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F Daschner

Publications and source records attributed to F Daschner.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Nosocomial infections intensive care units. A nation-wide prevalence study].

UNLABELLED: In a large, multicenter survey in 1994, the prevalence of nosocomial infections in German hospitals was examined, predominant pathogens were identified, and possible risk factors evaluated. In this paper the results from the intensive care units (ICUs) are presented. METHODS: Seventy-two representative hospitals in Germany were selected by randomisation and divided into four different groups according to their size (< 200 beds; 200-400 beds; 400-600 beds; > 600 beds). During 10 months four especially trained doctors documented the patients clinical and laboratory data and possible endogenous and exogenous risk factors for nosocomial infections. For better evaluation, they discussed the cases with the responsible senior officers and health care workers and visited the patients. Diagnosis of nosocomial infection was based on CDC criteria. RESULTS: In 515 patients in 89 ICUs, 78 hospital-acquired infections were documented (15.3%). The most common were pneumonia (5.9%), bronchitis (2.7%), urinary tract infections (2.4%), and septicaemia (2.2%). Possible exogenous risk factors included: peripheral venous catheters (65.6%); catheterisation of the urinary tract (64.5%); central venous catheters (60.4%); gastric tubes (38.0%); wound drainage (28.6%) and artificial ventilation (27.6%). The most frequent concomitant diseases were cardiovascular (61.9%), diabetes (20.2%), malignancies (18.8%), pre-existing infections (15.3%), and chronic respiratory disease (14.0%). The prevalence of nosocomial infections was higher in hospitals with more than 600 beds than in smaller ones (28.3% versus 12.9%, P < 0.001). Predominant pathogens were Pseudomonas aeruginosa, enterococci, Staphylococcus aureus, Candida spp., Escherichia coli, and Klebsiella spp.. Fifty per cent of the ICUs changed ventilation tubes and 66.3% changed infusion sets daily; 34.8% of patients received drugs for the prevention of stress ulcers that neutralise or decrease production of gastric acid; only 7.6% received sucralfate. Routine microbiological surveillance of tracheal aspirates and urine was done by 25.9% and 24.6% of the ICUs, respectively. DISCUSSION: Nosocomial infections are seen far more often in ICUs than on normal wards due to the immuno-suppressed state of many ICU patients and the continuous use of invasive diagnostic and therapeutic procedures. Most of these infections are of endogenous origin. Other prevalence surveys have shown results comparable to ours. Daily changing of ventilation tubes is no longer necessary, but is still routine in many hospitals. Infusion sets were also changed more often than required. The use of selective decontamination of the digestive tract for the prevention of pneumonia is still controversial; in our study it was practised in only 1.5% of the cases. The most commonly used drugs for the prevention of stress ulcers were H2-receptor blocking agents, although it has been shown that sucralfate is the better choice, as it can help prevent nosocomial pneumonia. Routine microbiological surveillance of tracheal aspirates and urine was done in 25.9% and 24.6% of the ICUs. No study so far has shown that routine cultures of tracheal secretions and urine have a preventive effect regarding infection.

Adult↗
PubMed1996

[Hospital infections in gynecology and obstetrics. An inclusive prevalence study in Germany].

In a German multicenter survey, 2206 gynaecological patients in 72 randomly selected hospitals were examined for the prevalence of nosocomial infections and possible risk factors. Hospital-acquired infections were diagnosed in 1.45% of the patients. The most common localisation was the urinary tract (0.91%). Septicaemia, vaginitis and infections of the upper and lower airways were only rarely seen. The following endogenous risk factors were identified: diseases of the cardiovascular system (16.1%), malignancies (12.2%) preexisting infections (6.1%), obesity (5.9%), and diabetes (5.0%). The most common exogenous risk factors were peripheral venous catheters (19.9%), catheterisation of the urinary tract (7.2%) and wound drainage (28.6%). 49% of the patients who underwent caesarean section and 50% of the hysterectomy patients received antimicrobial chemoprophylaxis.

Adult↗
PubMed1996

[Nosocomial infections in Germany--assessment and prevention. NIDEP Study, 1: On prevalence in surgery].

One aim of the NIDEP study (nosocomial infections in Germany: surveillance and prevention) was to determine in part 1 (surveillance) the prevalence of nosocomial infections (NI) in patients in surgical departments of 72 representatively selected hospitals in Germany. The surveillance was carried out by four previously validated physicians who applied the CDC criteria for NI. The overall rate of NI was 3.8%. Urinary tract infections (1.45%) and surgical wound infections (1.34%) were the most common NI. The highest rate of wound infections was noted after amputations (7.2%), conventional appendectomies (4.1%) or operations on the colon or rectum (3.8%). The use of perioperative antibiotics varied widely depending on the kind of operation and was not in accordance with international guidelines in all hospitals.

Adolescent↗
PubMed1996

[Postoperative wound infections in surgery--prevalence in Germany (Nosocomial Infections in Germany--Assessment and Prevention Study)].

Part of the NIDEP study was to determine the prevalence of surgical site infections in the surgical departments of 72 representatively selected hospitals. Four physicians, trained and validated in detecting nosocomial infections, carried out the surveillance, based on the CDC criteria for nosocomial infections. The prevalence of surgical site infections was 1.34% for all surgical patients (n = 5377) and 2.13% for all operated patients (n = 3383). Lower rates were found in patients with a low ASA score, clean wounds, and an average duration of the operation. Most surgical site infections were noted after amputations (7.2%), operations on colon or rectum (4.1%), and appendectomies (3.8%).

