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Biomedical subjects

J V Bennett

Publications and source records attributed to J V Bennett.

At least 37 records · Page 2Linked to original sources
PubMed1980

The SENIC Project. Study on the efficacy of nosocomial infection control (SENIC Project). Summary of study design.

With the emergence of nosocomial infections as a serious problem among US hospitals, the Center for Disease Control undertook in 1974 a nationwide study to evaluate approaches to infection control. The three-phased project, now known as the Study on the Efficacy of Nosocomial Infection Control, or SENIC Project, was designed with three primary objectives: 1) to determine whether (and, if so, to what degree) the implementation of infection surveillance and control programs (ISCPs) has lowered the rate ofnosocomi al infection, 2) to describe the current status of ISCPs and infection rates, and 3) to demonstrate the relationships among characteristics of hospitals and patients, components of ISCPs, and changes in the infection rate. With data collection completed in a nationally representative sample of hospitals, analysis is underway to identify approaches to infection control that are most effective for the least cost to hospitals and to point out additional specific questions to be answered by future research.

Centers for Disease Control and Prevention, U.S.↗
PubMed1979

A major focus of Legionnaires' disease in Bloomington, Indiana.

Thirty-nine cases of Legionnaires' disease in a 16-month period were identified in visitors to and residents of Bloomington, Indiana. Thirty-five patients had spent at least one night at the Indiana Memorial Union in the 2 weeks before becoming ill. Five of 32 sporadic cases nationwide between 1 January and 31 March 1978 were retrospectively shown to be in persons who had recently visited the Union. The risk of acquiring Legionnaires' disease as a Union visitor was at least 17 times greater than that for Bloomington residents 20 years or older. Employees who had worked at the Union 5 years or longer were more likely to be seropositive than workers in other Bloomington hotels. Legionnaires' disease bacterium was isolated from five environmental sites in Bloomington. A cooling tower may have been involved in disease spread, but it was not the only source. Hypochlorite solution was added to cooling tower water as a precautionary measure; however, one case was confirmed in a man with Union exposure 9 days after hypochlorite treatment had begun.

Adult↗
PubMed1979

Sporadic community-acquired Legionnaires' disease in the United States. A case-control study.

One hundred patients with sporadic, community-acquired, serologically confirmed Legionnaires' disease were matched with control subjects known by the patients (acquaintance controls) and control subjects chosen from among patients with negative serodiagnostic tests for Legionnaires' disease (clinical controls). Each clinical control subject was also matched with an acquaintance control of his own. Legionnaires' disease patients had smoked more cigarettes, consumed more alcohol, and were more likely to have resided near excavation sites than acquaintance or clinical control subjects. Parallel differences between clinical controls and their acquaintances were not seen. Legionnaires' disease patients had traveled away from home for more time during the 2 weeks before onset of illness than had their acquaintances. The difference was of greater magnitude than that between clinical control subjects and their acquaintances. Legionnaires' disease patients were more likely to have resided near construction sites than clinical controls, and there were more construction workers among patients than among clinical control subjects.

Adult↗
PubMed1978

An outbreak in 1965 of severe respiratory illness caused by the Legionnaires' disease bacterium.

In January 1977 an unsolved outbreak of infection at St. Elizabeth's Hospital (Washington, D.C.) that occurred in 1965 was linked with Legionnaires' disease. The link was made by fluorescent antibody testing with the bacterium isolated from tissues of persons with Legionnaires' disease in the 1976 outbreak in Philadelphia. In July and August 1965, an epidemic of severe respiratory disease characterized by abrupt onset of high fever, weakness, malaise, and nonproductive cough, frequently accompanied by radiographic evidence of pneumonia, affected at least 81 patients at St. Elizabeth's Hospital, a general psychiatric hospital. Fourteen (17%) of the affected patients died. Intensive epidemiologic and laboratory investigations in 1965 did not determine the etiology. The etiologic organism may have become airborne from sites of soil excavation.

