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Biomedical subjects

W M Valenti

Publications and source records attributed to W M Valenti.

At least 55 records · Page 3Linked to original sources
PubMed1984

Five-year surveillance of aminoglycoside usage in a university hospital.

Because an increased incidence of nosocomial bacteremia due to gentamicin-resistant organisms occurred in our hospital, amikacin was substituted for gentamicin as the primary empiric aminoglycoside. Prospective surveillance of aminoglycoside use and of bacterial resistance to aminoglycosides was done before and after the substitution. We compared the baseline period when gentamicin was the primary aminoglycoside with the subsequent period when amikacin accounted for 81% of aminoglycoside used. During the two periods the patient population did not differ with regard to indications for aminoglycoside therapy. Among the gram-negative organisms isolated, rates of amikacin resistance during the baseline (1.1%) and usage (1.05%) periods were not significantly different (p greater than 0.6). Resistance to gentamicin and tobramycin during the period of amikacin use showed a statistically significant decrease (p greater than 0.001) due to decreased resistance to gentamicin of Providencia, Serratia, indole-positive Proteus, and decreased resistance to tobramycin of Pseudomonas aeruginosa. Unrestricted use of amikacin does not necessarily lead to increase in amikacin resistance but may lead to a decrease in resistance to gentamicin and tobramycin among gram-negative organisms.

Amikacin↗
PubMed1982

Concurrent outbreaks of rhinovirus and respiratory syncytial virus in an intensive care nursery: epidemiology and associated risk factors.

An outbreak of viral respiratory disease occurred in eight infants in a neonatal intensive care unit during the 1980 winter respiratory season. Four infections with respiratory syncytial virus and four infections with rhinovirus were identified. Epidemiologic investigation revealed that viral respiratory infection was significantly associated with intubation with orotracheal tubes (P = 0.001), with the presence of both a nasal feeding tube plus an orotracheal tube together (P = 0.007), and with assisted ventilation (P = 0.009) when compared to uninfected controls. Twenty-seven of 85 (30.6%) personnel working in the unit at the time of the outbreak reported a history of upper respiratory illness during the week prior to the outbreak, and 46 (54.1%) of them had had contact with patients in areas of the hospital where patients infected with RSV and rhinovirus were housed. The data suggest that both viruses were transmitted to the babies by hospital personnel. Rhinoviruses can be nosocomial pathogen in neonates with compromised pulmonary function, and the clinical presentation of rhinovirus infection in neonates may be difficult to distinguish from that produced by RSV.

Cross Infection↗
PubMed1982

Absence of the booster phenomenon in serial tuberculin skin testing.

The Center for Disease has recently recommended that tuberculin skin testing of new hospital employees be done in two steps because of the so-called "booster phenomenon." To assess the feasibility of the two-step method in our hospital, we performed a pilot study using this method on all our new hospital employees during a 6-month period. From July 1, 1980, to December 31, 1980, all newly hired employees of the Strong Memorial Hospital were given a two-step tuberculin skin test as part of their preemployment health evaluation. During this time, 571 new employees were tested, 416 (73%) of whom completed both steps. The mean age of the 416 employees was 26 yr. Fourteen of 448 employees (3.1%) had positive reactions on the first test. None of the 416 employees had positive reactions on the second test. Additional visits for skin test administration, costs of informational materials, administrative expenses, and supplies added approximately $2,600 to the costs of our tuberculin skin testing program during the study period. The absence of the booster phenomenon in our employee population may be due to (1) the relatively young age of our hospital employee population who may be less likely to have remote infection with Mycobacterium tuberculosis and/or (2) the relatively uncommon occurrence of nontuberculous mycobacterial infection in our area of the country. Depending on the age of employees of an institution and its geographic location, the two-step method may not detect any additional reactors. We recommend that hospitals contemplating adoption of this method first perform a similar pilot study in order to assess the frequency of the booster phenomenon in their employee populations.

Adolescent↗
PubMed1980

Clostridium perfringens wound infection associated with elastic bandages.

Clostridium perfringens wound infections were associated with the use of nonsterile elastic outer bandages in diabetic patients who had undergone lower extremity amputation for vascular insufficiency. In each case a second surgical procedure was required. Elastic bandages similar to those used in these procedures were found to contain C perfringens and other clostridial species. This report illustrates the need for maintenance of a sterile, nonpermeable inner barrier to prevent transudation of bacteria into the wound and the potential benefit of using sterile elastic outer bandages after amputation for vascular insufficiency.

Aged↗