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Biomedical subjects

J L Gerberding

Publications and source records attributed to J L Gerberding.

At least 73 records · Page 4Linked to original sources
PubMed1990

Current epidemiologic evidence and case reports of occupationally acquired HIV and other bloodborne diseases.

Studies in which noninfected persons shared households with human immunodeficiency virus (HIV)-infected family members and friends, and had substantial though non-sexual contact with them revealed no transmissions of the HIV virus. These results suggest a similar low risk for healthcare workers, particularly those who have little or no contact with blood. However, occupational transmission of HIV, when it does occur, is most commonly caused by needlestick injuries. Nurses make up the largest group--nearly 80%--of hospital workers who contract HIV infection on the job. Generally, the risk ratio following an HIV needlestick is 1 in 250. Improper needle disposal, recapping and other ingrained behavior patterns are typical causes of needlestick accidents. Though the focus today is on HIV/acquired immunodeficiency syndrome (AIDS), it is important to realize that hepatitis B accounts for 200 to 300 deaths a year among healthcare workers. Awareness of the risk of needlestick injuries, and the considerable financial and emotional costs they can impose, should justify preliminary expenditures on needlestick prevention programs.

HIV Infections↗
PubMed1989

Prophylactic zidovudine after occupational exposure to the human immunodeficiency virus: an interim analysis.

Note from Dr. Merle A. Sande--Health care workers are at risk of acquiring human immunodeficiency virus (HIV) infection subsequent to accidental sticks with needles contaminated with blood from infected patients. The risk is small but real. Postexposure management is critically important, but few solid data are available. Can zidovudine (AZT, azidothymidine) prevent infection? How soon after exposure must the drug be given? At what dosage? For how long? Two leading authorities were asked to discuss this problem and to offer recommendations. Both have developed programs in their institutions, Dr. David K. Henderson at the Warren Grant Magnuson Clinical Center at the National Institutes of Health and Dr. Julie L. Gerberding at the University of California, San Francisco.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Diagnosis and management of HIV-infected patients with diarrhoea.

Diarrhoea and weight loss are found in more than 50% of patients with AIDS and in some patients can be so severe that death may occur even in the absence of opportunistic infections. Systematic evaluation of diarrhoeal illness in HIV-infected patients will often identify a treatable aetiology. Despite the tendency for recurrences, the majority of patients will respond to anti-infective therapy. A practical approach to the diagnosis and management of HIV-infected patients with diarrhoea is presented in this article.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Occupational health issues for providers of care to patients with HIV infection.

The perception that HIV is a highly contagious nosocomial pathogen persists despite a great deal of evidence to the contrary. However, health care workers are at a low but finite risk of occupational infection with the virus, particularly through accidental needle-stick inoculations with infected blood. Universal blood and body fluid precautions minimize the risk of nosocomial transmission of a variety of pathogens, including HIV, and should be routinely employed by all health care workers for all patients.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Efficacy of ciprofloxacin in animal models of infection: endocarditis, meningitis, and pneumonia.

Animal models of infection are very useful tools for identifying those situations in which antibacterial drugs, including the quinolones, may play special roles, i.e., for positioning a drug correctly for its role in the treatment of human disease. Ciprofloxacin has been studied extensively in discriminative animal models of infection, and its efficacy in the treatment of these infections has been compared with that of standard therapy. In a rabbit model of staphylococcal endocarditis, ciprofloxacin was as effective as nafcillin alone, as well as nafcillin and gentamicin in combination, in treating rabbits with methicillin-susceptible Staphylococcus aureus endocarditis. Additionally, its activity was equal to that of vancomycin in reducing vegetation titers in rabbits with methicillin-resistant staphylococcal endocarditis. In a rabbit model of pseudomonal meningitis, ciprofloxacin was as effective as the combination of ceftazidime and tobramycin in lowering bacterial titers. However, in this model, serum levels of ciprofloxacin (6 micrograms/ml) necessary to achieve a bactericidal effect in the cerebrospinal fluid were slightly higher than levels targeted for humans. In a model of pseudomonal pneumonia in neutropenic guinea pigs, the efficacy of ciprofloxacin was compared with that of tobramycin and ceftazidime, both alone and in combination: ciprofloxacin was as effective in lowering bacterial counts as was the combination of ceftazidime plus tobramycin and its activity was superior to that of either drug alone. Thus, data from studies of ciprofloxacin in the treatment of endocarditis, meningitis, and pneumonia in animal models of infection suggest that this quinolone may play an important role in the therapy of these difficult-to-manage infections in humans.

