Staphylococcus epidermidis as a cause of bacteremia.

Staphylococcus epidermidis is a biofilm-producing commensal organism found ubiquitously on human skin and mucous membranes, as well as on animals and in the environment. Biofilm formation enables this organism to evade the host immune system. Colonization of percutaneous devices or implanted medical devices allows bacteria access to the bloodstream.

Interactions of uroseptic Escherichia coli with renal (A-498) and gastrointestinal (HT-29) cell lines.

We investigated the ability of Escherichia coli isolated from septic patients with urinary tract infection (UTI) to translocate through the gastrointestinal (GI) tract of the same patients using cell-culture models. Forty-seven hospitalized patients with urosepsis were included in this study. E.

New method for assessing hand disinfection shows that pre-operative alcohol/chlorhexidine rub is as effective as a traditional surgical scrub.

Background: Several studies have shown that rubbing hands with an alcohol/chlorhexidine solution provides equivalent microbial decontamination to a conventional surgical scrub using aqueous chlorhexidine. However, the authors believe that these studies have methodological flaws that limit their applicability to the operating theatre environment. As such, a method was developed to compare products in an everyday operating theatre environment using working operating theatre personnel.

Expansive spread of IncI1 plasmids carrying blaCMY-2 amongst Escherichia coli.

Escherichia coli is a leading cause of urinary tract infections. One of the most common antibiotic classes used to treat such infections is the β-lactams, including cephalosporins. Resistance to the third-generation cephalosporins can be caused by production of extended-spectrum β-lactamases (ESBLs) or plasmid-mediated AmpC β-lactamases.

Successful treatment of iatrogenic multicentric Castleman's disease arising due to recrudescence of HHV-8 in a liver transplant patient.

We describe the case of a 59-year-old HIV-negative male who developed multicentric Castleman's disease (MCD) 1 year postliver transplantation due to recrudescence of a pretransplant human herpesvirus-8 (HHV-8) infection. He presented with fevers, dry cough, weight loss and drenching night sweats. Routine investigations were all unremarkable.

Efficacy of some colloidal silver preparations and silver salts against Proteus bacteria, one possible cause of rheumatoid arthritis.

There has been increased interest in the role of anti-Proteus antibodies in the aetiology of rheumatoid arthritis (RA) and whether chemotherapeutic agents active against Proteus species might reduce the risk and/or exacerbations of RA. We examined the in vitro antibacterial effects of ten different silver preparations which were either ionic silver [Ag(I)] solutions or nanoparticulate silver (NPS) (Ag(0)) suspensions against ATCC and two wild (clinical) strains of Proteus. The data establish the low minimum inhibitory concentration and minimum bactericidal concentration of all the silver formulations tested against these four Proteus strains.

The ecology of antibiotic use in the ICU: homogeneous prescribing of cefepime but not tazocin selects for antibiotic resistant infection.

Background: Antibiotic homogeneity is thought to drive resistance but in vivo data are lacking. In this study, we determined the impact of antibiotic homogeneity per se, and of cefepime versus antipseudomonal penicillin/β-lactamase inhibitor combinations (APP-β), on the likelihood of infection or colonisation with antibiotic resistant bacteria and/or two commonly resistant nosocomial pathogens (methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa). A secondary question was whether antibiotic cycling was associated with adverse outcomes including mortality, length of stay, and antibiotic resistance.

Catheter-associated bloodstream infection incidence and risk factors in adults with cancer: a prospective cohort study.

Central venous catheter-associated bloodstream infections (CABSIs) cause considerable morbidity in patients with cancer. We determined the incidence and risk factors for CABSI by performing a prospective observational cohort study of all adult patients requiring a central venous access device (CVAD) in a haematology-oncology unit. All CVADs were inserted under ultrasound guidance by trained operators in a dedicated interventional radiology facility.

Genetic relatedness and virulence gene profiles of Escherichia coli strains isolated from septicaemic and uroseptic patients.

