Resistant nosocomial enterococcal infections

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27106/1/0000098.pd

Association of Parenteral Nutrition Catheter Sepsis with Urinary Tract Infections

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141954/1/jpen0639.pd

Major trends in the microbial etiology of nosocomial infection

To determine trends in the microbial etiology of nosocomial infections in the 1980s, surveillance data on the microbiology of documented nosocomial infection reported to the National Nosocomial Infections Surveillance System and from the University of Michigan Hospital were analyzed. Antimicrobial susceptibility data on selected pathogens from both sources were also reviewed. Overall, Escherichia coli decreased from 23% of infections in 1980 to 16% in 1986-1989, Klebsiella pneumoniae dropped from 7% to 5%, whereas coagulase negative staphylococci increased from 4% to 9% and Candida albicans increased from 2% to 5%. Staphylococcus aureus, Pseudomonas aeruginosa, Enterobacter species and enterococci had minor increases, but antimicrobial resistant strains for these pathogens as well as coagulase-negative staphylococci were seen more frequently. In contrast to the 1970s, major shifts in the etiology of nosocomial infection have occurred in the decade of the 1980s. Taken as a whole, the shifts are away from more easily treated pathogens toward more resistant pathogens with fewer options for therapy. These shifts underscore the continued need for prevention and control to accompany new developments in therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29131/1/0000170.pd

Effect of controlled hemorrhage on tissue and serum cefazolin clearance

Effects of blood loss on tissue and serum antibiotic levels were investigated in 30 New Zealand white rabbits. Studies were conducted over a 3.5-hr period after intravenous administration of cefazolin, 30 mg/kg, in control animals (Groups I and IV, n = 5 each) and animals having 50% (Groups II and V, n = 5 each) or 100% (Groups III and VI, n = 5 each) of their blood volume removed and replaced with either Ringer's solution (Groups I, II, and III) or rabbit whole blood (Groups IV, V, and VI) sufficient to maintain central venous pressures at baseline levels. Periodic samples of retroperitoneal fat, iliac artery, and serum were assayed for cefazolin concentration by disc diffusion. Decreased tissue antibiotic levels were observed in animals undergoing 100% blood replacement (Groups III and VI) compared to controls (Groups I and IV) in both fat (P [les] 0.01) and artery (P [les] 0.01) at 90 min. Decreased antibiotic serum half-life accompanying hemorrhage existed when comparing Group II to I (P [les] 0.05), Group III to I (P [les] 0.01), and Group IV to V (P [les] 0.01). The increased antibiotic clearance related to blood loss in this study justifies reassessment of intraoperative dosing intervals. More frequent dosing may be required to maintain stable tissue and serum antibiotic levels during substantial operative hemorrhage.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29146/1/0000188.pd

Endoscopic Detection and Therapy of Colonic Actinomycosis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74352/1/j.1572-0241.1992.tb02942.x.pd