Some Selected Abstracts:


Bang AT, Bang RA, Reddy MH, Baitule SB, Deshmukh MD, Paul VK, de C Marshal TF. Simple clinical criteria to identify sepsis or pneumonia in neonates in the community needing treatment or referral. Pediatr Infect Dis J. 2005 Apr;24(4):335-41.

Society for Education, Action and Research in Community Health (SEARCH), Gadchiroli (Maharashtra), 442 605, India.

BACKGROUND: Sepsis, meningitis and pneumonia annually kill 1.1 million neonates in developing countries; most deaths occur at home. OBJECTIVES: To develop simple clinical criteria, enabling health workers in communities to identify neonates with potentially fatal sepsis; and to identify the danger signs alerting mothers to seek care. METHODS: In a field trial in 39 villages in Gadchiroli, India, trained health workers visited all neonates at home 8 times during the first 28 days of life, recording signs and outcome without interventions during 1995-1996 and with home-based management of sick neonates during 1996-1999. An independent neonatologist assigned the cause of death. We use the term "sepsis" to include sepsis, meningitis and pneumonia. We evaluated 31 signs as predictors of 43 sepsis deaths among 3567 neonates. We also evaluated mothers' observations as the danger signs to seek care. RESULTS: Simultaneous presence of any 2 of 7 signs (reduced or stopped sucking; weak or no cry; limbs becoming limp; vomiting or abdominal distension; baby cold to touch; severe chest indrawing; umbilical infection) predicted sepsis death with sensitivity 100%, specificity 92%, positive predictive value 27.2% and negative predictive value 100% in the nonintervention period. The criteria identified 10.6% of the neonates in the community as suspected sepsis, at a mean of 5.4 days before death. The criteria remained valid in the postintervention period. Any 1 of the 5 maternally observed danger signs (reduced sucking, drowsy or unconscious, baby cold to touch, fast breathing and chest indrawing) gave 100% sensitivity and identified 23.9% neonates for seeking care. CONCLUSION: These criteria identify neonates in the community who are at risk for dying of infection with excellent sensitivity, specificity and negative predictive value but a moderate positive predictive value. They can be used by health workers to select sick neonates for treatment or referral. One potentially fatal case would be treated per 4 presumptive cases treated.


Larson EL, Cimiotti J, Haas J, Parides M, Nesin M, Della-Latta P, Saiman L. Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. Arch Pediatr Adolesc Med. 2005 Apr;159(4):377-83  

School of Nursing, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, 630 W 168th Street, New York, NY 10032, USA.

BACKGROUND: The Centers for Disease Control and Prevention, Atlanta, Ga, recommend use of waterless alcohol hand products in lieu of traditional handwashing for patient care, but there are few data demonstrating the impact of this recommendation on health care-associated infections. OBJECTIVE: To compare the effect of 2 hand hygiene regimens on infection rates and skin condition and microbial counts of nurses' hands in neonatal intensive care units. DESIGN, SETTING, AND PARTICIPANTS: Clinical trial using a crossover design in 2 neonatal intensive care units in Manhattan, NY, from March 1, 2001, to January 31, 2003, including 2932 neonatal hospital admissions (51 760 patient days) and 119 nurse participants. INTERVENTION: Two hand hygiene products were tested: a traditional antiseptic handwash and an alcohol hand sanitizer. Each product was used for 11 consecutive months in each neonatal intensive care unit in random order. RESULTS: After adjusting for study site, birth weight, surgery, and follow-up time, there were no significant differences in neonatal infections between the 2 products; odds ratios for alcohol compared with handwashing were 0.98 (95% confidence interval [CI], 0.77-1.25) for any infection, 0.99 (95% CI, 0.77-1.33) for bloodstream infections, 1.61 (95% CI, 0.57-5.54) for pneumonia, 1.78 (95% CI, 0.94-3.37) for skin and soft tissue infections, and 1.26 (95% CI, 0.42-3.76) for central nervous system infections. The skin condition of participating nurses was significantly improved during the alcohol phase (P = .02 and P = .049 for observer and self-assessments, respectively), but there were no significant differences in mean microbial counts on nurses' hands (3.21 and 3.11 log(10) colony-forming units for handwashing and alcohol, respectively; P = .38). CONCLUSIONS: Infection rates and microbial counts on nurses' hands were equivalent during handwashing and alcohol phases, and nurses' skin condition was improved using alcohol. However, assessing the impact on infection rates of a single intervention is challenging because of multiple contributory factors such as patient risk, unit design, and staff behavior. Other practices such as frequency and quality of hand hygiene are likely to be as important as product in reducing risk of cross-transmission.


