Reduction in tuberculin skin-test conversion rate after improved adherence to tuberculosis isolation.

The rate of purified protein derivative (PPD) conversion in workers at our hospital increased to 1.7% in 1991. After implementation of mandatory respiratory isolation of patients with community-acquired pneumonia, the rate dropped to 0.

Use of heteroduplex analysis to classify legionellae on the basis of 5S rRNA gene sequences.

Seventeen different species of Legionella, 12 serogroups of Legionella pneumophila, and 2 Legionella-like amoebal pathogens (LLAP1 and Sarcobium lyticum) were examined by heteroduplex analysis of PCR products of the 5S rRNA gene. Eight different banding patterns were identified, indicating that heteroduplex analysis of this gene can be used to classify these bacteria according to base substitutions between species. This classification may have future applications in clinical and epidemiological studies.

Early switch from intravenous to oral antibiotics in hospitalized patients with infections: a 6-month prospective study.

We assessed what percentage of hospitalized patients treated with intravenous antibiotics would be candidates for early switch to oral therapy, and evaluated the clinical outcomes of patients after the switch. All hospitalized patients in whom an intravenous antibiotic was prescribed for treatment of an infection were prospectively screened to identify candidates for switch in therapy. Of the 655 patients treated with intravenous antibiotics, 300 (46%) were candidates for a switch, and the change was implemented in 262 (40%).

Community-acquired pneumonia in the elderly: association of mortality with lack of fever and leukocytosis.

Elderly patients with community-acquired pneumonia may not have a systemic inflammatory response characterized by fever and leukocytosis. We compared lack of fever and leukocytosis with mortality in elderly patients with community-acquired pneumonia. Patients with fever and leukocytosis (group A, 47 patients) were compared with those without fever and leukocytosis (group B, 17 patients).

Tuberculosis in Kentucky: current recommendations for empiric therapy.

Current guidelines for empiric therapy for pulmonary tuberculosis depend on the presence of INH or INH and rifampin resistance (MDRTB) in the community. The objective of this study was to determine the susceptibility of MTB in Kentucky and to consider which therapeutic modality for empiric therapy should be followed. The total number and rate of pulmonary tuberculosis was analyzed and compared to national trends.