Examination gloves as barriers to hand contamination in clinical practice.

Objective: To test the effectiveness of vinyl and latex gloves as barriers to hand contamination with gram-negative organisms and enterococci during routine hospital procedures.

Design And Interventions: We studied 137 procedures during which a health care worker's gloved hand contacted a patient's mucous membrane and was thus potentially contaminated with gram-negative rods or enterococci. Quantitative hand cultures were obtained from each health care worker before and after the gloved contact using a modified glove juice method, and the exterior glove surface was also quantitatively cultured after patient contact.

Evidence of multiple taxa within commercially available reference strains of Corynebacterium xerosis.

Attempts to identify coryneform isolates resembling Corynebacterium xerosis can lead clinical microbiologists to identification schemes with conflicting descriptions which result in confusing C. xerosis with Corynebacterium striatum. For the present study we purchased all available American Type Culture Collection and National Collection of Type Cultures reference cultures of C.

Shoulder strength with rotator cuff tears. Pre- and postoperative analysis.

Twenty-five patients with rotator cuff tears had bilateral isokinetic shoulder strength evaluations after a pain-relieving subacromial lidocaine injection. Shoulder strength testing was repeated at six months and again at 12 months after rotator cuff surgery. Strength was recorded as a ratio of peak torques comparing the operative with the nonoperative shoulder.

Effects of indomethacin on brain blood flow and cerebral metabolism in hypoxic newborn piglets.

We tested the hypotheses that in newborn piglets indomethacin (Indo) pretreatment blunts the hyperemic brain blood flow (BF) and alters the cerebral metabolic responses to hypoxia and that these responses are dose dependent. We studied 23 chronically instrumented piglets exposed to graded hypoxia (O2 content: 7.1-0.

Laboratory aspects of "Mycobacterium genavense," a proposed species isolated from AIDS patients.

"Mycobacterium genavense" is a proposed new species recently reported to cause disseminated infections in 18 patients with AIDS in Europe. We have recovered "M. genavense" as slowly growing fastidious mycobacteria in blood cultures of seven patients with AIDS.

Characterization of antibiotic-resistant Corynebacterium striatum strains.

Antibiotic-resistant Corynebacterium strains were isolated from 14 Harborview and one Veterans Administration Hospital patients in Seattle during the period 1987-90. These clindamycin-erythromycin resistant strains were shown to hybridize with the ermCd gene, which was cloned from a Corynebacterium diphtheriae plasmid and encodes for a rRNA methylase. Thirteen of these strains also hybridized with the tetM gene probes, and were tetracycline resistant.

Success of DNA fingerprinting after failure of biotyping, antimicrobial susceptibility testing, and plasmid analysis to reveal clonality of multiple blood and urine isolates from a patient with Escherichia coli urosepsis.

Multiple isolates of Escherichia coli from the blood and urine of a 60-year-old woman with acute pyelonephritis exhibited different biotypes, antimicrobial susceptibility patterns, and plasmid profiles, suggesting the presence of polymicrobial bacteriuria and leaving in question the origin of the bacteremia. Only after bacterial restriction endonuclease analysis of total bacterial DNA was it discovered that all isolates represented the same strain, with plasmid instability possibly accounting for the varied antimicrobial susceptibility patterns observed. We conclude that the biotype, antimicrobial susceptibility profile, and plasmid profile are sometimes inadequate to clarify the relationships between different clinical isolates of E.

Evaluation of the rapid CORYNE identification system for Corynebacterium species and other coryneforms.

The Rapid CORYNE system for identification of aerobic, nonsporeforming, gram-positive rods was evaluated according to the manufacturer's instructions with 177 organisms. After inoculation with a heavy suspension of growth, strips containing 20 cupules were incubated for 24 h, reagents were added, and the results of 21 biochemical reactions were recorded as numerical profiles. The strains consisted of pathogenic species of the genus Corynebacterium, primarily C.

Alternative agendas. System priorities for the 1990s will differ from those of the last decade.

The Sisters of Charity Health Care Systems (SCHCS) was established in 1979 in response to changes in the U.S. healthcare system and to new needs of sponsors and Catholic healthcare facilities.

Revitalizing the ministry.

The twentieth century's last decade presents religious institutes with a golden opportunity to confront the dilemmas surrounding sponsorship. Sponsors can develop a number of strategies to allay current anxieties and to transform potential crises into advantages. One is to revitalize the corporate mission by basing it on professed values rather than on existing structures.

