Bacterial contamination of health care workers' white coats.

Background: Patient-to-patient transmission of nosocomial pathogens has been linked to transient colonization of health care workers, and studies have suggested that contamination of health care workers' clothing, including white coats, may be a vector for this transmission.

Methods: We performed a cross-sectional study involving attendees of medical and surgical grand rounds at a large teaching hospital to investigate the prevalence of contamination of white coats with important nosocomial pathogens, such as methicillin-sensitive Stapylococcus aureus, methicillin-resistant S aureus (MRSA), and vancomycin-resistant enterococci (VRE). Each participant completed a brief survey and cultured his or her white coat using a moistened culture swab on lapels, pockets, and cuffs.

Prevalence of methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii in a long-term acute care facility.

Background: Patients in long-term acute care (LTAC) facilities often have many known risk factors for acquisition of antibiotic-resistant bacteria. However, the prevalence of resistance in these facilities has not been well described.

Methods: We performed a single-day, point-prevalence study of a 180-bed, university-affiliated LTAC facility in Baltimore to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii in the anterior nares, perirectal area, sputum, and wounds.

Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers.

Objective: To assess the rate of and the risk factors for the detection of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) on the protective gowns and gloves of healthcare workers (HCWs).

Methods: We observed the interactions between HCWs and patients during routine clinical activities in a 29-bed medical intensive care unit at the University of Maryland Medical Center, an urban tertiary care academic hospital.

Risk factors for colonization with extended-spectrum beta-lactamase-producing bacteria and intensive care unit admission.

Extended-spectrum beta-lactamase (ESBL)-producing bacteria are emerging pathogens. To analyze risk factors for colonization with ESBL-producing bacteria at intensive care unit (ICU) admission, we conducted a prospective study of a 3.5-year cohort of patients admitted to medical and surgical ICUs at the University of Maryland Medical Center.

Increasing prevalence of gastrointestinal colonization with ceftazidime-resistant gram-negative bacteria among intensive care unit patients.

Background: The occurrence of nosocomial infections due to third-generation cephalosporin-resistant gram-negative bacteria is increasing. Gastrointestinal colonization is an important reservoir for antibiotic-resistant bacteria, and it often precedes clinical infection.

Objective: To estimate the prevalence of gastrointestinal colonization with ceftazidime-resistant gram-negative bacteria among intensive care unit (ICU) patients at a university-affiliated tertiary-care hospital during 2 distinct periods and to assess whether, at any time during the index hospitalization, colonized patients had a clinical culture positive for the same organism that was recovered from surveillance culture.

Impact of freezing on the future utility of archived surveillance culture specimens.

The ability to recover bacteria from frozen culture specimens has important implications. The purpose of this study was to validate the utility of frozen specimens for recovery of several gram-positive and gram-negative bacterial species by culture. Results demonstrate that 98% of 250 bacterial isolates identified on initial culture were subsequently recovered by culture of frozen specimens after a median storage period of 564 days.

Identifying groups at high risk for carriage of antibiotic-resistant bacteria.

Background: No simple, cost-effective methods exist to identify patients at high risk for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci colonization outside intensive care settings. Without such methods, colonized patients are entering hospitals undetected and transmitting these bacteria to other patients. We aimed to develop a highly sensitive, simple-to-administer prediction rule to identify subpopulations of patients at high risk for colonization on hospital admission.

Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci co-colonization.

We assessed the prevalence, risk factors, and clinical outcomes of patients co-colonized with vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) upon admission to the medical and surgical intensive care units (ICUs) of a tertiary-care facility between January 1, 2002, and December 31, 2003. Co-colonization was defined as a VRE-positive perirectal surveillance culture with an MRSA-positive anterior nares surveillance culture collected concurrently. Among 2,440 patients, 65 (2.