AJIC Volume 22, Number 2 Abstracts 107

OUTBREAK OF NOSOCOMIAL CANDlDA PARAPSILOSIS FUNGBMIA. P. Ivlaamm, RN, CIC; H.M. Frey, MD, St. John’s Riveni& Hospital, Yonkas, NY.

C&ida pmqdilosis (C.per) hm&mk ls rrpmted with Total Pamnteml Nutrition (TPN)use. Ombreaksmayberwgnkedby mcakxkgbbmdcultmwbutthe-

the24hmrkfwimmdwasne&ve. Fmihacultmuintbephwmacyof- conlponcnts, hlbing, pumps, and aimpkg tools - aim negative. A survey of manufactmasofcompo~~tsreveakdnoothmrewgnizabkoutbraks. Amnxpccdve case contml smdy of casea (n = 11) and controls (n = 14) examking: type of line; length of stay; nursing unit; mttibioti&tmuid therapy; cuncumnt invasive pmcedw; rind mdulykg diagnom, mvcakd no signiftcmtt diiamlw Lluwen csw and mnhvls.

The multi suggest C.psr was inoculated onto the tubing hub during priming, before seal a@catlm. Although all adhued TPN sdutions were sterile, the am- hubs apparently kd to the fungemipc. Following ktmventia, no fmtha case3havebccnrrportEd.

ANTIBIOTIC USAGE AND RESISTANCE TRENDS IN A -ATION HOSPITAL. P. Fkhaty, RN, CIC,* B. Fitzpurkk, RPb, J. Liljutmnd, MD, T. O’Brien, MD. Bmintme Ho&&al, Braintree, MA.

for the &ivemc drug le@ion list kclude ll&kiuk nrishnt stapbykmccus -, Gmm mgative amlnogle r-rhmme, and Clomidium difticik meritis, all of which UettXkdblthiSlWXt8pdVCstudy.

SIGLLBD NURSING FACILITY (SNF) TUBERClJLCAX9 (TB) EXPOSURE INVESTIGATION. J. Altmcd, RN,* M. Harris, RN, C. Ftmke4, RN, E. Ardll, MD, R. D’Amata, PhD, A. Wallman, MD, A.B. Gktt, MD. Catholk Medical Cater, NY.

Bl&gmue AMulpm,screakgka188bcdmbImsNFinabighTB prmknce mra rweakd 9 ‘.xmv&on~” (8 msidmts ad 1 therapy asiaant) with 5 in cloxpiuximt~mmemit.

hmtl@om Me(bodobly: Evaluaticm of the 9 ?owata’ reveakd 5 with CXR ev&kace of old TB, prior positive PPD or kamwly mad PPD. kavkg 4

EVALUATION OF A HEPATITIS B VACCINE PROGRAM IN CORRBCTIONAL PERSONNEL IN MASSACHUSETTS. C. Johnsa, RN, MPH: FMSA Correctional cam, Dcdham, MA.

purpare: A hcp&is B vaccitke pro~nm was kitkted for pmmmcl k August 1992 in 22 prisml faciliw. Nearly 1600 offi- and 200 medical staff were immunized. when it was discovered that some kstimtiau hd used a S/8 or 1 inch needle for ktmmuscukr injection, poshwxkation testing was offered to all staff who had completed the vaccination.

Rewltx Of the 225 individuals who had &body de&mix&mu, 167 had adequate levels of amibody, a 74% vaccine response late. Mean age of adequate rtqmndwwu39ycprr. Meanageofkadequatetap&mxwas42ycan. No differences were noted by needle kngth, 82% in 518” group, 74% k tJu 1 inch, and 74% in the 1.5 inchgroup (x2=.433. p=.51). Whenanalyzed by age, theymmgeatage group, 2029, had the highest vpccine response rate, 83%. Vaccine response decreased with incrcask8 age. *=4.67, p=.O3.

c- chu ohsem& vaccke I.cspms late of 74% may be ml underrsrimptcbeaunctimekterval~third&scwsluMvailabkMdgrcptcrthnn6 months for some individuak. There was no observed effect of needle kngth on vaccine response. only 1.5 inch needks are now used for intramwxkr injection. We did obseNe de!cmkg vaccine nsponse with blmaslng age; 33% of those over 40 had an inadequatevacclne rrspon=.

SELF-RBPOR’IEL) CHANGES IN INFIXlION CONTROL PRACTICE AS A RESULT OF MEDICAYDENTAL OFFICE CONSULTATIONS. J. Jefferson, RN, MPH, CIC,* R. Battim. L. Chkmllo, RN, MS, CIC. NurpuSuffolk Hcdpital Council and New York State Dqwtnmt of Health, Hauppruge and Albany, NY.

kf&latlmlw&uehllald¶om&h&eain‘pmctiawereimpkmated, nmstcommmlly immam p Hqditls B immunization. Where volunmry site ikib followd wrvcy, la& 0fcompbuawithPcccptcd~0f1CDusi~tul. Howver. -to-s smt aft& on-site evakaim of IC pmc4iced &ulted in self-repxt& &tgea (mmpk&, in prqmsr, or planned) for 87.5% of the mcommendations. Consistent with pdult lexningthcory,educptionnecdsmbc~tmttm*pmFr. uh0ttghthe.9ppb m this cndcsv~r WPS s0mewtw kformpl, me kformshon sttggwu lhst didactic pmdmtatima on IC may not msult in the desired pIact& change and that on-sib? emkatim, in comhiim with education, though kbw inkaive, may be mom likely toraultkrpositivewtcome. Afuturedimctimfor-hcMlld&l&dfam z bdlavioml otltmmu of various educatiomd skate&a for teaching infection

Bkdt.w Four additirmat tiD cunvmtas were idm&cd. How&. one bad CXRcvi&xeofolddlsaseandhvobadmythematithoutdurmion. Thusonlyl fmtlmtNcnmvmn~wfamd. Nofamilymembaorvisltorcacdannfmmd. No apby& ~~t~vatm¶ or CXFt abnmmalidm v/em identified; Rcsida,ts’ CXRs and revkwofrcc&lydeceuedpatieatadidtmtwealactivedkwc. spumm/gastlic muIyacd(aswaikbk)wemne@ive. Nocagkwkg pmbIctlu WUE idmtiticd. -WnplsadOtlINH.

C- No msldmu, eqloyecd or visitors have widmce of rctivc TB. Convcnionr mmak lmexpkined de@e exhwstive reviw. Annut screen& may identify previously false negative PPD’s aa new conveners. Car&I attention must be given m -te pat, reading and kvutigation of -nm* WV-.