Long-Term Evaluation of Decontamination of Inhalation-Therapy Equipment and the Occurrence of Necrotizing Pneumonia

Pierce, Alan K.; Sanford, J.; Thomas, Grace D.; Leonard, J. S.; Fairley, H. Barrie

doi:10.1097/00132586-197106000-00024

Cited by 18 publications

(25 citation statements)

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“…The tract [8]. Outbreaks of B. cepacia respiratory tract acquisition have been associated with inadequate or contamination of nebulized medications or solutions have also been associated with outbreaks of nosocomial Gram-negative respiratory infections [12][13][14][15][16][17][18][19][20]. The Massachusetts General Hospital (MGH) is a 900-bed university teaching hospital and tertiary-care referral centre with 9 intensive-care units (ICUs) containing 113 beds.…”

Section: Introduction Us Hospitals Increased Significantly During Thementioning

confidence: 99%

Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak

Pegues

Ford

et al. 1996

Epidemiol. Infect.

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SUMMARYIn 1994 we investigated a large outbreak of Burkholderia (formerly Pseudomonas) cepacia respiratory tract acquisition. A case patient was defined as any patient with at least one sputum culture from which B. cepacia was isolated from 1 January to 31 December 1994. Seventy cases were identified. Most (40 [61 %]) occurred between 1 February and 31 March 1994; of these, 35 (86%) were mechanically ventilated patients, 30 of whom were in an intensive-care unit (ICU) when B. cepacia was first isolated. Compared with control patients who were mechanically ventilated in an ICU, these 30 case-patients were significantly more likely to have been ventilated for 2 or more days (30/30 v. 15/30; P < 0-001) or to have been intubated more than once (12/30 v. 2/30; OR = 9-3, 95 % CI 1P6-68-8; P = 0-002) before the first isolation of B. cepacia. By multivariate analysis, the 35 mechanically ventilated casepatients were significantly more likely to have received a nebulized medication (OR = 11 9, 95 % CI = 1-6-553 1; P < 0-001) and a cephalosporin antimicrobial (OR = 11 9, 95 % CI = 1-6-553 1) in the 10 days before the first isolation of B. cepacia, compared with B. cepacianegative control-patients matched by date and duration of most recent mechanical ventilation. Although B. cepacia was not cultured from medications or the hospital environment, all outbreak strains tested had an identical DNA restriction endonuclease digestion pattern by pulsed-field gel electrophoresis. Review of respiratory therapy procedures revealed opportunities for contamination of nebulizer reservoirs. This investigation suggests that careful adherence to standard procedures for administration of nebulized medications is essential to prevent nosocomial respiratory infections.

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Section: Introduction Us Hospitals Increased Significantly During Thementioning

confidence: 99%

Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak

Pegues

Ford

et al. 1996

Epidemiol. Infect.

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“…Although the lung is repeatedly inoculated with bacteria from the upper airways (1), pneumonia rarely 194 ensues, even when the inoculum contains pathogenic bacteria (2,3). This implies an efficient clearance mechanism capable of killing or eliminating the bacteria before their multiplication leads to clinical disease.…”

Section: Introductionmentioning

confidence: 99%

Early bacterial clearance from murine lungs. Species-dependent phagocyte response.

Rehm¹,

Gross²,

Pierce³

1980

J. Clin. Invest.

121

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“…Nach regelmäßiger Desinfektion der Vernebler, beispielsweise mit 0.25%iger Essigsäure ging die Pneumonierate von 7.9 auf 2.2% zurück [37]. Von nosokomia-len Pneumonien sind besonders Patienten mit endotrachealer Intubation und maschineller Beatmung bedroht, so dass die Annahme eines kausalen Zusammenhangs naheliegt.…”

Section: Hygienemaßnahmen Zur Verhinderung Der Nosokomialen Pneumonieunclassified

Die geschichtliche Entwicklung der Intensivmedizin in Deutschland Zeitgenössische Betrachtungen

Ke²

2000

Anaesthesist

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Long-Term Evaluation of Decontamination of Inhalation-Therapy Equipment and the Occurrence of Necrotizing Pneumonia

Cited by 18 publications

References 0 publications

Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak

Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak

Early bacterial clearance from murine lungs. Species-dependent phagocyte response.

Die geschichtliche Entwicklung der Intensivmedizin in Deutschland Zeitgenössische Betrachtungen

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