WorldWideScience

Sample records for bloodstream forms

  1. Trypanin, a component of the flagellar Dynein regulatory complex, is essential in bloodstream form African trypanosomes.

    Directory of Open Access Journals (Sweden)

    Katherine S Ralston

    2006-09-01

    Full Text Available The Trypanosoma brucei flagellum is a multifunctional organelle with critical roles in motility, cellular morphogenesis, and cell division. Although motility is thought to be important throughout the trypanosome lifecycle, most studies of flagellum structure and function have been restricted to the procyclic lifecycle stage, and our knowledge of the bloodstream form flagellum is limited. We have previously shown that trypanin functions as part of a flagellar dynein regulatory system that transmits regulatory signals from the central pair apparatus and radial spokes to axonemal dyneins. Here we investigate the requirement for this dynein regulatory system in bloodstream form trypanosomes. We demonstrate that trypanin is localized to the flagellum of bloodstream form trypanosomes, in a pattern identical to that seen in procyclic cells. Surprisingly, trypanin RNA interference is lethal in the bloodstream form. These knockdown mutants fail to initiate cytokinesis, but undergo multiple rounds of organelle replication, accumulating multiple flagella, nuclei, kinetoplasts, mitochondria, and flagellum attachment zone structures. These findings suggest that normal flagellar beat is essential in bloodstream form trypanosomes and underscore the emerging concept that there is a dichotomy between trypanosome lifecycle stages with respect to factors that contribute to cell division and cell morphogenesis. This is the first time that a defined dynein regulatory complex has been shown to be essential in any organism and implicates the dynein regulatory complex and other enzymatic regulators of flagellar motility as candidate drug targets for the treatment of African sleeping sickness.

  2. Channel-forming activities in the glycosomal fraction from the bloodstream form of Trypanosoma brucei.

    Directory of Open Access Journals (Sweden)

    Melisa Gualdron-López

    Full Text Available BACKGROUND: Glycosomes are a specialized form of peroxisomes (microbodies present in unicellular eukaryotes that belong to the Kinetoplastea order, such as Trypanosoma and Leishmania species, parasitic protists causing severe diseases of livestock and humans in subtropical and tropical countries. The organelles harbour most enzymes of the glycolytic pathway that is responsible for substrate-level ATP production in the cell. Glycolysis is essential for bloodstream-form Trypanosoma brucei and enzymes comprising this pathway have been validated as drug targets. Glycosomes are surrounded by a single membrane. How glycolytic metabolites are transported across the glycosomal membrane is unclear. METHODS/PRINCIPAL FINDINGS: We hypothesized that glycosomal membrane, similarly to membranes of yeast and mammalian peroxisomes, contains channel-forming proteins involved in the selective transfer of metabolites. To verify this prediction, we isolated a glycosomal fraction from bloodstream-form T. brucei and reconstituted solubilized membrane proteins into planar lipid bilayers. The electrophysiological characteristics of the channels were studied using multiple channel recording and single channel analysis. Three main channel-forming activities were detected with current amplitudes 70-80 pA, 20-25 pA, and 8-11 pA, respectively (holding potential +10 mV and 3.0 M KCl as an electrolyte. All channels were in fully open state in a range of voltages ±150 mV and showed no sub-conductance transitions. The channel with current amplitude 20-25 pA is anion-selective (P(K+/P(Cl-∼0.31, while the other two types of channels are slightly selective for cations (P(K+/P(Cl- ratios ∼1.15 and ∼1.27 for the high- and low-conductance channels, respectively. The anion-selective channel showed an intrinsic current rectification that may suggest a functional asymmetry of the channel's pore. CONCLUSIONS/SIGNIFICANCE: These results indicate that the membrane of glycosomes

  3. KREX2 is not essential for either procyclic or bloodstream form Trypanosoma brucei.

    Directory of Open Access Journals (Sweden)

    Jason Carnes

    Full Text Available BACKGROUND: Most mitochondrial mRNAs in Trypanosoma brucei require RNA editing for maturation and translation. The edited RNAs primarily encode proteins of the oxidative phosphorylation system. These parasites undergo extensive changes in energy metabolism between the insect and bloodstream stages which are mirrored by alterations in RNA editing. Two U-specific exonucleases, KREX1 and KREX2, are both present in protein complexes (editosomes that catalyze RNA editing but the relative roles of each protein are not known. METHODOLOGY/PRINCIPAL FINDINGS: The requirement for KREX2 for RNA editing in vivo was assessed in both procyclic (insect and bloodstream form parasites by methods that use homologous recombination for gene elimination. These studies resulted in null mutant cells in which both alleles were eliminated. The viability of these cells demonstrates that KREX2 is not essential in either life cycle stage, despite certain defects in RNA editing in vivo. Furthermore, editosomes isolated from KREX2 null cells require KREX1 for in vitro U-specific exonuclease activity. CONCLUSIONS: KREX2 is a U-specific exonuclease that is dispensable for RNA editing in vivo in T. brucei BFs and PFs. This result suggests that the U deletion activity, which is required for RNA editing, is primarily mediated in vivo by KREX1 which is normally found associated with only one type of editosome. The retention of the KREX2 gene implies a non-essential role or a role that is essential in other life cycle stages or conditions.

  4. JBP2, a SWI2/SNF2-like protein, regulates de novo telomeric DNA glycosylation in bloodstream form Trypanosoma brucei.

    Science.gov (United States)

    Kieft, Rudo; Brand, Verena; Ekanayake, Dilrukshi K; Sweeney, Kate; DiPaolo, Courtney; Reznikoff, William S; Sabatini, Robert

    2007-11-01

    Synthesis of the modified thymine base, beta-d-glucosyl-hydroxymethyluracil or J, within telomeric DNA of Trypanosoma brucei correlates with the bloodstream form specific epigenetic silencing of telomeric variant surface glycoprotein genes involved in antigenic variation. In order to analyze the function of base J in the regulation of antigenic variation, we are characterizing the regulatory mechanism of J biosynthesis. We have recently proposed a model in which chromatin remodeling by a SWI2/SNF2-like protein (JBP2) regulates the developmental and de novo site-specific localization of J synthesis within bloodstream form trypanosome DNA. Consistent with this model, we now show that JBP2 (-/-) bloodstream form trypanosomes contain five-fold less base J and are unable to stimulate de novo J synthesis in newly generated telomeric arrays. PMID:17706299

  5. Probing the metabolic network in bloodstream-form Trypanosoma brucei using untargeted metabolomics with stable isotope labelled glucose.

    Directory of Open Access Journals (Sweden)

    Darren J Creek

    2015-03-01

    Full Text Available Metabolomics coupled with heavy-atom isotope-labelled glucose has been used to probe the metabolic pathways active in cultured bloodstream form trypomastigotes of Trypanosoma brucei, a parasite responsible for human African trypanosomiasis. Glucose enters many branches of metabolism beyond glycolysis, which has been widely held to be the sole route of glucose metabolism. Whilst pyruvate is the major end-product of glucose catabolism, its transamination product, alanine, is also produced in significant quantities. The oxidative branch of the pentose phosphate pathway is operative, although the non-oxidative branch is not. Ribose 5-phosphate generated through this pathway distributes widely into nucleotide synthesis and other branches of metabolism. Acetate, derived from glucose, is found associated with a range of acetylated amino acids and, to a lesser extent, fatty acids; while labelled glycerol is found in many glycerophospholipids. Glucose also enters inositol and several sugar nucleotides that serve as precursors to macromolecule biosynthesis. Although a Krebs cycle is not operative, malate, fumarate and succinate, primarily labelled in three carbons, were present, indicating an origin from phosphoenolpyruvate via oxaloacetate. Interestingly, the enzyme responsible for conversion of phosphoenolpyruvate to oxaloacetate, phosphoenolpyruvate carboxykinase, was shown to be essential to the bloodstream form trypanosomes, as demonstrated by the lethal phenotype induced by RNAi-mediated downregulation of its expression. In addition, glucose derivatives enter pyrimidine biosynthesis via oxaloacetate as a precursor to aspartate and orotate.

  6. Surface electrical charge of bloodstream trypomastigotes of Trypanosoma cruzi strains.

    Science.gov (United States)

    de Sousa, M A

    1983-01-01

    Bloodstream trypomastigotes of some Trypanosoma cruzi strains were processed through DEAE-cellulose columns under standardized conditions. The results obtained suggest mainly that these strains present different surface charges, that there are subpopulations of bloodstream trypomastigotes as regards electrical charges and that the broad forms are less negative than the slender ones. PMID:6443631

  7. Surface electrical charge of bloodstream trypomastigotes of Trypanosoma cruzi strains

    OpenAIRE

    Maria Auxiliadora de Sousa

    1983-01-01

    Bloodstream trypomastigotes of some Trypanosoma cruzi strains were processed through DEAE-cellulose columns under standardized conditions. The results obtained suggest mainly that these strains present different surface charges, that there are subpopulations of bloodstream trypomastigotes as regards electrical charges and that the broad forms are less negative than the slender ones.Tripomastigotas sanguíneos de algumas cepas de Trypanosoma cruzi foram processadas em colunas de DEAE-celulose s...

  8. Replacing paper data collection forms with electronic data entry in the field: findings from a study of community-acquired bloodstream infections in Pemba, Zanzibar

    Directory of Open Access Journals (Sweden)

    Thriemer Kamala

    2012-02-01

    Full Text Available Abstract Background Entering data on case report forms and subsequently digitizing them in electronic media is the traditional way to maintain a record keeping system in field studies. Direct data entry using an electronic device avoids this two-step process. It is gaining in popularity and has replaced the paper-based data entry system in many studies. We report our experiences with paper- and PDA-based data collection during a fever surveillance study in Pemba Island, Zanzibar, Tanzania. Methods Data were collected on a 14-page case report paper form in the first period of the study. The case report paper forms were then replaced with handheld computers (personal digital assistants or PDAs. The PDAs were used for screening and clinical data collection, including a rapid assessment of patient eligibility, real time errors, and inconsistency checking. Results A comparison of paper-based data collection with PDA data collection showed that direct data entry via PDA was faster and 25% cheaper. Data was more accurate (7% versus 1% erroneous data and omission did not occur with electronic data collection. Delayed data turnaround times and late error detections in the paper-based system which made error corrections difficult were avoided using electronic data collection. Conclusions Electronic data collection offers direct data entry at the initial point of contact. It has numerous advantages and has the potential to replace paper-based data collection in the field. The availability of information and communication technologies for direct data transfer has the potential to improve the conduct of public health research in resource-poor settings.

  9. Clonal relationships among bloodstream isolates of Escherichia coli.

    OpenAIRE

    Maslow, J.N.; Whittam, T S; Gilks, C F; Wilson, R A; Mulligan, M E; Adams, K S; Arbeit, R D

    1995-01-01

    The clonal relationships among 187 bloodstream isolates of Escherichia coli from 179 patients at Boston, Mass., Long Beach, Calif., and Nairobi, Kenya, were determined by multilocus enzyme electrophoresis (MLEE), analysis of polymorphisms associated with the ribosomal operon (ribotyping), and serotyping. MLEE based on 20 enzymes resolved 101 electrophoretic types (ETs), forming five clusters; ribotyping resolved 56 distinct patterns concordant with the analysis by MLEE. The isolates at each s...

  10. Surface electrical charge of bloodstream trypomastigotes of Trypanosoma cruzi strains

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora de Sousa

    1983-12-01

    Full Text Available Bloodstream trypomastigotes of some Trypanosoma cruzi strains were processed through DEAE-cellulose columns under standardized conditions. The results obtained suggest mainly that these strains present different surface charges, that there are subpopulations of bloodstream trypomastigotes as regards electrical charges and that the broad forms are less negative than the slender ones.Tripomastigotas sanguíneos de algumas cepas de Trypanosoma cruzi foram processadas em colunas de DEAE-celulose sob condições padronizadas. Os resultados obtidos sugerem principalmente que estas cepas possuem cargas superficiais diferentes, que em relação a este aspecto existem subpopulações de tripomastigotas e que as formas largas são menos negativas do que as finas.

  11. Biofilm-based central line-associated bloodstream infections.

    Science.gov (United States)

    Yousif, Ammar; Jamal, Mohamed A; Raad, Issam

    2015-01-01

    Different types of central venous catheters (CVCs) have been used in clinical practice to improve the quality of life of chronically and critically ill patients. Unfortunately, indwelling devices are usually associated with microbial biofilms and eventually lead to catheter-related bloodstream infections (CLABSIs).An estimated 250,000-400,000 CLABSIs occur every year in the United States, at a rate of 1.5 per 1,000 CVC days and a mortality rate of 12-25 %. The annual cost of caring for patients with CLABSIs ranges from 296 million to 2.3 billion dollars.Biofilm formation occurs on biotic and abiotic surfaces in the clinical setting. Extensive studies have been conducted to understand biofilm formation, including different biofilm developmental stages, biofilm matrix compositions, quorum-sensing regulated biofilm formation, biofilm dispersal (and its clinical implications), and multi-species biofilms that are relevant to polymicrobial infections.When microbes form a matured biofilm within human hosts through medical devices such as CVCs, the infection becomes resistant to antibiotic treatment and can develop into a chronic condition. For that reason, many techniques have been used to prevent the formation of biofilm by targeting different stages of biofilm maturation. Other methods have been used to diagnose and treat established cases of CLABSI.Catheter removal is the conventional management of catheter associated bacteremia; however, the procedure itself carries a relatively high risk of mechanical complications. Salvaging the catheter can help to minimize these complications.In this article, we provide an overview of microbial biofilm formation; describe the involvement of various genetic determinants, adhesion proteins, organelles, mechanism(s) of biofilm formation, polymicrobial infections, and biofilm-associated infections on indwelling intravascular catheters; and describe the diagnosis, management, and prevention of catheter-related bloodstream infections

  12. Bloodstream infections in patients with solid tumors.

    Science.gov (United States)

    Gudiol, Carlota; Aguado, José María; Carratalà, Jordi

    2016-04-01

    Little information is currently available regarding bloodstream infection (BSI) in patients with solid tumors who, for a variety of reasons, are particularly predisposed to develop this condition. In this review we focus on the incidence, epidemiology, clinical features, etiology, antimicrobial resistance, and outcomes of BSI of adult cancer patients with solid tumors. Most episodes of BSI occur in non-neutropenic patients, in whom the site of primary or metastatic tumor often serves as the portal of entry. The urinary tract and the abdomen are the most frequent sources of infection, and cholangitis is the most common recurrent source of BSI. Gram-negative bacilli are becoming the leading cause of BSI in patients with solid tumors, and the rate of multidrug resistance is increasingly being recognized. The case-fatality rate in patients with solid tumors and BSI is high, especially among those with comorbidities, advanced neoplasms, corticosteroid therapy, and shock at presentation.

  13. Bloodstream Infections with Mycobacterium tuberculosis among HIV patients

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    This podcast looks at bloodstream infections with Mycobacterium tuberculosis and other pathogens among outpatients infected with HIV in Southeast Asia. CDC health scientist Kimberly McCarthy discusses the study and why bloodstream infections occur in HIV-infected populations.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/23/2010.

  14. When Prostate Cancer Circulates in the Bloodstream

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2015-10-01

    Full Text Available Management of patients with prostate cancer is currently based on imperfect clinical, biological, radiological and pathological evaluation. Prostate cancer aggressiveness, including metastatic potential, remains difficult to accurately estimate. In an attempt to better adapt therapeutics to an individual (personalized medicine, reliable evaluation of the intrinsic molecular biology of the tumor is warranted, and particularly for all tumor sites (primary tumors and secondary sites at any time of the disease progression. As a consequence of their natural tendency to grow (passive invasion or as a consequence of an active blood vessel invasion by metastase-initiating cells, tumors shed various materials into the bloodstream. Major efforts have been recently made to develop powerful and accurate methods able to detect, quantify and/or analyze all these circulating tumor materials: circulating tumors cells, disseminating tumor cells, extracellular vesicles (including exosomes, nucleic acids, etc. The aim of this review is to summarize current knowledge about these circulating tumor materials and their applications in translational research.

  15. New antibiotic agents for bloodstream infections.

    Science.gov (United States)

    Vergidis, Paschalis I; Falagas, Matthew E

    2008-11-01

    Infections due to multidrug-resistant pathogens have shown a dramatic worldwide increase in prevalence. Bloodstream infections (BSIs) represent an important cause of morbidity and mortality in hospitalised patients. Research in the field led to the introduction of several novel antibiotic agents in the fight against bacterial pathogens. New antibiotics used against Gram-positive bacteria, mainly meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, include daptomycin, linezolid, quinupristin/dalfopristin and semisynthetic lipoglycopeptides. Among the Gram-negative bacteria, extended-spectrum beta-lactamase-producing Enterobacteriaceae as well as highly resistant Pseudomonas and Acinetobacter isolates are of particular concern. Doripenem is a recently approved carbapenem. Polymyxins are reconsidered as valuable therapeutic options for Gram-negative infections. Tigecycline, a glycylcycline, and ceftobiprole, a novel cephalosporin under investigation, have activity both against Gram-positive and Gram-negative organisms. In addition to the above agents, alternative treatment approaches that require further investigation have also been introduced into clinical practice. These include antibiotic lock therapy and continuous intravenous administration of antibiotics. In this article, we review the above treatment options for BSIs based on current clinical evidence. Comparative trials specifically focusing on patients with bacteraemia were generally not performed; however, a proportion of patients from the reported studies did have bacteraemia. PMID:18723329

  16. Genotypic analysis of Acinetobacter bloodstream infection isolates in a Turkish university hospital.

    NARCIS (Netherlands)

    Alp, E.; Esel, D.; Yildiz, O.; Voss, A.; Melchers, W.J.G.; Doganay, M.

    2006-01-01

    Acinetobacter baumannii is a significant pathogen of bloodstream infections in hospital patients that frequently causes single clone outbreaks. We aimed to evaluate the genetic relatedness and antimicrobial susceptibility of Acinetobacter spp. bloodstream isolates, in order to obtain insight into th

  17. Mortality in enterococcal bloodstream infections increases with inappropriate antimicrobial therapy

    DEFF Research Database (Denmark)

    Suppli, M.; Aabenhus, R.; Harboe, Z.B.;

    2010-01-01

    Enterococcus species are common in nosocomial bloodstream infections and their incidence is rising. Although well recognized in several serious bacterial infections, the influence of appropriate antimicrobial therapy in enterococcal bacteraemia has not been fully settled. The aim of the study.......7-10), thrombocytopenia (3.9, 1.6-9.3), chronic liver failure (3.3, 1.1-10) and age >/=60 years (2.2, 0.99-5.0). Antibiotics not appropriately covering enterococci are frequently administered empirically in suspected bloodstream infections. Inappropriate antibiotic therapy was an independent risk factor for mortality...

  18. Interação entre Trypanosoma cruzi e macrófagos: diferenças entre tripomastigotas sangüí-colas e de cultivo de tecidos Trypanosoma cruzi interaction with macrophages: differences between tissue culture and bloodstream forms

    Directory of Open Access Journals (Sweden)

    Judith K. Kloetzel

    1984-08-01

    Full Text Available Macrófagos obtidos do peritoneo de camundongos após estímulo, com peptona, foram cultivados em lamínulas, infectados com tripomastigotas das cepas F e Y de T. cruzi, obtidos de cultivo de tecidos ou do sangue de camundongos infectados. Os parasitas, obtidos de cultivo de tecidos, tanto da cepa Y como os da cepa F, são interiorizados por macrófagos em proporção muito mais elevada do que os sanguícolas. Parasitas de cultivo de tecidos incubados com soro de camundongos normais, ou soro híperimune específico em diluição sub-aglutinante, comportam-se essencialmente como parasitas não opsonizados. Foram observadas diferenças a nível ultraestrutural na fase inicial de interação entre macrófagos e tripomastigotas das duas origens. Após 30 minutos, tripomastigotas de cultivo de tecidos localizam-se em agrupamentos na área de contato com os macrófagos. Enquanto os tripomastigotas sanguícolas estão na maioria das vezes no interior de vacúolos fagocíticos largos, após 3 horas de interação os tripomastigotas de cultura situam-se em um único vacúolo estreito. Tanto as formas de cultivo de tecidos quanto os tripomastigotas sanguícolas da cepa Y multiplicam-se em macrófagos; os tripomastigotas sanguícolas da cepa F são destruídos no interior da célula hospedeira, enquanto os tripomastigotas de cultivo de tecidos desta cepa são capazes de multiplicar-se.Mouse peritoneal elicited macrophages cultured on coverslips were infected with Trypanosoma cruzi trypomastigotes from both the F strain and Y strain obtained either from tissue culture or from the bloodstream of infected mice. Both the Y strain and F parasites obtained from tissue culture were interiorized by macrophages at a much higher rate than bloodstream trypomastigotes. Tissue culture parasites incubated with normal mouse serum, mouse plasma obtained at the 7th day after infection, or specific hyperimmune serum at subagglutinating concentration, behaved essentially as

  19. Neonatal bloodstream infections in a pediatric hospital in Vietnam

    DEFF Research Database (Denmark)

    Kruse, Alexandra Yasmin; Thieu Chuong, D.H.; Phuong, C.N.;

    2013-01-01

    Septicemia and bloodstream infections (BSIs) are major causes of neonatal morbidity and mortality in developing countries. We prospectively recorded all positive blood cultures (BSI) among neonates admitted consecutively to a tertiary pediatric hospital in Vietnam during a 12-month period. Among...

  20. Prevention of nosocomial bloodstream infections in preterm infants

    NARCIS (Netherlands)

    K. Helder MScN (Onno)

    2013-01-01

    textabstractProtecting patients from harm is the overarching theme of the studies presented here. More precisely, this thesis places a focus on the prevention of nosocomial or hospitalacquired bloodstream infections in preterm infants, thus saving them from further harm. A nosocomial infection is an

  1. Clonal relationships among bloodstream isolates of Escherichia coli.

    Science.gov (United States)

    Maslow, J N; Whittam, T S; Gilks, C F; Wilson, R A; Mulligan, M E; Adams, K S; Arbeit, R D

    1995-01-01

    The clonal relationships among 187 bloodstream isolates of Escherichia coli from 179 patients at Boston, Mass., Long Beach, Calif., and Nairobi, Kenya, were determined by multilocus enzyme electrophoresis (MLEE), analysis of polymorphisms associated with the ribosomal operon (ribotyping), and serotyping. MLEE based on 20 enzymes resolved 101 electrophoretic types (ETs), forming five clusters; ribotyping resolved 56 distinct patterns concordant with the analysis by MLEE. The isolates at each study site formed a genetically diverse group and demonstrated similar clonal structures, with the same small subset of lineages accounting for the majority of isolates at each site. Moreover, two ribotypes accounted for approximately 30% of the isolates at each study site. One cluster contained the majority (65%) of isolates and, by direct comparison of the ETs and ribotypes of individual isolates, was genetically indistinguishable from the largest cluster for each of two other collections of E. coli causing pyelonephritis and neonatal meningitis (R. K. Selander, T. K. Korhonen, V. Väisänen-Rhen, P. H. Williams, P. E. Pattison, and D. A. Caugent, Infect. Immun. 52:213-222, 1986; M. Arthur, C. E. Johnson, R. H. Rubin, R. D. Arbeit, C. Campanelli, C. Kim, S. Steinbach, M. Agarwal, R. Wilkinson, and R. Goldstein, Infect. Immun. 57:303-313, 1989), thus defining a virulent set of lineages. The isolates within these virulent lineages typically carried DNA homologous to the adhesin operon pap or sfa and the hemolysin operon hly and expressed O1, O2, O4, O6, O18, O25, or O75 antigens. DNA homologous to pap was distributed among isolates of each major cluster, whereas hly was restricted to isolates of two clusters, typically detected in pap-positive strains, and sfa was restricted to isolates of one cluster, typically detected in pap- and hly-positive strains. The occurrence of pap-positive isolates in the same geographically and genetically divergent lineages suggests that this

  2. Coordinated Molecular Cross-Talk between Staphylococcus aureus, Endothelial Cells and Platelets in Bloodstream Infection

    Directory of Open Access Journals (Sweden)

    Carolina D. Garciarena

    2015-12-01

    Full Text Available Staphylococcus aureus is an opportunistic pathogen often carried asymptomatically on the human body. Upon entry to the otherwise sterile environment of the cardiovascular system, S. aureus can lead to serious complications resulting in organ failure and death. The success of S. aureus as a pathogen in the bloodstream is due to its ability to express a wide array of cell wall proteins on its surface that recognise host receptors, extracellular matrix proteins and plasma proteins. Endothelial cells and platelets are important cells in the cardiovascular system and are a major target of bloodstream infection. Endothelial cells form the inner lining of a blood vessel and provide an antithrombotic barrier between the vessel wall and blood. Platelets on the other hand travel throughout the cardiovascular system and respond by aggregating around the site of injury and initiating clot formation. Activation of either of these cells leads to functional dysregulation in the cardiovascular system. In this review, we will illustrate how S. aureus establish intimate interactions with both endothelial cells and platelets leading to cardiovascular dysregulation.

  3. Comparison of serum procalcitonin in respiratory infections and bloodstream infections

    OpenAIRE

    Zhu, Yanhui; Yuan, Yulin; Huang, Huayi

    2015-01-01

    Purpose: This study observed the relationship between procalcitonin (PCT) and results of sputum culture, the relationship between PCT and results of blood culture to evaluate and compare the value of PCT in respiratory and bloodstream infections. Methods: We analyzed 1616 patients in which PCT and sputum culture were concurrently ordered and analyzed, and 1096 patients in which PCT and blood culture were concurrently ordered and analyzed from January 2014 to May 2015. PCT concentrations were ...

  4. Candida bracarensis Bloodstream Infection in an Immunocompromised Patient ▿

    OpenAIRE

    Warren, Thomas A.; McTaggart, Lisa; Richardson, Susan E.; Zhang, Sean X.

    2010-01-01

    Candida bracarensis is a recently described Candida species which is phenotypically similar to Candida glabrata. A case of C. bracarensis bloodstream infection in a bone marrow transplant patient is described and confirms this organism as an opportunistic human pathogen. The organism can be distinguished from C. glabrata by its white color on CHROMagar and by DNA sequence analysis using D1/D2 and internal transcribed spacer (ITS) primers.