Trad S, Ghosn J, Dormont D, Stankoff B, Bricaire F, Caumes E. Nuclear bilateral Bell's palsy and ageusia associated with Mycoplasma pneumoniae pulmonary infection. J Med Microbiol. 2005 Apr;54(Pt 4):417-9

Departement des Maladies Infectieuses et Tropicales, CHU Pitie-Salpetriere, 47-83 Boulevard de l'Hopital, 75013 Paris, France.

This case report describes a case of nuclear bilateral Bell's palsy and ageusia associated with Mycoplasma pneumoniae infection. Magnetic resonance imaging evidenced T2-weighted hyper-intense protuberantial lesions. Such topography leading to a nuclear palsy contrasts with previously reported infectious diplegia involving only peripheral facial nerves, and has not yet been described in the spectrum of M. pneumoniae post-infectious neurological manifestations.

Van Dissel JT, Numan SC, Van't Wout JW. Chills in 'early sepsis': good for you? J Intern Med. 2005 May;257(5):469-72 Erratum in: J Intern Med. 2005 Jul;258(1):92

Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.

We evaluated the predictive value of chills, bacteraemia and endotoxaemia for in-hospital mortality and survival at 5-10 years long-term follow-up in a prospective cohort of 'early sepsis' patients presenting with fever resulting from community-acquired pneumonia or pyelonephritis. Febrile patients with chills had bacteraemia more often (RR 3.1, 95% CI 1.8-5.4) than those without chills. Neither chills nor bacteraemia were significantly related to in-hospital mortality, but patients with endotoxaemia had a higher in-hospital mortality rate than those without endotoxaemia. Patients with chills had a significantly higher survival rate at long-term follow-up than those without chills on admission: the estimated risk of dying was 0.644 (95% CI 0.43-0.95, P = 0.029) for an individual with chills, compared to a person without chills, adjusting for the other factors [age cohort, underlying disease and the pro-inflammatory response in the blood, i.e. tumour necrosis factor-alpha (TNF-alpha) and blood leucocyte number, as scored on hospital admission] in the Cox proportional hazards model. Chills may characterize a patient subpopulation that upon pulmonary and urinary tract infection is able to raise a more rapid and/or efficient host response.


Valipour A, Kreuzer A, Koller H, Koessler W, Burghuber OC Bronchoscopy-guided topical hemostatic tamponade therapy for the management of life-threatening hemoptysis. Chest. 2005 Jun;127(6):2113-8.

Department of Respiratory and Critical Care Medicine and Ludwig-Boltzmann Institute for COPD, Otto-Wagner-Spital, Sanatoriumsstr. 2, 1140 Wien, Vienna, Austria.

