January, 2005

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

11084.  Butler KL, Best IM, Oster RA, Katon-Benitez I, Lynn Weaver W, Bumpers HL. Is bilateral protected specimen brush sampling necessary for the accurate diagnosis of ventilator-associated pneumonia? J Trauma. 2004 Aug;57(2):316-22.

11085.  Centers for Disease Control and Prevention (CDC). Tuberculosis transmission in a renal dialysis center--Nevada, 2003. MMWR Morb Mortal Wkly Rep. 2004 Sep 24;53(37):873-5.

11086.  Vincent JL. Ventilator-associated pneumonia. J Hosp Infect. 2004 Aug;57(4):272-80. Review.

11087.  Zheng L, Keller SF, Lyerly DM, Carman RJ, Genheimer CW, Gleaves CA, Kohlhepp SJ, Young S, Perez S, Ye K. Multicenter evaluation of a new screening test that detects Clostridium difficile in fecal specimens. J Clin Microbiol. 2004 Aug;42(8):3837-40.


11088.  Drinka PJ, Stemper ME, Gauerke CD, Miller JM, Reed KD. The identification of genetically related bacterial isolates using pulsed field gel electrophoresis on nursing home units: a clinical experience. J Am Geriatr Soc. 2004 Aug;52(8):1373-7.

11089.  Lescat M, Dupeyron C, Faubert E, Mangeney N. Pulse-field gel electrophoresis typing of methicillin-resistant Staphylococcus aureus strains susceptible to aminoglycosides isolated from 1993 to 2002. J Hosp Infect. 2004 Jul;57(3):253-7.

11090.  Moustaoui N, Soukri A, Elmdaghri N, Boudouma M, Benbachir M. Molecular biology of extended-spectrum beta-lactamase-producing Enterobacteriaceae responsible for digestive tract colonization. J Hosp Infect. 2004 Jul;57(3):202-8.

11091.  Pournaras S, Ikonomidis A, Kristo I, Tsakris A, Maniatis AN. CTX-M enzymes are the most common extended-spectrum beta-lactamases among Escherichia coli in a tertiary Greek hospital. J Antimicrob Chemother. 2004 Aug;54(2):574-5.


11092.  Richeldi L, Ewer K, Losi M, Bergamini BM, Roversi P, Deeks J, Fabbri LM, Lalvani A.  T  cell-based tracking of multidrug resistant tuberculosis infection after brief exposure. Am J Respir Crit Care Med. 2004 Aug 1;170(3):288-95.


11093.  Carlet J, Ben Ali A, Chalfine A. Epidemiology and control of antibiotic resistance in the intensive care unit. Curr Opin Infect Dis. 2004 Aug;17(4):309-16. Review.

11094.  Cooper BS, Stone SP, Kibbler CC, Cookson BD, Roberts JA, Medley GF, Duckworth G, Lai R, Ebrahim S. Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature. BMJ. 2004 Sep 4;329(7465):533. Review.

11095.  Rydock JP, Eian PK. Containment testing of isolation rooms. J Hosp Infect. 2004 Jul;57(3):228-32.



April, 2005

Some Selected Abstracts:


Davies P. Back to the basics of wound care: why nurses should question theirpractice. Prof Nurse. 2004 Oct; 20(2):29-31. Review.

School of Primary Health Care, University of Central England,

The high incidence of hospital-acquired infections, about a tenth of which occur in wounds, has propelled the issue of prevention to the top of the health-care agenda. Policy centres on hygiene, protective precautions and educating staff and patients. This article focuses on detection and treatment options for confirmed wound infections.


Vincent JL, Chierego M, Struelens M, Byl B. Infection control in the intensive care unit. Expert Rev Anti Infect Ther. 2004 Oct;2(5):795-805. Review.

Free University of Brussels, Department of Intensive Care, Erasme Hospital, Brussels, Belgium.

Nosocomial infections are common in many hospital departments, but particularly so on the intensive care unit, where they affect some 20 to 30% of patients. While early diagnosis and appropriate treatment are, of course, important, perhaps the greatest challenge is in the application of techniques to limit the development of such infections. This review will briefly discuss some of the background pathophysiology and epidemiology of nosocomial infection, and then focus on general and infection-specific preventative strategies individually and as part of broader infection-control programs with infection surveillance.


Warren DK, Hill HA, Merz LR, Kollef MH, Hayden MK, Fraser VJ, Fridkin SK. Cycling empirical antimicrobial agents to prevent emergence of antimicrobial-resistant Gram-negative bacteria among intensive care unit patients. Crit Care Med. 2004 Dec; 32(12):2450-6.

Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.

