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Biomedical subjects

A Hambraeus

Publications and source records attributed to A Hambraeus.

66 records · Page 4Linked to original sources
PubMed1978

Prevalence of hospital-associated infections in five Swedish hospitals in November 1975.

The prevalence rate of hospital-associated infections in 5 Swedish hospitals on November 4, 1975 is reported. In all, 4246 patients were included in the study, 3657 in acute disease clinics and 589 in chronic disease clinics. The overall prevalence rate was 17%, 11% in acute disease clinics and 59% in chronic disease clinics. The highest rate was found in intensive care units (72%), while in ophthalmological units it was 1%. 50% of all hospital-associated infections were urinary tract infections, 68% of which occurred in patients with an indwelling urinary catheter. 25% of all infections in acute disease clinics were postoperative wound infections, and 20% in chronic disease clinics were skin infections, including infections in varicose and decubital ulcers. 58% of the bacterial isolates from hospital-associated infections were gram-negative rods, while 12% were Staphylococcus aureus. Also in postoperative wound infections the gram-negative rods dominated over Staph. aureus, 35 vs. 23%. A prevalence study of this order of size seems adequate to assess the overall rate of hospital-associated infections in Sweden as compared to other countries. However, differences in prevalence rates between hospitals and clinics should be interpreted with great care. The seriousness and effect of reported infections must be evaluated otherwise, as well as the day-to-day infection control and the evaluation of prophylactic measures need other methods.

Acute Disease↗
PubMed1977

Bacterial contamination in a modern operating suite. 1. Effect of ventilation on airborne bacteria and transfer of airborne particles.

The effect of ventilation on airborne contamination was studied in a new operating suite containing operating rooms with conventional ventilation (17-20 turnovers/h) and operating rooms with zonal ventilation, where the turnover in the central part of the room was approximately 80/h. The efficacy of the ventilation was first examined with gas tracer experiments and found satisfactory. Experiments using potassium iodide particles showed the transfer between adjacent rooms in the suite to be less than 10(-3)% with closed doors and from 1% to 2.5 x 10(-2)% when the doors were opened once a minute. The transfer between two adjacent operating rooms was calculated to be approximately 10(-4)%. There is thus little risk of spread of airborne infection between operating rooms.Experiments with potassium iodide particles showed that in operating rooms with zonal ventilation the particle concentration in the centre of the room was about one-tenth that in the periphery; in conventionally ventilated operating rooms the concentration was about one-half. With bacteria-carrying particles generated by human activity the concentration in the centre of operating rooms with zonal ventilation was about half that in the periphery both during experimental activity and operations; in conventionally ventilated operating rooms it was about equal in both cases. Bacterial counts at the periphery were found to be lower in rooms with zonal ventilation ( approximately 50 c.f.u./m(3)) than in conventionally ventilated ( approximately 70 c.f.u./m(3)).

Air Microbiology↗
PubMed1977

Attempts to control clothes-borne infection in a burn unit. I. Experimental investigations of some clothes for barrier nursing.

Clothes-borne transmission is an important way of spread of infection from patient to patient which is not interrupted by common cotton gowns. New barrier garments were designed from spun-bonded olefin that, in particle penetration tests, was 100 times better as a filter than cotton cloth. Three designs, a gown, a loose coverall and a close overall, were compared with each other and with conventional cotton gowns in experimental exercise and nursing procedures. Staphylococcus aureus from burned patients were used as markers. The close coverall was 4-7 times better than the loose coverall or gown in preventing the soiling of clothes worn underneath it, but appeared to permit substantially more transfer from garments underneath it to a mock 'patient' and to the air than did the looser garments. A cotton gown reduced the soiling of clothes underneath it by more than 10 times and the contamination of a mock patient by more than 30 times as compared with no barrier garment. The close coverall further diminished the contamination of clothes but not the transfer to the patient. The possible mechanisms for the discrepancy between particle transmission tests annd experimental porcedures are discussed.

Aerosols↗
PubMed1977

Airborne contamination and postoperative infection after total hip replacement.

The results of 163 hip replacements at the Uppsala University Hospital are presented. Deep infection occurred in ten cases and was caused by Staphylococcus aureus in four early or intermediate infections and by anaerobes in four late infections. The remaining two infections (both of which were late) were probably associated with Staphylococcus albus--in one case possibly also with alpha streptococci. Two superficial infections not affecting the operative result were caused by Staphylococcus aureus and betahaemolytic streptococci. The results of environmental analyses of staphylococci and the total number of bacteria in the air during 77 operations did not indicate that airborne infection is a major cause of postoperative infections--there was no difference between the number of bacteria found in the air during operations after which infection occurred and uninfected operations, and the use of special zonal ventilation with high rates of air exchange in the operating area had no effect on the infection frequency.