We investigated the relationship between clonality and virulence factors (VFs) of a collection of Escherichia coli strains isolated from septicaemic and uroseptic patients with respect to their origin of translocation. Forty septicaemic and 30 uroseptic strains of E. coli were tested for their phylogenetic groupings, genetic relatedness using randomly amplified polymorphic DNA (RAPD), biochemical fingerprinting method (biochemical phenotypes [BPTs]), adherence to HT-29 cells and the presence of 56 E.

Persistence of multiple antibiotic resistant strains of Acinetobacter baumannii carrying class 1 integron in a hospital setting.

Forty-nine strains of multiresistant Aceinetobacter baumannii isolated from intensive care unit patients in Royal Brisbane and Women Hospital (RBWH) between 2001 and 2003 and four epidemiologically unrelated strains from three other hospitals were tested (n = 53) for their genetic relatedness using pulsed-field gel electrophoresis (PFGE) and for the presence of different classes of integrons. With PFGE, these strains were divided into three common (C) but closely related types (i.e.

Streptococcus bovis bacteraemia: identification within organism complex and association with endocarditis and colonic malignancy.

Aim: To identify Streptococcus bovis bacteraemia episodes and their clinical associations, including differences in associations by S. bovis biotypes (or species).

Methods: The study was performed at Princess Alexandra Hospital, Brisbane.

Ethanol lock therapy to treat tunnelled central venous catheter-associated blood stream infections: results from a prospective trial.

In order to assess the efficacy of 70% ethanol locks in addition to antibiotic therapy to treat tunnelled central venous catheter-associated bloodstream infections, a pilot study of 19 patients was performed prospectively using ethanol locks for 5 d in addition to antibiotic therapy to treat tunnelled central venous catheter-associated bacteraemia. 12 patients had mono-microbial infections and 7 had polymicrobial isolates. 17 of 19 patients completed ethanol lock therapy.

Surveillance culture utility and safety using low-volume blind bronchoalveolar lavage in the diagnosis of ventilator-associated pneumonia.

Background And Objectives: Surveillance cultures may improve the prediction of ventilator-associated pneumonia (VAP) and empirical antibiotic selection. This study examined the utility and patient safety of blind, non-protected, low-volume mini-bronchial lavage (BM-BAL) surveillance cultures in predicting VAP.

Methodology: A prospective, cohort study was performed in a large general intensive care unit.

The antimicrobial effect of heparin on common respiratory pathogens.

Aim: The mucolytic, anticoagulative, anti-inflammatory and neo-angiogenic properties of inhaled heparin may benefit patients with burns and cystic fibrosis. We assessed the antibacterial effects of unfractionated heparin.

Methods: Stored clinical isolates of Acinetobacter baumannii (n =4), Candida albicans (n = 5), Haemophilus influenzae (n =5), Klebsiella pneumoniae (n =4), methicillin-resistant Staphylococcus aureus (n=3), Pseudomonas aeruginosa (n = 2), and Streptococcus pneumoniae (n = 7) were subcultured on horse blood agar, incubated at 35 degrees C overnight, then inoculated into trypticase soy broth to a density of 1 McFarland standard.

Use of elastin fibres detected in non-directed low volume bronchial lavage in ventilated ICU patients.

Elastin fibres in sputum have been described as a more sensitive marker of pulmonary necrosis than plain chest X-rays. This study aimed to determine the prevalence of elastin fibres using non-directed non-protected mini-bronchoalveolar lavage (BM-BAL) in mechanically ventilated patients in the intensive care unit. Patients admitted to the general intensive care unit of a tertiary referral hospital requiring more than 48 hours of mechanical ventilation had surveillance BM-BAL performed on admission and were then examined weekly using potassium hydroxide wet preparations for the presence of elastin fibres.

Incubation time required for neonatal blood cultures to become positive.