OBJECTIVE: To determine the impact of the rotation of antimicrobial agents on the rates of infection, intestinal colonization, and acquisition with antimicrobial-resistant Gram-negative bacteria. DESIGN: Pre- and postintervention design. SETTING: A 19-bed, medical intensive care unit. PATIENTS: Individuals admitted to the study unit for >48 hrs. INTERVENTIONS: After a 5-month baseline observation period, four classes of antimicrobial agents with Gram-negative activity were cycled at 3- to 4-month intervals for 24 months. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the acquisition rate of antimicrobial resistance among Enterobacteriaceae and Pseudomonas aeruginosa obtained from rectal swab cultures performed on admission, weekly during the patients' stay, and at discharge. Rates and microbiology of nosocomial bloodstream infections and ventilator-associated pneumonia were also compared between baseline and cycling periods. The cycling program resulted in a significant change in prescribing practices; the predominant agent used changed with each cycle. Among study patients who were not already colonized with a resistant organism, the rate of acquisition of enteric colonization with bacteria resistant to any of the target drugs remained stable during the cycling period for P. aeruginosa (relative rate, 0.96; 95% confidence Interval, 0.47-2.16) and Enterobacteriaceae (relative rate, 1.57; 95% confidence interval, 0.80-3.43). Hospital-wide, P. aeruginosa from routine clinical cultures resistant to the target drugs increased during the cycling period. The proportion of Gram-negative bacteria isolated from cases of nosocomial bloodstream infection (29% baseline vs. 26% cycling; p = .11) and ventilator-associated pneumonia (80% vs. 41%; p = .06) did not significantly differ. CONCLUSIONS: In this study, antimicrobial cycling did not result in a significant change in enteric acquisition of resistant Gram-negative bacteria among intensive care unit patients.


Kukino J, Naito T, Mitsuhashi K, Oshima H, Sekiya S, Isonuma H, Watanabe K, Dambara T, Hayashida Y. Susceptibility of medical students to vaccine-preventable viral diseases: a serological study. J Infect Chemother. 2004 Dec; 10(6):335-7.

Department of General Medicine, Juntendo University School of Medicine, 2-1-1 Bunkyo-ku, Tokyo 113-8421, Japan.

As a measure for the prevention and control of nosocomial infections in medical school students, we examined the students' titers of antibodies to measles, rubella, varicella, and mumps viruses to determine whether vaccination was required. We also analyzed and discussed correlations among antibody titers to the viruses. Subjects were 363 Juntendo University students, ranging from freshmen to seniors. EIA was used to measure IgG antibody titers. Eight subjects (2.2%) had negative titers for measles, 36 (9.9%) for rubella, 8 (2.2%) for varicella, and 10 (2.7%) for mumps. Seronegative subjects were vaccinated against each virus and high seroconversion rates were obtained: 100% for measles and rubella, 67% for varicella, and 89% for mumps. In addition, we used Pearson's test to search for correlations among the antibody titers for each virus. A weak correlation was observed among antibody titers for measles, rubella, and mumps but not for varicella. These results suggest that MMR vaccine might be effective in people with low levels of antibody to measles, rubella, and mumps.


Pajkos A, Vickery K, Cossart Y. Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination? J Hosp Infect. 2004 Nov; 58(3):224-9.

Department of Infectious Diseases and Immunology, University of Sydney and The Australian Centre for Hepatitis Virology, Sydney, NSW 2006, Australia.

We predicted that biofilm would form on surfaces of endoscope tubing in contact with fluids, and may be difficult to remove by current washing procedures. Its presence may protect micro-organisms from disinfectant action and contribute to failure of decontamination prior to re-use. Tubing samples removed from 13 endoscopes that had been sent to an endoscope-servicing centre were examined for the presence of biofilm and bacteria by scanning electron microscopy. Biological deposits were present on all samples tested. Biofilm (bacteria plus exopolysaccharides matrix) was present on the suction/biopsy channels of five of 13 instruments, and was very extensive on one of these. Bacteria and microcolonies were often but not necessarily associated with surface defects on the tubing. All 12 air/water channels examined showed biofilm, and this was extensive on nine samples. Routine cleaning procedures do not remove biofilm reliably from endoscope channels, and this may explain the unexpected failure of decontamination encountered in practice despite good adherence to infection control guidelines.


Hall J, Hodgson G, Kerr KG. Provision of safe potable water for immuno- compromised patients in hospital. J Hosp Infect. 2004 Oct; 58(2):155-8.

Department of Infection Control, Leeds Teaching Hospitals Trust, Leeds, UK.

We conducted a survey of hospital drinking water provision for patients with immunocompromising conditions in 15 Trusts in the north of England. Ten trusts replied, reporting on provision of drinking water in 14 separate units. Of these, nine provided only tap water to all patients, irrespective of underlying condition. In two units, iced water, with ice from commercially available makers, was used. Five units distinguished between neutropenic and non-neutropenic patients, with the former group receiving cooled, boiled water (three units), sterile water and sterile water or carbonated water (one unit each). No unit provided filtered water. Water in jugs was changed daily, twice daily or only when empty in seven, three and four units, respectively. On 10 units, patients were allowed to provide their own drinking water, but no unit provided written advice to patients on potable water. A survey within our own Trust revealed similar inter-unit disparity. The options for potable water provision were reviewed, taking into account: microbiological quality, organoleptic (perceived taste/smell) acceptability, cost and factors relating to staff safety and patient confidentiality [as it was possible for human immunodeficiency virus (HIV) seropositive patients on some wards to be identified because they were provided with cooled, boiled water]. It concluded that end-line commercially available water filters were the optimal way to provide drinking water to immunocompromised patients in hospital.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

11645.    Combes A, Luyt CE, Fagon JY, Wollf M, Trouillet JL, Gibert C, Chastre J; PNEUMA Trial Group. Impact of methicillin resistance on outcome of Staphylococcus aureus ventilator-associated pneumonia. Am J Respir Crit Care Med. 2004 Oct 1;170(7):786-92. Epub 2004 Jul 08.