Aged↗
PubMed1977

Surveillance of hospital infections: at the bedside or at the bacteriological laboratory?

A prevalence study concerning wound infections in the surgical service at a university hospital was made during a 7-month period. One ward was visited every week during the wound dressing rounds and samples for bacteriologic culture were taken from clinical infections. The prevalence of infection varied between 0 and 21% (median value 8.2%) for surgical wounds and between 0 and 47% (median value 5.3%) for other wounds. Staphylococcus aureus made up 16% of the bacteria isolated from surgical wounds and the Enterobacteriacae 32.6%. For other wounds Staph. aureus and the Enterobacteriacae made up 22.6% each. A comparison of the number of cultures taken by investigators and that taken by the ward showed that the culturing frequency by the ward staff was so high that surveillance of infection by review of bacteriological culture records only, would give an almost equivalent degree of information concerning infection rates. This system is less time consuming and also has the advantage of giving epidemiological information. The drawback with the system is that little or no patient data are given on the requisitions from the ward. This makes it impossible to know from what kind of infections samples are taken.

Cross Infection↗
PubMed1973

Dispersal and transfer of Staphylococcus aureus in an isolation ward for burned patients.

The dispersal of Staphylococcus aureus from burned patients, the relation between nasal carriage by the staff and exposure to airborne Staph. aureus, and the transfer of Staph. aureus-carrying particles within the ward have been studied. The dispersal of Staph. aureus from burned patients was correlated to the size of the burn wound. The median values varied from 21 c.f.u./m.(2)/hr. for patients with small burns to 453 c.f.u./m.(2)/hr. for extensively burned patients. The size of the dispersed particles appeared to be smaller than that usually found in hospital wards. Carriage of nasal strains by the staff was correlated to the air counts; the number of patient sources did not seem to be of great importance. The transfer of Staph. aureus within the ward was at least 6 to 20 times that which would have been expected if transfer was due to air movement only.

Air Microbiology↗
PubMed1973

Transfer of Staphylococcus aureus via nurses' uniforms.

The contamination of gowns and uniforms worn in a burns unit and the transfer of patient's staphylococci by means of nurses' uniforms was investigated. The median values of staphylococci found on gowns and jackets worn during a routine nursing procedure were 3.0 x 10(4) and 1.4 x 10(3) respectively. From the results of model nursing experiments it appeared as if the fraction of staphylococci transferred from a patient's room to the air in a receiving room was 4 to 10 times less when protective gowns were worn than when no gowns were worn. The corresponding transfer directly to the model ;patient' was 100 times less. The protection afforded by a gown seemed mainly to be due to protection against contamination of the uniform worn underneath when nursing a burned patient. The discrepancy between the transfer of an airborne particle tracer and Staph. aureus-carrying particles earlier found in the ward could be explained by the dispersal of Staph. aureus from nurses' clothing.

Burns↗
PubMed1973

Studies on transmission of Staphylococcus aureus in an isolated ward for burned patients.

A one-year epidemiological investigation was made in an isolation ward for burned patients. The transmission of Staphylococcus aureus was mainly studied. In spite of the design of the ward the cross-infection rate was high. In all, 49 of 69 patients were infected 114 times. Twenty-six of the strains causing infection were found in a patient only, 10 in a member of the staff only and 23 in both patients and staff the week before they caused a new infection. There were three epidemic outbreaks caused by three strains of Staph. aureus all belonging to phage group III; one was resistant to methicillin. Environmental studies with settle plates showed that the number of staphylococci dispersed by a burned patient was often very high. In 8% of the observations in occupied bedrooms the air count of Staph. aureus was more than 1800 col./m.(2) hr. However, the counts of Staph. aureus in the corridor and service areas were low. This seems to indicate a rather good protection against airborne transfer of bacteria. Other routes of infection were probably of greater importance.

Age Factors↗
PubMed1972

The control by ventilation of airborne bacterial transfer between hospital patients, and its assessment by means of a particle tracer. 3. Studies with an airborne-particle tracer in an isolation ward for burned patients.

Airborne-particle transfer has been studied in a burns unit using potassium iodide particles. The observed rates of transfer were in good agreement with the values predicted by a theoretical model.An estimate of the average transfer between rooms under conditions of normal activity and with correctly functioning ventilation showed that the isolation system was highly efficient, the proportion transferred being probably less than 1 in 10(5). However, the ventilation often did not function as designed and under these conditions the efficiency was reduced by a maximum of a factor of ten. These rates of transfer do not seem great enough to account for the high rate of cross-infection found in this unit.

Air Microbiology↗