STUDY OBJECTIVES: Massive hemoptysis is a life-threatening condition. Therapeutic strategies such as interventional angiography, surgery, and/or bronchoscopy have been applied in the clinical setting with variable results. We investigated the efficacy of bronchoscopy-guided topical hemostatic tamponade therapy (THT) using oxidized regenerated cellulose (ORC) mesh in the management of life-threatening hemoptysis. DESIGN: Seventy-six consecutive patients underwent emergency bronchoscopy for massive hemoptysis. Fifty-seven patients (75%) had persistent endobronchial bleeding despite bronchoscopic wedging technique, cold saline solution lavage, and instillation of regional vasoconstrictors. These patients subsequently underwent THT according to the same procedure. SETTING: Teaching hospital, bronchoscopy unit of a 300-bed tertiary pulmonary referral center. RESULTS: THT with ORC was successfully performed on 56 of 57 patients (98%) with an immediate arrest of hemoptysis. All patients successfully treated with THT remained free of hemoptysis for the first 48 h. None required intensive care support or immediate surgery. Mean procedure time (+/- SD) of THT was 11.5 +/- 4.2 min. Recurrence of hemoptysis that was characterized as being mild (< 30 mL) to moderate (30 to 100 mL) developed in six patients (10.5%) 3 to 6 days after THT. Post-obstructive pneumonia developed in five subjects (9%) after endoscopic THT. A subgroup of patients (n = 14) underwent bronchoscopic follow-up 4 weeks after discharge. The ORC mesh was absorbed in all of these patients without signs of foreign body reaction. CONCLUSIONS: Endobronchial THT using ORC is a safe and practicable technique in the management of life-threatening hemoptysis with a high success and a relatively low complication rate.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

12870.  Allworth AM. Tsunami lung: a necrotising pneumonia in survivors of the Asian tsunami. Med J Aust. 2005 Apr 4;182(7):364.

12871.  Bang AT, Bang RA, Reddy MH, Baitule SB, Deshmukh MD, Paul VK, de C Marshal TF. Simple clinical criteria to identify sepsis or pneumonia in neonates in the community needing treatment or referral. Pediatr Infect Dis J. 2005 Apr;24(4):335-41.

12872.  Bardach N, Zhao S, Pantilat S, Johnston SC. Adjustment for do-not-resuscitate orders reverses the apparent in-hospital mortality advantage for minorities. Am J Med. 2005 Apr;118(4):400-8.

12873.  Bashir MSM, Shrivastava M. Study of Utilization of antimicrobial agents (AMA) in indoor paediatric patients of pneumonia at Indira Gandhi Medical College and Hospital Nagpur. Indian Med Gaz 2004;138(10):450-5.

12874.  Beynon KA, Young SA, Laing RT, Harrison TG, Anderson TP, Murdoch DR. Bordetella pertussis in adult pneumonia patients. Emerg Infect Dis. 2005 Apr;11(4):639-41.

12875.  Brown L, Shaw T, Wittlake WA. Does leucocytosis identify bacterial infections in febrile neonates presenting to the emergency department? Emerg Med J. 2005 Apr;22(4):256-9.

12876.  Cashat-Cruz M, Morales-Aguirre JJ, Mendoza-Azpiri M. Respiratory tract infections in children in developing countries. Semin Pediatr Infect Dis. 2005 Apr;16(2):84-92. Review.

12877.  Cederholm M, Haglund B, Axelsson O. Infant morbidity following amniocentesis and chorionic villus sampling for prenatal karyotyping. BJOG. 2005 Apr;112(4):394-402.

12878.  Dixit R, Dixit K, Dixit R. Acute purulent pericarditis due to citrobacter freundii: a case report and literature review. Lung India. 2005 Jan-Mar; 22(1): 22-26.

12879. Duke T. Neonatal pneumonia in developing countries. Arch Dis Child Fetal Neonatal Ed. 2005 May;90(3):F211-9. Review.

12880.  Greenberg DP, von Konig CH, Heininger U. Health burden of pertussis in infants and children. Pediatr Infect Dis J. 2005 May;24(5 Suppl):S39-43. Review.

12881.  Hiraga A, Mori M, Ogawara K, Kojima S, Kanesaka T, Misawa S, Hattori T, Kuwabara S.  Recovery patterns and long term prognosis for axonal Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry. 2005 May;76(5):719-22.

12882.  Houck PM, Bratzler DW. Administration of first hospital antibiotics for community-acquired pneumonia: does timeliness affect outcomes? Curr Opin Infect Dis. 2005 Apr;18(2):151-6. Review.

12883.  Kim DD, Page SM, McKenna DS, Kim CM. Neonatal group B streptococcus sepsis after negative screen in a patient taking oral antibiotics. Obstet Gynecol. 2005 May;105(5 Pt 2):1259-61.

