Bibliographic record
Abstract
Case Reports: This Report describes an outbreak of P. aeruginosa respiratory tract colonization and infection related to use of contaminated ultrasound transmission gel. Sixteen cardiovascular surgery patients were affected during the outbreak, seven with infection per NHSN criteria, and nine with colonization. Initial investigation suggested that TEE probes were the source of the outbreak. However, surveillance cultures of probes were negative, and there was no evidence that all case patients were linked to use of a particular probe. The ultrasound transmission gel, however, was contaminated with P. aeruginosa. One of two tested bottles of sealed, unopened product was contaminated with a Pseudomonas isolate >99% similar (using rep-PCR) to the outbreak strain, strongly suggesting contamination of the product prior to arrival at our hospital. At this point a health-care system-wide recall of all bottles of Other-Sonic ultrasound transmission gel was initiated, local and state health departments were contacted, and FDA notified.Contaminated ultrasound gels have been associated with outbreaks of infection in various settings and with various organisms. However, most of these outbreaks were attributed to inappropriate use of products. Although these gels contain parabens or methyl benzoate, which are thought to render them bacteriostatic, some gram-negative bacteria can degrade these components, and investigations of several reported outbreaks suggest extrinsic contamination of gels might easily occur.Numerous products are available for use as ultrasound transmission gels. No national guidelines exist in the United States recommending specific types of gel for specific procedures. In 2004, Health Canada issued recommendations for minimizing the health risks of using gels. These recommendations suggested use of single-use, sterile gels for invasive procedures that pass through a tissue, for all studies involving neonates, for all procedures involving sterile equipment or non-intact skin, and for procedures on intact mucous membranes. The results of this report further support such recommendations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.103 | 0.052 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".