11646.   Conroy FJ. Preventing the spread of MRSA: ...and the role of practices such as phlebotomy is worth considering. BMJ. 2004 Oct 23;329(7472):978.

11647.    Corona A, Wilson AP, Grassi M, Singer M. Prospective audit of bacteraemia management in a university hospital ICU using a general strategy of short-course monotherapy. J Antimicrob Chemother. 2004 Oct;54(4):809-17.

11648.    Davies P. Back to the basics of wound care: why nurses should question their practice. Prof Nurse. 2004 Oct;20(2):29-31. Review.

11649.    Dobbins BM, Kite P, Catton JA, Wilcox MH, McMahon MJ. In situ endoluminal brushing: a safe technique for the diagnosis of catheter-related bloodstream infection. J Hosp Infect. 2004 Nov;58(3):233-7.

11650.    Ferroni A, Beauvais R, Colomb V, Gaillard JL, Berche P, Hubert P, Poisson-Salomon AS.  Strategies for the diagnosis and treatment of bacteraemia in children with central venous catheters: an analysis. J Hosp Infect. 2004 Oct;58(2):128-36.

11651.    Hampton S. Nursing management of urinary tract infections for catheterized patients. Br J Nurs. 2004 Nov 11-24;13(20):1180-4. Review.

11652.    Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, Oh MD, Choe KW. Bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for mortality and treatment outcome, with special emphasis on antimicrobial therapy. Antimicrob Agents Chemother. 2004 Dec;48(12):4574-81.

11653.    Keith DD, Garrett KM, Hickox G, Echols B, Comeau E. Ventilator-associated pneumonia: improved clinical outcomes. J Nurs Care Qual. 2004 Oct-Dec;19(4):328-33; quiz 334-5.

11654.    Laupland KB, Kirkpatrick AW, Church DL, Ross T, Gregson DB. Intensive-care-unit-acquired bloodstream infections in a regional critically ill population. J Hosp Infect. 2004 Oct;58(2):137-45.

11655.    McDonald LC, Hageman JC. Vancomycin intermediate and resistant Staphylococcus aureus. What the nephrologist needs to know. Nephrol News Issues. 2004 Oct;18(11):63-4, 66-7, 71-2 passim. Review.

11656.    McGuire W, Clerihew L, Fowlie PW. Infection in the preterm infant. BMJ. 2004 Nov 27;329(7477):1277-80. Review.

11657.    Ostrosky-Zeichner L. Prophylaxis or preemptive therapy of invasive candidiasis in the intensive care unit? Crit Care Med. 2004 Dec;32(12):2552-3.

11658.    Randolph AG, Reder L, Englund JA. Risk of bacterial infection in previously healthy respiratory syncytial virus-infected young children admitted to the intensive care unit. Pediatr Infect Dis J. 2004 Nov;23(11):990-4.

11659.    Rupp ME, Fitzgerald T, Marion N, Helget V, Puumala S, Anderson JR, Fey PD. Effect of silver-coated urinary catheters: efficacy, cost-effectiveness, and antimicrobial resistance. Am J Infect Control. 2004 Dec;32(8):445-50.

11660.    Singhi SC, Reddy TC, Chakrabarti A. Oral itraconazole in treatment of candidemia in a pediatric intensive care unit. Indian J Pediatr. 2004 Nov;71(11):973-7.

11661.    Taneja N, Emmanuel R, Chari PS, Sharma M. A prospective study of hospital-acquired infections in burn patients at a tertiary care referral centre in North India. Burns. 2004 Nov;30(7):665-9.

11662.    Tekerekoglu MS, Durmaz R, Ay S, Cicek A, Kutlu O. Epidemiologic and clinical features of a sepsis caused by methicillin-resistant Staphylococcus epidermidis (MRSE) in a pediatric intensive care unit. Am J Infect Control. 2004 Oct;32(6):362-4.

11663.    Vincent JL, Chierego M, Struelens M, Byl B. Infection control in the intensive care unit. Expert Rev Anti Infect Ther. 2004 Oct;2(5):795-805. Review.

11664.    Warren DK, Hill HA, Merz LR, Kollef MH, Hayden MK, Fraser VJ, Fridkin SK. Cycling empirical antimicrobial agents to prevent emergence of antimicrobial-resistant Gram-negative bacteria among intensive care unit patients. Crit Care Med. 2004 Dec;32(12):2450-6.

11665. Wooltorton E. Medical gels and the risk of serious infection. CMAJ. 2004 Nov 23;171(11):1348.


11666.    Brink AJ, Feldman C, Grolman DC, Muckart D, Pretorius J, Richards GA, Senekal M, Sieling W. Appropriate use of the carbapenems. S Afr Med J. 2004 Oct;94(10 Pt 2):857-61. Review.

11667.   Cuenca J, Garcia-Erce JA, Munoz M, Izuel M, Martinez AA, Herrera A. Patients with pertrochanteric hip fracture may benefit from preoperative intravenous iron therapy: a pilot study. Transfusion. 2004 Oct;44(10):1447-52.

11668.   Cuevas O, Cercenado E, Vindel A, Guinea J, Sanchez-Conde M, Sanchez-Somolinos M, Bouza E. Evolution of the antimicrobial resistance of Staphylococcus spp. in Spain: five nationwide prevalence studies, 1986 to 2002. Antimicrob Agents Chemother. 2004 Nov;48(11):4240-5.

