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J L Gerberding

Publications and source records attributed to J L Gerberding.

77 records · Page 5Linked to original sources

Limitations of animal models in predicting beta-lactam efficacy for endocarditis and meningitis.

Animal models are important in predicting the efficacy in humans of antimicrobial agents for various disease conditions, including endocarditis and meningitis. Screening models are useful in assessing antibiotic effectiveness and toxicity; their advantages include simplicity, a reproducible course of infection, a well-defined therapeutic end point, and low cost. However, the inoculum size, the virulence of the organism, and the production of beta-lactamases can have important effects on outcome and must be considered in the interpretation of data obtained from such models. Discriminative models are those designed to mimic human disease as closely as possible with respect to infectious inoculum, host response, and course of disease. Each drug's pharmacokinetics must be carefully documented before being extrapolated to humans. Rigid criteria must be established to minimize misinterpretation of results from animal studies before conclusions from in vivo animal models are applied to human disease.

Animals↗

Health-care quality promotion through infection prevention: beyond 2000.

Health-care value purchasing, complex health-care systems, and information technology are the three most important change drivers influencing the interrelated themes of the 4th decennial conference: accountability, quality promotion through infection prevention across the health-care delivery system, and medical informatics. Among the change drivers influencing themes of future conferences may be a societal mandate for health promotion and health-care access for all.

Delivery of Health Care↗

Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States.

From October 4 to November 2, 2001, the first 10 confirmed cases of inhalational anthrax caused by intentional release of Bacillus anthracis were identified in the United States. Epidemiologic investigation indicated that the outbreak, in the District of Columbia, Florida, New Jersey, and New York, resulted from intentional delivery of B. anthracis spores through mailed letters or packages. We describe the clinical presentation and course of these cases of bioterrorism-related inhalational anthrax. The median age of patients was 56 years (range 43 to 73 years), 70% were male, and except for one, all were known or believed to have processed, handled, or received letters containing B. anthracis spores. The median incubation period from the time of exposure to onset of symptoms, when known (n=6), was 4 days (range 4 to 6 days). Symptoms at initial presentation included fever or chills (n=10), sweats (n=7), fatigue or malaise (n=10), minimal or nonproductive cough (n=9), dyspnea (n=8), and nausea or vomiting (n=9). The median white blood cell count was 9.8 X 10(3)/mm(3) (range 7.5 to 13.3), often with increased neutrophils and band forms. Nine patients had elevated serum transaminase levels, and six were hypoxic. All 10 patients had abnormal chest X-rays; abnormalities included infiltrates (n=7), pleural effusion (n=8), and mediastinal widening (seven patients). Computed tomography of the chest was performed on eight patients, and mediastinal lymphadenopathy was present in seven. With multidrug antibiotic regimens and supportive care, survival of patients (60%) was markedly higher (<15%) than previously reported.

Adult↗