Aim: We aimed to determine the laboratory detection time of bacteraemia in neonatal blood cultures, and whether this differed by: organism; samples deemed to represent true bacteraemia versus contaminants; and blood cultures collected from an infant <48 h of age (early) or >or=48 h of age (late).

Methods: A retrospective audit of all positive blood cultures collected from neonates in the Grantley Stable Neonatal Unit, Royal Women's Hospital, Brisbane, between 1 January 2000 and 31 December 2004 was undertaken. The bacteraemia detection method used was the BacTAlert system with Peds bottles.

A bronchoscopic scoring system for airway secretions--airway cellularity and microbiological validation.

There is currently no validated scoring system for quantification of airway secretions in children. A user friendly, valid scoring system of airway secretions during flexible bronchoscopy (FB) would be useful for comparative purposes in clinical medicine and research. The objective of this study was to validate our bronchoscopic secretion (BS) scoring system by examining the relationship between the amount of secretions seen at bronchoscopy with airway cellularity and microbiology.

Double-heater-wire circuits and heat-and-moisture exchangers and the risk of ventilator-associated pneumonia.

Objective: To compare the incidence of ventilator-associated pneumonia (VAP) in patients ventilated in intensive care by means of circuits humidified with a hygroscopic heat-and-moisture exchanger with a bacterial viral filter (HME) or hot-water humidification with a heater wire in both inspiratory and expiratory circuit limbs (DHW) or the inspiratory limb only (SHW).

Design: A prospective, randomized trial.

Setting: A metropolitan teaching hospital's general intensive care unit.

A prospective, randomized trial of rifampicin-minocycline-coated and silver-platinum-carbon-impregnated central venous catheters.

Objective: Central venous catheters are the predominant cause of nosocomial bacteremia; however, the effectiveness of different antimicrobial central venous catheters remains uncertain. We compared the infection rate of silver-platinum-carbon (SPC)-impregnated catheters with rifampicin-minocycline (RM)-coated catheters.

Design: A large, single-center, prospective randomized study.

Cough and reflux esophagitis in children: their co-existence and airway cellularity.

Background: There are no prospective studies that have examined for chronic cough in children without lung disease but with gastroesophageal reflux (GER). In otherwise healthy children undergoing flexible upper gastrointestinal endoscopy (esophago-gastroscopy), the aims of the study were to (1) define the frequency of cough in relation to symptoms of GER, (2) examine if children with cough and reflux esophagitis (RE) have different airway cellularity and microbiology in bronchoalveolar lavage (BAL) when compared to those without.

Methods: Data specific for chronic cough (> 4-weeks), symptoms of GER and cough severity were collected.

Sensitivity of respiratory bacteria to lignocaine.

Aim: Lignocaine, a topical anaesthetic agent, is generally used in variable concentrations usually between 2% and 4% on the vocal cords prior to flexible bronchoscopy and bronchoalveolar lavage (BAL) procedures. The aim of this study was to investigate whether 2% or 1% lignocaine significantly inhibits the growth of organisms commonly found in the respiratory tract, in particular Streptococcus pneumoniae.

Method: In order to determine the antibiotic effect of lignocaine on lower respiratory tract flora, five different organisms were examined in vitro using well diffusion, disc diffusion and microbroth dilution against 1% and 2% concentrations of lignocaine.

Barrier properties and cost implications of a single versus a double wrap for storing sterile instrument packs.

Background: Materials for wrapping sterile items continue to evolve, but evaluation of such products under clinical conditions is rare. The purpose of the current study was to test a new product before introducing it to the hospital's sterilizing processing unit.

Methods: Four hundred packs containing 1199 items were prepared.

Airway cellularity, lipid laden macrophages and microbiology of gastric juice and airways in children with reflux oesophagitis.

Background: Gastroesophageal reflux disease (GORD) can cause respiratory disease in children from recurrent aspiration of gastric contents. GORD can be defined in several ways and one of the most common method is presence of reflux oesophagitis. In children with GORD and respiratory disease, airway neutrophilia has been described.