  5. Molecular Detection of Bloodstream Pathogens in Critical Illness

    OpenAIRE

    Al_griw, Huda Hm

    2012-01-01

    Background: Critically ill patients are at particular risk of developing bloodstream infection. Such infections are associated with the development of sepsis, leading to a marked increase in mortality rate. Early detection of the causative organism and appropriate antibiotic treatment are therefore critical for optimum outcome of patients with nosocomial infection. Current infection diagnosis is based on standard blood culture techniques. However, microbiological culture has a number of limi...

  6. Bloodstream-To-Eye Infections Are Facilitated by Outer Blood-Retinal Barrier Dysfunction.

    Directory of Open Access Journals (Sweden)

    Phillip S Coburn

    Full Text Available The blood-retinal barrier (BRB functions to maintain the immune privilege of the eye, which is necessary for normal vision. The outer BRB is formed by tightly-associated retinal pigment epithelial (RPE cells which limit transport within the retinal environment, maintaining retinal function and viability. Retinal microvascular complications and RPE dysfunction resulting from diabetes and diabetic retinopathy cause permeability changes in the BRB that compromise barrier function. Diabetes is the major predisposing condition underlying endogenous bacterial endophthalmitis (EBE, a blinding intraocular infection resulting from bacterial invasion of the eye from the bloodstream. However, significant numbers of EBE cases occur in non-diabetics. In this work, we hypothesized that dysfunction of the outer BRB may be associated with EBE development. To disrupt the RPE component of the outer BRB in vivo, sodium iodate (NaIO3 was administered to C57BL/6J mice. NaIO3-treated and untreated mice were intravenously injected with 108 colony forming units (cfu of Staphylococcus aureus or Klebsiella pneumoniae. At 4 and 6 days postinfection, EBE was observed in NaIO3-treated mice after infection with K. pneumoniae and S. aureus, although the incidence was higher following S. aureus infection. Invasion of the eye was observed in control mice following S. aureus infection, but not in control mice following K. pneumoniae infection. Immunohistochemistry and FITC-dextran conjugate transmigration assays of human RPE barriers after infection with an exoprotein-deficient agr/sar mutant of S. aureus suggested that S. aureus exoproteins may be required for the loss of the tight junction protein, ZO-1, and for permeability of this in vitro barrier. Our results support the clinical findings that for both pathogens, complications which result in BRB permeability increase the likelihood of bacterial transmigration from the bloodstream into the eye. For S. aureus, however, BRB

  7. Bloodstream-To-Eye Infections Are Facilitated by Outer Blood-Retinal Barrier Dysfunction

    Science.gov (United States)

    Coburn, Phillip S.; Wiskur, Brandt J.; Miller, Frederick C.; LaGrow, Austin L.; Astley, Roger A.; Elliott, Michael H.; Callegan, Michelle C.

    2016-01-01

    The blood-retinal barrier (BRB) functions to maintain the immune privilege of the eye, which is necessary for normal vision. The outer BRB is formed by tightly-associated retinal pigment epithelial (RPE) cells which limit transport within the retinal environment, maintaining retinal function and viability. Retinal microvascular complications and RPE dysfunction resulting from diabetes and diabetic retinopathy cause permeability changes in the BRB that compromise barrier function. Diabetes is the major predisposing condition underlying endogenous bacterial endophthalmitis (EBE), a blinding intraocular infection resulting from bacterial invasion of the eye from the bloodstream. However, significant numbers of EBE cases occur in non-diabetics. In this work, we hypothesized that dysfunction of the outer BRB may be associated with EBE development. To disrupt the RPE component of the outer BRB in vivo, sodium iodate (NaIO3) was administered to C57BL/6J mice. NaIO3-treated and untreated mice were intravenously injected with 108 colony forming units (cfu) of Staphylococcus aureus or Klebsiella pneumoniae. At 4 and 6 days postinfection, EBE was observed in NaIO3-treated mice after infection with K. pneumoniae and S. aureus, although the incidence was higher following S. aureus infection. Invasion of the eye was observed in control mice following S. aureus infection, but not in control mice following K. pneumoniae infection. Immunohistochemistry and FITC-dextran conjugate transmigration assays of human RPE barriers after infection with an exoprotein-deficient agr/sar mutant of S. aureus suggested that S. aureus exoproteins may be required for the loss of the tight junction protein, ZO-1, and for permeability of this in vitro barrier. Our results support the clinical findings that for both pathogens, complications which result in BRB permeability increase the likelihood of bacterial transmigration from the bloodstream into the eye. For S. aureus, however, BRB permeability is

  8. Bloodstream-To-Eye Infections Are Facilitated by Outer Blood-Retinal Barrier Dysfunction.

    Science.gov (United States)

    Coburn, Phillip S; Wiskur, Brandt J; Miller, Frederick C; LaGrow, Austin L; Astley, Roger A; Elliott, Michael H; Callegan, Michelle C

    2016-01-01

    The blood-retinal barrier (BRB) functions to maintain the immune privilege of the eye, which is necessary for normal vision. The outer BRB is formed by tightly-associated retinal pigment epithelial (RPE) cells which limit transport within the retinal environment, maintaining retinal function and viability. Retinal microvascular complications and RPE dysfunction resulting from diabetes and diabetic retinopathy cause permeability changes in the BRB that compromise barrier function. Diabetes is the major predisposing condition underlying endogenous bacterial endophthalmitis (EBE), a blinding intraocular infection resulting from bacterial invasion of the eye from the bloodstream. However, significant numbers of EBE cases occur in non-diabetics. In this work, we hypothesized that dysfunction of the outer BRB may be associated with EBE development. To disrupt the RPE component of the outer BRB in vivo, sodium iodate (NaIO3) was administered to C57BL/6J mice. NaIO3-treated and untreated mice were intravenously injected with 108 colony forming units (cfu) of Staphylococcus aureus or Klebsiella pneumoniae. At 4 and 6 days postinfection, EBE was observed in NaIO3-treated mice after infection with K. pneumoniae and S. aureus, although the incidence was higher following S. aureus infection. Invasion of the eye was observed in control mice following S. aureus infection, but not in control mice following K. pneumoniae infection. Immunohistochemistry and FITC-dextran conjugate transmigration assays of human RPE barriers after infection with an exoprotein-deficient agr/sar mutant of S. aureus suggested that S. aureus exoproteins may be required for the loss of the tight junction protein, ZO-1, and for permeability of this in vitro barrier. Our results support the clinical findings that for both pathogens, complications which result in BRB permeability increase the likelihood of bacterial transmigration from the bloodstream into the eye. For S. aureus, however, BRB permeability is

  9. Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections.

    Science.gov (United States)

    Bordeau, Valérie; Cady, Anne; Revest, Matthieu; Rostan, Octavie; Sassi, Mohamed; Tattevin, Pierre; Donnio, Pierre-Yves; Felden, Brice

    2016-09-01

    Staphylococcus aureus is a commensal bacterium and pathogen. Identifying biomarkers for the transition from colonization to disease caused by this organism would be useful. Several S. aureus small RNAs (sRNAs) regulate virulence. We investigated presence and expression of 8 sRNAs in 83 S. aureus strains from 42 patients with sepsis or septic shock and 41 asymptomatic colonized carriers. Small pathogenicity island sRNAs sprB and sprC were clade specific. Six sRNAs had variable expression not correlated with clinical status. Expression of RNAIII was lower in strains from septic shock patients than in strains from colonized patients. When RNAIII was associated with expression of sprD, colonizing strains could be discriminated from strains in patients with bloodstream infections, including patients with sepsis and septic shock. Isolates associated with colonization might have sRNAs with target expression different from those of disease isolates. Monitoring expression of RNAIII and sprD could help determine severity of bloodstream infections. PMID:27224202

  10. Cytosolic peroxidases protect the lysosome of bloodstream African trypanosomes from iron-mediated membrane damage.

    Directory of Open Access Journals (Sweden)

    Corinna Hiller

    2014-04-01

    Full Text Available African trypanosomes express three virtually identical non-selenium glutathione peroxidase (Px-type enzymes which preferably detoxify lipid-derived hydroperoxides. As shown previously, bloodstream Trypanosoma brucei lacking the mitochondrial Px III display only a weak and transient proliferation defect whereas parasites that lack the cytosolic Px I and Px II undergo extremely fast lipid peroxidation and cell lysis. The phenotype can completely be rescued by supplementing the medium with the α-tocopherol derivative Trolox. The mechanism underlying the rapid cell death remained however elusive. Here we show that the lysosome is the origin of the cellular injury. Feeding the px I-II knockout parasites with Alexa Fluor-conjugated dextran or LysoTracker in the presence of Trolox yielded a discrete lysosomal staining. Yet upon withdrawal of the antioxidant, the signal became progressively spread over the whole cell body and was completely lost, respectively. T. brucei acquire iron by endocytosis of host transferrin. Supplementing the medium with iron or transferrin induced, whereas the iron chelator deferoxamine and apo-transferrin attenuated lysis of the px I-II knockout cells. Immunofluorescence microscopy with MitoTracker and antibodies against the lysosomal marker protein p67 revealed that disintegration of the lysosome precedes mitochondrial damage. In vivo experiments confirmed the negligible role of the mitochondrial peroxidase: Mice infected with px III knockout cells displayed only a slightly delayed disease development compared to wild-type parasites. Our data demonstrate that in bloodstream African trypanosomes, the lysosome, not the mitochondrion, is the primary site of oxidative damage and cytosolic trypanothione/tryparedoxin-dependent peroxidases protect the lysosome from iron-induced membrane peroxidation. This process appears to be closely linked to the high endocytic rate and distinct iron acquisition mechanisms of the infective

  11. The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature.

    Science.gov (United States)

    Bal, Zumrut Sahbudak; Sen, Semra; Karapinar, Deniz Yilmaz; Aydemir, Sohret; Vardar, Fadil

    2015-01-01

    Brevibacterium spp. are catalase-positive, non-spore-forming, non motile, aerobic Gram-positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. casei catheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature. PMID:25636191

  12. The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature

    Directory of Open Access Journals (Sweden)

    Zumrut Sahbudak Bal

    2015-04-01

    Full Text Available Brevibacteriumspp. are catalase-positive, non-spore-forming, non motile, aerobic Gram- positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. caseicatheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature.

  13. Emerging commercial molecular tests for the diagnosis of bloodstream infection.

    Science.gov (United States)

    Mwaigwisya, Solomon; Assiri, Rasha Assad M; O'Grady, Justin

    2015-05-01

    Bloodstream infection (BSI) by microorganisms can lead to sepsis. This condition has a high mortality rate, which rises significantly with delays in initiation of appropriate antimicrobial treatment. Current culture methods for diagnosing BSI have long turnaround times and poor clinical sensitivity. While clinicians wait for culture diagnosis, patients are treated empirically, which can result in inappropriate treatment, undesirable side effects and contribute to drug resistance development. Molecular diagnostics assays that target pathogen DNA can identify pathogens and resistance markers within hours. Early diagnosis improves antibiotic stewardship and is associated with favorable clinical outcomes. Nonetheless, limitations of current molecular diagnostic methods are substantial. This article reviews recent commercially available molecular methods that use pathogen DNA to diagnose BSI, either by testing positive blood cultures or directly testing patient blood. We critically assess these tests and their application in clinical microbiology. A view of future directions in BSI diagnosis is also provided. PMID:25866124

  14. Cefotaxime resistance and outcome of Klebsiella spp bloodstream infection.

    Science.gov (United States)

    Ortega, M; Marco, F; Soriano, A; Almela, M; Martínez, J A; López, J; Pitart, C; Mensa, J

    2011-12-01

    We attempt to describe the epidemiology and outcome associated with cefotaxime-resistant (CTX-R) Klebsiella spp bacteraemia. Klebsiella spp bloodstream infection episodes prospectively collected through a blood culture surveillance programme from January 1991 to December 2008 in a single institution were analysed. A total of 910 monomicrobial episodes of Klebsiella spp bacteraemia were identified during the study period. The most important sources were from urinary tract infection, unknown sources, billiary focus and catheter related infection. There were 112 (12%) CTX-R isolates. Out of 112 isolates, 98 were CTX-R by Extended-Spectrum β-Lactamase production. Shock on presentation and mortality were significantly more frequent in CTX-R than in CTX susceptible isolates. Inappropriate empirical therapy was received in 50 (45%) cases in the CTX-R Klebsiella spp group (13 cases of death, 26%). Predictive factors associated with CTX-R Klebsiella spp isolate were: previous β-lactam therapy (OR = 4.16), nosocomial acquired bacteraemia (OR = 1.93), solid organ trasplantation (OR = 2.09) and shock (OR = 1.90). Independent risk factors associated with mortality in Klebsiella spp bacteraemia were: age (OR = 1.03), liver cirrhosis (OR = 2.63), ultimately or rapidly fatal prognosis of underlying disease (OR = 2.44), shock (OR = 8.60), pneumonia (OR = 4.96) or intraabdominal (OR = 3.85) source of bacteraemia and CTX-R isolate (OR = 4.63). Klebsiella spp is an important cause of bloodstream infection. CTX-R isolates have been increasing since 2000. CTX-R is an independent factor associated with mortality in Klebsiella spp bacteraemia.

  15. Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Msangi Viola

    2007-05-01

    Full Text Available Abstract Background Bloodstream infection is a common cause of hospitalization, morbidity and death in children. The impact of antimicrobial resistance and HIV infection on outcome is not firmly established. Methods We assessed the incidence of bloodstream infection and risk factors for fatal outcome in a prospective cohort study of 1828 consecutive admissions of children aged zero to seven years with signs of systemic infection. Blood was obtained for culture, malaria microscopy, HIV antibody test and, when necessary, HIV PCR. We recorded data on clinical features, underlying diseases, antimicrobial drug use and patients' outcome. Results The incidence of laboratory-confirmed bloodstream infection was 13.9% (255/1828 of admissions, despite two thirds of the study population having received antimicrobial therapy prior to blood culture. The most frequent isolates were klebsiella, salmonellae, Escherichia coli, enterococci and Staphylococcus aureus. Furthermore, 21.6% had malaria and 16.8% HIV infection. One third (34.9% of the children with laboratory-confirmed bloodstream infection died. The mortality rate from Gram-negative bloodstream infection (43.5% was more than double that of malaria (20.2% and Gram-positive bloodstream infection (16.7%. Significant risk factors for death by logistic regression modeling were inappropriate treatment due to antimicrobial resistance, HIV infection, other underlying infectious diseases, malnutrition and bloodstream infection caused by Enterobacteriaceae, other Gram-negatives and candida. Conclusion Bloodstream infection was less common than malaria, but caused more deaths. The frequent use of antimicrobials prior to blood culture may have hampered the detection of organisms susceptible to commonly used antimicrobials, including pneumococci, and thus the study probably underestimates the incidence of bloodstream infection. The finding that antimicrobial resistance, HIV-infection and malnutrition predict fatal

  16. Biofilm formation is a risk factor for mortality in patients with Candida albicans bloodstream infection—Scotland, 2012–2013

    Science.gov (United States)

    Rajendran, R.; Sherry, L.; Nile, C.J.; Sherriff, A.; Johnson, E.M.; Hanson, M.F.; Williams, C.; Munro, C.A.; Jones, B.J.; Ramage, G.

    2016-01-01

    Bloodstream infections caused by Candida species remain a significant cause of morbidity and mortality in hospitalized patients. Biofilm formation by Candida species is an important virulence factor for disease pathogenesis. A prospective analysis of patients with Candida bloodstream infection (n = 217) in Scotland (2012–2013) was performed to assess the risk factors associated with patient mortality, in particular the impact of biofilm formation. Candida bloodstream isolates (n = 280) and clinical records for 157 patients were collected through 11 different health boards across Scotland. Biofilm formation by clinical isolates was assessed in vitro with standard biomass assays. The role of biofilm phenotype on treatment efficacy was also evaluated in vitro by treating preformed biofilms with fixed concentrations of different classes of antifungal. Available mortality data for 134 patients showed that the 30-day candidaemia case mortality rate was 41%, with predisposing factors including patient age and catheter removal. Multivariate Cox regression survival analysis for 42 patients showed a significantly higher mortality rate for Candida albicans infection than for Candida glabrata infection. Biofilm-forming ability was significantly associated with C. albicans mortality (34 patients). Finally, in vitro antifungal sensitivity testing showed that low biofilm formers and high biofilm formers were differentially affected by azoles and echinocandins, but not by polyenes. This study provides further evidence that the biofilm phenotype represents a significant clinical entity, and that isolates with this phenotype differentially respond to antifungal therapy in vitro. Collectively, these findings show that greater clinical understanding is required with respect to Candida biofilm infections, and the implications of isolate heterogeneity. PMID:26432192

  17. Catheter Removal versus Retention in the Management of Catheter-Associated Enterococcal Bloodstream Infections

    Directory of Open Access Journals (Sweden)

    Jonas Marschall

    2013-01-01

    Full Text Available BACKGROUND: Enterococci are an important cause of central venous catheter (CVC-associated bloodstream infections (CA-BSI. It is unclear whether CVC removal is necessary to successfully manage enterococcal CA-BSI.

  18. Bloodstream Infections in a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Mehmet Sah Ižpek

    2014-12-01

    Full Text Available Aim: To determine the pattern of bloodstream infections (BSIs and antimicrobial susceptibility of pathogens in a neonatal intensive care unit (NICU.Material and Method: Positive hemoculture of neonates diagnosed with nosocomial sepsis from March 2011 to March 2014 in the NICU of Diyarbakir Maternity and Children%u2019s Hospital, in the southeastern region of Anatolia, Turkey, were retrospectively reviewed. Results: A total of 148 pathogens were isolated in 142 neonates. The most common microorganisms isolated were Klebsiella pneumoniae (40.5% and Acinetobacter baumannii (29.7% which was a result of a hospital outbreak. Multi-drug resistant (MDR strains accounted for 20.0% of K. pneumoniae isolates and 93.2% of A. baumannii isolates. The sepsis-attributable mortality rate was higher in cases infected with MDR strains than in cases infected without MDR strains or Candida spp (24% vs. 9.7%, p=0.032. Discussion: In our unit, BSIs were more often caused by Gram negative bacteria. BSIs caused by MDR strains were associated with a higher rate of sepsis-attributable mortality.

  19. The changing epidemiology of Staphylococcus aureus bloodstream infection

    DEFF Research Database (Denmark)

    Galbraith, J.C.; Valiquette, G.; Kennedy, K.J.;

    2013-01-01

    Clin Microbiol Infect ABSTRACT: Although the epidemiology of Staphylococcus aureus bloodstream infection (BSI) has been changing, international comparisons are lacking. We sought to determine the incidence of S. aureus BSI and assess trends over time and by region. Population-based surveillance...... episodes of S. aureus BSI were identified. The overall annual incidence rate for S. aureus BSI was 26.1 per 100 000 population, and those for methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) were 24.2 and 1.9 per 100 000, respectively. Although the overall incidence...... of community-onset MSSA BSI (15.0 per 100 000) was relatively similar across regions, the incidence rates of hospital-onset MSSA (9.2 per 100 000), community-onset MRSA (1.0 per 100 000) and hospital-onset MRSA (0.8 per 100 000) BSI varied substantially. Whereas the overall incidence of S. aureus BSI did...

  20. Epidemiology, surveillance, and prevention of bloodstream infections in hemodialysis patients.

    Science.gov (United States)

    Patel, Priti R; Kallen, Alexander J; Arduino, Matthew J

    2010-09-01

    Infections cause significant morbidity and mortality in patients undergoing hemodialysis. Bloodstream infections (BSIs) are particularly problematic, accounting for a substantial number of hospitalizations in these patients. Hospitalizations for BSI and other vascular access infections appear to have increased dramatically in hemodialysis patients since 1993. These infections frequently are related to central venous catheter (CVC) use for dialysis access. Regional initiatives that have shown successful decreases in catheter-related BSIs in hospitalized patients have generated interest in replicating this success in outpatient hemodialysis populations. Several interventions have been effective in preventing BSIs in the hemodialysis setting. Avoiding the use of CVCs in favor of access types with lower associated BSI risk is among the most important. When CVCs are used, adherence to evidence-based catheter insertion and maintenance practices can positively influence BSI rates. In addition, facility-level surveillance to detect BSIs and stimulate examination of vascular access use and care practices is essential to a comprehensive approach to prevention. This article describes the current epidemiology of BSIs in hemodialysis patients and effective prevention strategies to decrease the incidence of these devastating infections.

  1. Central venous catheter-related bloodstream infection caused by Staphylococcus aureus: microbiology and risk factors

    Directory of Open Access Journals (Sweden)

    Geraldo Sadoyma

    2006-04-01

    Full Text Available Although central vascular catheters (CVC are indispensable in modern medicine, they are an important risk factor for primary bacteremias. We examined the incidence and risk factors associated with catheter-related bloodstream infection (CR-BSI caused by Staphylococcus aureus in surgical patients. A prospective study was carried out in the Hospital das Clínicas da Universidade Federal de Uberlândia (HC-UFU from September 2000 to December 2002. The skin insertion site, catheter tip, and blood were microbiologically analyzed. Demographics and risk factors were recorded for each patient, and cultures were identified phenotypically. Staphylococcus aureus was the most frequent pathogen, with an incidence rate of 4.9 episodes of CR-BSIs per 1,000 catheter/days. Based on logistic regression, the independent risk factors were: colonization on the insertion site =200 colony forming units (CFU/20 cm² (p=0.03; odds ratio (OR =6.89 and catheter tip (p=0.01; OR=7.95. The CR-BSI rate was high; it was mainly associated with S. aureus, and skin colonization at the insertion site and on the catheter tip were important risk factors for CR-BSI.

  2. Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

    NARCIS (Netherlands)

    Kett, D.H.; Azoulay, E.; Echeverria, P.M.; Vincent, J.L.; Pickkers, P.

    2011-01-01

    OBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the I

  3. A Gateway® compatible vector for gene silencing in bloodstream form Trypanosoma brucei

    OpenAIRE

    Kalidas, Savitha; Li, Qiong; Margaret A Phillips

    2011-01-01

    RNA interference is the most rapid method for generation of conditional knockdown mutants in Trypanosoma brucei. The dual T7 promoter (pZJM) and the stem-loop vectors have been widely used to generate stable inducible RNAi cell lines with the latter providing tighter regulatory control. However, the steps for cloning stem-loop constructs are cumbersome requiring either multiple cloning steps or multi-fragment ligation reactions. We report the development of a vector (pTrypRNAiGate) derived fr...

  4. Ribose 5-Phosphate Isomerase B Knockdown Compromises Trypanosoma brucei Bloodstream Form Infectivity

    OpenAIRE

    Inês Loureiro; Joana Faria; Christine Clayton; Sandra Macedo-Ribeiro; Nuno Santarém; Nilanjan Roy; Anabela Cordeiro-da-Siva; Joana Tavares

    2015-01-01

    Ribose 5-phosphate isomerase is an enzyme involved in the non-oxidative branch of the pentose phosphate pathway, and catalyzes the inter-conversion of D-ribose 5-phosphate and D-ribulose 5-phosphate. Trypanosomatids, including the agent of African sleeping sickness namely Trypanosoma brucei, have a type B ribose-5-phosphate isomerase. This enzyme is absent from humans, which have a structurally unrelated ribose 5-phosphate isomerase type A, and therefore has been proposed as an attractive dru...

  5. Involvement of lysosomes in the uptake of macromolecular material by bloodstream forms of Trypanosoma brucei.

    Science.gov (United States)

    Opperdoes, F R; Van Roy, J

    1982-09-01

    To investigate whether the lysosomes of Trypanosoma brucei are capable of uptake of macromolecules after internalization by the cell, we used Triton WR-1339, a non-digestible macromolecular compound, which is known to cause a marked decrease in the density of hepatic lysosomes due to massive intralysosomal storage. Intraperitoneal administration of 0.4 g/kg Triton WR-1339 to rats infected with T. brucei led to the development of a large vacuole in the trypanosomes between nucleus and kinetoplast within 22 h. Higher doses (2 g/kg) led to the disappearance of the trypanosomes from the blood and resulted in permanent cures (greater than 100 days). Lysosomes isolated from the trypanosomes of animals treated with a sub-curative dose showed a decrease in equilibrium density of 0.03 g/cm3 in sucrose gradients. These lysosomes were partly damaged as evidenced by a reduction in latency and an increase in the non-sedimentable part of lysosomal enzymes. We conclude that acid proteinase and alpha-mannosidase-containing organelles of T. brucei take up exogenous macromolecules and must therefore be considered as true lysosomes and that Triton WR-1339 acts in T. brucei as a true lysosomotropic drug. Its trypanocidal action probably results from an interference with lysosomal function.

  6. Alkaloids Induce Programmed Cell Death in Bloodstream Forms of Trypanosomes (Trypanosoma b. brucei

    Directory of Open Access Journals (Sweden)

    Michael Wink

    2008-10-01

    Full Text Available The potential induction of a programmed cell death (PCD in Trypanosoma b. brucei by 55 alkaloids of the quinoline, quinolizidine, isoquinoline, indole, terpene, tropane, steroid, and piperidine type was studied by measuring DNA fragmentation and changes in mitochondrial membrane potential. For comparison, the induction of apoptosis by the same alkaloids in human leukemia cells (Jurkat APO-S was tested. Several alkaloids of the isoquinoline, quinoline, indole and steroidal type (berberine, chelerythrine, emetine, sanguinarine, quinine, ajmalicine, ergotamine, harmine, vinblastine, vincristine, colchicine, chaconine, demissidine and veratridine induced programmed cell death, whereas quinolizidine, tropane, terpene and piperidine alkaloids were mostly inactive. Effective PCD induction (EC50 below 10 µM was caused in T. brucei by chelerythrine, emetine, sanguinarine, and chaconine. The active alkaloids can be characterized by their general property to inhibit protein biosynthesis, to intercalate DNA, to disturb membrane fluidity or to inhibit microtubule formation.

  7. Alkaloids Induce Programmed Cell Death in Bloodstream Forms of Trypanosomes (Trypanosoma b. brucei)

    OpenAIRE

    Michael Wink; Vera Rosenkranz

    2008-01-01

    The potential induction of a programmed cell death (PCD) in Trypanosoma b. brucei by 55 alkaloids of the quinoline, quinolizidine, isoquinoline, indole, terpene, tropane, steroid, and piperidine type was studied by measuring DNA fragmentation and changes in mitochondrial membrane potential. For comparison, the induction of apoptosis by the same alkaloids in human leukemia cells (Jurkat APO-S) was tested. Several alkaloids of the isoquinoline, quinoline, indole and steroidal type (berberine, c...

