1
40
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/s0196-0644(05)81032-7" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/s0196-0644(05)81032-7</a>
Pages
842–848
Issue
7
Volume
21
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Difficulty in predicting bacteremia in elderly emergency patients.
Publisher
An entity responsible for making the resource available
Annals of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1992
1992-07
Subject
The topic of the resource
80 and over; Aged; Bacteremia/*diagnosis/microbiology; Bacteriological Techniques; Blood Chemical Analysis; Cognition Disorders/diagnosis; Confidence Intervals; Escherichia coli/isolation & purification; Female; Hospitals; Humans; Male; Odds Ratio; Predictive Value of Tests; Regression Analysis; Retrospective Studies; Sensitivity and Specificity; Teaching; Urinary Tract Infections/microbiology
Creator
An entity primarily responsible for making the resource
Fontanarosa P B; Kaeberlein F J; Gerson L W; Thomson R B
Description
An account of the resource
STUDY OBJECTIVES: To characterize the clinical presentation and identify factors predictive of bacteremia in elderly patients. DESIGN: Retrospective review of emergency department charts, hospital records, and microbiology reports. SETTING: Community teaching hospital with annual ED census of 65,000 adults. PARTICIPANTS: Seven hundred fifty elderly patients (aged 65 to 99 years) who were evaluated by the emergency physician, had blood cultures obtained in the ED, and were hospitalized with a suspected infectious process during a 12-month period. MEASUREMENTS: Records were analyzed for demographic information, underlying diseases, clinical presentation, laboratory findings, sources of infection, and causative organisms. Using contingency tables, 79 patients with positive blood cultures were compared with a random sample of 136 patients with sterile blood cultures to identify clinical variables significantly (P less than .05) associated with bacteremia. Logistic regression analysis was performed with significant factors to develop a model to predict bacteremia. Sensitivity, specificity, and predictive values were calculated for the model. MAIN RESULTS: The prevalence of bacteremia was 10.6%. Escherichia coli was the most commonly isolated pathogen (29% of cases), and the urinary tract was the most common source of infection (44.3% of cases). Logistic regression analysis showed that altered mental status (odds ratio, 2.88; 95% confidence interval [Cl], 1.52 to 5.50), vomiting (odds ratio, 2.63; 95% Cl, 1.16 to 6.15), and WBC band forms of more than 6% (0.06) (odds ratio, 3.50; 95% Cl, 1.58 to 5.27) were independent predictors of bacteremia. The presence of at least one of these three factors had a sensitivity of 0.85 (95% Cl, 0.75 to 0.92) and a specificity of 0.46 (95% Cl, 0.38 to 0.55) for predicting bacteremia in the study group. The positive predictive value was 0.16 (95% Cl, 0.12 to 0.19) and the negative predictive value was 0.96 (95% Cl, 0.94 to 0.98) for the ED patient group that met inclusion criteria. CONCLUSION: Elderly patients fail to manifest identifiable clinical features indicative of bloodstream infection. The sensitivity and specificity of the best statistical model for identifying bacteremic elderly patients suggest that clinical indicators alone are unreliable predictors of bacteremia in the geriatric ED population studied.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0196-0644(05)81032-7" target="_blank" rel="noreferrer noopener">10.1016/s0196-0644(05)81032-7</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
1992
80 and over
Aged
Annals of emergency medicine
Bacteremia/*diagnosis/microbiology
Bacteriological Techniques
Blood Chemical Analysis
Cognition Disorders/diagnosis
Confidence Intervals
Department of Emergency Medicine
Escherichia coli/isolation & purification
Female
Fontanarosa P B
Gerson L W
Hospitals
Humans
Kaeberlein F J
Male
NEOMED College of Medicine
Odds Ratio
Predictive Value of Tests
Regression Analysis
Retrospective Studies
Sensitivity and Specificity
Teaching
Thomson R B
Urinary Tract Infections/microbiology
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.2146/ajhp130118" target="_blank" rel="noreferrer noopener">http://doi.org/10.2146/ajhp130118</a>
Pages
1908–1912
Issue
21
Volume
70
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Evaluation and use of a rapid Staphylococcus aureus assay by an antimicrobial stewardship program.
Publisher
An entity responsible for making the resource available
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
2013-11
Subject
The topic of the resource
Humans; Time Factors; Microbial Sensitivity Tests; Sensitivity and Specificity; Prospective Studies; Hospitals; Anti-Bacterial Agents/administration & dosage/*pharmacology; Bacteriological Techniques; False Negative Reactions; Methicillin-Resistant Staphylococcus aureus/*isolation & purification; Staphylococcal Infections/*diagnosis/microbiology; Staphylococcus aureus/*isolation & purification; Cell Culture Techniques; Chromatography; Human; Funding Source; Community; Affinity; Observational Methods; Biological Assay – Methods; Methicillin-Resistant Staphylococcus Aureus – Analysis
Creator
An entity primarily responsible for making the resource
Trienski Tamara L; Barrett Heather L; Pasquale Timothy R; DiPersio Joseph R; File Thomas M Jr
Description
An account of the resource
PURPOSE: The performance of a rapid test for methicillin-resistant Staphylococcus aureus (MRSA) in a large community hospital was investigated. METHODS: A prospective observational study was conducted to evaluate an immunochromatographic assay (Alere PBP2a Culture Colony Test, Alere Scarborough, Inc.) for rapid differentiation of MRSA and methicillin-susceptible S. aureus (MSSA) strains using isolates cultured overnight on common laboratory media. S. aureus isolates cultured for 12-24 hours were tested with the assay, which detects penicillin-binding protein 2a (PBP2a) and provides results in six minutes. The test results were compared with data from standard overnight antimicrobial susceptibility testing to determine the assay's sensitivity and specificity. Changes in therapy associated with use of the rapid assay were evaluated. RESULTS: Over an 11-month period, 661 inpatient isolates from mostly nonhematologic sites were tested. There were six false-negative results, indicating assay sensitivity of 98.4%, with no false positives (specificity of 100%). Eight invalid test results were documented. During designated evaluation periods, a total of 169 patient cases involving PBP2a testing were reviewed by the hospital's antimicrobial stewardship pharmacist. In 63 of those cases (37%), changes in therapy were implemented on the day of test result posting. Interventions often involved switching patients from inappropriate to appropriate MRSA therapy or optimizing MRSA- or MSSA-targeted therapy. CONCLUSION: An assay for quickly differentiating between MRSA and MSSA was highly sensitive, highly specific, and inexpensive in actual hospital use and led to rapid prescription of appropriate antistaphylococcal therapy 24-48 hours after culture specimens were collected.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.2146/ajhp130118" target="_blank" rel="noreferrer noopener">10.2146/ajhp130118</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2013
Affinity
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
Anti-Bacterial Agents/administration & dosage/*pharmacology
Bacteriological Techniques
Barrett Heather L
Biological Assay – Methods
Cell Culture Techniques
Chromatography
Community
Department of Internal Medicine
DiPersio Joseph R
False Negative Reactions
File Thomas M Jr
Funding Source
Hospitals
Human
Humans
Methicillin-Resistant Staphylococcus Aureus – Analysis
Methicillin-Resistant Staphylococcus aureus/*isolation & purification
Microbial Sensitivity Tests
NEOMED College of Medicine
Observational Methods
Pasquale Timothy R
Prospective Studies
Sensitivity and Specificity
Staphylococcal Infections/*diagnosis/microbiology
Staphylococcus aureus/*isolation & purification
Time Factors
Trienski Tamara L