11669.   Duttweiler L, Nadal D, Frey B. Pulmonary and systemic bacterial co-infections in severe RSV bronchiolitis. Arch Dis Child. 2004 Dec;89(12):1155-7.

11670.   Goldrick BA. Emerging infections: respiratory syncytial virus. Am J Nurs. 2004 Nov;104(11):54-6.

11671.   Gund V, Cooper M, Parekh N. Methicillin-resistant Staphylococcus aureus in the critically ill. Br J Anaesth. 2004 Dec;93(6):872-3.

11672.   Kukino J, Naito T, Mitsuhashi K, Oshima H, Sekiya S, Isonuma H, Watanabe K, Dambara T, Hayashida Y. Susceptibility of medical students to vaccine-preventable viral diseases: a serological study. J Infect Chemother. 2004 Dec;10(6):335-7.

11673.   Majumdar S, Kirby A, Berry N, Williams C, Hassan I, Eddleston J, Burnie JP. An outbreak of imipenem-resistant Pseudomonas aeruginosa in an intensive care unit. J Hosp Infect. 2004 Oct;58(2):160-1.

11674.   Mochizuki T, Okamoto N, Yagishita T, Takuhiro K, Mashiko K, Ogawa F, Tosaka N, Kurokawa A, Yamamoto Y. Analysis of antimicrobial drug resistance of Staphylococcus aureus strains by WHONET 5: microbiology laboratory database software. J Nippon Med Sch. 2004 Oct;71(5):345-51.

11675.   O'Dowd A. MRSA cases halved within four years? Just how realistic is the new target? Nurs Times. 2004 Nov 16-22;100(46):12-3.

11676.   Pajkos A, Vickery K, Cossart Y. Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination? J Hosp Infect. 2004 Nov;58(3):224-9.

11677.    Pastila S, Sammalkorpi KT, Vuopio-Varkila J, Kontiainen S, Ristola MA. Control of methicillin-resistant Staphylococcus aureus outbreak involving several hospitals. J Hosp Infect. 2004 Nov;58(3):180-6.

11678.   Ruef C. Selective decontamination of the digestive tract--the risks of prevention. Infection. 2004 Oct;32(5):255-6.

11679.   Tsukayama DT, van Loon HJ, Cartwright C, Chmielewski B, Fluit AC, van der Werken C, Verhoef J; RADAR trial. The evolution of Pseudomonas aeruginosa during antibiotic rotation in a medical intensive care unit: the RADAR-trial. Int J Antimicrob Agents. 2004 Oct;24(4):339-45.

11680.   Winston LG, Charlebois ED, Pang S, Bangsberg DR, Perdreau-Remington F, Chambers HF. Impact of a formulary switch from ticarcillin-clavulanate to piperacillin-tazobactam on colonization with vancomycin-resistant enterococci. Am J Infect Control. 2004 Dec;32(8):462-9.

11681.   Yaman A, Tasova Y, Kibar F, Inal AS, Saltoglu N, Buyukcelik O, Kurtaran B, Dundar IH.  Investigation of the antibiotic susceptibility patterns of pathogens causing nosocomial infections. Saudi Med J. 2004 Oct;25(10):1403-9.

11682. Hospital hygiene sweeps resistance under the carpet. Lancet Infect Dis. 2004 Dec;4(12):713.


11683.    Akerman N. Preventing the spread of MRSA: ...the epidemiological nature of the problem should be tackled... BMJ. 2004 Oct 23;329(7472):978.

11684.    Akioyame M, Radford P. Precautions against infection from anaesthetic procedures. Anaesthesia. 2004 Oct;59(10):1026; discussion 1026-7.

11685.    Arya SC, Agarwal N, Agarwal S, George S, Singh K. Nosocomial infection: hospital infection surveillance and control. J Hosp Infect. 2004 Nov;58(3):242-3.

11686.    Coelho J, Woodford N, Turton J, Livermore DM. Multiresistant acinetobacter in the UK: how big a threat? J Hosp Infect. 2004 Nov;58(3):167-9. Review.

11687.    Cromer AL, Hutsell SO, Latham SC, Bryant KG, Wacker BB, Smith SA, Bendyk HA, Valainis GT, Carney MC. Impact of implementing a method of feedback and accountability related to contact precautions compliance. Am J Infect Control. 2004 Dec;32(8):451-5.

11688.    Dale BA. Preventing the spread of MRSA: all frontline staff need to be involved... BMJ. 2004 Oct 23;329(7472):978.

11689.    Dealler S. Methicillin-resistant Staphylococcus aureus infections and colonizations in an intensive care unit apparently stopped by environmental factors. J Hosp Infect. 2004 Nov;58(3):238.

11690.   Dellamonica J, Boisseau N, Goubaux B, Raucoules-Aime M. Comparison of manufacturers' specifications for 44 types of heat and moisture exchanging filters. Br J Anaesth. 2004 Oct;93(4):532-9.

11691.    Drinka PJ. Long term tracking of methicillin-resistant Staphylococcus aureus in a large skilled nursing facility. J Am Geriatr Soc. 2004 Nov;52(11):1968.

11692.    Hall J, Hodgson G, Kerr KG. Provision of safe potable water for immunocompromised patients in hospital. J Hosp Infect. 2004 Oct;58(2):155-8.