  8. Secular Trends in Nosocomial Bloodstream Infections : Antibiotic-Resistant Bacteria Increase the Total Burden of Infection

    NARCIS (Netherlands)

    Ammerlaan, H. S. M.; Harbarth, S.; Buiting, A. G. M.; Crook, D. W.; Fitzpatrick, F.; Hanberger, H.; Herwaldt, L. A.; van Keulen, P. H. J.; Kluytmans, J. A. J. W.; Kola, A.; Kuchenbecker, R. S.; Lingaas, E.; Meessen, N.; Morris-Downes, M. M.; Pottinger, J. M.; Rohner, P.; dos Santos, R. P.; Seifert, H.; Wisplinghoff, H.; Ziesing, S.; Walker, A. S.; Bonten, M. J. M.

    2013-01-01

    Background. It is unknown whether rising incidence rates of nosocomial bloodstream infections (BSIs) caused by antibiotic-resistant bacteria (ARB) replace antibiotic-susceptible bacteria (ASB), leaving the total BSI rate unaffected. Methods. We investigated temporal trends in annual incidence densit

  9. Bloodstream Infections in Very Low Birth Weight Infants with Intestinal Failure

    NARCIS (Netherlands)

    Cole, Conrad R.; Hansen, Nellie I.; Higgins, Rosemary D.; Bell, Edward F.; Shankaran, Seetha; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Das, Abhik; Stoll, Barbara J.

    2012-01-01

    Objective To examine pathogens and other characteristics associated with late-onset bloodstream infections (BSIs) in infants with intestinal failure (IF) as a consequence of necrotizing enterocolitis (NEC). Study design Infants weighing 401-1500 g at birth who survived for >72 hours and received car

  10. Routine Surveillance for Bloodstream Infections in a Pediatric Hematopoietic Stem Cell Transplant Cohort: Do Patients Benefit?

    Directory of Open Access Journals (Sweden)

    Heather Rigby

    2007-01-01

    Full Text Available BACKGROUND: Hematopoietic stem cell transplant (HSCT recipients are at a high risk for late bloodstream infection (BSI. Controversy exists regarding the benefit of surveillance blood cultures in this immunosuppressed population. Despite the common use of this practice, the practical value is not well established in non-neutropenic children following HSCT.

  11. Patients with Central Lines - What You Need to Know to Avoid a Bloodstream Infection PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-03-01

    This 60 second PSA is based on the March, 2011 CDC Vital Signs report which indicates bloodstream infections in patients with central lines are largely preventable when healthcare providers use CDC-recommended infection control steps.  Created: 3/1/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/1/2011.

  12. Early oral switch therapy in low-risk Staphylococcus aureus bloodstream infection (SABATO) : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Kaasch, Achim J.; Fätkenheuer, Gerd; Prinz-Langenohl, Reinhild; Paulus, Ursula; Hellmich, Martin; Weiß, Verena; Jung, Norma; Rieg, Siegbert; Kern, Winfried V.; Seifert, Harald; Lewalter, Karl; Lemmen, Sebastian; Stijnis, Cornelis; Van der Meer, Jan; Soriano, Alex; Ruiz, Laura Morata; Arastéh, Keikawus; Stocker, Hartmut; Kluytmans, Jan; Veenemans, Jacobien; Brodt, Hans Reinhard; Stephan, Christoph; Wolf, Timo; Kessel, Johanna; Joost, Insa; Sinha, Bhanu; van Assen, Sander; Wilting, Kasper; Tobias Welte, Welte; Christiane Mölgen, Mölgen; Julia Freise, Freise; Brunkhorst, Frank; Pletz, Mathias; Hagel, Stefan; Becker, Christian; Frieling, Thomas; Kösters, Katrin; Reuter, Stefan; Hsiao, Mikai; Rupp, Jan; Dalhoff, Klaus; Turner, David; Snape, Susan; Crusz, Shanika; Venkatesan, Pradhib; Salzberger, Bernd; Hanses, Frank; Rodriguez-Baño, Jesùs; Méndez, Adoración Valiente; López-Cortés, Luis Eduardo; Cisneros, José Miguel; Navarro-Amuedo, Maria Dolores; Bonten, Marc; Oosterheert, Jan Jelrik; Ekkelenkamp, Miquel

    2015-01-01

    Background: Current guidelines recommend that patients with Staphylococcus aureus bloodstream infection (SAB) are treated with long courses of intravenous antimicrobial therapy. This serves to avoid SAB-related complications such as relapses, local extension and distant metastatic foci. However, in

  13. Cluster of Candida parapsilosis primary bloodstream infection in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Silva Carmem Lúcia P. da

    2001-01-01

    Full Text Available Candida parapsilosis is an increasingly important bloodstream pathogen in neonatal intensive care units (NICU. We investigated a cluster of bloodstream infections in a NICU to determine whether nosocomial transmission occurred. During a 3-day period, 3 premature infants hospitalized in the same unit presented with sepsis caused by C. parapsilosis. Electrophoretic karyotype of the organisms was performed by using pulsed field gel electrophoresis in a countour-clamped homogeneous electric field system. The isolate from 1 newborn could not be typed, and the isolates from the remaining 2 infants had identical patterns. All 3 cases are described. We conclude that nosocomial transmission of C. parapsilosis occurred and that neonates under intensive care may represent a risk group for this pathogen.

  14. Current strategies for the prevention and management of central line-associated bloodstream infections

    Directory of Open Access Journals (Sweden)

    Zhuolin Han

    2010-11-01

    Full Text Available Zhuolin Han, Stephen Y Liang, Jonas MarschallDivision of Infectious Diseases, Washington University School of Medicine in St Louis, St Louis, MO, USAAbstract: Central venous catheters are an invaluable tool for diagnostic and therapeutic purposes in today’s medicine, but their use can be complicated by bloodstream infections (BSIs. While evidence-based preventive measures are disseminated by infection control associations, the optimal management of established central line-associated BSIs has been summarized in infectious diseases guidelines. We prepared an overview of the state-of-the-art of prevention and management of central line-associated BSIs and included topics such as the role of antibiotic-coated catheters, the role of catheter removal in the management, and a review of currently used antibiotic compounds and the duration of treatment.Keywords: central venous catheters, bloodstream infections, guidelines, prevention

  15. The Impact of Infectious Disease Specialist Consultation for Staphylococcus aureus Bloodstream Infections: A Systematic Review.

    Science.gov (United States)

    Paulsen, Julie; Solligård, Erik; Damås, Jan Kristian; DeWan, Andrew; Åsvold, Bjørn Olav; Bracken, Michael B

    2016-03-01

    Staphylococcus aureus is a common cause of severe bloodstream infection. We performed a systematic review to assess whether consultation with infectious disease specialists decreased all-cause mortality or rate of complications of S aureus bloodstream infections. The review also assessed parameters associated with the quality of management of the infection. We searched for eligible studies in PubMed, Embase, Scopus, and clinical trials.gov as well as the references of included studies. We identified 22 observational studies and 1 study protocol for a randomized trial. A meta-analysis was not performed because of the high risk of bias in the included studies. The outcomes are reported in a narrative review. Most included studies reported survival benefit, in the adjusted analysis. Recommended management strategies were carried out significantly more often among patients seen by an infectious disease specialist. Trials, such as cluster-randomized controlled trials, can more validly assess the studies at low risk of bias. PMID:27047985

  16. Catheter related bloodstream infection%导管相关血流感染

    Institute of Scientific and Technical Information of China (English)

    陶建平

    2012-01-01

    儿科患者发生的医院获得性菌血症,绝大多数与血管内装置相关,本文根据国内外指南和新的研究,对导管相关血流感染的流行病学、发病机制、诊断及预防和管理作一综述.%Most nosocomial bloodstream infections among pediatric patients are related to the usage of an intravascular device.This article reviewed catheter related bloodstream infections from aspects of epidemiology,pathogenesis,diagnosis,prevention and care based on guidelines and new research both in abroad and at home.

  17. The krebs cycle enzyme α-ketoglutarate decarboxylase is an essential glycosomal protein in bloodstream African trypanosomes.

    Science.gov (United States)

    Sykes, Steven; Szempruch, Anthony; Hajduk, Stephen

    2015-03-01

    α-Ketoglutarate decarboxylase (α-KDE1) is a Krebs cycle enzyme found in the mitochondrion of the procyclic form (PF) of Trypanosoma brucei. The bloodstream form (BF) of T. brucei lacks a functional Krebs cycle and relies exclusively on glycolysis for ATP production. Despite the lack of a functional Krebs cycle, α-KDE1 was expressed in BF T. brucei and RNA interference knockdown of α-KDE1 mRNA resulted in rapid growth arrest and killing. Cell death was preceded by progressive swelling of the flagellar pocket as a consequence of recruitment of both flagellar and plasma membranes into the pocket. BF T. brucei expressing an epitope-tagged copy of α-KDE1 showed localization to glycosomes and not the mitochondrion. We used a cell line transfected with a reporter construct containing the N-terminal sequence of α-KDE1 fused to green fluorescent protein to examine the requirements for glycosome targeting. We found that the N-terminal 18 amino acids of α-KDE1 contain overlapping mitochondrion- and peroxisome-targeting sequences and are sufficient to direct localization to the glycosome in BF T. brucei. These results suggest that α-KDE1 has a novel moonlighting function outside the mitochondrion in BF T. brucei.

  18. National Bloodstream Infection Surveillance in Switzerland 2008-2014: Different Patterns and Trends for University and Community Hospitals.

    Science.gov (United States)

    Buetti, Niccolò; Marschall, Jonas; Atkinson, Andrew; Kronenberg, Andreas

    2016-09-01

    OBJECTIVE To characterize the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in community and university hospitals. DESIGN Observational, retrospective, multicenter laboratory surveillance study. METHODS Data on bloodstream infections from 2008 through 2014 were obtained from the Swiss infection surveillance system, which is part of the Swiss Centre for Antibiotic Resistance (ANRESIS). We compared pathogen prevalences across 26 acute care hospitals. A subanalysis for community-acquired and hospital-acquired bloodstream infections in community and university hospitals was performed. RESULTS A total of 42,802 bloodstream infection episodes were analyzed. The most common etiologies were Escherichia coli (28.3%), Staphylococcus aureus (12.4%), and polymicrobial bloodstream infections (11.4%). The proportion of E. coli increased from 27.5% in 2008 to 29.6% in 2014 (P = .04). E. coli and S. aureus were more commonly reported in community than university hospitals (34.3% vs 22.7%, Phospitals (41.0% vs 32.4%, Pinfections increased in community hospitals only. Community-acquired polymicrobial infections (9.9% vs 5.6%, Phospitals. CONCLUSIONS The role of E. coli as predominant pathogen in bloodstream infections has become more pronounced. There are distinct patterns in community and university hospitals, potentially influencing empirical antibiotic treatment. Infect Control Hosp Epidemiol 2016;37:1060-1067.

  19. Three Epidemics of Invasive Multidrug-Resistant Salmonella Bloodstream Infection in Blantyre, Malawi, 1998–2014

    OpenAIRE

    Feasey, Nicholas A.; Masesa, Clemens; Jassi, Chikondi; Faragher, E. Brian; Mallewa, Jane; Mallewa, Macpherson; MacLennan, Calman A.; Msefula, Chisomo; Robert S Heyderman; Gordon, Melita A.

    2015-01-01

    Background.  The Malawi Liverpool Wellcome Trust Clinical Research Programme (MLW) has routinely collected specimens for blood culture from febrile patients, and cerebrospinal fluid from patients with suspected meningitis, presenting to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, since 1998. Methods.  We present bloodstream infection (BSI) and meningitis surveillance data from 1998 to 2014. Automated blood culture, manual speciation, serotyping, and antimicrobial susceptibility...

  20. Risk of vancomycin-resistant enterococci bloodstream infection among patients colonized with vancomycin-resistant enterococci

    Directory of Open Access Journals (Sweden)

    Ahu Kara

    2015-02-01

    Full Text Available Background:Vancomycin-resistant enterococci colonization has been reported to increase the risk of developing infections, including bloodstream infections.Aim:In this study, we aimed to share our experience with the vancomycin-resistant enterococci bloodstream infections following gastrointestinal vancomycin-resistant enterococci colonization in pediatric population during a period of 18 months.Method:A retrospective cohort of children admitted to a 400-bed tertiary teaching hospital in Izmir, Turkey whose vancomycin-resistant enterococci colonization was newly detected during routine surveillances for gastrointestinal vancomycin-resistant enterococci colonization during the period of January 2009 and December 2012 were included in this study. All vancomycin-resistant enterococci isolates found within 18 months after initial detection were evaluated for evidence of infection.Findings: Two hundred and sixteen patients with vancomycin-resistant enterococci were included in the study. Vancomycin-resistant enterococci colonization was detected in 136 patients (62.3% while they were hospitalized at intensive care units; while the remaining majority (33.0% were hospitalized at hematology-oncology department. Vancomycinresistant enterococci bacteremia was present only in three (1.55% patients. All these patients were immunosuppressed due to human immunodeficiency virus (one patient and intensive chemotherapy (two patients.Conclusion:In conclusion, our study found that 1.55% of vancomycin-resistant enterococcicolonized children had developed vancomycin-resistant enterococci bloodstream infection among the pediatric intensive care unit and hematology/oncology patients; according to our findings, we suggest that immunosupression is the key point for developing vancomycinresistant enterococci bloodstream infections.

  1. Delays in Appropriate Antibiotic Therapy for Gram-Negative Bloodstream Infections: A Multicenter, Community Hospital Study

    OpenAIRE

    Moehring, Rebekah W.; Richard Sloane; Chen, Luke F.; Smathers, Emily C.; Schmader, Kenneth E.; Fowler, Vance G.; Weber, David J.; Sexton, Daniel J.; Anderson, Deverick J.

    2013-01-01

    BACKGROUND: Gram-negative bacterial bloodstream infection (BSI) is a serious condition with estimated 30% mortality. Clinical outcomes for patients with severe infections improve when antibiotics are appropriately chosen and given early. The objective of this study was to estimate the association of prior healthcare exposure on time to appropriate antibiotic therapy in patients with gram-negative BSI. METHOD: We performed a multicenter cohort study of adult, hospitalized patients with gram-ne...

  2. Efficacy of an infection control programme in reducing nosocomial bloodstream infections in a Senegalese neonatal unit.

    Science.gov (United States)

    Landre-Peigne, C; Ka, A S; Peigne, V; Bougere, J; Seye, M N; Imbert, P

    2011-10-01

    Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Pnosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries.

  3. Tsukamurella catheter-related bloodstream infection in a pediatric patient with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Kristen A. Wendorf

    2010-03-01

    Full Text Available Catheter-related bloodstream infections (CR-BSI are important complications in patients with long-term indwelling central venous catheters. In this report, we present the case of a 14-year-old male with pulmonary hypertension treated with continuous treprostinil infusion, who presented with a CR-BSI caused by a Tsukamurella species. This case highlights the potential for this unusual organism to cause infection in immunocompetent patients.

  4. Muscle Releases Alpha-Sarcoglycan Positive Extracellular Vesicles Carrying miRNAs in the Bloodstream

    OpenAIRE

    Michele Guescini; Barbara Canonico; Francesco Lucertini; Serena Maggio; Giosué Annibalini; Elena Barbieri; Francesca Luchetti; Stefano Papa; Vilberto Stocchi

    2015-01-01

    In the past few years, skeletal muscle has emerged as an important secretory organ producing soluble factors, called myokines, that exert either autocrine, paracrine or endocrine effects. Moreover, recent studies have shown that muscle releases microRNAs into the bloodstream in response to physical exercise. These microRNAs affect target cells, such as hormones and cytokines. The mechanisms underlying microRNA secretion are poorly characterized at present. Here, we investigated whether muscle...

  5. Control method exploration of nosocomial bloodstream infection and its effect evaluation

    Institute of Scientific and Technical Information of China (English)

    CHAI Wen-zhao; WANG Xiao-ting; ZHOU Jiong; LI Xin; LUO Hong-bo; LIU Da-wei

    2012-01-01

    Background Currently,slightly more than 50% of bloodstream infections (BSIs) are hospital acquired.When these infections occur in patients in intensive care units,they are associated with a high mortality rate,additional hospital days and excess hospital costs.Because of multifactor of nosocomial BSIs,measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice.The aim of this study was to explore special way in accordance with self-hospital base on common principle.Methods In one ward of the Intensive Care Unit,Peking Union Medical College Hospital,at first,we divided the all operation about bloodstream way into three sections used as keypoints.By surveying keypoints respectively,some operation faults of blood way were discovered.For decreasing the mobidity of nosocomial BSls,some intervention measurements were executed.The rate of nosocomial BSIs was analyzed by chi-square test.Results According to the statistics from January to June,we received and cured 618 patients in total; among them,there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month.After intervention measurements from July to December 2011,we received and cured 639 patients in total with seven cases of nosocomial BSI,and the average occurrence was 1.2 cases/month (P <0.05).From January to April 2012,no nosocomial BSI occurred in the investigated ward.Conclusion Removing the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.

  6. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Lars Skov Dalgaard

    Full Text Available Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients.In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients during 1995-2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression.Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI, 12.5-15.0 per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50-0.56 per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8% and Escherichia coli (12.6%. The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%-20% vs. 18% (95% CI, 15%-20%.Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls.

  7. Risk and Prognosis of Bloodstream Infections among Patients on Chronic Hemodialysis: A Population-Based Cohort Study

    Science.gov (United States)

    Skov Dalgaard, Lars; Nørgaard, Mette; Jespersen, Bente; Jensen-Fangel, Søren; Østergaard, Lars Jørgen; Schønheyder, Henrik Carl; Søgaard, Ole Schmeltz

    2015-01-01

    Background and Objectives Infections are common complications among patients on chronic hemodialysis. This population-based cohort study aims to estimate risk and case fatality of bloodstream infection among chronic hemodialysis patients. Methods In this population-based cohort study we identified residents with end-stage renal disease in Central and North Jutland, Denmark who had hemodialysis as first renal replacement therapy (hemodialysis patients) during 1995–2010. For each hemodialysis patient, we sampled 19 persons from the general population matched on age, gender, and municipality. Information on positive blood cultures was obtained from regional microbiology databases. All persons were observed from cohort entry until first episode of bloodstream infection, emigration, death, or end of hemodialysis treatment, whichever came first. Incidence-rates and incidence-rate ratios were computed and risk factors for bloodstream infection assessed by Poisson regression. Case fatality was compared by Cox regression. Results Among 1792 hemodialysis patients and 33 618 matched population controls, we identified 461 and 1126 first episodes of bloodstream infection, respectively. Incidence rates of first episode of bloodstream infection were 13.7 (95% confidence interval (CI), 12.5–15.0) per 100 person-years among hemodialysis patients and 0.53 (95% CI, 0.50–0.56) per 100 person-years among population controls. In hemodialysis patients, the most common causative microorganisms were Staphylococcus aureus (43.8%) and Escherichia coli (12.6%). The 30-day case fatality was similar among hemodialysis patients and population controls 16% (95% CI, 13%–20%) vs. 18% (95% CI, 15%–20%). Conclusions Hemodialysis patients have extraordinary high risk of bloodstream infection while short-term case fatality following is similar to that of population controls. PMID:25910221

  8. Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics

    Directory of Open Access Journals (Sweden)

    Mariana V. Arnoni

    2007-04-01

    Full Text Available The aim of this study was to identify the risk factors for nosocomial bloodstream infections by multidrug resistant Gram-negative bacilli. From November 2001 to December 2003, in the Pediatric Department of the Santa Casa de São Paulo, a retrospective case-control study was developed concerning patients who had nosocomial bloodstream infection caused by Gram-negative bacilli. Patients with multidrug resistant infections were designated as case patients, and control patients were those with an infection that did not meet the criteria for multidrug resistance. Previous use of central venous catheter and previous use of vancomycin plus third generation cephalosporins were associated to a higher chance of infections by multidrug resistant Gram-negative bacilli (Odds ratio - 5.8 and 5.2, respectively. Regarding sensitivity of the isolated agents, 47.8% were multidrug resistant, 54.2% were Klebsiella spp. ESBL producers and 36.4% were imipenem resistant Pseudomonas aeruginosa. The lethality rate was 36.9% in the studied cases and this rate was significantly higher in the group of patients with multidrug resistant infections (p=0.013. Risk factor identification as well as the knowledge of the susceptibility of the nosocomial infectious agents gave us the possibility to perform preventive and control strategies to reduce the costs and mortality related to these infections.

  9. Muscle Releases Alpha-Sarcoglycan Positive Extracellular Vesicles Carrying miRNAs in the Bloodstream.

    Directory of Open Access Journals (Sweden)

    Michele Guescini

    Full Text Available In the past few years, skeletal muscle has emerged as an important secretory organ producing soluble factors, called myokines, that exert either autocrine, paracrine or endocrine effects. Moreover, recent studies have shown that muscle releases microRNAs into the bloodstream in response to physical exercise. These microRNAs affect target cells, such as hormones and cytokines. The mechanisms underlying microRNA secretion are poorly characterized at present. Here, we investigated whether muscle tissue releases extracellular vesicles (EVs, which carry microRNAs in the bloodstream under physiological conditions such as physical exercise. Using density gradient separation of plasma from sedentary and physically fit young men we found EVs positive for TSG101 and alpha-sarcoglycan (SGCA, and enriched for miR-206. Cytometric analysis showed that the SGCA+ EVs account for 1-5% of the total and that 60-65% of these EVs were also positive for the exosomal marker CD81. Furthermore, the SGCA-immuno captured sub-population of EVs exhibited higher levels of the miR-206/miR16 ratio compared to total plasma EVs. Finally, a significant positive correlation was found between the aerobic fitness and muscle-specific miRNAs and EV miR-133b and -181a-5p were significantly up-regulated after acute exercise. Thus, our study proposes EVs as a novel means of muscle communication potentially involved in muscle remodeling and homeostasis.

  10.   Bloodstream Bacterial Pathogens and their Antibiotic Resistance Pattern in Dhahira Region, Oman

    Directory of Open Access Journals (Sweden)

    PP Geethanjali

    2011-07-01

    Full Text Available Objectives: To describe the epidemiological, clinical, microbiological characteristics and antimicrobial resistance pattern of Bloodstream infections in Dhahira region, Oman.Methods: Clinical data was collected from all patients with positive blood cultures for two years period. Standard laboratory methods were used for blood culture. Antibiotic sensitivity was tested using Kirby-Bauer disc diffusion method.Results: Of the 360 bacterial pathogens isolated from 348 patients, 57.8�0were gram-positive and 42.2�0were gram-negative. The common isolates were: Streptococcus species 76 (21.1� coagulase-negative Staphylococci 75 (20.8� Escherichia coli 43 (11.9� Staphylococcus aureus 41 (11.4� Overall, mortality was 21.3�0(74/348. Staphylococcus species (Staphylococcus aureus and CoNS were more commonly resistant to Trimethoprim/ Sulphamethoxazole (35.3�20and Penicillin (25.9� Streptococcus species were resistant to Trimethoprim/Sulphamethoxazole (39.1�20and Erythromycin (19.6�Conclusion: Bloodstream infections are important causes of morbidity and mortality in our patients, especially among chronically ill elderly adult males. Prescription of proven resistant antibiotics to suspected bacteremic patients needs attention in Dhahira region.

  11. Determination of germ tube, phospholipase, and proteinase production by bloodstream isolates of Candida albicans

    Directory of Open Access Journals (Sweden)

    Antonella Souza Mattei

    2013-06-01

    Full Text Available Introduction Candida albicans is a commensal and opportunistic agent that causes infection in immunocompromised individuals. Several attributes contribute to the virulence and pathogenicity of this yeast, including the production of germ tubes (GTs and extracellular hydrolytic enzymes, particularly phospholipase and proteinase. This study aimed to investigate GT production and phospholipase and proteinase activities in bloodstream isolates of C. albicans. Methods One hundred fifty-three C. albicans isolates were obtained from blood samples and analyzed for GT, phospholipase, and proteinase production. The assays were performed in duplicate in egg yolk medium containing bovine serum albumin and human serum. Results Detectable amounts of proteinase were produced by 97% of the isolates, and 78% of the isolates produced phospholipase. GTs were produced by 95% of the isolates. A majority of the isolates exhibited low levels of phospholipase production and high levels of proteinase production. Conclusions Bloodstream isolates of C. albicans produce virulence factors such as GT and hydrolytic enzymes that enable them to cause infection under favorable conditions.

  12. Algorithm for pre-emptive glycopeptide treatment in patients with haematologic malignancies and an Enterococcus faecium bloodstream infection

    NARCIS (Netherlands)

    Zhou, Xuewei; Arends, Jan P; Span, Lambert Fr; Friedrich, Alexander W

    2013-01-01

    INTRODUCTION: Nowadays Enterococcus faecium has become one of the most emerging and challenging nosocomial pathogens. The aim of this study was to determine risk factors in haematology patients who are at risk of an Enterococcus faecium bloodstream infection (BSI) and should be considered for pre-em

  13. The Aetiology of the Bloodstream Infections in the Patients Who Presented to a Tertiary Care Teaching Hospital in Kathmandu, Nepal

    OpenAIRE

    Pandey, Santwana; Raza, Shahid; Bhatta, Chandra Prakash

    2013-01-01

    Background: Bloodstream infections are associated with a significant patient morbidity and mortality. The detection of microorganisms in the patients’ blood has a great diagnostic and prognostic significance. The early positive results provide valuable diagnostic information, based on which the appropriate antimicrobial therapy can be initiated.

  14. Patients with Central Lines — What You Need to Know to Avoid a Bloodstream Infection

    Centers for Disease Control (CDC) Podcasts

    2011-03-01

    This podcast is based on the March, 2011 CDC Vital Signs report which indicates bloodstream infections in patients with central lines are largely preventable when healthcare providers use CDC-recommended infection control steps.  Created: 3/1/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/1/2011.