Air Microbiology↗
PubMed1978

The role of nationwide nosocomial infection surveillance in detecting epidemic bacteremia due to contaminated intravenous fluids.

Since January, 1970, the Center for Disease Control (CDC) has corridnated surveillance of nosocomial infections in a group of voluntarily cooperating hispitals in the United States. In 1970, this surveillance system failed to realize one of its major goals: detection of a nationwide epidemic of septicemia caused by contaminated intravenous products. However, retrospective review of infections reported to CDC revealed that the data received were sufficient for the outbreak to have been recognized. Beginning in July, 1970, one month after the contaminated products were first distributed and five months before the outbreak was actually detected. CDC data showed a persistent increase in the incidence of Enterobacter and Erwinia (presently designated Enterobacter agglomerans) bacteremia. Furthermore, monthly rates of cases of bacteremia caused by these organisms were higher in hospitals using the contaminated intravenous products than for hospitals not using them. Failure to detect this outbreak at the time of its occurrence was due to delays in data processing and insufficiently sophisticated data analysis. Based on this experience, CDC has modified the surveillance system to aid recognition of future outbreaks.

Cross Infection↗
PubMed1978

Human infections: economic implications and prevention.

Morbidity and mortality from infectious diseases clearly remain high. Economic assessments should not be based soley on the costs of existing disease but should incorporate costs saved by preventive efforts as well as savings likely to be attained within several years by improved preventive measures. These factors can be used to assess the relative needs for research for specific infections and to compare the economic importance of infections with that of other health problems. Preventive activities for individuals and for larger groups are outlined, and the relation of research to prevention and control of infections is presented.

Botulism↗
PubMed1976

Serologic therapy of tetanus in the United States, 1965-1971.

To study the influence of tetanus antitoxins on the outcome of human tatanus, we analyzed data on 545 cases reported to the Center for Disease Control from 1965 through 1971. Patients treated with antitoxin had a significantly lower case-fatality ratio than untreated patients, and the effect of serotherapy was not modified significantly by the age or race of the subjects. Antitoxin of equine origin and human tetanus immune globulin (TIG) were equally effective. The data on the effect of different doses of TIG suggest that 500 units may be as effective as the currently recommended therapeutic dose of 3,000 to 10,000 units. The importance of possible bias introduced by unmeasured factors such as quality of supportive therapy could not be determined, but confounding by 11 recorded potentially confounding factors was minimal.

Adolescent↗
PubMed1976

Nationwide epidemic of septicemia caused by contaminated intravenous products. I. Epidemiologic and clinical features.

Between mid-1970 and April 1, 1971, Enterobacter cloacae or E. agglomerans septicemia developed in 378 patients in 25 American hospitals while they were receiving intravenous products manufactured by one company. Each of the hospitals noted a marked increase in the incidence of such septicemia during this period. Enterobacter agglomerans (formerly designated Erwinia, herbicola-lathyri group) was better known as a plant pathogen and had been a human blood pathogen only rarely in the past. Septicemia caused by E. cloacae had also been uncommon.

Adult↗
PubMed1976

Nursery outbreak of peritonitis with pneumoperitoneum probably caused by thermometer-induced rectal perforation.

Between June 16 and October 9, 1974, 9 neonates at a small, community hospital were stricken with an unusual, serious illness manifested by peritonitis and pneumoperitoneum; 3 died. Although the illness was initially thought to be necrotizing entercolitis, clinical, laboratory, and epidemiologic evidence strongly suggested that it was instead the result of gastrointestinal perforation. in case-control studies employing 3 different conposure to a particular nurses' aide. Other studies including a comparison of expected and actual exposures of ill infants to nursery personnel further linked this nurses' aide to illness. Since rectal temperature-taking was the only procedure possibly predisposing to gastrointestinal perforation that was routinely practiced in the nursery, it was hypothesized that the illness might be the result of rectal perforations. In order that rectal temperature-taking technique could be observed, each nurse and nurses' aide on the OB-GYN service was asked to take part in a general practical examination of nursing skills on a life-like baby doll. The mean and median depths to which nursing personnel inserted the thermometer exceeded the maximum depth recommended to prevent perforation. The nurses' aide epidemiologically associated with illness inserted the thermometer to almost twice the maximum recommended depth-farther than all the personnel who worked primarily in the nursery. After this nurses' aide was removed from the nursery and axillary temperature-taking replaced rectal temperature-taking as the nursery routine, the outbreak ceased.