11693.   Ingham HR. Role of isolation unit in MRSA control. J Hosp Infect. 2004 Oct;58(2):161-2.

11694.    Kelly L, Clark K. The effectiveness of training and taste testing when using respirator masks. J Hosp Infect. 2004 Nov;58(3):240-1.

11695.    Liyanage C, Egbu C. FM services have vital role. Health Estate. 2004 Oct;58(9):47-54.

11696.    Nandrup-Bus I. There is not enough evidence to recommend the widespread use of topical antimicrobials on the umbilical cord stump. J Hosp Infect. 2004 Oct;58(2):165.

11697.    Newsom SW. MRSA--past, present, future. J R Soc Med. 2004 Nov;97(11):509-10.

11698.    Rogues AM, Placet-Thomazeau B, Parneix P, Vincent I, Ploy MC, Marty N, Merillou B, Labadie JC, Gachie JP. Use of antibiotics in hospitals in south-western France. J Hosp Infect. 2004 Nov;58(3):187-92.

11699.    Rosato AE, Tallent SM, Edmond MB, Bearman GM. Susceptibility of coagulase-negative staphylococcal nosocomial bloodstream isolates to the chlorhexidine/silver sulfadiazine-impregnated central venous catheter. Am J Infect Control. 2004 Dec;32(8):486-8.

11700.   Schleder BJ, Pinzon L. You can make a difference in 5 minutes. Evid Based Nurs. 2004 Oct;7(4):102-3.

11701. Woodford EM, Wilson KA, Marriott JF. Professionals' awareness of operational antibiotic prescribing controls in UK NHS hospitals. J Hosp Infect. 2004 Nov;58(3):193-9.



July, 2005

Some Selected Abstracts:


Gaonkar TA, Geraldo I, Caraos L, Modak SM. An alcohol hand rub containing a synergistic combination of an emollient and preservatives: prolonged activity against transient pathogens. J Hosp Infect. 2005 Jan;59(1):12-8.

Department of Surgery, College of Physicians and Surgeons, Columbia University, 650 West, 168th Street, New York, NY 10032, USA.

A new alcohol-based hand antiseptic (Octoxy hand rub) containing a synergistic combination of an emollient (Octoxyglycerine) and preservatives was developed and evaluated for immediate and prolonged activity against transient bacteria. The in vitro and in vivo antimicrobial efficacy was compared with other alcohol hand rubs containing preservative/antimicrobial (Prevacare and Avagard). In vitro evaluation was carried out using a tube-dilution method and a pig-skin model. Rapid and prolonged efficacy in vivo was evaluated against Staphylococcus epidermidis on the hands of volunteers. Octoxy hand rub was 100% effective in rapidly killing pathogens including methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium in vitro. In volunteers, all three hand rubs gave a significant reduction in microbial count within 15s. Octoxy hand rub showed significantly higher efficacy against S. aureus and Escherichia coli than Avagard and Prevacare 15 min after application to the pig-skin model, and against S. epidermidis in both the pig-skin model and in volunteers. Use of Octoxy hand rub with broad-spectrum immediate and prolonged antimicrobial activity may be a very effective way of improving hand hygiene without exposing the hands to higher concentrations of antimicrobials.


Gupta E, Dar L, Narang P, Srivastava VK, Broor S. Serodiagnosis of dengue during an outbreak at a tertiary care hospital in Delhi. Indian J Med Res. 2005 Jan;121(1):36-8.

Department of Microbiology, All India Institute of Medical Sciences, New Delhi.

Dengue, an important human arboviral infection, is endemic in many parts of India. Outbreaks are now reported quite frequently from different parts of the country. We report here findings of serological investigation of serum samples received during a recent outbreak of dengue infection in Delhi from September to November 2003. Acute phase serum samples from suspected cases of dengue infection (including dengue fever, dengue haemorrhagic fever and dengue shock syndrome) of duration 5 days, were tested for dengue specific IgM antibodies by enzyme linked immuno sorbant assay (ELISA). Of the 874 serum samples tested, 456 (52.3% ) were positive for dengue specific IgM antibodies. The maximum number of positive cases was reported in October, peaking in second and third week. Patients in the age group of 21-30 yr accounted for 34.2 per cent of positive cases. This outbreak was less severe as compared to the previous 1996 outbreak and showed a shift towards an older age group.


Jumaa PA. Hand hygiene: simple and complex. Int J Infect Dis. 2005 Jan;9(1):3-14.

Department of Medical Microbiology, Faculty of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.

This review gives an overview of hand hygiene in healthcare and in the community, including some aspects which have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of microorganisms which cause infection both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors which determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognised that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs. New strategies to promote hand hygiene worldwide include the formation of public-private partnerships.


Silvestri L, Petros AJ, Sarginson RE, de la Cal MA, Murray AE, van Saene HK. Handwashing in the intensive care unit: a big measure with modest effects. J Hosp Infect. 2005 Mar;59(3):172-9.

Emergency Department and Unit of Anaesthesia and Intensive Care, Presidio Ospedaliero di Gorizia, Via Vittorio Veneto 171, 34170 Gorizia, Italy.