  15. Antifungal susceptibility of invasive Candida bloodstream isolates from the Asia-Pacific region.

    Science.gov (United States)

    Tan, Thean Yen; Hsu, Li Yang; Alejandria, Marissa M; Chaiwarith, Romanee; Chinniah, Terrence; Chayakulkeeree, Methee; Choudhury, Saugata; Chen, Yen Hsu; Shin, Jong Hee; Kiratisin, Pattarachai; Mendoza, Myrna; Prabhu, Kavitha; Supparatpinyo, Khuanchai; Tan, Ai Ling; Phan, Xuan Thi; Tran, Thi Thanh Nga; Nguyen, Gia Binh; Doan, Mai Phuong; Huynh, Van An; Nguyen, Su Minh Tuyet; Tran, Thanh Binh; Van Pham, Hung

    2016-07-01

    Bloodstream infections caused by Candida species are of increasing importance and associated with significant mortality. We performed a multi-centre prospective observational study to identify the species and antifungal susceptibilities of invasive bloodstream isolates of Candida species in the Asia-Pacific region. The study was carried out over a two year period, involving 13 centers from Brunei, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Identification of Candida species was performed at each study center, and reconfirmed at a central laboratory. Susceptibility testing was performed using a commercial broth dilution panel (Sensititre YeastOne YST-010, Thermofisher, United Kingdom) with susceptibility categorisation (S = susceptible, S-DD = susceptible dose-dependent) applied using breakpoints from the Clinical Laboratory Standards Institute. Eight hundred and sixty-one Candida isolates were included in the study. The most common species were C. albicans (35.9%), C. tropicalis (30.7%), C. parapsilosis (15.7%), and C. glabrata (13.6%). Non-albicans species exceeded C. albicans species in centers from all countries except Taiwan. Fluconazole susceptibility was almost universal for C. albicans (S = 99.7%) but lower for C. tropicalis (S = 75.8%, S-DD = 6.1%), C. glabrata (S-DD = 94.9%), and C. parapsilosis (S = 94.8%). Echinocandins demonstrated high rates of in vitro susceptibility (S>99%) against C. albicans, C. tropicalis, and C. parapsilosis This study demonstrates that non-albicans species are the most common isolates from bloodstream infections in most countries in the Asia-Pacific region, with C. tropicalis as the predominant species. Because of the prevalence of reduced susceptibility to fluconazole in non-albicans species, the study indicates that echinocandins should be the antifungal of choice in clinically unstable or high-risk patients with documented candidemia. PMID:26868904

  16. Taurolidine lock is superior to heparin lock in the prevention of catheter related bloodstream infections and occlusions.

    Directory of Open Access Journals (Sweden)

    Evelyn D Olthof

    Full Text Available BACKGROUND AND AIMS: Patients on home parenteral nutrition (HPN are at risk for catheter-related complications; mainly infections and occlusions. We have previously shown in HPN patients presenting with catheter sepsis that catheter locking with taurolidine dramatically reduced re-infections when compared with heparin. Our HPN population therefore switched from heparin to taurolidine in 2008. The aim of the present study was to compare long-term effects of this catheter lock strategy on the occurrence of catheter-related bloodstream infections and occlusions in HPN patients. METHODS: Data of catheter-related complications were retrospectively collected from 212 patients who received HPN between January 2000 and November 2011, comprising 545 and 200 catheters during catheter lock therapy with heparin and taurolidine, respectively. We evaluated catheter-related bloodstream infection and occlusion incidence rates using Poisson-normal regression analysis. Incidence rate ratios were calculated by dividing incidence rates of heparin by those of taurolidine, adjusting for underlying disease, use of anticoagulants or immune suppressives, frequency of HPN/fluid administration, composition of infusion fluids, and duration of HPN/fluid use before catheter creation. RESULTS: Bloodstream infection incidence rates were 1.1/year for heparin and 0.2/year for taurolidine locked catheters. Occlusion incidence rates were 0.2/year for heparin and 0.1/year for taurolidine locked catheters. Adjusted incidence ratios of heparin compared to taurolidine were 5.9 (95% confidence interval, 3.9-8.7 for bloodstream infections and 1.9 (95% confidence interval, 1.1-3.1 for occlusions. CONCLUSIONS: Given that no other procedural changes than the catheter lock strategy were implemented during the observation period, these data strongly suggest that taurolidine decreases catheter-related bloodstream infections and occlusions in HPN patients compared with heparin.

  17. Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review 1

    Science.gov (United States)

    Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

    2016-01-01

    ABSTRACT Objective: to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. Method: systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. Results: the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. Conclusions: care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units. PMID:27598378

  18. JVG9, a benzimidazole derivative, alters the surface and cytoskeleton of Trypanosoma cruzi bloodstream trypomastigotes

    Science.gov (United States)

    Díaz-Chiguer, Dylan L; Hernández-Luis, Francisco; Nogueda-Torres, Benjamín; Castillo, Rafael; Reynoso-Ducoing, Olivia; Hernández-Campos, Alicia; Ambrosio, Javier R

    2014-01-01

    Trypanosoma cruzi has a particular cytoskeleton that consists of a subpellicular network of microtubules and actin microfilaments. Therefore, it is an excellent target for the development of new anti-parasitic drugs. Benzimidazole 2-carbamates, a class of well-known broad-spectrum anthelmintics, have been shown to inhibit the in vitro growth of many protozoa. Therefore, to find efficient anti-trypanosomal (trypanocidal) drugs, our group has designed and synthesised several benzimidazole derivatives. One, named JVG9 (5-chloro-1H-benzimidazole-2-thiol), has been found to be effective against T. cruzi bloodstream trypomastigotes under both in vitro and in vivo conditions. Here, we present the in vitro effects observed by laser scanning confocal and scanning electron microscopy on T. cruzi trypomastigotes. Changes in the surface and the distribution of the cytoskeletal proteins are consistent with the hypothesis that the trypanocidal activity of JVG9 involves the cytoskeleton as a target. PMID:25317703

  19. The interactions between bloodstream and vascular structure on aortic dissecting aneurysmal model: A numerical study

    Science.gov (United States)

    Chen, Zeng-Sheng; Fan, Zhan-Ming; Zhang, Xi-Wen

    2013-06-01

    Stent-graft implantation is an important means of clinical treatment for aortic dissecting aneurysm (ADA). However, researches on fluid dynamics effects of stent were rare. Computer simulation was used to investigate the interactions between bloodstream and vascular structure in a stented ADA, which endures the periodic pulse velocity and pressure. We obtained and analyzed the flow velocity distribution, the wall displacement and wall stress in the ADA. By comparing the different results between a non-stented and a stented ADA, we found that the insertion of a vascular graft can make the location of maximum stress and displacement move from the aneurysm lumen wall to the artery wall, accompanied with a greatly decrease in value. These results imply that the placement of a stent-graft of any kind to occlude ADA will result in a decreased chance of rupture.

  20. Bloodstream infection among children presenting to a general hospital outpatient clinic in urban Nepal.

    Directory of Open Access Journals (Sweden)

    Rahul Pradhan

    Full Text Available BACKGROUND: There are limited data on the etiology and characteristics of bloodstream infections in children presenting in hospital outpatient settings in South Asia. Previous studies in Nepal have highlighted the importance of murine typhus as a cause of febrile illness in adults and enteric fever as a leading bacterial cause of fever among children admitted to hospital. METHODS: We prospectively studied a total of 1084 febrile children aged between 2 months and 14 years presenting to a general hospital outpatient department in Kathmandu Valley, Nepal, over two study periods (summer and winter. Blood from all patients was tested by conventional culture and by real-time PCR for Rickettsia typhi. RESULTS: Putative etiological agents for fever were identified in 164 (15% patients. Salmonella enterica serovar Typhi (S. Typhi was identified in 107 (10%, S. enterica serovar Paratyphi A (S. Paratyphi in 30 (3%, Streptococcus pneumoniae in 6 (0.6%, S. enterica serovar Typhimurium in 2 (0.2%, Haemophilus influenzae type b in 1 (0.1%, and Escherichia coli in 1 (0.1% patient. S. Typhi was the most common organism isolated from blood during both summer and winter. Twenty-two (2% patients were PCR positive for R. typhi. No significant demographic, clinical and laboratory features distinguished culture positive enteric fever and murine typhus. CONCLUSIONS: Salmonella infections are the leading cause of bloodstream infection among pediatric outpatients with fever in Kathmandu Valley. Extension of immunization programs against invasive bacterial disease to include the agents of enteric fever and pneumococcus could improve the health of children in Nepal.

  1. 肾移植患者血流感染死亡的危险因素分析%Analysis of the risk factors for death in patients with bloodstream infections after renal transplantation

    Institute of Scientific and Technical Information of China (English)

    蒋欣; 曲青山; 李明; 邢利; 苗书斋

    2014-01-01

    OBJECTIVE To investigate the risk factors for death in patients with bloodstream infections after renal transplantation ,to provide the basis for prevention of bloodstream infections and clinical evaluation of patient prognosis .METHODS The clinical data of 217 patients with bloodstream infections after renal transplantation were retrospectively analyzed .The general information ,clinical data and related laboratory results of the patients were collected through the self-made survey form .The risk factors for death were analyzed by single factor analysis and multi factor analysis with the establishment of database .Data were analyzed by SPSS 17 .0 .RESULTS Totally 78 .80% of bloodstream infections after renal transplantation was nosocomial infections ,29 .95% were due to non-standard use of antibiotics .There were 72 cases of death in the 217 patients ,the mortality was 33 .18% .The main type of primary disease was chronic glomerulonephritis (66 .82% ) .The multivariate analysis showed that septic shock and platelet count <50 × 109/L were the independent risk factors for death in patients with blood-stream infections after renal transplantation .CONCLUSION Septic shock and platelet count <50 × 109/L are inde-pendent risk factors for death in patients with bloodstream infection after renal transplantation ,the clinical preven-tion measures should be adopted ,as soon as possible to avoid blood infection and reduce mortality in patients with renal transplantation .%目的:探讨肾移植患者血流感染死亡的危险因素,为临床评估患者预后和预防血流感染的发生提供依据。方法回顾性分析自2002年6月-2013年6月接受肾移植发生血流感染的217例患者临床资料,通过自制的调查表格收集患者的一般信息、临床资料和相关的实验室检查结果,建立数据库后通过单因素分析和多因素分析探讨肾移植患者并发血流感染死亡危险因素,数据采用SPSS 17.0进行分析。

  2. Equipe interdisciplinar reduz infecção sanguínea relacionada ao cateter venoso central em Unidade de Terapia Intensiva Pediátrica Interdisciplinary task-force reduces catheter-related bloodstream infection in a Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Ricardo Vilela

    2010-12-01

    Full Text Available OBJETIVO: Avaliar o impacto de intervenções interdisciplinares nos indicadores de infecção de corrente sanguínea relacionada ao cateter venoso central e microrganismos isolados, em uma Unidade de Terapia Intensiva Pediátrica. MÉTODOS: Estudo de intervenção do tipo antes e depois. Foi criado um programa educativo e constituída uma equipe interdisciplinar de intervenção composta por médicos e enfermeiros da unidade e do Serviço de Controle de Infecção Hospitalar. As intervenções foram compostas por medidas diretas e indiretas educativas e processuais. O período pré-intervenção (Fase 1, de junho de 2003 a maio de 2004, foi comparado ao período pós-intervenção nas Fases 2 (junho de 2004 a maio de 2005 e 3 (junho de 2005 a maio de 2006. As taxas de infecção foram comparadas por ANOVA, sendo significante pOBJECTIVE: To determine the impact of interdisciplinary interventions on central venous catheter-related bloodstream infections rates in a Pediatric Intensive Care Unit (PICU and on the bloodstream infection organisms. METHODS: Interventional study type before-and-after. An educational program was performed and an interdisciplinary team of interventions was created. This team was formed by nurses and doctors of the PICU and of the Infection Control Committee. The interventions were composed by direct and indirect educational and procedural measures. Task-force interventions were developed from Jun/2003 to May/2004. This pre-intervention period (Phase 1 was compared with two post-intervention periods: Phases 2 (Jun/2004 to May/2005 and 3 (Jun/2005 to May/2006. Central venous catheter-related bloodstream infection rates during the three periods were compared by ANOVA, being significant p<0.05. RESULTS: 1,234 patients were studied from June 1st 2003 to May 31, 2006. The number of central venous catheter-related bloodstream infections was 22.72 per 1,000 catheter-days in Phase 1, and 6.81 and 5.87 in Phases 2 and 3

  3. Delay in the administration of appropriate antimicrobial therapy in Staphylococcus aureus bloodstream infection : A prospective multicenter hospital-based cohort study

    NARCIS (Netherlands)

    Kaasch, A. J.; Rieg, S.; Kuetscher, J.; Brodt, H. -R.; Widmann, T.; Herrmann, M.; Meyer, C.; Welte, T.; Kern, P.; Haars, U.; Reuter, S.; Huebner, I.; Strauss, R.; Sinha, B.; Brunkhorst, F. M.; Hellmich, M.; Faetkenheuer, G.; Kern, W. V.; Seifert, H.

    2013-01-01

    Early broad-spectrum antimicrobial treatment reduces mortality in patients with septic shock. In a multicenter, prospective observational study, we explored whether delayed appropriate antimicrobial therapy (AAT) influences outcome in Staphylococcus aureus bloodstream infection (SAB). Two hundred an

  4. The application of High Resolution Melting Analysis (HRMA) for rapid detection of bacteria responsible for bloodstream infections

    OpenAIRE

    Ozbak, Hani

    2013-01-01

    Abstract: Background: The diagnosis of bloodstream infection is a significant challenge for healthcare providers and is often associated with severe illness (sepsis) and poor outcomes. Rapid detection and identification of pathogens followed by characterisation of antibiotic resistance could help direct early treatment and improve patient care. Standard blood culture methods, which usually take 2-5 days to complete, can confirm if there is a bacteraemia or not in suspected patients. However, ...

  5. A simple method to purify biologically and antigenically preserved bloodstream trypomastigotes of Trypanosoma cruzi using Deae-cellulose columns

    OpenAIRE

    Maria Auxiliadora de Sousa

    1983-01-01

    A method to purify trypanosomastigotes of some strains of Trypanosoma cruzi (Y, CL, FL, F, "Berenice", "Colombiana" and "São Felipe") from mouse blood by using DEAE-cellulose columns was standardized. This procedure is a modification of the Lanham & Godfrey methods and differs in some aspects from others described to purify T. cruzi bloodstream trypomastigotes, mainly by avoidance of prior purifications of parasites. By this method, the broad trypomastigotes were mainly isolated, accounting f...

  6. Molecular and Clinical Characteristics of Hospital and Community Onset Methicillin-Resistant Staphylococcus aureus Strains Associated with Bloodstream Infections

    OpenAIRE

    Wang, Shu-Hua; Hines, Lisa; van Balen, Joany; José R Mediavilla; Pan, Xueliang; Hoet, Armando E; Kreiswirth, Barry N.; Pancholi, Preeti; Stevenson, Kurt B.

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) are classified epidemiologically as health care-associated hospital onset (HAHO)-, health care-associated community onset (HACO)-, or community-associated (CA)-MRSA. Clinical and molecular differences between HAHO- and HACO-MRSA BSI are not well known. Thus, we evaluated clinical and molecular characteristics of MRSA BSI to determine if distinct features are associated with HAHO- or HACO-MRSA strains. Molecular ge...

  7. Monitoring Quality of Care Through Linkage of Administrative Data: National Trends in Bloodstream Infection in UK PICUs 2003-2012

    OpenAIRE

    Harron, K.; Parslow, R.; Mok, Q; Tibby, S. M.; WADE, A.; Muller-Pebody, B; Gilbert, R.

    2015-01-01

    Objectives: Interventions to reduce hospital-acquired bloodstream infection (BSI) have succeeded in reducing rates in US paediatric intensive care units (PICUs) but there is a lack of evidence for the impact of similar interventions in the UK. We assessed variation in BSI rates within and between PICUs over a 10-year period, during which time infection control strategies (care bundles) were implemented. Design: Observational study linking laboratory data to national audit data of paediatric i...

  8. Risk-adjusted monitoring of blood-stream infection in paediatric intensive care: a data linkage study

    OpenAIRE

    Harron, K.; WADE, A.; Muller-Pebody, B; Goldstein, H.; Parslow, R.; Gray, J.; Hartley, J. C.; Mok, Q; Gilbert, R.

    2013-01-01

    PURPOSE: National monitoring of variation in the quality of infection control in paediatric intensive care units (PICUs) requires comparisons of risk-adjusted rates. To inform the development of a national monitoring system, we evaluated the effects of risk-adjustment and outcome definition on comparisons of blood-stream infection (BSI) rates in PICU, using linkage of risk-factor data captured by national audit (PICANet) with laboratory records of BSI. METHODS: Admission data for two children...

  9. Genome-wide expression profiling of in vivo-derived bloodstream parasite stages and dynamic analysis of mRNA alterations during synchronous differentiation in Trypanosoma brucei

    Directory of Open Access Journals (Sweden)

    Ghazal Peter

    2009-09-01

    Full Text Available Abstract Background Trypanosomes undergo extensive developmental changes during their complex life cycle. Crucial among these is the transition between slender and stumpy bloodstream forms and, thereafter, the differentiation from stumpy to tsetse-midgut procyclic forms. These developmental events are highly regulated, temporally reproducible and accompanied by expression changes mediated almost exclusively at the post-transcriptional level. Results In this study we have examined, by whole-genome microarray analysis, the mRNA abundance of genes in slender and stumpy forms of T.brucei AnTat1.1 cells, and also during their synchronous differentiation to procyclic forms. In total, five biological replicates representing the differentiation of matched parasite populations derived from five individual mouse infections were assayed, with RNAs being derived at key biological time points during the time course of their synchronous differentiation to procyclic forms. Importantly, the biological context of these mRNA profiles was established by assaying the coincident cellular events in each population (surface antigen exchange, morphological restructuring, cell cycle re-entry, thereby linking the observed gene expression changes to the well-established framework of trypanosome differentiation. Conclusion Using stringent statistical analysis and validation of the derived profiles against experimentally-predicted gene expression and phenotypic changes, we have established the profile of regulated gene expression during these important life-cycle transitions. The highly synchronous nature of differentiation between stumpy and procyclic forms also means that these studies of mRNA profiles are directly relevant to the changes in mRNA abundance within individual cells during this well-characterised developmental transition.

  10. Elimination of Bloodstream Infections Associated with Candida albicans Biofilm in Intravascular Catheters

    Directory of Open Access Journals (Sweden)

    Freshta Akbari

    2015-06-01

    Full Text Available Intravascular catheters are among the most commonly inserted medical devices and they are known to cause a large number of catheter related bloodstream infections (BSIs. Biofilms are associated with many chronic infections due to the aggregation of microorganisms. One of these organisms is the fungus Candida albicans. It has shown to be one of the leading causes of catheter-related BSIs. The presence of biofilm on intravascular catheters provide increased tolerance against antimicrobial treatments, thus alternative treatment strategies are sought. Traditionally, many strategies, such as application of combined antimicrobials, addition of antifungals, and removal of catheters, have been practiced, but they were not successful in eradicating BSIs. Since these fungal infections can result in significant morbidity, mortality, and increased healthcare cost, other promising preventive strategies, including antimicrobial lock therapy, chelating agents, alcohol, and biofilm disruptors, have been applied. In this review, current success and failure of these new approaches, and a comparison with the previous strategies are discussed in order to understand which preventative treatment is the most effective in controlling the catheter-related BSIs.

  11. Bacillus Cereus catheter related bloodstream infection in a patient in a patient with acute lymphblastic leukemia

    Directory of Open Access Journals (Sweden)

    Lütfiye Öksüz

    2012-01-01

    Full Text Available Bacillus cereus infection is rarely associated with actual infection and for this reason single positive blood culture is usually regarded as contamination . However it may cause a number of infections, such catheter-related blood stream infections. Significant catheter-related bloodstream infections (CRBSI caused by Bacillus spp. are mainly due to B.cereus and have been predominantly reported in immunocompromised hosts1 . Catheter removal is generally advised for management of infection. In this report, catheter-related bacteremia caused by B.cereus in a patient with acute lymphoblastıc leukemia (ALL in Istanbul Medical Faculty was presented.A 44-year old man presented with fatigue, weight loss, epistaxis and high fever. A double-lumen Hickman–catheter (Bard 12.0 Fr, Round Dual Lumen was inserted by surgical cut-down to access the right subclavian vein which would be necessary for allogeneic stem cell transplantation. Three weeks later the patient presented with high fever and headache. Bacillus spp. was isolated from the cathether while blood culture obtained from the peripheral vein remained negative. The bacterial identification was confirmed as B.cereus using VITEK identification system It has been reported Bacillus cereus septicemia may be fatal in immunocompromised hosts despite broad-spectrum appropriate treatment10. Catheter removal is essential for prevention of recurrent bacteremia. Long-term cathater salvage should be reserved for appropriate patient group.

  12. Magnet® Hospital Recognition Linked to Lower Central Line-Associated Bloodstream Infection Rates.

    Science.gov (United States)

    Barnes, Hilary; Rearden, Jessica; McHugh, Matthew D

    2016-04-01

    Central-line-associated bloodstream infections (CLABSI) are among the deadliest heathcare-associated infections, with an estimated 12-25% mortality rate. In 2014, the Centers for Medicare and Medicaid Services (CMS) began to penalize hospitals for poor performance with respect to selected hospital-acquired conditions, including CLABSI. A structural factor associated with high-quality nursing care and better patient outcomes is The Magnet Recognition Program®. The purpose of this study was to explore the relationship between Magnet status and hospital CLABSI rates. We used propensity score matching to match Magnet and non-Magnet hospitals with similar hospital characteristics. In a matched sample of 291 Magnet hospitals and 291 non-Magnet hospitals, logistic regression models were used to examine whether there was a link between Magnet status and CLABSI rates. Both before and after matching, Magnet hospital status was associated with better (lower than the national average) CLABSI rates (OR = 1.60, 95%CI: 1.10, 2.33 after matching). While established programs such as Magnet recognition are consistently correlated with high-quality nursing work environments and positive patient outcomes, additional research is needed to determine whether Magnet designation produces positive patient outcomes or rewards existing excellence.

  13. New Insight on Epidemiology and Management of Bacterial Bloodstream Infection in Patients with Hematological Malignancies.

    Science.gov (United States)

    Menzo, Sara Lo; la Martire, Giulia; Ceccarelli, Giancarlo; Venditti, Mario

    2015-01-01

    Bloodstream infections (BSI) are a significant cause of morbidity and mortality in onco-hematologic patients. The Gram-negative bacteria were the main responsible for the febrile neutropenia in the sixties; their impact declined due to the use of fluoroquinolone prophylaxis. This situation was followed by the gradual emergence of Gram-positive bacteria also following the increased use of intravascular devices and the introduction of new chemotherapeutic strategies. In the last decade, the Gram-negative etiology is raising again because of the emergence of resistant strains that make questionable the usefulness of current strategies for prophylaxis and empirical treatment. Gram-negative BSI attributable mortality is relevant, and the appropriate empirical treatment significantly improves the prognosis; on the other hand the adequate delayed treatment of Gram-positive BSI does not seem to have a high impact on survival. The clinician has to be aware of the epidemiology of his institution and colonizations of his patients to choose the most appropriate empiric therapy. In a setting of high endemicity of multidrug-resistant infections also the choice of targeted therapy can be a challenge, often requiring strategies based on off-label prescriptions and low grade evidence. In this review, we summarize the current evidence for the best targeted therapies for difficult to treat bacteria BSIs and future perspectives in this topic. We also provide a flow chart for a rational approach to the empirical treatment of febrile neutropenia in a multidrug resistant, high prevalence setting. PMID:26185609

  14. Magnet® Hospital Recognition Linked to Lower Central Line-Associated Bloodstream Infection Rates.

    Science.gov (United States)

    Barnes, Hilary; Rearden, Jessica; McHugh, Matthew D

    2016-04-01

    Central-line-associated bloodstream infections (CLABSI) are among the deadliest heathcare-associated infections, with an estimated 12-25% mortality rate. In 2014, the Centers for Medicare and Medicaid Services (CMS) began to penalize hospitals for poor performance with respect to selected hospital-acquired conditions, including CLABSI. A structural factor associated with high-quality nursing care and better patient outcomes is The Magnet Recognition Program®. The purpose of this study was to explore the relationship between Magnet status and hospital CLABSI rates. We used propensity score matching to match Magnet and non-Magnet hospitals with similar hospital characteristics. In a matched sample of 291 Magnet hospitals and 291 non-Magnet hospitals, logistic regression models were used to examine whether there was a link between Magnet status and CLABSI rates. Both before and after matching, Magnet hospital status was associated with better (lower than the national average) CLABSI rates (OR = 1.60, 95%CI: 1.10, 2.33 after matching). While established programs such as Magnet recognition are consistently correlated with high-quality nursing work environments and positive patient outcomes, additional research is needed to determine whether Magnet designation produces positive patient outcomes or rewards existing excellence. PMID:26809115

  15. Survey of physicians' perspectives and knowledge about diagnostic tests for bloodstream infections.

    Directory of Open Access Journals (Sweden)

    Rosemary C She

    Full Text Available Physicians rely on blood culture to diagnose bloodstream infections (BSI despite its limitations. As new technologies emerge for rapid BSI diagnosis, optimization of their application to patient care requires an understanding of clinicians' perspectives on BSI diagnosis and how a rapid test would influence medical decisions.We administered a 26-question survey to practitioners in infectious diseases/microbiology, critical care, internal medicine, and hematology/oncology services in USA and Germany about current standards in diagnosing and treating BSI and a hypothetical rapid BSI test.Responses from 242 providers had roughly equal representation across specialties. For suspected BSI patients, 78% of practitioners would administer empiric broad spectrum antibiotics although they estimated, on average, that 31% of patients received incorrect antibiotics while awaiting blood culture results. The ability of blood culture to rule in or rule out infection was very/extremely acceptable in 67% and 36%, respectively. Given rapid test results, 60-87% of practitioners would narrow the spectrum of antimicrobial therapy depending on the microorganism detected, with significantly higher percentages when resistance determinants were also tested. Over half of respondents felt a rapid test would be very/extremely influential on clinical practice.Limitations of blood culture were perceived as a barrier to patient care. A rapid test to diagnose BSI would impact clinical practice, but the extent of impact may be limited by prevailing attitudes and practices. Opportunities exist for interventions to influence practitioners' behaviors in BSI management particularly with emergence of newer diagnostic tests.

