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Biomedical subjects

Joseph M Campos

Publications and source records attributed to Joseph M Campos.

4 recordsLinked to original sources

Cluster of Trichosporon mucoides in children associated with a faulty bronchoscope.

BACKGROUND: Several outbreaks of Pseudomonas aeruginosa infection associated with a specific model of fiberoptic bronchoscope have been reported. In a 3-week period in September 2000, we noticed an increased number of Trichosporon mucoides isolates recovered from bronchoalveolar lavage (BAL) specimens collected at our hospital. We investigated the circumstances surrounding these isolates. METHODS: Outbreak investigation was conducted, and the medical records of the affected patients were reviewed retrospectively for evidence of positive cultures for T. mucoides from BAL specimens. Specimens collected during the investigation were inoculated onto fungal culture medium and yeasts were identified with API-20C (BioMèrieux-Vitek). RESULTS: During the 3-week period BAL specimens from six patients yielded growth of T. mucoides. These six high risk patients had emergency bronchoscopy performed as a workup for pneumonia and/or respiratory distress. A Model BF XP-40 bronchoscope (Olympus) had been used in all six patients. Cultures of the bronchoscope (external body and the lumen), bronchoscope disinfector, 2% glutaraldehyde disinfecting solution and water filters/supply were performed. Only fluid from the bronchoscope lumen yielded growth of T. mucoides. Air sample cultures of the bronchoscopy suites were negative. Medical records review disclosed that affected patients were not readmitted with infection with T. mucoides and had no adverse outcomes. The bronchoscope was removed from service and returned to the manufacturer. CONCLUSION: Routine surveillance and aggressive investigation identified persistent T. mucoides contamination of one bronchoscope. The bronchoscope manufacturer later recalled the BF XP-40 model for corrective revision.

Adolescent↗

Risk of resistant infections with Enterobacteriaceae in hospitalized neonates.

OBJECTIVE: To determine the risk factors associated with progression from colonization to infection with health care-associated antimicrobial-nonsusceptible Enterobacteriaceae (ANE) in critically ill neonates. STUDY DESIGN: During a 3-year period (1998 to 2000), surveillance rectal cultures were performed on neonates admitted to our Level III neonatal intensive care unit after a cluster of four cases of ANE infection were identified in 1998. ANE were defined as members of the Enterobacteriaceae family that exhibited nonsusceptibility to ceftazidime or laboratory evidence of extended spectrum beta-lactamase (ESBL) production. RESULTS: A total of 1,710 patients were admitted to the neonatal intensive care unit during the study period. Of the 1,710 patients 300 (18%) were excluded from the risk factor analysis. Of the 1,410 remaining neonates the incidence of health care-associated ANE colonization was 17% (240 of 1,410 patients), and 14% of the colonized patients (34 of 240 patients) developed ANE infections. Of the 206 ANE-colonized patients who did not develop disease, 60 (29%) harbored ESBL-producing isolates. Of the 34 ANE-infected patients, 14 (41%) yielded growth of ESBL-producing isolates. Multiple logistic regression analysis revealed that colonized neonates with very low birth weights (<1,000 g) and those who had received prolonged exposures to antimicrobial agents were at increased risk of ANE infections. CONCLUSIONS: Colonization with ANE places hospitalized neonates at risk for development of systemic infections. Very low birth weight (<1,000 g) and prolonged exposure to antimicrobial agents were the only two independent risk factors associated with ANE infection.

Age Factors↗