Diphtheria among alcoholic urban adults. A decade of experience in Seattle.
Three outbreaks of Corynebacterium diphtheriae infection occurred in Seattle's Skid Road from 1972 through 1982. The first involved a single toxigenic, intermedius biotype clone, whereas the second and third outbreaks involved nontoxigenic mitis and gravis strains. Of 1100 total infections, 947 (86%...
| Publicado en: | Annals of Internal Medicine Vol. 111; no. 1; pp. 71 - 83 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
American College of Physicians
7/1/89
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137745415&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137745415 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00034819 AIM jtl: Annals of Internal Medicine issn: 00034819 maglogo: N pubinfo: dt: 7/1/89 vid: 111 iid: 1 pid: 1652 pub: American College of Physicians place: Philadelphia, Pennsylvania artinfo: ui: 137745415 137745415 NLM2472081 137745415 10.7326/0003-4819-111-1-71 NLM2472081 137745415 ppf: 71 ppct: 12 formats: tig: atl: Diphtheria among alcoholic urban adults. A decade of experience in Seattle. aug: au: Harnisch, J P Tronca, E Nolan, C M Turck, M Holmes, K K affil: Harborview Medical Center, Seattle, Washington sug: subj: Urban Health Health Diphtheria Epidemiology Alcoholism Complications Diphtheria Antitoxin Therapeutic Use Skin Diseases, Infectious Epidemiology Erythromycin Therapeutic Use Human Washington Skin Diseases, Infectious Therapy Disease Outbreaks Homeless Persons Carrier State Epidemiology Antibiotics Therapeutic Use Middle Age Diphtheria Therapy Child Adult Male Hospitalization Drug Resistance, Microbial Respiratory Tract Infections Epidemiology Eye Diseases Epidemiology Female Validation Studies Comparative Studies Evaluation Research Multicenter Studies Middle Aged: 45-64 years Child: 6-12 years Adult: 19-44 years Male Female ab: Three outbreaks of Corynebacterium diphtheriae infection occurred in Seattle's Skid Road from 1972 through 1982. The first involved a single toxigenic, intermedius biotype clone, whereas the second and third outbreaks involved nontoxigenic mitis and gravis strains. Of 1100 total infections, 947 (86%) were cutaneous. The incidence was highest in winter and spring. In Skid Road, the estimated attack rate during 17 months in 1974 to 1975 was 5% for whites and 27% for native Americans. Streptococcus pyogenes was isolated from 73% of diphtheritic and 41% of nondiphtheritic skin lesions (P less than 0.001). Skin infection and environmental contamination by C. diphtheriae were correlated. Complications occurred in 21% of symptomatic nasopharyngeal and 3% of cutaneous toxigenic intermedius infections (P less than 0.001), and were significantly correlated with ages 60 years or more. Preferential use of erythromycin for diphtheria and pyodermas preceded plasmid-mediated resistance to erythromycin in C. diphtheriae. Diphtheria outbreaks in urban alcoholic persons are associated with poor hygiene, crowding, season, contaminated fomites, underlying skin disease, hyperendemic streptococcal pyoderma, and introduction of new strains from exogenous reservoirs. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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