  16. Risk factors and outcomes of imipenem-resistant Acinetobacter bloodstream infection in North-eastern Malaysia

    Institute of Scientific and Technical Information of China (English)

    Zakuan Zainy Deris; Mohd Nazri Shafei; Azian Harun

    2011-01-01

    Objective: To determine the risk factors and outcomes of imipenem-resistant Acinetobacterbaumannii (IRAB) bloodstream infection (BSI) cases, since there is very little publication on Acinetobacter baumannii infections from Malaysia. Methods: A cross sectional study of 41 cases (73.2%) of imipenem-sensitive Acinetobacter baumanii (ISAB) and 15 cases (26.8%) of IRAB was conducted in a teaching hospital which was located at North-Eastern state of Malaysia. Results:There was no independent risk factor for IRAB BSI identified but IRAB BSI was significantly associated with longer bacteraemic days [OR 1.23 (95% CI 1.01, 1.50)]. Although prior use of carbepenems and cephalosporin were higher among IRAB than ISAB group, statistically they were not significant. There was no significant difference in term of outcomes between the two groups. Conclusions: Although statistically not significant, this analysis compliments previous publication highlighting the importance of appropriate empiric antibiotic usage in hospital especially carbepenems and need further evaluation with bigger subjects.

  17. Microbiologic characterization of isolates from a dalbavancin clinical trial for catheter-related bloodstream infections.

    Science.gov (United States)

    Goldstein, Beth P; Jones, Ronald N; Fritsche, Thomas R; Biedenbach, Douglas J

    2006-02-01

    Dalbavancin, a new-generation semisynthetic lipoglycopeptide in phase 3 clinical development, has been documented to be more active than vancomycin or teicoplanin against Gram-positive bacteria, including multidrug-resistant strains, by in vitro testing and in animal models. The human pharmacokinetics of dalbavancin predicts efficacy at weekly dosing intervals. In a phase 2 open-label clinical trial, dalbavancin exhibited superiority when compared with vancomycin against catheter-related bloodstream infection (CR-BSI). The majority of pathogens identified in this study as in clinical practice were coagulase-negative staphylococci (CoNS), necessitating rigorous characterization of duplicate isolates to rule out contaminants and to validate cases for study evaluations. At follow-up for the intent-to-treat population, overall pathogen eradication was 92.3% for dalbavancin and 75.9% for vancomycin. We describe the details of organisms isolated, their epidemiologic/genetic characterization, susceptibility patterns against glycopeptides, and the eradication rates by organism group. In conclusion, dalbavancin was active against all isolated pathogens associated with CR-BSI (CoNS, Staphylococcus aureus and Enterococcus faecalis; all MIC results, < or = 0.25 microg/mL) and achieved significant (P < 0.05) clinical success when compared with vancomycin. PMID:16458124

  18. Three Epidemics of Invasive Multidrug-Resistant Salmonella Bloodstream Infection in Blantyre, Malawi, 1998–2014

    Science.gov (United States)

    Feasey, Nicholas A.; Masesa, Clemens; Jassi, Chikondi; Faragher, E. Brian; Mallewa, Jane; Mallewa, Macpherson; MacLennan, Calman A.; Msefula, Chisomo; Heyderman, Robert S.; Gordon, Melita A.

    2015-01-01

    Background. The Malawi Liverpool Wellcome Trust Clinical Research Programme (MLW) has routinely collected specimens for blood culture from febrile patients, and cerebrospinal fluid from patients with suspected meningitis, presenting to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, since 1998. Methods. We present bloodstream infection (BSI) and meningitis surveillance data from 1998 to 2014. Automated blood culture, manual speciation, serotyping, and antimicrobial susceptibility testing were performed at MLW. Population data for minimum-incidence estimates in urban Blantyre were drawn from published estimates. Results. Between 1998 and 2014, 167 028 blood cultures were taken from adult and pediatric medical patients presenting to QECH; Salmonella Typhi was isolated on 2054 occasions (1.2%) and nontyphoidal Salmonella (NTS) serovars were isolated 10 139 times (6.1%), of which 8017 (79.1%) were Salmonella Typhimurium and 1608 (15.8%) were Salmonella Enteritidis. There were 392 cases of NTS meningitis and 9 cases of Salmonella Typhi meningitis. There have been 3 epidemics of Salmonella BSI in Blantyre; Salmonella Enteritidis from 1999 to 2002, Salmonella Typhimurium from 2002 to 2008, and Salmonella Typhi, which began in 2011 and was ongoing in 2014. Multidrug resistance has emerged in all 3 serovars and is seen in the overwhelming majority of isolates, while resistance to third-generation cephalosporins and fluoroquinolones is currently uncommon but has been identified. Conclusions. Invasive Salmonella disease in Malawi is dynamic and not clearly attributable to a single risk factor, although all 3 epidemics were associated with multidrug resistance. To inform nonvaccine and vaccine interventions, reservoirs of disease and modes of transmission require further investigation. PMID:26449953

  19. Incidence, Clinical Characteristics and Attributable Mortality of Persistent Bloodstream Infection in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Hsu, Jen-Fu; Chu, Shih-Ming; Lee, Chiang-Wen; Yang, Pong-Hong; Lien, Reyin; Chiang, Ming-Chou; Fu, Ren-Huei; Huang, Hsuan-Rong; Tsai, Ming-Horng

    2015-01-01

    Background An atypical pattern of neonatal sepsis, characterized by persistent positive blood culture despite effective antimicrobial therapy, has been correlated with adverse outcomes. However, previous studies focused only on coagulate-negative staphylococcus infection. Methods All episodes of persistent bloodstream infection (BSI), defined as 3 or more consecutive positive blood cultures with the same bacterial species, at least two of them 48 hours apart, during a single sepsis episode, were enrolled over an 8-year period in a tertiary level neonatal intensive care unit. These cases were compared with all non-persistent BSI during the same period. Results We identified 81 episodes of persistent BSI (8.5% of all neonatal late-onset sepsis) in 74 infants, caused by gram-positive pathogens (n=38, 46.9%), gram-negative pathogens (n=21, 25.9%), fungus (n=20, 24.7%) and polymicrobial bacteremia (n=2, 2.5%). Persistent BSI does not differ from non-persistent BSI in most clinical characteristics and patient demographics, but tends to have a prolonged septic course, longer duration of feeding intolerance and more frequent requirement of blood transfusions. No difference was observed for death attributable to infection (9.8% vs. 6.5%), but neonates with persistent BSI had significantly higher rates of infectious complications (29.6% vs. 9.2%, P < 0.001), death from all causes (21.6% vs. 11.7%, P = 0.025), and duration of hospitalization among survivors [median (interquartile range): 80.0 (52.5-117.5) vs. 64.0 (40.0-96.0) days, P = 0.005] than those without persistent BSI. Conclusions Although persistent BSI does not contribute directly to increased mortality, the associated morbidities, infectious complications and prolonged septic courses highlight the importance of aggressive treatment to optimize outcomes. PMID:25875677

  20. NEW INSIGHT ON EPIDEMIOLOGY AND MANAGEMENT OF BACTERIAL BLOODSTREAM INFECTION IN PATIENTS WITH HEMATOLOGICAL MALIGNACIES

    Directory of Open Access Journals (Sweden)

    Sara Lo Menzo

    2015-07-01

    Full Text Available Bloodstream infections (BSI are an important cause of morbidity and mortality in onco-hematologic patients. The Gram-negative etiology was the main responsible of the febrile neutropenia in the sixties and its impact declined due to the use of fluoroquinolone prophylaxis; this situation was followed by the gradual emergence of Gram-positive bacteria also following of the increased use of intravascular devices and the introduction of new chemotherapeutic strategies. In the last decade the Gram-negative etiology is raising again because of the emergence of resistant strains that make questionable the usefulness of currentstrategies for prophylaxis and empirical treatment. Gram-negative BSI attributable mortality is relevant and the appropriate empirical treatment significantly improves the prognosis; on the other hand the delayed adequate treatment of Gram-positive BSI does not seem to have an high impact on survival. The clinician has to be aware of the epidemiology of his institution and of colonizations of his patients in order to choose the most appropriate empiric therapy. Ina setting of high endemicity of multidrug-resistant infections, even the choice of a targeted therapy can be a challenge, often requiring strategies based on off-label prescriptions and low grade evidences. In this review we summarize the current evidences for the best targeted therapies for difficult to treat bacteria BSIs and future perspectives in this topic. We also provide a flow chart for a rational approach to the empirical treatment of febrile neutropenia in a multidrug resistant high prevalence setting.

  1. A multicentre analysis of epidemiology of the nosocomial bloodstream infections in Japanese university hospitals.

    Science.gov (United States)

    Nagao, M

    2013-09-01

    Nosocomial bloodstream infections (BSIs) are an important cause of morbidity and mortality. The current study analysed data from a concurrent surveillance programme to examine the current epidemiological trends for nosocomial BSIs at 22 Japanese university hospitals from 1 April 2008 to 31 March 2012. The number of blood culture sets taken, the rate of multiple blood culture sets and the rates of antibiotic-resistant isolates among six major nosocomial BSI pathogens (Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Candida spp.) not including coagulase-negative staphylococci, were evaluated. The clinical characteristics of nosocomial BSIs caused by these pathogens were also collected for 2941 patients. The number of blood culture sets taken per bed increased during the 4-year study period (from 4.07 in 2008 to 5.37 in 2011), and the rates of multiple blood culture sets also increased (from 29.9% in 2008 to 50.0% in 2011). Methicillin resistance was detected in 50.2% of S. aureus isolates. The prevalence rates of extended-spectrum beta-lactamase-producing E. coli and Klebsiella spp. isolates increased annually during the study period, and the average prevalence rates were 12.3% and 5.8%, respectively. The overall crude mortality of nosocomial BSIs due to the six pathogens evaluated was 24.5% (43.2% in ICU settings and 20.5% in non-ICU settings). Thus, our multicentre study evaluated the current epidemiological trends for nosocomial BSIs, and we found that further efforts are needed to increase the use of multiple blood culture sets and improve the prognosis of nosocomial BSIs in Japanese university hospitals.

  2. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection.

    Science.gov (United States)

    Zingg, Walter; Cartier, Vanessa; Inan, Cigdem; Touveneau, Sylvie; Theriault, Michel; Gayet-Ageron, Angèle; Clergue, François; Pittet, Didier; Walder, Bernhard

    2014-01-01

    Central line-associated bloodstream infection (CLABSI) is the major complication of central venous catheters (CVC). The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88-0.96]; P<0.001) after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days) in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22). Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI. PMID:24714418

  3. Can inpatient hospital experiences predict central line-associated bloodstream infections?

    Directory of Open Access Journals (Sweden)

    Daniel M Saman

    Full Text Available BACKGROUND: Factors that increase the risk of central line-associated bloodstream infections (CLABSIs are not fully understood. Recently, Hospital Compare began compiling data from hospital-required reporting to the CDC's National Healthcare Safety Network on CLABSIs in intensive care units (ICUs, at over 4,000 Medicare-certified hospitals in the United States, and made this data accessible on a central website. Also available on the same website are results from the Hospital Consumer Assessment of Healthcare Providers and Systems survey of patients' hospital experiences. Utilizing both databases, our objective was to determine whether patients' hospital experiences were significantly associated with increased risk for reported ICU CLABSI. METHODS AND FINDINGS: We conducted a zero-inflated Poisson regression analysis at the hospital level on CLABSI-observed cases by ICUs in acute care hospitals (n = 1987 in the United States between January 1, 2011, and December 31, 2011. During this period there were a total of 10,866 CLABSI cases and 9,543,765 central line days. In our final model, the percent of patients who reported that they "sometimes" or "never" received help as soon as they wanted was significantly associated with an increased risk for CLABSIs. CONCLUSIONS: Using national datasets, we found that inpatients' hospital experiences were significantly associated with an increased risk of ICU reported CLABSIs. This study suggests that hospitals with lower staff responsiveness, perhaps because of an understaffing of nurse and supportive personnel, are at an increased risk for CLABSIs. This study bolsters the evidence that patient surveys may be a useful surrogate to predicting the incidence of hospital acquired conditions, including CLABSIs. Moreover, our study found that poor staff responsiveness may be indicative of greater hospital problems and generally poorly performing hospitals; and that this finding may be a symptom of hospitals

  4. Bloodstream infection following 217 consecutive systemic-enteric drained pancreas transplants

    Directory of Open Access Journals (Sweden)

    Mark Walter

    2006-08-01

    Full Text Available Abstract Background Combined kidney pancreas transplantation (PTx evolved as excellent treatment for diabetic nephropathy. Infections remain common and serious complications. Methods 217 consecutive enteric drained PTxs performed from 1997 to 2004 were retrospectively analyzed with regard to bloodstream infection. Immunosuppression consisted of antithymocyteglobuline induction, tacrolimus, mycophenolic acid and steroids for the majority of cases. Standard perioperative antimicrobial prophylaxis consisted of pipercillin/tazobactam in combination with ciprofloxacin and fluconazole. Results One year patient, pancreas and kidney graft survival were 96.4%, 88.5% and 94.8%, surgical complication rate was 35%, rejection rate 30% and rate of infection 59%. In total 46 sepsis episodes were diagnosed in 35 patients (16% with a median onset on day 12 (range 1–45 post transplant. Sepsis source was intraabdominal infection (IAI (n = 21, a contaminated central venous line (n = 10, wound infection (n = 5, urinary tract infection (n = 2 and graft transmitted (n = 2. Nine patients (4% experienced multiple episodes of sepsis. Overall 65 pathogens (IAI sepsis 39, line sepsis 15, others 11 were isolated from blood. Gram positive cocci accounted for 50 isolates (77%: Coagulase negative staphylococci (n = 28, i.e. 43% (nine multi-resistant, Staphylococcus aureus (n = 11, i.e. 17% (four multi-resistant, enterococci (n = 9, i.e. 14% (one E. faecium. Gram negative rods were cultured in twelve cases (18%. Patients with blood borne infection had a two year pancreas graft survival of 76.5% versus 89.4% for those without sepsis (p = 0.036, patient survival was not affected. Conclusion Sepsis remains a serious complication after PTx with significantly reduced pancreas graft, but not patient survival. The most common source is IAI.

  5. Staphylococcus species and their Methicillin-Resistance in 7424 Blood Cultures for Suspected Bloodstream Infections

    Directory of Open Access Journals (Sweden)

    Ariana ALMAŞ

    2011-06-01

    Full Text Available Objectives: The aim of this study was to evaluate the distribution of Staphylococcus species in bloodstream infections and to assess their susceptibility to methicillin. Material and Methods: Between January 1st 2008 - December 31st 2010, 7424 blood culture sets were submitted to the Laboratory Department of the Hospital for Clinical Infectious Diseases in Cluj-Napoca, Romania. The blood cultures were performed using BacT/Alert until January 2010 and BacT/Alert 3D automated system (bioMérieux after that date. The blood culture bottles were incubated at 37°C in a continuously monitoring system for up to 7 days. The strain identifications were performed by conventional methods, ApiStaph galleries and Vitek 2 Compact system. Susceptibility to methicillin was determined by disk diffusion method with cefoxitin disk and by using Vitek 2 Compact system. Results: From the total number of performed blood cultures, 568 were positive with Staphylococcus species. From 168 bacteriemic episodes 103 were with Staphylococcus aureus. Among 65 coagulase-negative staphylococci isolates, Staphylococcus epidermidis was the most frequently isolated species (34, followed by Staphylococcus hominis (15, Staphylococcus haemolyticus (8, Staphylococcus saprophyticus (3, Staphylococcus cohnii (1, Staphylococcus auricularis (1, and 3 strains that were not identified at species level. Methicillin resistance was encountered in 53.40% of Staphylococcus aureus strains and in 80% of coagulase-negative staphylococci. Conclusions: An important percentage of blood cultures were contaminated with Staphylococcus species. The main species identified in true bacteriemia cases were Staphylococcus aureus and Staphylococcus epidermidis. The percentage of methicillin-resistance, proved to be high not only for coagulase-negative staphylococci but also for Staphylococcus aureus.

  6. The Changing Epidemiology of Bloodstream Infections and Resistance in Hematopoietic Stem Cell Transplantation Recipients

    Directory of Open Access Journals (Sweden)

    Mücahit Yemişen

    2016-08-01

    Full Text Available Objective: Patients receiving hematopoietic stem cell transplantation (HSCT are exposed to highly immunosuppressive conditions and bloodstream infections (BSIs are one of the most common major complications within this period. Our aim, in this study, was to evaluate the epidemiology of BSIs in these patients retrospectively. Materials and Methods: The epidemiological properties of 312 patients with HSCT were retrospectively evaluated. Results: A total of 312 patients, followed between 2000 and 2011, who underwent autologous (62% and allogeneic (38% HSCT were included in the study. The most common underlying malignancies were multiple myeloma (28% and Hodgkin lymphoma (21.5%. A total of 142 (45% patients developed at least 1 episode of BSI and 193 separate pathogens were isolated from the blood cultures. There was a trend of increase in the numbers of BSIs in 2005-2008 and a relative increase in the proportion of gram-positive infections in recent years (2009-2011, and central venous catheter-related BSI was found to be most common source. Coagulase-negative staphylococci (49.2% and Acinetobacter baumannii (8.8% were the most common pathogens. Extended-spectrum beta-lactamase-producing strains were 23% and 22% among Escherichia coli and Klebsiella spp. isolates, respectively. Quinolone resistance was detected in 10% of Enterobacteriaceae. Resistance to carbapenems was not detected in Enterobacteriaceae, while it was seen at 11.1% and 23.5% in Pseudomonas and Acinetobacter strains, respectively. Conclusion: A shift was detected from gram-negative bacteria to gram-positive in the etiology over the years and central lines were the most common sources of BSIs.

  7. Molecular epidemiology and antimicrobial resistance of methicillin-resistant Staphylococcus aureus bloodstream isolates in Taiwan, 2010.

    Directory of Open Access Journals (Sweden)

    Chih-Jung Chen

    Full Text Available The information of molecular characteristics and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA is essential for control and treatment of diseases caused by this medically important pathogen. A total of 577 clinical MRSA bloodstream isolates from six major hospitals in Taiwan were determined for molecular types, carriage of Panton-Valentine leukocidin (PVL and sasX genes and susceptibilities to 9 non-beta-lactam antimicrobial agents. A total of 17 genotypes were identified in 577 strains by pulsotyping. Five major pulsotypes, which included type A (26.2%, belonging to sequence type (ST 239, carrying type III staphylococcal chromosomal cassette mec (SCCmec, type F (18.9%, ST5-SCCmecII, type C (18.5%, ST59-SCCmecIV, type B (12.0%, ST239-SCCmecIII and type D (10.9%, ST59-SCCmecVT/IV, prevailed in each of the six sampled hospitals. PVL and sasX genes were respectively carried by ST59-type D strains and ST239 strains with high frequencies (93.7% and 99.1%, respectively but rarely detected in strains of other genotypes. Isolates of different genotypes and from different hospitals exhibited distinct antibiograms. Multi-resistance to ≥3 non-beta-lactams was more common in ST239 isolates (100% than in ST5 isolates (97.2%, P = 0.0347 and ST59 isolates (8.2%, P<0.0001. Multivariate analysis further indicated that the genotype, but not the hospital, was an independent factor associated with muti-resistance of the MRSA strains. In conclusion, five common MRSA clones with distinct antibiograms prevailed in the major hospitals in Taiwan in 2010. The antimicrobial susceptibility pattern of invasive MRSA was mainly determined by the clonal distribution.

  8. Trypanosome Motion Represents an Adaptation to the Crowded Environment of the Vertebrate Bloodstream

    Science.gov (United States)

    Heddergott, Niko; Krüger, Timothy; Babu, Sujin B.; Wei, Ai; Stellamanns, Erik; Uppaluri, Sravanti; Pfohl, Thomas; Stark, Holger; Engstler, Markus

    2012-01-01

    Blood is a remarkable habitat: it is highly viscous, contains a dense packaging of cells and perpetually flows at velocities varying over three orders of magnitude. Only few pathogens endure the harsh physical conditions within the vertebrate bloodstream and prosper despite being constantly attacked by host antibodies. African trypanosomes are strictly extracellular blood parasites, which evade the immune response through a system of antigenic variation and incessant motility. How the flagellates actually swim in blood remains to be elucidated. Here, we show that the mode and dynamics of trypanosome locomotion are a trait of life within a crowded environment. Using high-speed fluorescence microscopy and ordered micro-pillar arrays we show that the parasites mode of motility is adapted to the density of cells in blood. Trypanosomes are pulled forward by the planar beat of the single flagellum. Hydrodynamic flow across the asymmetrically shaped cell body translates into its rotational movement. Importantly, the presence of particles with the shape, size and spacing of blood cells is required and sufficient for trypanosomes to reach maximum forward velocity. If the density of obstacles, however, is further increased to resemble collagen networks or tissue spaces, the parasites reverse their flagellar beat and consequently swim backwards, in this way avoiding getting trapped. In the absence of obstacles, this flagellar beat reversal occurs randomly resulting in irregular waveforms and apparent cell tumbling. Thus, the swimming behavior of trypanosomes is a surprising example of micro-adaptation to life at low Reynolds numbers. For a precise physical interpretation, we compare our high-resolution microscopic data to results from a simulation technique that combines the method of multi-particle collision dynamics with a triangulated surface model. The simulation produces a rotating cell body and a helical swimming path, providing a functioning simulation method for a

  9. DNA microarray analysis of Staphylococcus aureus causing bloodstream infection: bacterial genes associated with mortality?

    Science.gov (United States)

    Blomfeldt, A; Aamot, H V; Eskesen, A N; Monecke, S; White, R A; Leegaard, T M; Bjørnholt, J V

    2016-08-01

    Providing evidence for microbial genetic determinants' impact on outcome in Staphylococcus aureus bloodstream infections (SABSI) is challenging due to the complex and dynamic microbe-host interaction. Our recent population-based prospective study reported an association between the S. aureus clonal complex (CC) 30 genotype and mortality in SABSI patients. This follow-up investigation aimed to examine the genetic profiles of the SABSI isolates and test the hypothesis that specific genetic characteristics in S. aureus are associated with mortality. SABSI isolates (n = 305) and S. aureus CC30 isolates from asymptomatic nasal carriers (n = 38) were characterised by DNA microarray analysis and spa typing. Fisher's exact test, least absolute shrinkage and selection operator (LASSO) and elastic net regressions were performed to discern within four groups defined by patient outcome and characteristics. No specific S. aureus genetic determinants were found to be associated with mortality in SABSI patients. By applying LASSO and elastic net regressions, we found evidence suggesting that agrIII and cna were positively and setC (=selX) and seh were negatively associated with S. aureus CC30 versus non-CC30 isolates. The genes chp and sak, encoding immune evasion molecules, were found in higher frequencies in CC30 SABSI isolates compared to CC30 carrier isolates, indicating a higher virulence potential. In conclusion, no specific S. aureus genes were found to be associated with mortality by DNA microarray analysis and state-of-the-art statistical analyses. The next natural step is to test the hypothesis in larger samples with higher resolution methods, like whole genome sequencing. PMID:27177754

  10. In vivo observation of the hypo-echoic "black hole" phenomenon in rat arterial bloodstream: a preliminary Study.

    Science.gov (United States)

    Nam, Kweon-Ho; Paeng, Dong-Guk

    2014-07-01

    The "black hole," a hypo-echoic hole at the center of the bloodstream surrounded by a hyper-echoic zone in cross-sectional views, has been observed in ultrasound backscattering measurements of blood with red blood cell aggregation in in vitro studies. We investigated whether the phenomenon occurs in the in vivo arterial bloodstream of rats using a high-frequency ultrasound imaging system. Longitudinal and cross-sectional ultrasound images of the rat common carotid artery (CCA) and abdominal aorta were obtained using a 40-MHz ultrasound system. A high-frame-rate retrospective imaging mode was employed to precisely examine the dynamic changes in blood echogenicity in the arteries. When the imaging was performed with non-invasive scanning, blood echogenicity was very low in the CCA as compared with the surrounding tissues, exhibiting no hypo-echoic zone at the center of the vessel. Invasive imaging of the CCA by incising the skin and subcutaneous tissues at the imaging area provided clearer and brighter blood echo images, showing the "black hole" phenomenon near the center of the vessel in longitudinal view. The "black hole" was also observed in the abdominal aorta under direct imaging after laparotomy. The aortic "black hole" was clearly observed in both longitudinal and cross-sectional views. Although the "black hole" was always observed near the center of the arteries during the diastolic phase, it dissipated or was off-center along with the asymmetric arterial wall dilation at systole. In conclusion, we report the first in vivo observation of the hypo-echoic "black hole" caused by the radial variation of red blood cell aggregation in arterial bloodstream.

  11. Clinical-epidemiological characteristics and outcome of patients with catheter-related bloodstream infections in Europe (ESGNI-006 Study)

    DEFF Research Database (Denmark)

    Muñoz, P; Bouza, E; San Juan, R;

    2004-01-01

    (1.55 vs. 0.33/1,000 admissions). Most (67%) catheters were non-tunneled central venous catheters, were in the jugular vein (44%), had been implanted for > 7 days (70%), were made of polyurethane (61%) and were multi-lumen (67%). In 36% of cases, catheters were implanted by physicians other than......This study analysed 89 episodes of catheter-related bloodstream infection (CR-BSI) occurring during one week in 107 hospitals from 21 European countries (1.02 episodes/1,000 admissions). Patients from European Union (EU) countries had a higher incidence of CR-BSI than patients from non-EU countries...

  12. Reconstitution of a surface transferrin binding complex in insect form Trypanosoma brucei.

    OpenAIRE

    Ligtenberg, M.J.; Bitter, W.; Kieft, R.; Steverding, D; Janssen, H.; Calafat, J.; Borst, P

    1994-01-01

    In the bloodstream of the mammalian host, Trypanosoma brucei takes up host transferrin by means of a high-affinity uptake system, presumably a transferrin receptor. Transferrin-binding activity is seen in the flagellar pocket and is absent in insect form trypanosomes. By transfection we have reconstituted a transferrin-binding complex in insect form trypanosomes. Formation of this complex requires the products of two genes that are part of a variant surface glycoprotein expression site, expre...

  13. Teaching Form as Form

    DEFF Research Database (Denmark)

    Keiding, Tina Bering

    2012-01-01

    means that form serves both as the connective value and as the concept for reflection. In other words, form is observed as form, not anything else. The didactical challenge of teaching form as form is accentuated by students’ everyday-based pre-orientation towards function at the expense of form...... reveal highly-structured courses, which alternates systematically between steering and free experimental activities. Consistent with a strong focus on content and the student’s interaction with content, the contributions hardly address the role of the teacher or the interplay between teachers...... and students. This is not to say that teachers do not engage in teaching. They clearly do and obviously play a major role in the progression in course structure and reflection on the student’s learning. My point is that, by neglecting the role of the teacher and the interplay between the teacher and students...