Coryneform bacteria in infectious diseases: clinical and laboratory aspects.

Coryneform isolates from clinical specimens frequently cannot be identified by either reference laboratories or research laboratories. Many of these organisms are skin flora that belong to a large number of taxonomic groups, only 40% of which are in the genus Corynebacterium. This review provides an update on clinical presentations, microbiological features, and pathogenic mechanisms of infections with nondiphtheria Corynebacterium species and other pleomorphic gram-positive rods.

Relevance to prenatal diagnosis of the identification of a human Y/autosome translocation by Y-chromosome-specific in situ hybridisation.

Routine cytogenetic analysis of an amniotic fluid sample revealed a large brightly fluorescent region in the short arm of chromosome 14 in an otherwise normal male karyotype (46,XY,14p+ + +). This site was also present in the paternal karyotype. In situ hybridisation to a Y-chromosome-specific DNA probe confirmed that the father had a Y/14 translocation.

C-reactive protein concentrations pre- and post-transfusion.

In a prospective study, serum C-reactive protein (CRP) levels were analysed before and after 18 transfusional episodes, using a fluorescence polarization immunoassay. Only patients with a stable CRP value for two consecutive days before transfusion were assessed. Although small rises in CRP concentrations occurred following 55.

Advances in carpal bone injury and disease.

This article has reviewed many of the landmark discoveries in the diagnosis and management of carpal injuries and disease. It is apparent that much investigation remains to be done to advance our understanding of this complex joint.

Evaluation of four mycobacterial blood culture media: BACTEC 13A, Isolator/BACTEC 12B, Isolator/Middlebrook agar, and a biphasic medium.

Four commercially available mycobacterial blood culture systems were compared for sensitivity and time to detection of growth. A 5-ml volume of SPS-anticoagulated blood was cultured in a BACTEC 13A vial and a modified M7H11/BHI biphasic medium. In addition, two aliquots of Isolator concentrates, each derived from 5 ml of blood, were inoculated into a BACTEC 12B vial and onto a pair of Middlebrook 7H11 agar plates (M7H11).

The molecular epidemiology of three biotypes of Corynebacterium diphtheriae in the Seattle outbreak, 1972-1982.

Between 1972 and 1982 Seattle experienced a diphtheria outbreak involving 1,100 cases, primarily adults with cutaneous lesions. Biotyping revealed three consecutive overlapping outbreaks including 433 toxinogenic intermedius cases. Isolates from each quarter year were examined for DNA restriction fragment patterns and hybridization patterns with three DNA probes.

Bronchobiliary fistula: complete percutaneous treatment with biliary drainage and stricture dilation.

Percutaneous transhepatic cholangiography was performed on an 18-year-old man who presented with jaundice and cholangitis 19 months after right hepatic lobe resection. The cholangiogram demonstrated a bronchobiliary fistula and a stricture of the common hepatic duct. Percutaneous therapy consisting of biliary drainage and balloon dilation cholangioplasty was successful in eradicating the fistula and reestablishing normal bile flow.

United they thrive: merger of two healthcare systems.

On March 15, 1987, the Sisters of St. Francis of Perpetual Adoration of Colorado Springs and the Sisters of Charity of Cincinnati agreed to consolidate. It marked the culmination of years of building mutual trust and months of intense negotiations.

Hand infections. Bacteriology and treatment: a prospective study.

In a prospective, double-blind study, 193 patients hospitalized for established hand infections were randomized to receive either cefamandole intravenously followed by cephalexin by mouth or methicillin intravenously followed by dicloxacillin by mouth. Careful aerobic and anaerobic cultures were performed. Multiple organisms grew in cultures from 84% of the patients (over three isolates per infection on average).

Rectal swab cultures for Clostridium difficile surveillance studies.

We compared the recovery of Clostridium difficile from hospitalized patients by two collection methods: rectal swabs and stool cultures. Rectal swab cultures were as sensitive as stool cultures and were more easily obtained. Transport of swabs in an anaerobic VACUTAINER system resulted in longer survival times compared with transport in Amies medium.

Whole chromosomal DNA probes for rapid identification of Mycobacterium tuberculosis and Mycobacterium avium complex.

Whole chromosomal DNA probes were used to identify clinical isolates of Mycobacterium tuberculosis, Mycobacterium avium complex, and Mycobacterium gordonae. The probe for M. tuberculosis was prepared from Mycobacterium bovis BCG, which has been shown to be closely related to M.