

  • The Standardization of Bronchoscopic Techniques for Ventilator-Associated Pneumonia

  • G. Umber-to Meduri, Jean Chastre
  • Published online by Cambridge University Press:
    21 June 2016, pp. 640-649

  • During the last decade, several centers have directed their research efforts at defining more efficient modalities for the accurate diagnosis of ventilator-associated pneumonia (VAP). Accurate diagnosis is an essential prerequisite for clinical investigation. Initial studies, which correlated histologic findings and quantitative bacterial cultures of the lung with the findings of protected specimen brush cultures have stimulated clinical investigation of VAF! Two diagnostic techniques, protected specimen brushing (PSB) and bronchoalveolar lavage (BAL), have been extensively investigated and have shown promising results. Advancements in the field, however, have been limited by the lack of standardization, particularly for BAL. In this communication, we attempt to standardize methodology for presently available bronchoscopic techniques and interpretation of data obtained by bronchoscopy to facilitate comparisons among investigations and to promote multicenter collaboration.

Letters to the Editor

Departments

  • Heliport-associated Nosocomial Mucormycoses

  • Mark J. Abzug, Sherry Gardner, Mary P. Glode, Margrete Cymanski, Martha H. Roe, Lorrie F. Odom
  • Published online by Cambridge University Press:
    21 June 2016, pp. 325-328
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Editorial

  • The Medical Waste Conundrum Revisited

  • Stephen A. Streed
  • Published online by Cambridge University Press:
    21 June 2016, pp. 385-386
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Letters to the Editor

Departments

  • The authors reply

  • V. Lorian, L. Amaral
  • Published online by Cambridge University Press:
    21 June 2016, p. 693
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Original Articles

  • Resistance to Imipenem Among Selected Gram-Negative Bacilli in the United States

  • Robert P. Gaynes, David H. Culver, The National Nosocomial Infections Surveillance System
  • Published online by Cambridge University Press:
    21 June 2016, pp. 10-14
  • Objectives:

    Identification of imipenem resistance among selected gram-negative bacilli, especially Pseudomonas aeruginosa and Enterobacter species.

    Methods:

    We analyzed 1986-1990 National Nosocomial Infection Surveillance (NNIS) data from 3,316 P aeruginosa isolates and 1,825 Enterobacter species isolates for which susceptibility results to imipenem were reported.

    Results:

    For P aeruginosa, 11.1% of the isolates were resistant to imipenem; 16.1% were either intermediate-susceptible or resistant to the drug. A logistic regression model found that resistance was more common among P aeruginosa isolated from the respiratory tract, patients in intensive care units, and in teaching hospitals. Additionally, resistance to imipenem increased by 25% in teaching hospitals from 1986-1988 to 1989-1990. For Enterobacter species, 1.3% of the isolates were resistant to imipenem; 2.3% were either intermediate-susceptible or resistant to the drug. However, imipenem resistance for these isolates did not differ between the two periods and was not more common in patients in an intensive care unit or infections at any specific site.

    Conclusions:

    The frequency of resistance to imipenem is greater among P aeruginosa than among Enterobacter species. Resistance to imipenem among the P aeruginosa isolates is more common from strains isolated from patients with nosocomial infections in an intensive care unit, from the respiratory tract, and from teaching hospitals. Resistance appears to be increasing among nosocomial P aeruginosa isolated in teaching hospitals.

Editorial

  • The A, B, C, D, and E of Viral Hepatitis: Spelling Out the Risks for Healthcare Workers

  • Ludwig A. Lettau
  • Published online by Cambridge University Press:
    21 June 2016, pp. 77-81
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Letters to the Editors

Departments

  • John M. Boyce, MD, was asked to reply to this letter

  • John M. Boyce
  • Published online by Cambridge University Press:
    21 June 2016, pp. 571-574
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Letters to the Editor

Departments

  • Reduction of C difficile-Associated Diarrhea

  • Sandra J. Pfaff
  • Published online by Cambridge University Press:
    21 June 2016, p. 510
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  • Streptococcus salivarius Meningitis Following Myelography

  • Chatrchai Watanakunakorn, Charlotte Stahl
  • Published online by Cambridge University Press:
    21 June 2016, p. 454
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Page 2 of 14