Discontinuation Patterns and Cost Avoidance of a Pharmacist-Driven Methicillin-Resistant Staphylococcus aureus Nasal Polymerase Chain Reaction Testing Protocol for De-escalation of Empiric Vancomycin for Suspected Pneumonia.

A pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR)-based testing protocol with a 70% acceptance rate for vancomycin discontinuation within 24 hours of negative results significantly reduced unnecessary vancomycin use with an estimated cost avoidance of $40 per vancomycin course. We found high concordance (141 of 147, 96%) of culture-based versus PCR-based MRSA nasal screening.

Serotypes of Salmonella isolated from faeces of patients with acute diarrhoea in Gwangju Area, Korea, during 2000-2009.

The purpose of this study was to determine the changing pattern of Salmonella serotypes causing acute diarrhoea in humans in Gwangju area, Korea, during 2000-2009. A total of 596 Salmonella isolated from culture of 29,896 faecal samples of patients with acute diarrhoea were included in this study. Faecal samples were collected from local hospitals and clinics in Gwangju area during January 2000-December 2009. The mean annual frequency of isolates for the 10 years was 2.0% (range, 0.9-6.0). The isolates were serologically classified into 43 different serotypes. The 10 most common serotypes were Salmonella Enteritidis (47.9%), S. Typhimurium (20.4%), S. Braenderup (3.2%), S. Montevideo (2.9%), S. Paratyphi B (2.9%), S. London (2.3%), S. Bardo (1.7%), S. Virchow (1.7%), S. Infantis (1.5%) and S. Typhi (1.5%), accounting for 86% of all the isolates. Temporal variations were observed in the distribution of different Salmonella serotypes over the years, and only S. Enteritidis and S. Typhimurium were persistent throughout the study period. Although age specificity varied with serotypes, Salmonella was isolated most frequently from children below 5 years of age (179/596, 30.0%). A seasonal trend was apparent, and the highest rates were found in the summer months. This is the first report of the annual frequency of isolation of Salmonella serotypes, and seasonal and age-specific patterns of salmonellosis in humans in Gwangju area, Korea, over a decade-long period.

Sequence analysis of hemagglutinin and nucleoprotein genes of measles viruses isolated in Korea during the 2000 epidemic.

To characterize the genetic properties of currently circulating measles viruses in Korea, the complete nucleotide sequences of hemagglutinin (H) protein and nucleoprotein (N) genes of Korean viruses were analyzed. The entire genes of H and N were directly amplified by RT-PCR from each clinical specimen and sequenced. Sequence analyses of H and N genes indicated that all Korean viruses had a high degree of homology (>99.8%) when compared with each other. The Korean viruses differed from other wild-type viruses by as much as 6.8% in the H gene and 6.5% in the N gene at the nucleotide level. The deduced amino acid variability was up to 6.4% for the H protein and up to 6.5% for the N protein. Phylogenetic analyses of nucleotide sequences and deduced amino acid sequences of the H and N genes revealed that all Korean viruses were grouped into the clade H1.

Proposed test method for and evaluation of wheelchair seating system (WCSS) crashworthiness.

Safety of motor vehicle seats is of great importance in providing crash protection to the occupant. An increasing number of wheelchair users use their wheelchairs as motor vehicle seats when traveling. A voluntary standard requires that compliant wheelchairs be dynamically sled impact tested. However, testing to evaluate the crashworthiness of add-on wheelchair seating systems (WCSS) independent of their wheelchair frame is not addressed by this standard. To address this need, this study developed a method to evaluate the crash-worthiness of WCSS with independent frames. Federal Motor Vehicle Safety Standards (FMVSS) 207 test protocols, used to test the strength of motor vehicle seats, were modified and used to test the strength of three WCSS. Forward and rearward loads were applied at the WCSS center of gravity (CGSS), and a moment was applied at the uppermost point of the seat back. Each of the three tested WCSS met the strength requirements of FMVSS 207. Wheelchair seat-back stiffness was also investigated and compared to motor vehicle seat-back stiffness.

Development of frontal impact crashworthy wheelchair seating design criteria using computer simulation.

When designing wheelchairs for use as motor vehicle seats, special design criteria must be followed to assure the crash safety of the wheelchair user. Failure of seating system components under crash loading conditions could lead to serious injury or fatality. In this study, seat and seat-back loading in a frontal crash are explored using computer simulation techniques. A previously validated simulation model consisting of a powerbase wheelchair and a seated 50th-percentile male test dummy subjected to a 20g/30mph frontal impact were used for the study. Since such a wide range of seating systems are available, parametric analyses were conducted to evaluate the influence of surface stiffness and seat-back angle on wheelchair seat and back loading. Seat loading varied with stiffness, ranging from 819-3,273 lb., while seat-back loading was found to be between 1,427-2,691 lb., depending upon back stiffness and recline angle.