  14. A simple method to purify biologically and antigenically preserved bloodstream trypomastigotes of Trypanosoma cruzi using Deae-cellulose columns

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora de Sousa

    1983-09-01

    Full Text Available A method to purify trypanosomastigotes of some strains of Trypanosoma cruzi (Y, CL, FL, F, "Berenice", "Colombiana" and "São Felipe" from mouse blood by using DEAE-cellulose columns was standardized. This procedure is a modification of the Lanham & Godfrey methods and differs in some aspects from others described to purify T. cruzi bloodstream trypomastigotes, mainly by avoidance of prior purifications of parasites. By this method, the broad trypomastigotes were mainly isolated, accounting for higher recoveries obtained with strains having higher percentages of these forms: processing of infected blood from irradiated mice could be advantageous by increasing the recovery of parasites (percentage and/or total number and elution of more slender trypomastigotes. Trypomastigotes purified by this method presented normal morphology and motility, remained infective to triatomine bugs and mice, showing in the latter prepatent periods and courses parasitemia similar to those of control parasites, and also reproducing the polymorphism pattern of each strain. Their virulence and pathogenicity also remained considerably preserved, the latter property being evaluated by LD 50 tests, mortality rates and mean survival time of inoculated mice. Moreover, these parasites presented positive, clear and peripheral immunofluorescence reaction at titres similar to those of control organisms, thus suggesting important preservation of their surface antigens.Usando colunas de DEAE-cellulose foi padronizado um método para purificação de tripomastigotas de várias cepas de Trypanosoma cruzi (Y, CL, FL, F, "Berenice", "Columbiana" e "São Felipe" a partir do sangue de camundongos. Este método é uma modificação daqueles descritos por Lanham & Godfrey e difere em vários aspectos de outros descritos para purificar as formas sanguíneas deste parasita, particularmente na dispensa de pré-purificações. Por ele foram isolados principalmente os tripomastigotas largos

  15. Central venous catheter-related bloodstream infections in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Harsha V Patil

    2011-01-01

    Full Text Available Context: Central venous catheter-related bloodstream infection (CRBSI is associated with high rates of morbidity and mortality in critically ill patients. Aims: This study was conducted to determine the incidence of central venous catheter-related infections (CRIs and to identify the factors influencing it. So far, there are very few studies that have been conducted on CRBSI in the intensive care unit in India. Settings and Design: This was a prospective, observational study carried out in the medical intensive care unit (MICU over a period of 1 year from January to December 2004. Materials and Methods: A total of 54 patients with indwelling central venous catheters of age group between 20 and 75 years were included. The catheters were cultured using the standard semiquantitative culture (SQC method. Statistical analysis used SPSS-10 version statistical software. Results: A total of 54 CVC catheters with 319 catheter days were included in this study. Of 54 patients with CVCs studied for bacteriology, 39 (72.22% catheters showed negative SQCs and also negative blood cultures. A total of 15 (27.77% catheters were positive on SQC, of which 10 (18.52% were with catheter-associated infection and four (7.41% were with catheter-associated bacteremia; the remaining one was a probable catheter-associated bacteremia. CRIs were high among catheters that were kept in situ for more than 3 days and emergency procedures where two or more attempts were required for catheterization (P 3 days, inexperienced venupucturist, more number of attempts and emergency CVC were associated with more incidence of CVCBSIs, with P <0.02. The duration of catheter in situ was negatively correlated (-0.53 and number of attempts required to put CVC was positively correlated (+0.39 with incidence of CVCBSIs. Sixty-five percent of the isolates belonged to the CONS group (13/20. Staphylococcus epidermidis showed maximum susceptibility to amikacin, doxycycline and amoxycillin with

  16. Comparison of the systemic inflammatory response syndrome between monomicrobial and polymicrobial Pseudomonas aeruginosa nosocomial bloodstream infections

    Directory of Open Access Journals (Sweden)

    Wenzel Richard P

    2005-10-01

    Full Text Available Abstract Background Some studies of nosocomial bloodstream infection (nBSI have demonstrated a higher mortality for polymicrobial bacteremia when compared to monomicrobial nBSI. The purpose of this study was to compare differences in systemic inflammatory response and mortality between monomicrobial and polymicrobial nBSI with Pseudomonas aeruginosa. Methods We performed a historical cohort study on 98 adults with P. aeruginosa (Pa nBSI. SIRS scores were determined 2 days prior to the first positive blood culture through 14 days afterwards. Monomicrobial (n = 77 and polymicrobial BSIs (n = 21 were compared. Results 78.6% of BSIs were caused by monomicrobial P. aeruginosa infection (MPa and 21.4% by polymicrobial P. aeruginosa infection (PPa. Median APACHE II score on the day of BSI was 22 for MPa and 23 for PPa BSIs. Septic shock occurred in 33.3% of PPa and in 39.0% of MPa (p = 0.64. Progression to septic shock was associated with death more frequently in PPa (OR 38.5, CI95 2.9–508.5 than MPa (OR 4.5, CI95 1.7–12.1. Maximal SIR (severe sepsis, septic shock or death was seen on day 0 for PPa BSI vs. day 1 for MPa. No significant difference was noted in the incidence of organ failure, 7-day or overall mortality between the two groups. Univariate analysis revealed that APACHE II score ≥20 at BSI onset, Charlson weighted comorbidity index ≥3, burn injury and respiratory, cardiovascular, renal and hematologic failure were associated with death, while age, malignant disease, diabetes mellitus, hepatic failure, gastrointestinal complications, inappropriate antimicrobial therapy, infection with imipenem resistant P. aeruginosa and polymicrobial nBSI were not. Multivariate analysis revealed that hematologic failure (p Conclusion In this historical cohort study of nBSI with P. aeruginosa, the incidence of septic shock and organ failure was high in both groups. Additionally, patients with PPa BSI were not more acutely ill, as judged by APACHE II

  17. Molecular Identification and Echinocandin Susceptibility of Candida parapsilosis Complex Bloodstream Isolates in Italy, 2007-2014.

    Directory of Open Access Journals (Sweden)

    Grazia Lovero

    Full Text Available The Candida parapsilosis group encompasses three species: C. parapsilosis, C. orthopsilosis, and C. metapsilosis. Here, we describe the incidence and echinocandin susceptibility profile of bloodstream isolates of these three species collected from patients admitted to an Italian university hospital from 2007 to 2014. Molecular identification of cryptic species of the C. parapsilosis complex was performed using polymerase chain reaction amplification of the gene encoding secondary alcohol dehydrogenase, followed by digestion with the restriction enzyme BanI. Minimum inhibitory concentrations were determined using the broth microdilution method according to European Committee for Antimicrobial Susceptibility Testing (EUCAST EDef 7.2 and Clinical Laboratory Standards Institute (CLSI M27-A3 guidelines, and the results were compared with those obtained using the E-test and Sensititre methods. Of the 163 C. parapsilosis complex isolates, 136 (83.4% were identified as C. parapsilosis, and 27 (16.6% as C. orthopsilosis. The species-specific incidences were 2.9/10,000 admissions for C. parapsilosis and 0.6/10,000 admissions for C. orthopsilosis. No resistance to echinocandins was detected with any of the methods. The percent essential agreement (EA between the EUCAST and E-test/Sensititre methods for anidulafungin, caspofungin, and micafungin susceptibility was, respectively, as follows: C. parapsilosis, 95.6/97.8, 98.5/88.2, and 93.4/96.3; C. orthopsilosis, 92.6/92.6, 96.3/77.8, and 63.0/66.7. The EA between the CLSI and E-test/Sensititre methods was, respectively, as follows: C. parapsilosis, 99.3/100, 98.5/89.0, and 96.3/98.5; C. orthopsilosis, 96.3/92.6, 100/81.5, and 92.6/88.9. Only minor discrepancies, ranging from 16.9% (C. parapsilosis to 11.1% (C. orthopsilosis, were observed between the CLSI and E-test/Sensititre methods. In conclusion, this epidemiologic study shows a typical C. parapsilosis complex species distribution, no echinocandin

  18. Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients: An Investigation of Device Utility and Catheter-Related Bloodstream Infection Rates.

    Science.gov (United States)

    Friedman, Bruce C; Mian, Mohammad A H; Mullins, Robert F; Hassan, Zaheed; Shaver, Joseph R; Johnston, Krystal K

    2015-01-01

    The objective of this study is to determine the catheter-related bloodstream infection (CRBSI) rate in a severely burned patient population, many of whom required prolonged use of central venous catheters (CVCs). Between January 2008 and June 2012, 151 patients underwent placement of 455 five-lumen minocycline/rifampin-impregnated CVCs. CRBSI was defined as at least one blood culture (>100,000 colonies) and one simultaneous roll-plate CVC tip culture (>15 colony forming units) positive for the same organism. Most patients had accidental burns (81.5%) with a mean TBSA of 50%. A mean of three catheters were inserted per patient (range, 1-25). CVCs were inserted in the femoral vein (91.2%), subclavian vein (5.3%), and internal jugular vein (3.3%). Mean overall catheter indwell time was 8 days (range, 0-39 days). The overall rate of CRBSI per 1000 catheter days was 11.2; patients with a TBSA >60% experienced significantly higher rates of CRBSI than patients with a TBSA ≤60% (16.2 vs 7.3, P = .01). CVCs placed through burned skin were four times more likely to be associated with CRBSI than CVCs placed through intact skin. The most common infectious organism was Acinetobacter baumannii. Deep venous thrombosis developed in eleven patients (7%). The overall rate of CRBSI was 11.2, consistent with published rates of CRBSI in burn patients. Thus, femoral placement of 5-lumen CVCs did not result in increased CRBSI rates. These data support the safety of femoral CVC placement in burn patients, contrary to the Centers for Disease Control recommendation to avoid femoral CVC insertion.

  19. Impact of a modified Broviac maintenance care bundle on bloodstream infections in paediatric cancer patients

    Directory of Open Access Journals (Sweden)

    Furtwängler, Rhoikos

    2015-11-01

    Full Text Available Background: During intensive chemotherapy, bloodstream infection (BSI represents an important complication in paediatric cancer patients. Most patients carry a long-term central venous access device (CVAD. Improved maintenance care of these vascular catheters may decrease the risk of BSI.Methods: Intervention study (adapted CVAD prevention protocol with two observation periods (P1: 09-2009 until 05-2011; P2: 09-2011 until 05-2013; prospective surveillance of all laboratory confirmed BSIs. In P2, ready to use sterile NaCl 0.9% syringes were used for CVAD flushing and octenidine/isopropanol for the disinfection of catheter hubs and 3-way stopcocks. Results: During P1, 84 patients were included versus 81 patients during P2. There were no significant differences between the two patient populations in terms of median age, gender, underlying malignancy or disease status (first illness or relapse. Nearly all CVADs were Broviac catheters. The median duration from implantation to removal of the CVAD was 192 days (Inter-quartile-range (IQR; 110–288 days in P1 and 191 days (IQR; 103–270 days in P2. 28 BSI were diagnosed in 22 patients in P1 (26% of all patients experienced at least one BSI and 15 BSI in 12 patients in P2 (15% of all patients. The corresponding results for incidence density (ID were 0.44 (CI95 0.29–0.62 for P1 vs. 0.34 (0.19–0.53 BSI per 100 inpatient days for P2 and for incidence rate (IR 7.76 (5.16–10.86 in P1 vs. 4.75 (2.66–7.43 BSI per 1,000 inpatient CVAD utilization days. In P1, 9 BSI were caused by CoNS vs. only 2 in P2 (IR 2.49; CI95 0.17–4.17 vs. 0.63; CI95 0.08–1.72. In P1 two BSI (7% lead to early removal of the device. During P2 one CVAD was prematurely removed due to a Broviac-related BSI (6.7%.Conclusion: The preventive protocol investigated in this study led to a reduction of BSI in paediatric cancer patients. This result was clinically relevant but – due to insufficient power in a single centre observation

  20. Burden of antimicrobial resistance in European hospitals : excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins

    NARCIS (Netherlands)

    de Kraker, M. E. A.; Wolkewitz, M.; Davey, P. G.; Koller, W.; Berger, J.; Nagler, J.; Icket, C.; Kalenic, S.; Horvatic, J.; Seifert, H.; Kaasch, A.; Paniara, O.; Argyropoulou, A.; Bompola, M.; Smyth, E.; Skally, M.; Raglio, A.; Dumpis, U.; Kelmere, A. Melbarde; Borg, M.; Xuereb, D.; Ghita, M. C.; Noble, M.; Kolman, J.; Grabljevec, S.; Turner, D.; Lansbury, L.; Grundmann, H.

    2011-01-01

    This study determined excess mortality and length of hospital stay (LOS) attributable to bloodstream infection (BSI) caused by third-generation-cephalosporin-resistant Escherichia coli in Europe. A prospective parallel matched cohort design was used. Cohort I consisted of patients with third-generat

  1. Etiology and epidemiology of catheter related bloodstream infections in patients receiving home parenteral nutrition in a gastromedical center at a tertiary hospital in denmark

    DEFF Research Database (Denmark)

    Nielsen, Xiaohui Chen; Chen, Ming; Hellesøe, Anne-Marie Blok;

    2012-01-01

    We conducted a retrospective epidemiologic study of catheter related bloodstream infections (CRBSI) in patients receiving long-term home parenteral nutrition (HPN) from January 2002 to December 2005. Our results showed that coagulase negative staphylococci (CoNS) were the most prevalent pathogens...

  2. DNA microarray genotyping and virulence and antimicrobial resistance gene profiling of methicillin-resistant Staphylococcus aureus bloodstream isolates from renal patients.

    LENUS (Irish Health Repository)

    McNicholas, Sinead

    2012-02-01

    Thirty-six methicillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates from renal patients were genetically characterized by DNA microarray analysis and spa typing. The isolates were highly clonal, belonging mainly to ST22-MRSA-IV. The immune evasion and enterotoxin gene clusters were found in 29\\/36 (80%) and 33\\/36 (92%) isolates, respectively.

  3. DNA microarray genotyping and virulence and antimicrobial resistance gene profiling of methicillin-resistant Staphylococcus aureus bloodstream isolates from renal patients.

    LENUS (Irish Health Repository)

    McNicholas, Sinead

    2011-12-01

    Thirty-six methicillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates from renal patients were genetically characterized by DNA microarray analysis and spa typing. The isolates were highly clonal, belonging mainly to ST22-MRSA-IV. The immune evasion and enterotoxin gene clusters were found in 29\\/36 (80%) and 33\\/36 (92%) isolates, respectively.

  4. Absence of microbial adaptation to taurolidine in patients on home parenteral nutrition who develop catheter related bloodstream infections and use taurolidine locks

    NARCIS (Netherlands)

    Olthof, E.D.; Rentenaar, R.J.; Rijs, A.J.M.M.; Wanten, G.J.A.

    2013-01-01

    BACKGROUND & AIMS: Some home parenteral nutrition (HPN) patients develop catheter related bloodstream infections (CRBSI) despite using an anti-microbial catheter lock solution taurolidine. The aim of this study was to assess whether long-term use of taurolidine leads to selective growth of microorga

  5. Bloodstream infections during the onset of necrotizing enterocolitis and their relation with the pro-inflammatory response, gut wall integrity and severity of disease in NEC

    NARCIS (Netherlands)

    Heida, F. H.; Hulscher, J. B. F.; Schurink, M.; van Vliet, M. J.; Kooi, E. M. W.; Kasper, D. C.; Pones, M.; Bos, A. F.; Benkoe, T. M.

    2015-01-01

    Introduction: Bacterial involvement is believed to play a pivotal role in the development and disease outcome of NEC. However, whether a bloodstream infection (BSI) predisposes to NEC (e.g. by activating the pro-inflammatory response) or result from the loss of gut wall integrity during NEC developm

  6. “What the Eyes Don’t See, the Heart Doesn’t Grieve Over”: Epidemiology and Risk Factors for Bloodstream Infections following Cardiac Catheterization

    OpenAIRE

    Dicks, Kristen V.; Staheli, Russell; Anderson, Deverick J.; Miller, Becky A.; Jones, W. Schuyler; Harrison, J. Kevin; Sexton, Daniel J.; Moehring, Rebekah W.; Chen, Luke F.

    2012-01-01

    No standard definition exists for surveillance and characterization of the epidemiology of bloodstream infections (BSIs) after cardiac catheterization (CC) procedures. We proposed a novel case definition and determined the epidemiology and risk factors of BSIs after CC procedure using this new definition.

  7. Draft Genome Sequence of Extremely Drug-Resistant Pseudomonas aeruginosa (ST357) Strain CMC_VB_PA_B22862 Isolated from a Community-Acquired Bloodstream Infection

    Science.gov (United States)

    Pragasam, Agila Kumari; Yesurajan, Francis; Doss C, George Priya; George, Biju; Devanga Ragupathi, Naveen Kumar; Walia, Kamini

    2016-01-01

    Extremely drug-resistant Pseudomonas aeruginosa strains causing severe infections have become a serious concern across the world. Here, we report draft genome sequence of P. aeruginosa with an extremely drug-resistant profile isolated from a patient with community-acquired bloodstream infection in India.

  8. Bloodstream infections during the onset of necrotizing enterocolitis and their relation with the pro-inflammatory response, gut wall integrity and severity of disease in NEC

    NARCIS (Netherlands)

    Heida, F.H.; Hulscher, J.B.; Schurink, M.; Vliet, M.J. van; Kooi, E.M.; Kasper, D.C.; Pones, M.; Bos, A.F; Benkoe, T.M.

    2015-01-01

    INTRODUCTION: Bacterial involvement is believed to play a pivotal role in the development and disease outcome of NEC. However, whether a bloodstream infection (BSI) predisposes to NEC (e.g. by activating the pro-inflammatory response) or result from the loss of gut wall integrity during NEC developm

  9. Effect of a vascular access team on central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit : a systematic review

    NARCIS (Netherlands)

    Legemaat, Monique M; Jongerden, IP; van Rens, Roland M F P T; Zielman, Marjanne; van den Hoogen, Agnes

    2015-01-01

    OBJECTIVE: To review the effect of a vascular access team on the incidence of central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit. DATA SOURCES: MEDLINE, CINAHL, Embase, Web-of-Science and the Cochrane Library were searched until December 2013. STUDY

  10. Etiological characteristics of 108 patients with secondary bloodstream infections%继发性血流感染108例病原学特点分析

    Institute of Scientific and Technical Information of China (English)

    黄仁刚; 杨兴祥; 喻华; 龙姗姗; 林健梅; 江南

    2015-01-01

    Objective To investigate the etiological characteristics of laboratory-confirmed bloodstream infections with identi-fied infective sources. Methods The data of the patients with laboratory-confirmed bloodstream infections and identified infective sources, who were treated at Sichuan Provincial People's Hospital from Jan. 2011 to Jun. 2013 were collected to analyze the etiological characteristics retrospectively. Results A total of 108 patients with identified infective sources were enrolled in this study, of whom 93 patients suffered from monomicrobial infection, and 15 patients suffered from polymicrobial infection. Bloodstream infections were com-monly found in urinary tract, abdominal cavity and respiratory tract. Infection with Escherichia coli. accounted for 75.8%and 42.4%in patients with bloodstream infections in urinary tract and abdominal cavity, respectively; Infection with Acinetobacter baumannii ac-counted for 62.5%in patients with bloodstream infections in respiratory tract, and Acinetobacter baumannii was resistant to carbapen-em antibiotics. The 30-day mortality of 108 patients with bloodstream infections was 19.4%. The patients with bloodstream infections in urinary tract had the lowest 30-day mortality rate (3.0%), while the patients with bloodstream infections in lower respiratory tract had the highest 30-day mortality rate (45.8%). The 30-day mortality rates of the patients with bloodstream infections with non-fermentation gram negative bacillus and fungi were 55.0%and 50.0%, respectively. Conclusions The pathogen distribution of the patients with different sources of bloodstream infections varies widely. Appropriate antibiotic therapy should take infective sources, types of bacteria and drug resistance into consideration.%目的 研究感染来源明确的血流感染患者的病原学特点. 方法 收集四川省人民医院2011年1月—2013年6月实验室确诊、感染来源明确的血流感染患者临床资料,回

  11. Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital.

    Science.gov (United States)

    Martínez-Morel, H R; Sanchez-Payá, J; García-Shimizu, P; Mendoza-García, J L; Tenza-Iglesias, I; Rodríguez-Díaz, J C; Merino-DE-Lucas, E; Nolasco, A

    2016-07-01

    The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1-100%, P education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs. PMID:26758404

  12. Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals.

    Directory of Open Access Journals (Sweden)

    Dora E Corzo-Leon

    Full Text Available INTRODUCTION: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI. OBJECTIVE: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City. DESIGN: Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010. METHODS: All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis. RESULTS: CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days. C. albicans was the predominant species (46%, followed by C. tropicalis (26%. C. glabrata was isolated from patients with diabetes (50%, and elderly patients. Sixty-four patients (86% received antifungals. Amphotericin-B deoxycholate (AmBD was the most commonly used agent (66%. Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥ 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001, and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001. Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed. CONCLUSIONS: The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI.

  13. Clinical and Microbiological Characteristics of Heteroresistant and Vancomycin-Intermediate Staphylococcus aureus from Bloodstream Infections in a Brazilian Teaching Hospital

    Science.gov (United States)

    da Costa, Thaina Miranda; Morgado, Priscylla Guimarães Migueres; Cavalcante, Fernanda Sampaio; Damasco, Andreia Paredes; Nouér, Simone Aranha; dos Santos, Kátia Regina Netto

    2016-01-01

    This study analyzed clinical and microbiological characteristics of heteroresistant (hVISA) and vancomycin-intermediate Staphylococcus aureus (VISA) from bloodstream infections (BSI) in a Brazilian teaching hospital, between 2011 and 2013. Minimum inhibitory concentrations (MIC) of antimicrobials were determined by broth microdilution method and SCCmec was detected by PCR. Isolates with a vancomycin MIC ≥ 2mg/L were cultured on BHI agar with 3, 4 or 6 mg/L (BHIa3, BHIa4 or BHIa6) of vancomycin and BHIa4 with casein (BHIa4ca). Macromethod Etest® and Etest® Glicopeptides Resistance Detection were also used. VISA and hVISA isolates were confirmed by the population analysis profile then typed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing. Medical data from the patients were obtained from their medical records. Among 110 consecutive isolates, 31 (28%) were MRSA and carried the SCCmec type II (15 isolates) or IV (16 isolates). Vancomycin MIC50 and MIC90 were 1 and 2 mg/L, respectively. MRSA isolates had increased non-susceptibility to daptomycin (p = 0.0003). Six (5%) isolates were VISA, four of which were MRSA, three SCCmec type II/USA100/ST5 and one type IV/USA800/ST3192. One MRSA SCCmec II isolate grew on agar BHIa3, BHIa4 and BHIa4ca, and it was confirmed as hVISA. Among the six VISA isolates, five (83%) grew on BHIa3 and three (50%) on BHI4ca. Four of the six VISA isolates and the one hVISA isolate were from patients who had undergone dialysis. Thus, a possible dissemination of the SCCmec II/USA100/ST5 lineage may have occurred in the hospital comprising the VISA, hVISA and daptomycin non-susceptible S. aureus Brazilian isolates from health care associated bloodstream infections. PMID:27575698

  14. Antimicrobial Resistance and Molecular Epidemiology of Escherichia coli Causing Bloodstream Infections in Three Hospitals in Shanghai, China.

    Directory of Open Access Journals (Sweden)

    Su Wang

    Full Text Available Escherichia coli (E. coli is one of the most frequent and lethal causes of bloodstream infections (BSIs. We carried out a retrospective multicenter study on antimicrobial resistance and phylogenetic background of clinical E. coli isolates recovered from bloodstream in three hospitals in Shanghai. E. coli isolates causing BSIs were consecutively collected between Sept 2013 and Sept 2014. Ninety isolates randomly selected (30 from each hospital were enrolled in the study. Antimicrobial susceptibility testing was performed by disk diffusion. PCR was used to detect antimicrobial resistance genes coding for β-lactamases (TEM, CTX-M, OXA, etc., carbapenemases (IMP, VIM, KPC, NDM-1 and OXA-48, and phylogenetic groups. eBURST was applied for analysis of multi-locus sequence typing (MLST. The resistance rates for penicillins, second-generation cephalosporins, fluoroquinolone and tetracyclines were high (>60%. Sixty-one of the 90 (67.8% strains enrolled produced ESBLs and no carbapenemases were found. Molecular analysis showed that CTX-M-15 (25/61, CTX-M-14 (18/61 and CTX-M-55 (9/61 were the most common ESBLs. Phylogenetic group B2 predominated (43.3% and exhibited the highest rates of ESBLs production. ST131 (20/90 was the most common sequence type and almost assigned to phylogenetic group B2 (19/20. The following sequence types were ST405 (8/90 and ST69 (5/90. Among 61 ESBL-producers isolates, B2 (26, 42.6% and ST131 (18, 29.5% were also the most common phylogenetic group and sequence type. Genetic diversity showed no evidence suggesting a spread of these antimicrobial resistant isolates in the three hospitals. In order to provide more comprehensive and reliable epidemiological information for preventing further dissemination, well-designed and continuous surveillance with more hospitals participating was important.

  15. Antimicrobial Resistance and Molecular Epidemiology of Escherichia coli Causing Bloodstream Infections in Three Hospitals in Shanghai, China.