Handwashing is widely accepted as the cornerstone of infection control in the intensive care unit. Nosocomial infections are frequently viewed as an indicator of poor compliance of handwashing. The aim of this review is to evaluate the effectiveness of handwashing on infection rates in the intensive care unit, and to analyse the failure of handwashing. A literature search identified nine studies that evaluated the impact of handwashing or hand hygiene on infection rates, and demonstrated a low level of evidence for the efforts to control infection with handwashing. Poor compliance cannot be blamed as the only reason for the failure of handwashing to control infection. Handwashing on its own does not abolish, but only reduces transmission, as it is dependent on the bacterial load on the hand of healthcare workers. Finally, recent studies, using surveillance cultures of throat and rectum, have shown that, under ideal circumstances, handwashing can only influence 40% of all intensive care unit infections. A randomised clinical trial with the intensive care as randomisation unit is required to support handwashing as the cornerstone of infection control.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

  1. Arrich J, Sodeck GH, Sengolge G, Konnaris C, Mullner M, Laggner AN, Domanovits H. Clostridium difficile causing acute renal failure: case presentation and review. World J Gastroenterol. 2005 Feb 28;11(8):1245-7. Review.

  2. Buck C, Bertram N, Ackermann T, Sauerbruch T, Derendorf H, Paar WD.  Pharmacokinetics of piperacillin-tazobactam: intermittent dosing versus continuous infusion. Int J Antimicrob Agents. 2005 Jan;25(1):62-7.

  3. Erbay A, Bodur H, Akinci E, Colpan A. Evaluation of antibiotic use in intensive care units of a tertiary care hospital in Turkey. J Hosp Infect. 2005 Jan;59(1):53-61.

  4. Gupta E, Dar L, Narang P, Srivastava VK, Broor S. Serodiagnosis of dengue during an outbreak at a tertiary care hospital in Delhi. Indian J Med Res. 2005 Jan;121(1):36-8.

  5. Mukhopadhyay C, Bhargava A, Ayyagari A. Role of mechanical ventilation & development of multidrug resistant organisms in hospital acquired pneumonia. Indian J med Res 2003, 118(Dec), 229-35.

  6. Okimoto N, Yamato K, Honda Y, Kurihara T, Osaki K, Asaoka N, Fujita K, Ohba H. Clinical effect of intravenous ciprofloxacin on hospital-acquired pneumonia. J Infect Chemother. 2005 Feb;11(1):52-4.

  7. Stephan F, Ghiglione S, Decailliot F, Yakhou L, Duvaldestin P, Legrand P.  Effect of excessive environmental heat on core temperature in critically ill patients. An observational study during the 2003 European heat wave. Br J Anaesth. 2005 Jan;94(1):39-45.

  8. Verma R K, Bhattacharyya P, Sen M R, Geeta Kumari. Comparative efficacy of cefpirome & ceftazidime alone or in combination with isepamycin in empiric treatment of septicaemia in patients admitted to ICU. J Anaesthesiol clin Pharm 2004, 20(4), 369-77.


  1. Niederman MS. Reexamining quinolone use in the intensive care unit: use them right or lose the fight against resistant bacteria. Crit Care Med. 2005 Feb;33(2):443-4.


  1. An G. Mathematical modeling in medicine: a means, not an end. Crit Care Med. 2005 Jan;33(1):253-4.

  2. Baird C, Nunn T, Gregori A. Inadequate standards of hygiene in an operating theatre changing room. J Hosp Infect. 2005 Mar;59(3):268-9.

  3. Booth CM, Stewart TE. Severe acute respiratory syndrome and critical care medicine: the Toronto experience. Crit Care Med. 2005 Jan;33(1 Suppl):S53-60.

  4. Daschner F. MRSA--really time for a more pragmatic approach? J Hosp Infect. 2005 Mar;59(3):259;

  5. de La Cal MA, Cerda E, Garcia-Hierro P, van Saene HK, Gomez-Santos D, Negro E, Lorente JA. Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract: a randomized, placebo-controlled, double-blind trial. Ann Surg. 2005 Mar;241(3):424-30.

  6. Fuller J. Cover up and clean up to prevent deadly infections. Nursing. 2005 Jan;35(1):31.

  7. Gaonkar TA, Geraldo I, Caraos L, Modak SM. An alcohol hand rub containing a synergistic combination of an emollient and preservatives: prolonged activity against transient pathogens. J Hosp Infect. 2005 Jan;59(1):12-8.

  8. Hartley J. Do trust inspections truly reflect hospital hygiene? Nurs Times. 2005 Jan 4-10;101(1):12-3.

  9. Hawkey P, Perry C. MRSA: how we can clean up our act. Interview by Carolyn Scott. Prof Nurse. 2005 Jan;20(5):15-6.

  10. Hirsemann S, Sohr D, Gastmeier K, Gastmeier P. Risk factors for surgical site infections in a free-standing outpatient setting. Am J Infect Control. 2005 Feb;33(1):6-10.

  11. Huskins WC, Goldmann DA. Controlling meticillin-resistant Staphylococcus aureus, aka "Superbug". Lancet. 2005 Jan 22;365(9456):273-5.

  12. Jeanes A. Keeping hospitals clean: how nurses can reduce health-care-associated infection. Prof Nurse. 2005 Feb;20(6):35-7. Review.

  13. Jowitt D, Morris AJ. The questionable value of microbiological sampling when commissioning new operating theatres. J Hosp Infect. 2005 Mar;59(3):267-8.

  14. Jumaa PA. Hand hygiene: simple and complex. Int J Infect Dis. 2005 Jan;9(1):3-14. Review.

  15. Kniehl E, Becker A, Forster DH. Bed, bath and beyond: pitfalls in prompt eradication of methicillin-resistant Staphylococcus aureus carrier status in healthcare workers. J Hosp Infect. 2005 Mar;59(3):180-7.