Cross Infection↗
PubMed1995

[Humidifiers].

Explore the source record for details and available documents.

Air Microbiology↗
PubMed1993

Enhancement of in vitro bactericidal activity of neutrophils from trauma patients in the presence of granulocyte colony-stimulating factor.

In order to determine whether granulocyte colony-stimulating factor (G-CSF) can enhance the bactericidal activity of polymorphonuclear leukocytes (PMNL) in trauma patients, PMNL obtained from severely injured patients one or two days after trauma were incubated with G-CSF and Staphylococcus aureus for different periods of time. G-CSF at a concentration of 6000 units/ml significantly improved the antibacterial activity of PMNL in trauma patients (n = 10) and healthy volunteers (n = 12) during the incubation period of 180 min. No difference in the bactericidal function of PMNL could be found between severely injured patients and healthy donors.

Adult↗
PubMed1993

Ribotyping of Pseudomonas aeruginosa strains isolated from surgical intensive care patients.

To elucidate the sources of Pseudomonas aeruginosa on a surgical intensive care unit, rDNA restriction fragment length polymorphism analysis (ribotyping) was applied to analyze strains isolated during a 4-month prospective study. Samples included 1635 from 153 patients, 2463 from 97 staff members, and 581 from the environment. Only 18 patients were colonized. Isolation from their animate and inanimate environment was very low, with 3 and 2 samples, respectively, being positive. Samples from tap water were negative. Ribotyping could easily distinguish 16 different digest patterns with identical follow-up isolates of the same patient. Horizontal transmission occurred only twice. The discriminatory power of ribosomal DNA in differentiating strains was dependent on the restriction enzymes used; among eight different enzymes, PvuII was the most sensitive, producing 15 different patterns. Ribotyping showed high sensitivity in typing P. aeruginosa isolates and confirmed that colonization occurs from endogenous rather than from exogenous sources.

Animals↗
PubMed1993

Pseudomonas aeruginosa in a neonatal intensive care unit: reservoirs and ecology of the nosocomial pathogen.

Pseudomonas aeruginosa is one of the leading nosocomial pathogens. In hospitals, organisms are commonly recovered from moist environments. To determine the reservoir and population dynamics of particular strains, highly discriminative typing methods are required. Hybridization of enzymatically restricted P. aeruginosa DNA with two gene probes led to the identification of infecting and colonizing strains prevalent over a 5-month period in a neonatal intensive care unit. Four genotypically distinct strains were repetitively isolated from tap water from several faucets on the ward. P. aeruginosa isolates recovered from tap water on adjacent wards supplied by the same water system had different genotypes, while samples taken from the mains were negative for the organism. Serotyping of O antigens showed variable reproducibility and could not elucidate the strain-specific reservoirs. It is concluded that organisms are transmitted horizontally between faucets and prevail in reservoirs for prolonged periods.

Blotting, Southern↗
PubMed1993

[The bactericidal effect of oxybuprocaine. A possible cause of false negative results in bronchoalveolar lavage].

New approaches in the diagnosis of pneumonia, especially in intensive care units, are quantitative cultures of bronchoalveolar (BAL) fluid or the protected specimen brush. The sensitivity of these methods, however, has often been found to be as low as 50-60%. One possible explanation for the low sensitivity of these diagnostic tools is the antimicrobial activity of local anaesthetics used in bronchoscopy. Therefore, we investigated the bactericidal properties of oxybuprocaine, a topical anaesthetic used for bronchoscopy in our clinic, in order to test the reliability of specimens obtained from BAL. METHODS. The bactericidal activity of oxybuprocaine in concentrations of 1%, 0.1%, 0.05% and 0.01% was tested by constructing time-kill curves for Streptococcus pneumoniae, Hemophilus influenzae, Pseudomonas aeruginosa and Escherichia coli. Five stains of each bacterial species were tested. The inoculum size was 10(4) ml, and bacteria were counted after 10, 20, 30, 60 and 120 min. RESULTS. The resulting time-kill curves are demonstrated in Figs. 1-4. The most sensitive bacteria were S. pneumoniae and H. influenzae, in which significant bactericidal activity could be shown even with a 0.01% solution of oxybuprocaine. E. coli and P. aeruginosa were also inhibited, but only at the highest concentration of 1%. CONCLUSIONS. The use of local anaesthetics before material is taken for culture, e.g. from BAL, may give rise to false-negative results and should therefore be avoided or reduced. For each local anaesthetic used in bronchoscopy, the concentrations that can be used without the risk of false-negative results should be determined.

Anesthetics, Local↗
PubMed1993

[Microbiological and economic studies of abbreviated procedures for surgical hand disinfection].

An investigation was performed of whether shortened procedures for surgical hand disinfection (2 and 3 min, respectively) are equally effective as the usual German standard procedure of 5 min duration and, in addition, which saving of working time and costs would be achievable if shorter procedures were employed. The shortened procedures were: 1) 3 min alcoholic disinfectant (1 min prior handwashing) and 2) 1 min chlorhexidine detergent (Hibiscrub), 2 min 0.5% chlorhexidine in 70% isopropanol (Hibisol). The two shortened procedures were equally effective as the standard procedure (test of equivalence, p < 0.05). The savings of working time and costs calculated for 17708 operations were 1) 2360 h or 79768 German marks and 2) 3540 h or 119652 German marks, respectively.

Bacteria↗