    Science.gov (United States)

    Wang, Su; Zhao, Sheng-Yuan; Xiao, Shu-Zhen; Gu, Fei-Fei; Liu, Qing-Zhong; Tang, Jin; Guo, Xiao-Kui; Ni, Yu-Xing; Han, Li-Zhong

    2016-01-01

    Escherichia coli (E. coli) is one of the most frequent and lethal causes of bloodstream infections (BSIs). We carried out a retrospective multicenter study on antimicrobial resistance and phylogenetic background of clinical E. coli isolates recovered from bloodstream in three hospitals in Shanghai. E. coli isolates causing BSIs were consecutively collected between Sept 2013 and Sept 2014. Ninety isolates randomly selected (30 from each hospital) were enrolled in the study. Antimicrobial susceptibility testing was performed by disk diffusion. PCR was used to detect antimicrobial resistance genes coding for β-lactamases (TEM, CTX-M, OXA, etc.), carbapenemases (IMP, VIM, KPC, NDM-1 and OXA-48), and phylogenetic groups. eBURST was applied for analysis of multi-locus sequence typing (MLST). The resistance rates for penicillins, second-generation cephalosporins, fluoroquinolone and tetracyclines were high (>60%). Sixty-one of the 90 (67.8%) strains enrolled produced ESBLs and no carbapenemases were found. Molecular analysis showed that CTX-M-15 (25/61), CTX-M-14 (18/61) and CTX-M-55 (9/61) were the most common ESBLs. Phylogenetic group B2 predominated (43.3%) and exhibited the highest rates of ESBLs production. ST131 (20/90) was the most common sequence type and almost assigned to phylogenetic group B2 (19/20). The following sequence types were ST405 (8/90) and ST69 (5/90). Among 61 ESBL-producers isolates, B2 (26, 42.6%) and ST131 (18, 29.5%) were also the most common phylogenetic group and sequence type. Genetic diversity showed no evidence suggesting a spread of these antimicrobial resistant isolates in the three hospitals. In order to provide more comprehensive and reliable epidemiological information for preventing further dissemination, well-designed and continuous surveillance with more hospitals participating was important.

  16. Collaborative form(s)

    DEFF Research Database (Denmark)

    Gunn, Wendy

    the process of research rather than its object. In its temporal orientation, anthropology by means of design moves, ‘…forward with people in tandem with their desires and aspirations rather than going back over times passed’ (ibid 2013: 141). Doing design by means of anthropology takes as its most fundamental......Gunn asks us to consider beauty as collaborative forms of action generated by moving between design by means of anthropology and anthropology by means of design. Specifically, she gives focus to play-like reflexions on practices of designing energy products, systems and infrastructure. Design...

  17. Bloodstream Infection in Neutropenic Cancer Patients Related to Short-Term Nontunnelled Catheters Determined by Quantitative Blood Cultures, Differential Time to Positivity, and Molecular Epidemiological Typing with Pulsed-Field Gel Electrophoresis

    OpenAIRE

    Seifert, Harald; Cornely, Oliver; Seggewiss, Kerstin; Decker, Mathias; Stefanik, Danuta; Wisplinghoff, Hilmar; Fätkenheuer, Gerd

    2003-01-01

    To determine the rate of catheter-related bloodstream infection (CRBSI) among cases of primary bloodstream infection (BSI) in febrile neutropenic cancer patients with short-term nontunnelled catheters, quantitative paired blood cultures (Isolator) from the central venous catheter (CVC) and peripheral vein were obtained between November 1999 and January 2001. Bactec blood culture bottles were obtained to determine the differential time to positivity (DTP). CRBSI was defined as a quantitative b...

  18. Healthcare Burden, Risk Factors, and Outcomes of Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections after Stem Cell Transplantation.

    Science.gov (United States)

    Dandoy, Christopher E; Haslam, David; Lane, Adam; Jodele, Sonata; Demmel, Kathy; El-Bietar, Javier; Flesch, Laura; Myers, Kasiani C; Pate, Abigail; Rotz, Seth; Daniels, Paulina; Wallace, Gregory; Nelson, Adam; Waters, Heather; Connelly, Beverly; Davies, Stella M

    2016-09-01

    Mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) lead to significant morbidity, mortality, and healthcare resource utilization in hematopoietic stem cell transplant (HSCT) patients. Determination of the healthcare burden of MBI-LCBIs and identification of patients at risk of MBI-LCBIs will allow researchers to identify strategies to reduce MBI-LCBI rates. The objective of our study was to describe the incidence, risk factors, timing, and outcomes of MBI-LCBIs in hematopoietic stem cell transplant patients. We performed a retrospective analysis of 374 patients who underwent HSCT at a large free-standing academic children's hospital to determine the incidence, risk factors, and outcomes of patients that developed a bloodstream infection (BSI) including MBI-LCBI, central line-associated BSI (CLABSI), or secondary BSI in the first year after HSCT. Outcome measures included nonrelapse mortality (NRM), central venous catheter removal within 7 days of positive culture, shock, admission to the pediatric intensive care unit (PICU) within 48 hours of positive culture, and death within 10 days of positive culture. One hundred seventy BSIs were diagnosed in 100 patients (27%): 80 (47%) MBI-LCBIs, 68 (40%) CLABSIs, and 22 (13%) secondary infections. MBI-LCBIs were diagnosed at a significantly higher rate in allogeneic HSCT patients (18% versus 7%, P = .007). Reduced-intensity conditioning (OR, 1.96; P = .015) and transplant-associated thrombotic microangiopathy (OR, 2.94; P = .0004) were associated with MBI-LCBI. Nearly 50% of all patients with a BSI developed septic shock, 10% died within 10 days of positive culture, and nearly 25% were transferred to the PICU. One-year NRM was significantly increased in patients with 1 (34%) and more than 1 (56%) BSIs in the first year post-HSCT compared with those who did not develop BSIs (14%) (P ≤ .0001). There was increased 1-year NRM in patients with at least 1 MBI-LCBI (OR, 1.94; P

  19. Nationwide German Multicenter Study on Prevalence of Antibiotic Resistance in Staphylococcal Bloodstream Isolates and Comparative In Vitro Activities of Quinupristin-Dalfopristin

    OpenAIRE

    von Eiff, Christof; Reinert, Ralf René; Kresken, Michael; Brauers, Johannes; Hafner, Dieter; Peters, Georg

    2000-01-01

    Antibiotic-resistant gram-positive bacteria have become an increasing problem in the last two decades. In order to evaluate the prevalence of antibiotic resistance in staphylococcal bloodstream isolates in Germany, 2,042 staphylococci collected in 21 tertiary-care hospitals were investigated during a 3-year period (March 1996 to March 1999). Altogether, 1,448 S. aureus isolates and 594 coagulase-negative staphylococci (CoNS) that comprised 13 different species were included. Furthermore, the ...

  20. Cytomegalovirus infection in patients with sepsis due to bloodstream infections: lower risk and better outcomes in new versus already hospitalised intensive care unit admissions.

    Science.gov (United States)

    R, Osawa; M, Wagener; Ns, Singh

    2016-09-01

    Few studies have examined cytomegalovirus (CMV) reactivation exclusively in immunocompetent patients with sepsis due to bloodstream infections. In a cohort of CMV-seropositive critically ill otherwise non-immunosuppressed patients with sepsis due to bloodstream infection, weekly testing for CMV viraemia was performed. Outcomes were assessed at 30 days or until death/discharge from the intensive care unit (ICU). CMV viraemia developed in 20% (20/100) of the patients. Age (P=0.044) and blood transfusions (P=0.022) were significantly associated with CMV viraemia. There was no difference in the primary endpoint (mortality and/or multi-organ failure) between patients with and without CMV viraemia (P=0.49). However, CMV viraemia was associated with significantly fewer ICU-free days (P=0.023) and fewer ventilator-free days (P=0.031). Patients hospitalised in the ICU for more than 48 hours prior to the onset of bloodstream infection were more likely to develop CMV viraemia (P=0.006), have high-grade viraemia (P=0.010), and fewer ICU-free days (P=0.018) and ventilator-free days (P=0.029) than those admitted within 48 hours of bloodstream infection. Thus, CMV reactivation was associated with fewer ICU- and ventilator-free days, however overall mortality was not affected. Patients already in the ICU at the onset of sepsis had higher risk of CMV reactivation and worse outcomes than new ICU-bound patients suggesting that a targeted approach for interventions for CMV could conceivably be directed towards those with a more protracted course of illness. PMID:27608339

  1. Use of Ceftolozane/Tazobactam in the Treatment of Multidrug-resistant Pseudomonas aeruginosa Bloodstream Infection in a Pediatric Leukemia Patient.

    Science.gov (United States)

    Aitken, Samuel L; Kontoyiannis, Dimitrios P; DePombo, April M; Bhatti, Micah M; Tverdek, Frank P; Gettys, Suzanne C; Nicolau, David P; Nunez, Cesar A

    2016-09-01

    Multidrug-resistant Pseudomonas aeruginosa is of increasing concern in pediatric patients. Ceftolozane/tazobactam is a novel cephalosporin/β-lactamase inhibitor combination with activity against multidrug-resistant Pseudomonas; however, no data exist on its use in children. This report summarizes the treatment of a multidrug-resistant P. aeruginosa bloodstream infection in a pediatric leukemia patient with ceftolozane/tazobactam and provides the first description of its pharmacokinetics in pediatrics. PMID:27254038

  2. Long-term, low-dose tigecycline to treat relapsing bloodstream infection due to KPC-producing Klebsiella pneumoniae after major hepatic surgery

    OpenAIRE

    Luca Morelli; Dario Tartaglia; Niccolò Furbetta; Matteo Palmeri; Simone Ferranti; Enrico Tagliaferri; Giulio Di Candio; Franco Mosca

    2015-01-01

    A 68-year-old male underwent a right hepatectomy, resection of the biliary convergence, and a left hepatic jejunostomy for a Klatskin tumour. The postoperative course was complicated by biliary abscesses with relapsing bloodstream infections due to Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp). A 2-week course of combination antibiotic therapy failed to provide source control and the bacteraemia relapsed. Success was obtained with a regimen of tigecycline ...

  3. Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: a linked retrospective cohort study

    OpenAIRE

    Henderson, K. L.; MÜLLER-PEBODY, B.; WADE, A.; Sharland, M.; MINAJI, M.; Johnson, A P; Gilbert, R.

    2014-01-01

    SUMMARY Paediatricians recognize that using the time-dependent community-acquired vs. hospital-acquired bloodstream infection (BSI) dichotomy to guide empirical treatment no longer distinguishes between causative pathogens due to the emergence of healthcare-associated BSIs. However, paediatric epidemiological evidence of the aetiology of BSIs in relation to hospital admission in England is lacking. For 12 common BSI-causing pathogens in England, timing of laboratory reports of positive paedia...

  4. Linkage, evaluation and analysis of national electronic healthcare data: application to providing enhanced blood-stream infection surveillance in paediatric intensive care.

    OpenAIRE

    Katie Harron; Harvey Goldstein; Angie Wade; Berit Muller-Pebody; Roger Parslow; Ruth Gilbert

    2013-01-01

    Background: Linkage of risk-factor data for blood-stream infection (BSI) in paediatric intensive care (PICU) withbacteraemia surveillance data to monitor risk-adjusted infection rates in PICU is complicated by a lack of uniqueidentifiers and under-ascertainment in the national surveillance system. We linked, evaluated and performedpreliminary analyses on these data to provide a practical guide on the steps required to handle linkage of suchcomplex data sources.Methods: Data on PICU admissions...

  5. Risk of bloodstream infection in children admitted to paediatric intensive care units in England and Wales following emergency inter-hospital transfer.

    OpenAIRE

    Harron, K.; Mok, Q; Parslow, R.; Muller-Pebody, B; Gilbert, R.; Ramnarayan, P

    2014-01-01

    Purpose Adherence to full sterile procedures may be compromised when central venous catheters are inserted as part of emergency resuscitation and stabilisation, particularly outside the intensive care unit. Half of emergency admissions to paediatric intensive care units (PICU) in the UK occur after stabilisation at other hospitals. We determined whether bloodstream infection (BSI) occurred more frequently in children admitted to PICU after inter-hospital transfer compared to within-hospital a...

  6. Metabolic labeling with (14C)-glucose of bloodstream and cell culture trypanosoma cruzi trypomastigotes:

    International Nuclear Information System (INIS)

    Trypomastigote forms of Trypanosoma cruzi from infected mouse blood and from cell culture were metabolically labeled by incubation with D-(14C)-glucose. Analysis by polyacrylamide gel electrophoresis of lysates from parasites of two strains (RA and CA1) showed a significantly different pattern. The difference was mainly quantitative when the blood and cell culture trypomastigotes of the RA strain were compared. Analysis of the culture medium by paper electrophoresis showed an anionic exometabolite only in the blood forms of both strains. (Author)

  7. A 12-year review of Staphylococcus aureus bloodstream infections in haemodialysis patients: more work to be done.

    LENUS (Irish Health Repository)

    Fitzgerald, S F

    2012-02-01

    Staphylococcus aureus bloodstream infections (BSI) are a significant cause of morbidity and mortality in haemodialysis patients. This study describes a 12-year retrospective review of S. aureus BSI in a large haemodialysis centre in a tertiary referral hospital. The overall rate of S. aureus BSI was 17.9 per 100 patient-years (range 9.7-36.8). The rate of meticillin-resistant S. aureus (MRSA) BSI was 5.6 per 100 patient-years (range 0.9-13.8). Infective complications occurred in 11% of episodes, the most common being infective endocarditis (7.6%). Ten percent of patients died within 30 days of S. aureus being isolated from blood. Most cases of S. aureus BSI (83%) were related to vascular catheters. The provision of lower-risk vascular access, such as arteriovenous fistulae, and reduced use of intravascular catheters should be priorities in all haemodialysis units. Where alternative vascular access cannot be established, interventions to reduce the risk of catheter-related infections should be implemented to reduce morbidity and mortality in this vulnerable patient group.

  8. Erratum to: Seasonal trend and clinical presentation of Bacillus cereus bloodstream infection: association with summer and indwelling catheter.

    Science.gov (United States)

    Kato, K; Matsumura, Y; Yamamoto, M; Nagao, M; Ito, Y; Takakura, S; Ichiyama, S

    2016-05-01

    Bacillus cereus, an opportunistic pathogen, can cause fatal infection. However, B. cereus bloodstream infections (BSIs) have not been well characterised. From 2008 to 2013, B. cereus isolates from all of the specimens and patients with B. cereus BSIs were identified. Environmental samples were collected to detect B. cereus contamination. We also characterised the clinical presentation of B. cereus BSI through analyses of risk factors for BSI and mortality. A total of 143 clinical B. cereus isolates was detected. Fifty-one patients with nosocomial infections were diagnosed as B. cereus BSI, and 37 had contaminated blood cultures. The number of B. cereus isolates and BSI patients was significantly greater from June to September than from January to April (3.4 vs. 1.0 per month and 1.4 vs. 0.2, respectively). All BSIs were nosocomial and related to central or peripheral vascular catheter. Urinary catheter [odds ratio (OR) 6.93, 95 % confidence interval (CI) 2.40-20.0] was the independent risk factor associated with BSI patients when compared to patients regarded as contaminated. In-hospital mortality among BSI patients was 20 % and was associated with urinary catheter (OR 12.3, 95 % CI 0.67-225, p=0.045) and higher Charlson index (OR 1.99, 95 % CI 1.26-3.12). The number of B. cereus isolates and BSI increased during summer. Inpatients with indwelling vascular or urinary catheters should be carefully monitored for potential B. cereus BSIs. PMID:27010814

  9. CLABSI Conversations: Lessons From Peer-to-Peer Assessments to Reduce Central Line-Associated Bloodstream Infections.

    Science.gov (United States)

    Pham, Julius Cuong; Goeschel, Christine A; Berenholtz, Sean M; Demski, Renee; Lubomski, Lisa H; Rosen, Michael A; Sawyer, Melinda D; Thompson, David A; Trexler, Polly; Weaver, Sallie J; Weeks, Kristina R; Pronovost, Peter J

    2016-01-01

    A national collaborative helped many hospitals dramatically reduce central line-associated bloodstream infections (CLABSIs), but some hospitals struggled to reduce infection rates. This article describes the development of a peer-to-peer assessment process (CLABSI Conversations) and the practical, actionable practices we discovered that helped intensive care unit teams achieve a CLABSI rate of less than 1 infection per 1000 catheter-days for at least 1 year. CLABSI Conversations was designed as a learning-oriented process, in which a team of peers visited hospitals to surface barriers to infection prevention and to share best practices and insights from successful intensive care units. Common practices led to 10 recommendations: executive and board leaders communicate the goal of zero CLABSI throughout the hospital; senior and unit-level leaders hold themselves accountable for CLABSI rates; unit physicians and nurse leaders own the problem; clinical leaders and infection preventionists build infection prevention training and simulation programs; infection preventionists participate in unit-based CLABSI reduction efforts; hospital managers make compliance with best practices easy; clinical leaders standardize the hospital's catheter insertion and maintenance practices and empower nurses to stop any potentially harmful acts; unit leaders and infection preventionists investigate CLABSIs to identify root causes; and unit nurses and staff audit catheter maintenance policies and practices. PMID:27031355

  10. Risk factors for mortality in patients with bloodstream infections during the pre-engraftment period after hematopoietic stem cell transplantation

    Science.gov (United States)

    Karpov, Igor; Milanovich, Natalia; Uss, Anatoly; Iskrov, Igor

    2016-01-01

    Background Bloodstream infections (BSI) remain a frequent complication during the pre-engraftment period after hematopoietic stem cell transplantation (HSCT), resulting in high mortality rates. This study evaluated risk factors for mortality in hematopoietic stem cell transplant recipients with BSI in the pre-engraftment period. Methods This prospective case control study was performed at the Center of Hematology and Bone Marrow Transplantation in Minsk, Republic of Belarus. Data relating to patient age and gender, date and type of transplantation, conditioning chemotherapy regimen, microorganisms isolated from blood, and antibacterial therapy were prospectively collected from all hematopoietic stem cell recipients with microbiologically proven cases of BSI in the pre-engraftment period. The primary outcome was all-cause 30-day mortality after onset of febrile neutropenia. Results A total of 135 adult patients with microbiologically proven BSI after HSCT were studied, with 65.2% of cases caused by gram-negative microorganisms and 21.5% by non-fermenting bacteria. Inadequate empiric antibacterial therapy and isolation of carbapenem-resistant non-fermenting gram-negative bacteria (Acinetobacter baumannii and Pseudomonas aeruginosa) were independently associated with increased all-cause 30-day mortality in these patients. Conclusion The risk factors for mortality in adult patients with BSI in the pre-engraftment period after HSCT were inadequacy of empirical antibacterial therapy and isolation of carbapenem-resistant A. baumannii or P. aeruginosa. PMID:27382554

  11. Candida albicans bloodstream isolates in a German university hospital are genetically heterogenous and susceptible to commonly used antifungals.

    Science.gov (United States)

    Huyke, Johanna; Martin, Ronny; Walther, Grit; Weber, Michael; Kaerger, Kerstin; Bougnoux, Marie-Elisabeth; Elias, Johannes; Kurzai, Oliver

    2015-10-01

    From an eight-year-span, 99 Candida bloodstream isolates were collected at the University Hospital Wuerzburg, Germany. In this study, all strains were analyzed using molecular and phenotypic typing methods. Confirmatory species identification revealed three isolates that were initially diagnosed as C. albicans to be actually C. dubliniensis. Two isolates contained a mixed culture of C. albicans and C. glabrata, in one of the specimens both species could be separated while it was not possible to recover C. albicans in the other sample. The remaining 95 C. albicans isolates were profiled by multilocus sequence typing (MLST). Phylogenetic analyses showed a highly heterogenous collection of strains, associated with many different clades and constituting a set of new diploid sequence types (DST). For all strains with identical DST, patient data were reviewed for potential nosocomial transmission. In addition, all isolates were tested for their susceptibility to amphotericin B, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole. No clinically relevant resistance could be detected. Furthermore, these data underline that correlation between minimal inhibitory concentrations for caspofungin and anidulafungin is low.

  12. Cefazolin versus Nafcillin for Methicillin-Sensitive Staphylococcus aureus Bloodstream Infection in a California Tertiary Medical Center.

    Science.gov (United States)

    Pollett, S; Baxi, S M; Rutherford, G W; Doernberg, S B; Bacchetti, P; Chambers, H F

    2016-08-01

    Recent observational studies have suggested possible reductions in mortality in patients receiving cefazolin versus antistaphylococcal penicillins. We examined 90-day mortality in patients receiving cefazolin compared to nafcillin for methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infection (BSI). We identified persons with MSSA BSI admitted to San Francisco General Hospital from January 2008 to July 2013 through a hospital-wide infection surveillance system and confirmed 90-day mortality using U.S. national vital registries. We included persons receiving cefazolin or nafcillin as the predominant intravenous antimicrobial agent; all participants received inpatient Infectious Diseases service consultation. We estimated the association between receipt of cefazolin and 90-day risk of death by multivariate logistic regression, including a propensity score for receiving cefazolin as the second predictor. Of 230 MSSA BSI cases, 30 received nafcillin and 70 received cefazolin as the predominant antimicrobial; 10 died within 90 days, 5 from each group. Unadjusted analysis showed substantial but not statistically significant reduced odds of death in those receiving cefazolin (odds ratio, 0.38; 95% confidence interval [CI], 0.10 to 1.44). Multivariate analysis with propensity scores found a similar adjusted odds ratio (0.40; 95% CI, 0.09 to 1.74; P = 0.22). We found a large reduction in 90-day mortality in those receiving cefazolin compared to nafcillin for MSSA BSI, but this finding was not statistically significant. The magnitude of effect seen in this and other studies justifies further study. PMID:27216053

  13. Surveillance of bloodstream infections in pediatric cancer centers – what have we learned and how do we move on?

    Directory of Open Access Journals (Sweden)

    Simon, Arne

    2016-05-01

    Full Text Available Pediatric patients receiving conventional chemotherapy for malignant disease face an increased risk of bloodstream infection (BSI. Since BSI may represent an acute life-threatening event in patients with profound immunosuppression, and show further negative impact on quality of life and anticancer treatment, the prevention of BSI is of paramount importance to improve and guarantee patients’ safety during intensive treatment. The great majority of all pediatric cancer patients (about 85% have a long-term central venous access catheter in use (type Broviac or Port; CVAD. Referring to the current surveillance definitions a significant proportion of all BSI in pediatric patients with febrile neutropenia is categorized as CVAD- BSI. This state of the art review summarizes the epidemiology and the distinct pathogen profile of BSI in pediatric cancer patients from the perspective of infection surveillance. Problems in executing the current surveillance definition in this patient population are discussed and a new concept for the surveillance of BSI in pediatric cancer patients is outlined.

  14. The impact of HIV infection on blood leukocyte responsiveness to bacterial stimulation in asymptomatic patients and patients with bloodstream infection

    Science.gov (United States)

    Huson, Michaëla A M; Hoogendijk, Arie J; de Vos, Alex F; Grobusch, Martin P; van der Poll, Tom

    2016-01-01

    Introduction HIV-induced changes in cytokine responses to bacteria may influence susceptibility to bacterial infections and the consequent inflammatory response. Methods We examined the impact of HIV on whole blood responsiveness to bacterial stimulation in asymptomatic subjects and patients with bacterial bloodstream infection (BSI). Whole blood was stimulated ex vivo with two bacterial Toll-like receptor agonists (lipopolysaccharide and lipoteichoic acid) and two pathogens (Streptococcus pneumoniae and non-typhoidal Salmonella), which are relevant in HIV-positive patients. Production of interferon-γ, tumour necrosis factor-α, interleukin-1β and interleukin-6 was used as a read-out. Results In asymptomatic subjects, HIV infection was associated with reduced interferon-γ, release after stimulation and priming of the pro-inflammatory cytokine response to non-typhoidal Salmonella. In patients with BSI, we found no such priming effect, nor was there evidence for more profound sepsis-induced immunosuppression in BSI patients with HIV co-infection. Conclusions These results suggest a complex effect of HIV on leukocyte responses to bacteria. However, in patients with sepsis, leukocyte responses were equally blunted in patients with and without HIV infection. PMID:27189532

  15. High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus

    Science.gov (United States)

    Viedma, Esther; Chaves, Fernando; Lalueza, Antonio; Fortún, Jesús; Loza, Elena; Pujol, Miquel; Ardanuy, Carmen; Morales, Isabel; de Cueto, Marina; Resino-Foz, Elena; Morales-Cartagena, Alejandra; Rico, Alicia; Romero, María P.; Orellana, María Ángeles; López-Medrano, Francisco; Fernández-Ruiz, Mario; Aguado, José María

    2016-01-01

    We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011–June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 μg/mL and 0.5 μg/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2–5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1–5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications. PMID:27192097

  16. POLYCLONAL OUTBREAK OF BLOODSTREAM INFECTIONS CAUSED BY Burkholderia cepacia COMPLEX IN HEMATOLOGY AND BONE MARROW TRANSPLANT OUTPATIENT UNITS

    Directory of Open Access Journals (Sweden)

    Icaro Boszczowski

    2014-01-01

    Full Text Available Aim: The objective was to describe an outbreak of bloodstream infections by Burkholderia cepacia complex (Bcc in bone marrow transplant and hematology outpatients. Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases were identified. Demographic and clinical data were evaluated. Environment and healthcare workers' (HCW hands were cultured. Species were determined and typed. Reinforcement of hand hygiene, central venous catheter (CVC care, infusion therapy, and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared for the CVCs. Multi-dose heparin and saline were prepared on counter common to both units. Findings: 14 patients had B. multivorans (one patient had also B. cenopacia, six non-multivorans Bcc and one did not belong to Bcc. Clone A B. multivorans occurred in 12 patients (from Hematology; in 10 their CVC had been used on February 11/12. Environmental and HCW cultures were negative. All patients were treated with meropenem, and ceftazidime lock-therapy. Eight patients (30% were hospitalized. No deaths occurred. After control measures (multidose vial for single patient; CVC lock with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of cabinet to store prepared medication, no new cases occurred. Conclusions: This polyclonal outbreak may be explained by a common source containing multiple species of Bcc, maybe the laminar flow cabinet common to both units. There may have been contamination by B. multivorans (clone A of multi-dose vials.

  17. Comparison of severity of illness scoring systems for patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Wenzel Richard P

    2006-08-01

    Full Text Available Abstract Background Several acute illness severity scores have been proposed for evaluating patients on admission to intensive care units but these have not been compared for patients with nosocomial bloodstream infection (nBSI. We compared three severity of illness scoring systems for predicting mortality in patients with nBSI due to Pseudomonas aeruginosa. Methods We performed a historical cohort study on 63 adults in intensive care units with P. aeruginosa monomicrobial nBSI. Results The Acute Physiology, Age, Chronic Health Evaluation II (APACHE II, Sequential Organ Failure Assessment (SOFA, and Simplified Acute Physiologic Score (SAPS II, were calculated daily from 2 days prior through 2 days after the first positive blood culture. Calculation of the area under the receiver operating characteristic (ROC curve confirmed that APACHE II and SAPS II at day -1 and SOFA at day +1 were better predictors of outcome than days -2, 0 and day 2 of BSI. By stepwise logistic regression analysis of these three scoring systems, SAPS II (OR: 13.03, CI95% 2.51–70.49 and APACHE II (OR: 12.51, CI95% 3.12–50.09 on day -1 were the best predictors for mortality. Conclusion SAPS II and APACHE II are more accurate than the SOFA score for predicting mortality in this group of patients at day -1 of BSI.

