Control of health care-associated infections (HAI): winning both the battles and the war.

At present, the United States (US) experiences its greatest life expectancy due mainly to improvements in mortality from cardiovascular diseases, which include coronary heart disease and stroke. These, in turn, are due largely to decreases in cigarette smoking as well as earlier and more aggressive diagnoses and treatments. These advances in health care delivery are, not surprisingly, accompanied by increasing numbers of complicating health care-associated infections (HAI).

Origin of the old testament plagues: explications and implications.

Analyses of past disasters may supply insights to mitigate the impact of recurrences. In this context, we offer a unifying causative theory of Old Testament plagues, which has present day public health implications. We propose the root cause to have been an aberrant El Niño-Southern Oscillation teleconnection that brought unseasonable and progressive climate warming along the ancient Mediterranean littoral, including the coast of biblical Egypt, which, in turn, initiated the serial catastrophes of biblical sequence - in particular arthropod-borne and arthropod-caused diseases.

Emergence of highly antibiotic-resistant Pseudomonas aeruginosa in relation to duration of empirical antipseudomonal antibiotic treatment.

Objective: This study examines antibiotic resistance in Pseudomonas aeruginosa in hospitalized patients in relation to prior empirical antibiotic therapy.

Design: Two retrospective case analyses comparing patients who manifested P aeruginosa with differing patterns of antibiotic resistance.

Setting And Participants: Patients acquiring P aeruginosa in a community hospital.

An apparent excess of operative site infections: analyses to evaluate false-positive diagnoses.

Objective: To investigate an apparent excess of operative site infections (OSI) reported according to doctor's diagnosis (presumptive OSI) by applying objective criteria for classification (documented OSI). To examine potential consequences of habitual overdiagnosis of OSI.

Design: A case-control design was used to examine the clinical course of 18 case patients (12 presumptive OSI, six documented OSI) and 18 matched controls.

Recorded criteria as a "gold standard" for sensitivity and specificity estimates of surveillance of nosocomial infection: a novel method to measure job performance.

Objectives: To compare the accuracy of infection control practitioners' (ICPs') classifications of operative site infection in Florida Consortium for Infection Control (FCIC) hospitals, in two time periods, 1990 to 1991 and 1991 to 1992, and to estimate the effect of duration of surveillance experience on that accuracy.

Methods: Medical record reviewers examined records of all patients classified by an ICP as infected, to distinguish false-positives from true infections based on evidence of standard infection criteria and the ICP's contemporaneous clinical observations. Reviewers also examined a random sample of 100 records from patients classified as noninfected for evidence of undetected infections (false-negatives).