Self-paced learning stations for tuberculosis respirator training: report of a pilot program.

Background: In response to the Centers for Disease Control and Prevention's recently issued "Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities, 1994," during May 1994 we implemented and evaluated a pilot tuberculosis respirator training program that used four self-directed learning stations, through which participants proceeded at their own pace. Employee tuberculin skin testing was included in the training program.

Methods: The time required to train each employee was recorded.

Computer-assisted antimicrobial surveillance in a community teaching hospital.

A computer-assisted, pharmacy-managed antimicrobial surveillance service is described. Rising drug costs and inappropriate use of antimicrobial drugs led to the January 1994 implementation of an antimicrobial surveillance program at a 369-bed community teaching hospital. A computer interface between the pharmacy and microbiology laboratory data-bases was established that allows pharmacists quick access to culture and susceptibility test results and provides timely reports identifying patients for whom intervention may be necessary.

Catheter lavage and drainage of pneumococcal pericarditis.

An 88 year old woman with streptococcal pneumonia developed purulent pericarditis and cardiac tamponade despite treatment with antibiotics. Percutaneous pericardial drainage was effected with a 6 French pigtail catheter inserted via the subxyphoid approach. Catheter drainage was continued for 7 days in conjunction with systemic antibiotics.

Munchausen's syndrome with hematuria and sepsis: an unusual case.

An unusual case of Munchausen's syndrome is described in which a former microbiology technician was suspected of inoculating himself with contaminated material to produce sepsis and ingesting warfarin in the form of rat poison to cause hematuria. This combination of factitious disorders has rarely been reported. Other unusual features included a nonemergent presentation through the hospital emergency room and a clinical profile not typical of previously published cases.

DF-2 septicemia following whirlpool spa immersion.

We describe the case of a 31-year-old asplenic man who developed DF-2 bacteremia, septic shock, and pneumonia after recreational immersion in a whirlpool spa. The patient did not have a history of dog bite or contact with canine secretions, although he owned two dogs. DF-2 could not be isolated from the whirlpool spa.