12884.  Kolak J, van Saene HK, de la Cal MA, Silvestre L, Peric M. Control of bacterial pneumonia during mechanical ventilation. Croat Med J. 2005 Apr;46(2):183-96. Review.

12885.  Lindgren VA, Ames NJ. Caring for patients on mechanical ventilation: what research indicates is best practice. Am J Nurs. 2005 May;105(5):50-60; quiz 61. Review.

12886.  Ortiz P, Monivas V, Fuentes R, Toquero J.  Endophthalmitis, pneumonia, and a heart murmur. Heart. 2005 Apr;91(4):532.

12887.  Rello J, Rodriguez A. Optimal outcome in patients with community-acquired pneumonia: Take the main course before the dessert. Crit Care Med. 2005 May;33(5):1149.

12888.  Rothstein E, Edwards K. Health burden of pertussis in adolescents and adults. Pediatr Infect Dis J. 2005 May;24(5 Suppl):S44-7. Review.

12889.  Roy L, Isler M. Surgical images: musculoskeletal. Costal hemangioma presenting as rib pain after pneumonia. Can J Surg. 2005 Apr;48(2):152.

12890.  Schieveld JN, Leentjens AF. Delirium in severely ill young children in the pediatric intensive care unit (PICU). J Am Acad Child Adolesc Psychiatry. 2005 Apr;44(4):392-4; discussion 395. Review.

12891.  Schurink CA, Lucas PJ, Hoepelman IM, Bonten MJ. Computer-assisted decision support for the diagnosis and treatment of infectious diseases in intensive care units. Lancet Infect Dis. 2005 May;5(5):305-12. Review.

12892.  Stein DL, Haramati LB, Spindola-Franco H, Friedman J, Klapper PJ. Intrathoracic lymphadenopathy in hospitalized patients with pneumococcal pneumonia. Chest. 2005 Apr;127(4):1271-5.

12893.  Tarver RD, Teague SD, Heitkamp DE, Conces DJ Jr. Radiology of community-acquired pneumonia. Radiol Clin North Am. 2005 May;43(3):497-512, viii. Review.

12894.  Trad S, Ghosn J, Dormont D, Stankoff B, Bricaire F, Caumes E. Nuclear bilateral Bell's palsy and ageusia associated with Mycoplasma pneumoniae pulmonary infection. J Med Microbiol. 2005 Apr;54(Pt 4):417-9.

12895.  Upadhyay M, Singh S, Murlidharan J, Kaur N, Majumdar S. Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock. Indian Pediatrics. 2005 Mar; 42(3): 223-231.

12896.  van der Meer V, Neven AK, van den Broek PJ, Assendelft WJ. Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review. BMJ. 2005 Jul 2;331(7507):26.

12897.  Van Dissel JT, Numan SC, Van't Wout JW.  Chills in 'early sepsis': good for you? J Intern Med. 2005 May;257(5):469-72. Erratum in: J Intern Med. 2005 Jul;258(1):92.

12898. Worrall G, Young B, Knight V. Inappropriate use of antibiotics for acute respiratory tract infections in a rural emergency department. Can J Rural Med. 2005 Spring;10(2):86-8.

12899.  Wunderink RG. Slow response times: is it the pneumonia or the physician? Crit Care Med. 2005 Jun;33(6):1429-30.


12900.  Campbell IT. Aspiration and the laryngeal mask airway. Br J Anaesth. 2005 Apr;94(4):545-6; author reply 546-7.

12901.  Cook T. Who is at increased risk of pulmonary aspiration? Br J Anaesth. 2005 May;94(5):690-1; author reply 691.

12902.  Coutsoudis A, Pillay K, Spooner E, Coovadia HM, Pembrey L, Newell ML. Routinely available cotrimoxazole prophylaxis and occurrence of respiratory and diarrhoeal morbidity in infants born to HIV-infected mothers in South Africa. S Afr Med J. 2005 May;95(5):339-45.

12903.  Faden H, Wynn RJ, Campagna L, Ryan RM. Outbreak of adenovirus type 30 in a neonatal intensive care unit. J Pediatr. 2005 Apr;146(4):523-7.