Animals↗
PubMed1987

Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions.

This prospective cohort study was designed to evaluate the risk of occupational transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and cytomegalovirus (CMV) to health care workers with intensive exposure to HIV-infected patients. Seventy-five percent of the 270 subjects had been exposed to patients with AIDS and AIDS-related conditions (ARC) for at least one year before enrollment, 18% worked in specialized AIDS units, and 35% sustained a total of 342 accidental parenteral exposures to HIV-infected body fluids. At the time of enrollment, none had antibody to HIV, and none of the 175 subjects retested 10 months later had acquired antibody. No evidence of increased risk of acquiring CMV or HBV was obtained. These results indicate that health care workers are at minimal risk for HIV, CMV, and HBV transmission from occupational exposure to patients with AIDS or ARC, even when intensively exposed for prolonged periods of time.

AIDS-Related Complex↗
PubMed1987

The risk for otolaryngologists who treat patients with AIDS and AIDS virus infection: report of an in-process study.

The risk of contracting acquired immune deficiency syndrome (AIDS) is a concern to otolaryngologists and other health care workers. Failure to appreciate this valid concern is dangerous, but overestimating it may be equally injurious to the delivery of good patient care. We review the data on antibody titers and recovery of cultured virus in blood, saliva, middle ear fluid, cerumen, tears, and nasal mucous. We also report the initial findings of a prospective study of otolaryngologists at the San Francisco General Hospital. It appears that the risk of transmission of AIDS is low and can be minimized by sound infection control measures similar to those for hepatitis B.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Recommended infection-control policies for patients with human immunodeficiency virus infection. An update.

HIV is not readily transmitted to health care workers, even after accidental parenteral exposure to infected blood. Existing guidelines for reducing exposure to blood and other body fluids will protect workers who care for patients infected with this pathogen. New infection-control guidelines for patients with AIDS are therefore not required. Awareness of the potential for nosocomial transmission of HIV has resulted in a renewed respect for the principles and practice of infection control. The procedures that the task force recommended to prevent contact with body fluids will reduce exposure not only to HIV but also to other potentially contagious pathogens in the health care environment. Implementation and enforcement of these guidelines for all patients could greatly reduce the incidence of nosocomial and occupationally acquired infections.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Clinical aspects of adult epiglottitis.

Epiglottitis in adults has been considered a medical rarity. Recent evidence suggests that this disorder is seen in adults regularly, though uncommonly, in clinical practice. We present 14 cases of adult epiglottitis. Most cases were blood culture-negative; Hemophilus influenzae was isolated from blood cultures in two cases and Hemophilus parainfluenzae in one case. There were no deaths. Epiglottitis in adults differs from pediatric epiglottitis in the mode of presentation, bacterial cause and clinical course.

Acute Disease↗
PubMedDate not supplied

Use of animal models in evaluation of the quinolones.

Discriminative animal models of infection are important in helping to define the role of new antibacterial drugs in the treatment of human diseases. Several animal models have been used to compare the efficacies of quinolones with those of standard therapies against selected bacterial pathogens. In animal models of endocarditis, pefloxacin, enoxacin, and ciprofloxacin have been shown to be equivalent to standard therapies against methicillin-sensitive Staphylococcus aureus and as effective as vancomycin against methicillin-resistant strains. Difloxacillin has been shown to be equivalent to vancomycin in a model of osteomyelitis due to S. aureus. Ciprofloxacin is as effective as the combination of ceftazidime and tobramycin in a model of pseudomonal meningitis, although the levels of ciprofloxacin (6 mg/L) in serum required to produce a bactericidal effect in the cerebrospinal fluid are higher than those usually obtained in humans. Ciprofloxacin and other quinolones are also effective therapy for pseudomonal infections in neutropenic animals with pneumonia, peritonitis, osteomyelitis, and endocarditis. Data obtained from these animal studies suggest that the quinolones may have an important role in the treatment of endocarditis, meningitis, osteomyelitis, and other serious infections in humans caused by S. aureus and Pseudomonas aeruginosa.

Animals↗