  16. Leenders AC, Renders NR, Pelk M, Janssen M. Tonsillectomy for treatment of persistent methicillin-resistant Staphylococcus aureus throat carriage. J Hosp Infect. 2005 Mar;59(3):266-7.

  17. Leone M. Endpoint: quality of life. Crit Care Med. 2005 Jan;33(1):267-8;

  18. Messager S, Hammer KA, Carson CF, Riley TV. Effectiveness of hand-cleansing formulations containing tea tree oil assessed ex vivo on human skin and in vivo with volunteers using European standard EN 1499. J Hosp Infect. 2005 Mar;59(3):220-8.

  19. Nseir S, Di Pompeo C, Soubrier S, Delour P, Lenci H, Roussel-Delvallez M, Onimus T, Saulnier F, Mathieu D, Durocher A. First-generation fluoroquinolone use and subsequent emergence of multiple drug-resistant bacteria in the intensive care unit. Crit Care Med. 2005 Feb;33(2):283-9.

  20. O'Grady NP, Dezfulian C. The femoral site as first choice for central venous access? Not so fast. Crit Care Med. 2005 Jan;33(1):234-5.

  21. Rodriguez NA, Miracle DJ, Meier PP. Sharing the science on human milk feedings with mothers of very-low-birth-weight infants. J Obstet Gynecol Neonatal Nurs. 2005 Jan-Feb;34(1):109-19. Review.

  22. Silvestri L, Petros AJ, Sarginson RE, de la Cal MA, Murray AE, van Saene HK.  Handwashing in the intensive care unit: a big measure with modest effects. J Hosp Infect. 2005 Mar;59(3):172-9. Review.

  23.  Tvedt C, Bukholm G. Alcohol-based hand disinfection: a more robust hand-hygiene method in an intensive care unit. J Hosp Infect. 2005 Mar;59(3):229-34.

  24. Warren MM, Gibb AP, Walsh TS. Antibiotic prescription practice in an intensive are unit using twice-weekly collection of screening specimens: a prospective audit in a large UK teaching hospital. J Hosp Infect. 2005 Feb;59(2):90-5.



October, 2005

Some Selected Abstracts:


 Auriti C, Rava L, Di Ciommo V, Ronchetti MP, Orzalesi M Short antibiotic prophylaxis for bacterial infections in a neonatal intensive care unit: a randomized controlled trial. J Hosp Infect. 2005 Apr;59(4):292-8.

Division of Neonatal Intensive Care, Bambino Gesu Children's Hospital, Rome, Italy.

We compared the effectiveness of a single dose and a three-day course of antibiotic prophylaxis in preventing bacterial infections in high-risk neonates. The study was a prospective, randomized controlled trial conducted in a 20-bed tertiary referral neonatal intensive care unit (NICU). A series of 130 neonates admitted consecutively to the NICU, fulfilling risk factors for infection, were assigned at random to receive intravenous antibiotic prophylaxis with ampicillin and netilmicin either in two daily doses for 72 h (three-day-administration group, 67 infants) or in a single bolus injection on admission (bolus group, 63 infants). Hospital-acquired infection, the main outcome measure, was defined as infection that developed at least 48 h after admission, and vertical infection (maternally transmitted) was considered to be present when clinical symptoms and abnormal laboratory findings became evident within 48 h of birth. Infections were considered as suspected when clinical and laboratory findings of infection were present, without positive cultures, and as confirmed when positive cultures were also present. No significant differences were found between the two groups of neonates studied in mean birth weight, gestational age or postnatal age on admission. The incidence of vertical infection was similar in the two groups (16/67, 23.9% vs. 14/63, 22.2%). Of the 130 newborns studied, 29 (22.3%) acquired at least one nosocomial infection during their NICU stay; total hospital-acquired infections, calculated as the incidence density of infection (the number of infective episodes divided by the number of days in the NICU), were less frequent among newborns who received the three-day course than the bolus (relative risk 0.69). This difference, although not statistically significant, depended on the different incidence density of confirmed nosocomial infections rather than on suspected infections (relative risk 0.59; 95% confidence interval 0.32-1.09; P=0.1). There were no significant differences between the two groups in overall mortality. A single bolus administration on admission is therefore likely to be as effective as a three-day course of antibiotic prophylaxis in preventing bacterial infection in high-risk infants admitted to an NICU.


Preston RM. Aseptic technique: evidence-based approach for patient safety. Br J Nurs. 2005 May 26-Jun 8;14(10):540-2, 544-6.

University of Luton.

The fact that there is a relationship between the standards of aseptic technique performance and the rise in hospital infection rates has been suggested by the Department of Heath's (DoH's, 2004) 'Winning Ways' document. This literature review considers how the aseptic technique is performed in the UK, and examines the nature of ritualistic and evidence-based practice underpinning this skill-based procedure. The findings have identified an emerging glove culture and continuing poor hand-hygiene practices. The alternative 'clean technique' is also adopted widely in clinical practice which confuses the aseptic theory-practice gap. While it is hard to pinpoint an actual time or event that causes infection, it is unlikely nurses will ever become involved in litigation as a result of a poorly performed aseptic technique. However, the review concludes that nurses should not become too complacent. It briefly considers how performance of the aseptic technique can be improved, through creative educational strategy, applied risk assessment and clinical audits of nurses' practices.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

12839.  Akash Deep, Ghildly ALR, Kandian S, Shinkre N. Clinical and microbiological profile of nosocomial infections in the pediatric intensive care unit (PICU). Indian J Pediat 2004;41 (12):1238-46.

