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.

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.

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.

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.

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.

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.

Cough quality in children: a comparison of subjective vs. bronchoscopic findings.

Background: Cough is the most common symptom presenting to doctors. The quality of cough (productive or wet vs dry) is used clinically as well as in epidemiology and clinical research. There is however no data on the validity of cough quality descriptors.

An in vitro study of the anti-microbial efficacy of a 1% silver sulphadiazine and 0.2% chlorhexidine digluconate cream, 1% silver sulphadiazine cream and a silver coated dressing.

Unlabelled: Burn sepsis is a leading cause of mortality and morbidity in patients with major burns. The use of topical anti-microbial agents has helped improve the survival in these patients. There are a number of anti-microbials available, one of which, Silvazine (1% silver sulphadiazine (SSD) and 0.