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DSHS Authors: 2018 Research Articles by DSHS Staff

The following list includes peer-reviewed research articles that have been written by staff of the Texas Department of State Health Services in the last five years. For more information about these articles or for a full-text copy, please contact the Medical and Research Library by e-mail at library@dshs.texas.gov by calling (512) 776-7559.

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mrl-diamond2018 Articles (in date order with most recent first)

Forrester MB. Pediatric exposures to Bombina toads reported to poison centers. Pediatr Emerg Care 2018;34:25-26.
OBJECTIVES: Fire-bellied toads (genus Bombina) secrete toxins from their skin that may cause problems to humans, particularly if they get in the eye. This study aimed to describe pediatric exposures to fire-bellied toads reported to a large poison center system. METHODS: Cases were fire-bellied toad exposures among patients aged 13 years or younger reported to Texas poison centers during 2000-2014. The distribution by various demographic and clinical factors was determined. RESULTS: Of 20 total exposures, the mean patient age was 5.8 years (range, 2-13 years); 70% of the patients were boys. The exposure route was ocular (70%), dermal (55%), and ingestion (20%). Eighty-five percent of the exposures occurred at the patient's own residence. Sixty percent of the patients were managed onsite, and 40% were already at or en route to a health care facility. The medical outcome was as follows: minor effects (45%), moderate effects (5%), and not followed but judged to have minimal clinical effects (50%). The most common reported symptoms were ocular irritation/pain (65%), dermal irritation/pain (30%), and red eye (20%). Decontamination by dilution/irrigation/wash was reported in 95% of the patients. CONCLUSIONS: Few pediatric exposures to fire-bellied toads were reported. Those that were reported were most likely to involve ocular followed by dermal routes. The exposures tended not to be serious and could be managed outside of a health care facility.

Glowicz J, Crist M, Gould C, Moulton-Meissner H, Noble-Wang J, de Man TJB, Perry KA, Miller Z, Yang WC, Langille S, Ross J, Garcia B, et al. A multistate investigation of health care-associated Burkholderia cepacia complex infections related to liquid docusate sodium contamination, January-October 2016. Am J Infect Control. 2018 Jan 9. pii: S0196-6553(17)31287-7. doi: 10.1016/j.ajic.2017.11.018. [Epub ahead of print]
Background: Outbreaks of health care-associated infections (HAIs) caused by Burkholderia cepacia complex (Bcc) have been associated with medical devices and water-based products. Water is the most common raw ingredient in nonsterile liquid drugs, and the significance of organisms recovered from microbiologic testing during manufacturing is assessed using a risk-based approach. This incident demonstrates that lapses in manufacturing practices and quality control of nonsterile liquid drugs can have serious unintended consequences. Methods: An epidemiologic and laboratory investigation of clusters of Bcc HAIs that occurred among critically ill, hospitalized, adult and pediatric patients was performed between January 1, 2016, and October 31, 2016. Results: One hundred and eight case patients with Bcc infections at a variety of body sites were identified in 12 states. Two distinct strains of Bcc were obtained from patient clinical cultures. These strains were found to be indistinguishable or closely related to 2 strains of Bcc obtained from cultures of water used in the production of liquid docusate, and product that had been released to the market by manufacturer X. Conclusions: This investigation highlights the ability of bacteria present in nonsterile, liquid drugs to cause infections or colonization among susceptible patients. Prompt reporting and thorough investigation of potentially related infections may assist public health officials in identifying and removing contaminated products from the market when lapses in manufacturing occur.

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Last updated January 23, 2018