12904.  Fraser DW. The challenges were legion. Lancet Infect Dis. 2005 Apr;5(4):237-41.

12905.  Jellish WS, Kartha V, Fluder E, Slogoff S. Effect of metoclopramide on gastric fluid volumes in diabetic patients who have fasted before elective surgery. Anesthesiology. 2005 May;102(5):904-9.

12906.  Kaplan LJ. Tracheal access: on the cusp of a decision? Crit Care Med. 2005 May;33(5):1159-60.

12907.  Meyer HJ, Monticelli F, Kiesslich J. Fatal embolism of the anterior spinal artery after local cervical analgetic infiltration. Forensic Sci Int. 2005 May 10;149(2-3):115-9.


12908.  Acquarolo A, Urli T, Perone G, Giannotti C, Candiani A, Latronico N. Antibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study. Intensive Care Med. 2005 Apr;31(4):510-6.

12909.  Burnett M, Genao I, Wong WF. Race, culture, and trust: why should I take a shot if I'm not sick? Ethn Dis. 2005 Spring;15(2 Suppl 3):S3-13-S3-6.

12910.  Cocanour CS, Ostrosky-Zeichner L, Peninger M, Garbade D, Tidemann T, Domonoske BD, Li T, Allen SJ, Luther KM.  Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit. Surg Infect (Larchmt). 2005 Spring;6(1):65-72.

12911.  Counts M. Telithromycin--a ketolide antibiotic for the treatment of outpatients with community-acquired respiratory tract infections. Clin Nurse Spec. 2005 May-Jun;19(3):121-3. Review.

12912.  Durbin CG Jr. Indications for and timing of tracheostomy. Respir Care. 2005 Apr;50(4):483-7. Review.

12913.  Epstein SK. Late complications of tracheostomy. Respir Care. 2005 Apr;50(4):542-9. Review.

12914.  Ferrara AM. New fluoroquinolones in lower respiratory tract infections and emerging patterns of pneumococcal resistance. Infection. 2005 Jun;33(3):106-14. Review.

12915.  Koturoglu G, Kurugol Z, Cetin N, Hizarcioglu M, Vardar F, Helvaci M, Capar Z, Ozkinay F, Ozkinay C. Complications of varicella in healthy children in Izmir, Turkey. Pediatr Int. 2005 Jun;47(3):296-9.

12916.  Larson EL, Cimiotti J, Haas J, Parides M, Nesin M, Della-Latta P, Saiman L.  Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. Arch Pediatr Adolesc Med. 2005 Apr;159(4):377-83.

12917.  Lawson P. Zapping VAP with evidence-based practice. Nursing. 2005 May;35(5):66-7.

12918.  Mason DJ, Flynn L. The state of the science: focus on cardiopulmonary disease. Am J Nurs. 2005 Jun;105(6):79. Review.

12919.  Phua J, Kong K, Lee KH, Shen L, Lim TK. Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure. Intensive Care Med. 2005 Apr;31(4):533-9.

12920.  Ray DE, Matchett SC, Baker K, Wasser T, Young MJ. The effect of body mass index on patient outcomes in a medical ICU. Chest. 2005 Jun;127(6):2125-31.

12921.  Satcher D. Adult immunization disparities: a challenge for the public health/primary care partnership. Ethn Dis. 2005 Spring;15(2 Suppl 3):S3-1-S3-3.

12922.  Scheurer DB, Miller JG, Blair DI, Pride PJ, Walker GM, Cawley PJ. Hospitalists and improved cost savings in patients with bacterial pneumonia at a state level. South Med J. 2005 Jun;98(6):607-10.

12923.  Valipour A, Kreuzer A, Koller H, Koessler W, Burghuber OC. Bronchoscopy-guided topical hemostatic tamponade therapy for the management of life-threatening hemoptysis. Chest. 2005 Jun;127(6):2113-8.

12924. Waterer GW. Monotherapy versus combination antimicrobial therapy for pneumococcal pneumonia. Curr Opin Infect Dis. 2005 Apr;18(2):157-63. Review.