12840.  Auriti C, Rava L, Di Ciommo V, Ronchetti MP, Orzalesi M. Short antibiotic prophylaxis for bacterial infections in a neonatal intensive care unit: a randomized controlled trial. J Hosp Infect. 2005 Apr;59(4):292-8.

12841.  Burgess CM, Wolverson AS, Dale MT. Cervical epidural abscess: a rare complication of intravenous cannulation. Anaesthesia. 2005 Jun;60(6):605-8.

12842.  Farnell S. Are tympanic thermometers a source of cross-infection? Nurs Times. 2005 May 10-16;101(19):62-3.

12843.  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.

12844.  Shorr AF, Jackson WL, Kelly KM, Fu M, Kollef MH. Transfusion practice and blood stream infections in critically ill patients. Chest. 2005 May;127(5):1722-8.

12845.  Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PT. Neonatal sepsis: an international perspective. Arch Dis Child Fetal Neonatal Ed. 2005 May;90(3):F220-4. Review.


12846.  Banning M. Transmission and epidemiology of MRSA: current perspectives. Br J Nurs. 2005 May 26-Jun 8;14(10):548-51, 554. Review.

12847.  Brun-Buisson C, Girou E. Isolation of patients with MRSA infection. Lancet. 2005 Apr 9-15;365(9467):1303; author reply 1304-5.

12848.  Castillo JR, Gordon SM, Arroliga AC. Cross-transmission in the intensive care unit: one piece of the puzzle. Crit Care Med. 2005 May;33(5):1147-8.

12849.  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.

12850.  Grundmann H, Barwolff S, Tami A, Behnke M, Schwab F, Geffers C, Halle E, Gobel UB, Schiller R, Jonas D, Klare I, Weist K, Witte W, Beck-Beilecke K, Schumacher M, Ruden H, Gastmeier P. How many infections are caused by patient-to-patient transmission in intensive care units? Crit Care Med. 2005 May;33(5):946-51.

12851.  Kampf G, Ostermeyer C, Heeg P. Surgical hand disinfection with a propanol-based hand rub: equivalence of shorter application times. J Hosp Infect. 2005 Apr;59(4):304-10.

12852.  Khader A, Srivastava R, Parekh N. Intravascular catheter-associated infection. Anesth Analg. 2005 Apr;100(4):1216-7; author reply 1217.

12853.  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.

12854.  Lawson P. Zapping VAP with evidence-based practice. Nursing. 2005 May;35(5):66-7.

12855.  Merle V, Van Rossem V, Tavolacci MP, Czernichow P. Knowledge and opinions of surgical patients regarding nosocomial infections. J Hosp Infect. 2005 Jun;60(2):169-71.

12856.  O'Donnell MJ, Tuttlebee CM, Falkiner FR, Coleman DC. Bacterial contamination of dental chair units in a modern dental hospital caused by leakage from suction system hoses containing extensive biofilm. J Hosp Infect. 2005 Apr;59(4):348-60.

12857.  Preston RM. Aseptic technique: evidence-based approach for patient safety. Br J Nurs. 2005 May 26-Jun 8;14(10):540-2, 544-6. Review.

12858.  Quagliarello V. Infective endocarditis: global, regional, and future perspectives. JAMA. 2005 Jun 22;293(24):3061-2.

12859.  Seal DV. Multiple use of single use solutions: a dangerous practice. Br J Ophthalmol. 2005 Jun;89(6):783.

12860.  Stevens S. On being patient-focused. Health Serv J. 2005 Jun 2;115(5958):17.

12861.  Taneja N, Biswal M, Emmanuel R, Singh M, Sharma M. Hydrogen peroxide fogging in an overcrowded tertiary care referral centre: some practical queries. J Hosp Infect. 2005 May;60(1):85.

12862. Vonberg RP, Eckmanns T, Bruderek J, Ruden H, Gastmeier P. Use of terminal tap water filter systems for prevention of nosocomial legionellosis. J Hosp Infect. 2005 Jun;60(2):159-62.

12863.  Wilkes AR. Reducing the risk of prion transmission in anaesthesia. Anaesthesia. 2005 Jun;60(6):527-9.

12864. Winter G. A bug's life. Nurs Stand. 2005 Apr 27-May 3;19(33):16-8.


12865.  Eaton L. Hand washing is more important than cleaner wards in controlling MRSA. BMJ. 2005 Apr 23;330(7497):922.

12866.  Hunt DC, Mohammudally A, Stone SP, Dacre J. Hand-hygiene behaviour, attitudes and beliefs in first year clinical medical students. J Hosp Infect. 2005 Apr;59(4):371-3.

12867.  Wallis L. Taking the fight to the streets. Nurs Stand. 2005 Apr 13-19;19(31):69-70.

12868.  Winter G. Origin of the species. Nurs Stand. 2005 May 4-10;19(34):24-5.

12869.  Zerr DM. Alcohol hand rub: a simple solution in search of champions. Arch Pediatr Adolesc Med. 2005 May;159(5):502-3.