Body Temperature↗
PubMed1976

An outbreak of nosocomial Proteus rettgeri urinary tract infection.

Between December 1, 1971, and November 30, 1972, 11 patients on a single physical rehabilitation ward in a large St. Louis, Missouri, community hospital developed Proteus rettgeri urinary tract infections; P. rettgeri isolates from each patient were indole-negative and resistant in vitro to all antibiotics tested. Infected patients were more likely to have indwelling urinary tract catheters than were matched control patients, and all had previously received systemic antibiotic therapy. Retrospective epidemiologic investigation and microbiologic samplig at the time of the investigation failed to detect a common source of infection. Infected patients appeared to be the major reservoir of the epidemic strain, and indirect-contact transmission of the organism via nursing personnel probably occurred. Data collected from a prospective study suggested that placing catheterized patients in rooms that did not contain other catheterized patients may be an effective control measure.

Anti-Bacterial Agents↗
PubMed1975

Nationwide epidemic of septicemia caused by contaminated intravenous products: mechanisms of intrinsic contamination.

Between 1 July 1970 and April 1971, in many hospitals in this country, there were outbreaks of nosocomial septicemia caused by Enterobacter cloacae of E. agglomerans (formerly Erwinia, herbicola-lathyri). All of these hospitals used infusion products manufactured by one company, Abbott Laboratories, and all affected patients had onset of septicemia while receiving the company's infusion products. Septicemia was epidemiologically and microbiologically traced to intrinsic contamination of the company's screw-cap closure for infusion bottles which was sealed with a newly introduced elastomer liner. Epidemic organisms were isolated from these closures. Investigations both in the laboratory and in the manufacturing plant into the mechanism of contamination of these products revealed the following. (i) Epidemic strains were present in numerous areas throughout the manufacturing plants. (ii) Viable microorganisms gained access to the interior of screw-cap closures after the autoclave step of production. (iii) Cooling closures actively drew moisture through the thread interstices into the inner-most depths of the closure. (iv) Transfer of contaminants from closures to fluid was easily effected by simple manipulations duplicating normal in-hospital use. (v) The red-rubber liner used in the company's screw-cap closures before the introduction of elastomer contained a broad-spectrum antimicrobial inhibitor. The findings from this epidemic and the associated studies show that the screw-cap closure as it is now designed cannot be considered secure for products that must remain sterile.

Cross Infection↗
PubMed1975

Public health considerations in the management of meningococcal disease.

We discuss chemoprophylaxis of household contacts of cases, the current status and use of meningococcal vaccine, and the role of surveillance of household contacts. Available data on secondary attack rates strongly support the need for chemoprophylaxis of household contacts of meningococcal disease cases. Until the current difficulties with side reactions to minocycline are resolved, we recommend the use of rifampin. Surveillance of household contacts alone is an untested, generally impractical, and probably ineffective method of preventing secondary cases of meningococcal disease, although it may have some effect in preventing death by encouraging prompt and appropriate treatment of cases. We recommend the use of serogroups A or C vaccine, or both, in populations experiencing an epidemic of serogroups A or C meningococcal disease. The use of serogroups A or C meningococcal polysaccharide vaccines should also be considered, along with chemoprophylaxis for household contacts of sporadic cases due to either of these organisms.

Anti-Bacterial Agents↗