  18. 成人原发血流感染494例临床分析%Clinical analysis of adult primary bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    张黎; 刘正印; 徐英春; 李太生; 杨启文; 王爱霞

    2012-01-01

    Objective Evaluate the microbiological and epidemiological characteristics of primary bloodstream infections as well as the associated patients' clinical features at Peking Union Medical College Hospital.Method Microbiological and clinical data of the adult patients with primary bloodstream infections during January 1,2008 and December 31,2009 were retrospectively collected and evaluated.Pearson x2 test was used to compare the difference between proportions and Logistic regression was used in multivariate analysis.Result Five hundred and eighty-six strains of microbes were isolated from 494 adult patients with primary bloodstream infections.There were 80 patients with polymicrobial primary bloodstream infection of the 586 isolates,coagulase-negative staphylococci ( 175,29.9% ) was the most common,followed by Escherichia coli( 93,15.9% ),Enterococcus species ( 60,10.2% ),Streptococcus species ( 41,7.0% ),and Staphylococcus Aureus (39,6.7% ).Central-line was the leading suspected infective source among the suspected infective source involving 108 (18.4%) isolates. Excluded the 108 isolates with suspected sources,77 (45.3%) out of 167 patients with the primary bloodstream infections caused by coagulasc-negative staphylococci or Staphylococcus Aureus had a central-line,with a higher proportion of the patients with a central-line than the patients with bloodstream infection caused by other pathogens ( x2 =10.419,P =0.001 ).One hundred and fourteen patients died during hospitalization,with the crude mortality rate 23.0%.Fifty-nine patients (11.9%) died due to primary bloodstream infection.The patients with polymicrobial bloodstream infection were with a higher attributable mortality( OR =2.159 ;95% CI 1.165 -4.002 ;x2 =6.194,P =0.013 ).In the multivariate analysis,the independent risk factors of crude mortality rate to primary bloodstream infections were elderly patients,central neurological disorder,mechanical ventilation,and reservation a central

  19. Risk factors for bloodstream infections in 66 patients in ICU%ICU 66例血流感染患者危险因素分析

    Institute of Scientific and Technical Information of China (English)

    姚彬; 习慧明

    2012-01-01

    OBJECTIVE To investigate the risk factors for bloodstream infections in the intensive care unit (ICU), to analyze the distribution of pathogens and their drug resistance so as to provide basis for the prevention and treatment of bloodstream infections and reduce the incidence of bloodstream infections and the mortality. METHODS Totally 66 patients with bloodstream infections were investigated retrospectively in the ICU of Beijing Haidian Hospital between 2009 and 2011, the risk factors for bloodstream infections, the distribution of pathogens, and the drug resistance characteristics were analyzed. RESULTS A total of 70 strains of pathogens were isolated from 66 patients with bloodstream infections, including 32 (45. 7%) strains of gram-negative bacteria,28 (40. 0%) strains of gram-positive bacteria, and 10 (14.3%) strains of fungi; the main pathogens causing bloodstream infections were coagulase-negative Staphylococci (25. 7%), Acinetobacter baumannii (12.9%), Yeast (12. 9%), Burkholderia cepacia (10.0%), Enterococcus feces (8.6%), and Escherichia coli (8. 6%). Those patients with the bloodstream infections had poor prognosis and the mortality rate was high, up to 69. 23%. The chronic underlying disease, low immunity, invasive operation,and the abuse of antibiotics were risk factors of bloodstream infections. CONCLUSION The distribution of the gram-negative bacteria is as basically same as the gram-positive bacteria in the pathogens causing blood stream infections in the ICU during the three years. A. baumannii is the main species of gram-negative bacteria, and coagulase-negative Staphylococci was the predominant species of gram-positive bacteria. The strict aseptic operation, careful nursing of catheter, intensifying the blood culture, and reasonable use of antibiotics are the effective measures to prevent and treat the bloodstream infections.%目的 了解重症监护病房(ICU)血流感染的危险因素、病原菌分布特点及其耐药性,为更好地预防

  20. Risk factors for catheter-related bloodstream infection: a prospective multicenter study in Brazilian intensive care units

    Directory of Open Access Journals (Sweden)

    Daniela Bicudo

    2011-08-01

    Full Text Available INTRODUCTION: Central venous catheters (CVC are devices of great importance in health care. The advantages gained from the use of catheters outweigh the complications that might result from their use, among which bloodstream infections (BSI. In spite of its importance, few national studies have addressed this issue. OBJECTIVE: The aim this study was to determine the incidence of BSI in patients with CVC, hospitalized in ICU, as well as the variables associated with this complication. METHODS: Multicentric cohort study carried out at ICUs of three hospitals at Universidade Federal de São Paulo complex. RESULTS: A total of 118 cases of BSI in 11.546 catheters day were observed: 10.22 BSI per 1,000 catheters day. On average, BSI was associated to seven additional days of hospital stay in our study (p < 0.001, with a significant difference between types of catheters. Concerning the place of insertion, there was no statistical difference in BSI rates. CONCLUSION: We concluded that a patient who uses a catheter for longer than 13 days presents a progressive risk for infection of approximately three times higher in relation to a patient who uses the catheter for less than 13 days (p < 0.001. The median duration of catheter use was 14 days among patients with BSI and 9 days in patients without infection (p < 0.001. There was higher prevalence of Gram-negative infections. The risk factors for BSI were utilization of multiple-lumen catheters, duration of catheterization and ICU length of stay.

  1. Surveillance length and validity of benchmarks for central line-associated bloodstream infection incidence rates in intensive care units.

    Directory of Open Access Journals (Sweden)

    Patricia S Fontela

    Full Text Available INTRODUCTION: Several national and regional central line-associated bloodstream infections (CLABSI surveillance programs do not require continuous hospital participation. We evaluated the effect of different hospital participation requirements on the validity of annual CLABSI incidence rate benchmarks for intensive care units (ICUs. METHODS: We estimated the annual pooled CLABSI incidence rates for both a real regional (<100 ICUs and a simulated national (600 ICUs surveillance program, which were used as a reference for the simulations. We simulated scenarios where the annual surveillance participation was randomly or non-randomly reduced. Each scenario's annual pooled CLABSI incidence rate was estimated and compared to the reference rates in terms of validity, bias, and proportion of simulation iterations that presented valid estimates (ideal if ≥ 90%. RESULTS: All random scenarios generated valid CLABSI incidence rates estimates (bias -0.37 to 0.07 CLABSI/1000 CVC-days, while non-random scenarios presented a wide range of valid estimates (0 to 100% and higher bias (-2.18 to 1.27 CLABSI/1000 CVC-days. In random scenarios, the higher the number of participating ICUs, the shorter the participation required to generate ≥ 90% valid replicates. While participation requirements in a countrywide program ranged from 3 to 13 surveillance blocks (1 block = 28 days, requirements for a regional program ranged from 9 to 13 blocks. CONCLUSIONS: Based on the results of our model of national CLABSI reporting, the shortening of participation requirements may be suitable for nationwide ICU CLABSI surveillance programs if participation months are randomly chosen. However, our regional models showed that regional programs should opt for continuous participation to avoid biased benchmarks.

  2. Differential Gel Electrophoresis (DIGE) Evaluation of Naphthoimidazoles Mode of Action: A Study in Trypanosoma cruzi Bloodstream Trypomastigotes

    Science.gov (United States)

    Brunoro, Giselle Villa Flor; Faça, Vitor Marcel; Caminha, Marcelle Almeida; Ferreira, André Teixeira da Silva; Trugilho, Monique; de Moura, Kelly Cristina Gallan; Perales, Jonas; Valente, Richard Hemmi; Menna-Barreto, Rubem Figueiredo Sadok

    2016-01-01

    Background The obligate intracellular protozoan Trypanosoma cruzi is the causative agent of Chagas disease, a neglected illness affecting millions of people in Latin America that recently entered non-endemic countries through immigration, as a consequence of globalization. The chemotherapy for this disease is based mainly on benznidazole and nifurtimox, which are very efficient nitroderivatives against the acute stage but present limited efficacy during the chronic phase. Our group has been studying the trypanocidal effects of naturally occurring quinones and their derivatives, and naphthoimidazoles derived from β-lapachone N1, N2 and N3 were the most active. To assess the molecular mechanisms of action of these compounds, we applied proteomic techniques to analyze treated bloodstream trypomastigotes, which are the clinically relevant stage of the parasite. Methodology/Principal Findings The approach consisted of quantification by 2D-DIGE followed by MALDI-TOF/TOF protein identification. A total of 61 differentially abundant protein spots were detected when comparing the control with each N1, N2 or N3 treatment, for 34 identified spots. Among the differentially abundant proteins were activated protein kinase C receptor, tubulin isoforms, asparagine synthetase, arginine kinase, elongation factor 2, enolase, guanine deaminase, heat shock proteins, hypothetical proteins, paraflagellar rod components, RAB GDP dissociation inhibitor, succinyl-CoA ligase, ATP synthase subunit B and methionine sulfoxide reductase. Conclusion/Significance Our results point to different modes of action for N1, N2 and N3, which indicate a great variety of metabolic pathways involved and allow for novel perspectives on the development of trypanocidal agents. PMID:27551855

  3. Comparison of pathogen DNA isolation methods from large volumes of whole blood to improve molecular diagnosis of bloodstream infections.

    Directory of Open Access Journals (Sweden)

    Anne J M Loonen

    Full Text Available For patients suffering from bloodstream infections (BSI molecular diagnostics from whole blood holds promise to provide fast and adequate treatment. However, this approach is hampered by the need of large blood volumes. Three methods for pathogen DNA isolation from whole blood were compared, i.e. an enzymatic method (MolYsis, 1-5 ml, the novel non-enzymatic procedure (Polaris, 1-5 ml, and a method that does not entail removal of human DNA (Triton-Tris-EDTA EasyMAG, 200 µl. These methods were evaluated by processing blood spiked with 0-1000 CFU/ml of Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. Downstream detection was performed with real-time PCR assays. Polaris and MolYsis processing followed by real-time PCRs enabled pathogen detection at clinically relevant concentrations of 1-10 CFU/ml blood. By increasing sample volumes, concurrent lower cycle threshold (Ct values were obtained at clinically relevant pathogen concentrations, demonstrating the benefit of using larger blood volumes. A 100% detection rate at a concentration of 10 CFU/ml for all tested pathogens was obtained with the Polaris enrichment, whereas comparatively lower detection rates were measured for MolYsis (50-67% and EasyMAG (58-79%. For the samples with a concentration of 1 CFU/ml Polaris resulted in most optimal detection rates of 70-75% (MolYsis 17-50% and TTE-EasyMAG 20-36%. The Polaris method was more reproducible, less labour intensive, and faster (45 minutes (including Qiagen DNA extraction vs. 2 hours (MolYsis. In conclusion, Polaris and MolYsis enrichment followed by DNA isolation and real-time PCR enables reliable and sensitive detection of bacteria and fungi from 5 ml blood. With Polaris results are available within 3 hours, showing potential for improved BSI diagnostics.

  4. Clinical and microbiological characteristics of bloodstream infections in a tertiary hospital in Maceió, Alagoas, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Tereza Freitas Tenório

    2010-04-01

    Full Text Available We observed the clinical and microbiological characteristics of several stages of bloodstream infections (BSI, as well as the mortality attributed to it in a tertiary hospital in the northeast of Brazil (in the city of Maceió, Alagoas. A prospective cohort of 143 patients who had at least one positive blood culture was enrolled in the study. Their clinical evolution was followed up for 30 days from October 2005 to December 2006. The relation among the qualitative variables was verified through Chi-square test. The significance level was 5%. The statistical package adopted was SPSS 15.0 for Windows. Up to the thirtieth day, 30.1% of the patients presented bacteremia and 69.9% developed sepsis.Among these, 20.3% developed severe sepsis and 10.5% septic shock. The mortality attributed to it was 37.8%. In bacteremia, sepsis, severe sepsis, and septic shock conditions, mortality rates were 9.3%, 50%, 65.5%, and 84.6%, respectively. Respiratory (32.2% and urinary (14% sources and the ones related to central venous catheter (14% were prevalent. In the wards 55.12% of the cases developed sepsis, whereas in the intensive care units, the rate was 87.69% (p < 0.05. Chronic renal failure, diabetes melitus, and neuropathy were present in 21.7%, 26.6%, and 29.4% of the cases, respectively. Coagulase-negative Staphylococcus (25.9%, Staphylococcus aureus (21%, and Klebsiella pneumoniae (14% were the most present microorganism in the sample. The high morbidity and mortality rates in this study are attributed to the lack of knowledge on BSI characteristics and on instituted protocols for detection and treatment in early stages.

  5. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Trelha Gauna

    2013-08-01

    Full Text Available Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3% patients started dialysis due to urgency, 37 (62.7% had BSI, and 12 (20% died. Hyperemia at the catheter insertion site (64.9% was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases, non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes, and Candida species (6. Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.

  6. Nosocomial bloodstream infection in patients caused by Staphylococcus aureus: drug susceptibility, outcome, and risk factors for hospital mortality

    Institute of Scientific and Technical Information of China (English)

    CHEN Rong; YAN Zhong-qiang; FENG Dan; LUO Yan-ping; WANG Lei-li; SHEN Ding-xia

    2012-01-01

    Background Previous studies have different viewpoints about the clinical impact of methicillin resistance on mortality of hospital-acquired bloodstream infection (BSI) patients with Staphylococcus aureus (S.aureus).The objective of this study was to investigate the mortality of hospital-acquired BSI with S.aureus in a military hospital and analyze the risk factors for the hospital mortality.Methods A retrospective cohort study was performed in patients admitted to the biggest military tertiary teaching hospital in China between January 2006 and May 2011.All included patients had clinically significant nosocomial BSI with S.aureus.Multivariate Logistic regression analysis was used to identify the risk factors for hospital mortality of patients with S.aureus BSI.Results One hundred and eighteen patients of more than one year old were identified as clinically and microbiologically confirmed nosocomial bacteraemia due to S.aureus,and 75 out of 118 patients were infected with methicillin-resistant S.aureus (MRSA).The overall mortality of nosocomial S.aureus BSI was 28.0%.Methicillin resistance in S.aureus bacteremia was associated with significant increase in the length of hospitalization and high proportion of inappropriate empirical antibiotic treatment.After Logistic regression analysis,the severity of clinical manifestations (APACHE Ⅱ score) (odds ratio (OR) 1.22,95% confidence interval (CI) 1.12-1.34) and inadequacy of empirical antimicrobial therapy (OR 0.25,95% CI 0.09-0.69) remained as risk factors for hospital mortality.Conclusions Nosocomial S.aureus BSI was associated with high in-hospital mortality.Methicillin resistance in S.aureus has no significant impact on the outcome of patients with staphylococcal bacteremia.Proper empirical antimicrobial therapy is very important to the prognosis.

  7. Clinical and molecular characteristics of bloodstream infections caused by Candida albicans in children from 2003 to 2011.

    Science.gov (United States)

    Tsai, M-H; Wang, S-H; Hsu, J-F; Lin, L-C; Chu, S-M; Huang, H-R; Chiang, M-C; Fu, R-H; Lu, J-J; Huang, Y-C

    2015-11-01

    We investigated the clinical and molecular characteristics of Candida albicans bloodstream infection (BSI) in children from a tertiary-level medical centre in Taiwan over a 9-year period from January 2003 to December 2011. We performed multilocus sequence typing (MLST) to investigate the genetic relatedness of these C. albicans BSI isolates. A total of 79 episodes of C. albicans BSI in 76 paediatric patients were identified, including 41 (51.9%) from the paediatric intensive care unit, 24 (30.4%) from the neonatal intensive care unit and 14 (17.7%) from general wards. More than half (59.5%) of these patients had underlying chronic co-morbidities, and the majority (94.9%) had a catheter or some other artificial device. All the isolates were susceptible to the antifungal agents tested. Only 32.9% (26/79) received effective antifungal agents within 24 h of onset of candidaemia. Twenty-five (31.6%) patients had persistent candidaemia (>3 days after the start of antifungal treatment) and candidaemia-attributable mortality rate was 22.8% (18/79). The 72 isolates available for MLST yielded 53 unique diploid sequence types (DSTs). Forty-five DSTs were singletons and eight DSTs were shared by 27 (37.5%) isolates. Seventy-one (98.6%) isolates were clustered within previously known clades. Based on the definition of two or more strains with shared DST occurring within a period of 90 days, 10.1% of the infections were categorized as nosocomial clusters, most commonly identified in the intensive care units. Although cluster-associated candidaemia was not associated with a higher mortality rate, none of the clusters were identified by the hospital infection control team.

  8. FACTORS ASSOCIATED WITH MORTALITY AMONG PATIENTS WITH CENTRAL VENOUS CATHETER-RELATED BLOODSTREAM INFECTION IN AN INTENSIVE CARE UNIT

    Directory of Open Access Journals (Sweden)

    Priscilla Roberta Silva Rocha

    2012-01-01

    Full Text Available Central venous catheterization is a common practice in the management of critically ill patients and is associated with various complications, such as Bloodstream Infections (BSI, which are major determinants of increased morbidity, mortality and healthcare expenses. Few studies have addressed factors that predict mortality in patients with this complication. The aim of this study was to investigate factors associated with mortality in patients with Central Venous Catheter (CVC-related BSI in an intensive care unit of a tertiary care hospital in the Federal District, Brazil. This was a retrospective and observational study, in which all CVC-related BSI that occurred between January 2008 and December 2010 were reviewed. We obtained demographic, clinical, biochemical and microbiological data from medical records and investigated its association with mortality during ICU stay. There were 4,504 ICU admissions during the study period and 68 were complicated by CVC-related BSI (4.09 per 1000 catheter-days, most due to gram-negative organisms (45.6%. Overall mortality was 59.7%. Death risk was significantly associated with mechanical ventilation (OR 27.8, 95% CI 3.28-250, p-1 in survivors vs. 73.9 mg dL-1 in non-survivors, p = 0.001. Mortality was not associated with other clinical or biochemical features, neither with microbiological variables, although lethality was high among patients with gram-positive infections (77% Vs 58.33% for fungi and 54.83% for gram-negative. CVC-related BSI was associated with high absolute mortality, which was predicted by mechanical ventilation and a higher number of invasive devices other than the CVC. Knowledge of local factors predictive of mortality is critical for planning strategies to reduce death risk associated with this complication.

  9. Carbapenemase-producing Klebsiella pneumoniae bloodstream infections: lowering mortality by antibiotic combination schemes and the role of carbapenems.

    Science.gov (United States)

    Daikos, George L; Tsaousi, Sophia; Tzouvelekis, Leonidas S; Anyfantis, Ioannis; Psichogiou, Mina; Argyropoulou, Athina; Stefanou, Ioanna; Sypsa, Vana; Miriagou, Vivi; Nepka, Martha; Georgiadou, Sarah; Markogiannakis, Antonis; Goukos, Dimitris; Skoutelis, Athanasios

    2014-01-01

    Carbapenemase-producing Klebsiella pneumoniae strains (CP-Kps) are currently among the most important nosocomial pathogens. An observational study was conducted during 2009 to 2010 in two hospitals located in a high-prevalence area (Athens, Greece). The aims were (i) to evaluate the clinical outcome of patients with CP-Kp bloodstream infections (BSIs), (ii) to identify predictors of mortality, and (iii) to evaluate the various antibiotic schemes employed. A total of 205 patients with CP-Kp BSIs were identified: 163 (79.5%) were infected with KPC or KPC and VIM, and 42 were infected with VIM producers. For definitive treatment, 103 patients received combination therapy (two or more active drugs), 72 received monotherapy (one active drug), and 12 received therapy with no active drug. The remaining 18 patients died within 48 h after the onset of bacteremia. The all-cause 28-day mortality was 40%. A significantly higher mortality rate was observed in patients treated with monotherapy than in those treated with combination therapy (44.4% versus 27.2%; P=0.018). The lowest mortality rate (19.3%) was observed in patients treated with carbapenem-containing combinations. In the Cox proportion hazards model, ultimately fatal disease (hazards ratio [HR], 3.25; 95% confidence interval [CI], 1.51 to 7.03; P=0.003), the presence of rapidly fatal underlying diseases (HR, 4.20; 95% CI, 2.19 to 8.08; Ptherapy was strongly associated with survival (HR of death for monotherapy versus combination, 2.08; 95% CI, 1.23 to 3.51; P=0.006), mostly due to the effectiveness of the carbapenem-containing regimens.

  10. The Likelihood of Hospital Readmission among Patients with Hospital-Onset Central Line-Associated Bloodstream Infections

    Science.gov (United States)

    Khong, Carolyn; Baggs, James; Kleinbaum, David; Cochran, Ronda; Jernigan, John A.

    2015-01-01

    Objective We sought to determine whether central line-associated bloodstream infections (CLABSI) increase the likelihood of readmission. Design Retrospective matched cohort study for the years 2008–2009. Setting Acute care hospitals. Participants Medicare recipients. CLABSI and readmission status were determined by linking National Healthcare Safety Network surveillance data to the Centers for Medicare & Medicaid Services’ Medical Provider and Analysis Review in eight states. Frequency matching was used on ICD-9-CM procedure code category and intensive care unit status. Methods We compared the rate of readmission among patients with and without CLABSI during an index hospitalization. Cox proportional hazard analysis was used to assess rate of readmission (the first hospitalization within 30 days post-index discharge). Multivariate models included the following covariates: race, sex, length of index hospitalization stay central line procedure code, GAGNE co-morbidity score, and individual chronic conditions. Results Of the 8,097 patients, 2,260 were readmitted within 30 days (27.9%). The rate of first readmission was 7.1 events/person-year (PY) for CLABSI patients and 4.3 events/PY for non-CLABSI patients (p <0.001). The final model revealed a small but significant increase in the rate of 30 day readmissions for patients with a CLABSI compared to similar non-CLABSI patients. In the first readmission for CLABSI patients, we also observed an increase in diagnostic categories consistent with CLABSI including septicemia and complications of a device. Conclusions Our analysis found a statistically significant association between CLABSI status and readmission, suggesting that CLABSI may have adverse health impact that extends beyond hospital discharge. PMID:25990620

  11. EFFECT OF INFLIXIMAB ON PARAMETERS OF REMODELING OF ARTERIAL BLOODSTREAM, RANKL AND OSTEOPROTEGERIN LEVELS IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Larisa Aleksandrovna Knyazeva

    2013-01-01

    Full Text Available Objective. To study the effect of infliximab (INF on serum levels of RANKL and osteoprotegerin (OPG, as well as on structural and functional properties of the vascular wall in patients with rheumatoid arthritis (RA.Material and Methods. A total of 79 RA patients who corresponded to the classification criteria ACR (1987 or ACR/EULAR (2010 and were seronegative for IgM rheumatoid factor (RF were examined. The mean age of patients was 43.6±8.5 years. The serum levels of OPG and RANKL were determined by ELISA (Biomedica, Austria; the common carotid arteries (CCAs were visualized using an Acuson X/10 ultrasonic complex equipped with a 7 MHz linear sensor in the β-mode prior to therapy and after 12-month therapy with INF.Results and Discussion. An increased OPG level was observed mostly in patients with RA duration up to 1 year; an increase in RANKL level was pronounced stronger in patients with PA duration over 2 years. The disturbance of structural and functional properties of the arterial bloodstream was revealed, manifesting itself as an increase in the intimamedia complex thickness, diameter and rigidity index of CCA that were stronger pronounced in patients with late onset RA. A correlation analysis showed the presence of reliable relationship between the RANKL and OPG levels and CCA remodeling parameters. INF therapy showed high clinical effectiveness and correction effect on the RANKL/OPG system. In addition, it was accompanied by a reduction of signs of CCA remodeling, which was stronger pronounced in patients with early RA.Conclusion. The results prove the reasonability of using INF at early stages of RA in order to optimize the therapy and achieve more efficient control of cardiovascular complications.

  12. Use of Six Sigma strategies to pull the line on central line-associated bloodstream infections in a neurotrauma intensive care unit.

    Science.gov (United States)

    Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen

    2015-01-01

    The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks. PMID:25768963

  13. Characteristics of neonates with culture-proven bloodstream infection who have low levels of C-reactive protein (≦10 mg/L)

    OpenAIRE

    Lai, Mei-Yin; Tsai, Ming-Horng; Lee, Chiang-Wen; Chiang, Ming-Chou; Lien, Reyin; Fu, Ren-Huei; Huang, Hsuan-Rong; Chu, Shih-Ming; Hsu, Jen-Fu

    2015-01-01

    Background Elevated C-reactive protein (CRP) level is widely used in clinical practice as a marker to distinguish between neonates with or without sepsis. However, some neonates with bacteremia have a CRP level within the normal range and they are not well characterized. Methods All episodes of neonatal culture-proven bloodstream infections (BSIs) between July 2004 and June 2012 were enrolled. Patients characteristics were compared for three CRP groups (low, ≤ 10 mg/L; intermediate, 11–100 mg...

  14. CORRELATION OF VOLUME BLOOD CIRCULATION IN THE HEPATIC ARTERY AND THE STATE OF MICROCIRCULATORY BLOODSTREAM OF THE TRANSPLANTED LIVER AFTER ITS REVASCULIZATION

    Directory of Open Access Journals (Sweden)

    D. A. Granov

    2014-01-01

    Full Text Available Aim: optimization of the surgical treatment policy with orthotopic liver transplantation (OLT depending on the results of intraoperative fl owmetry and the state of intrahepatic microcirculatory bloodstream according to immunohistochemical (IHC study of microspecimens of the donor’s liver.Materials and methods. 60 patients are included in the study. Group I (n = 30 comprised of patients for whom it was not necessary to perform any additional interventions on the bloodstream in the hepatopancreatobiliary area during OLT. Group II (n = 30 had patients with insuffi cient arterial blood supply for the graft in the intraoperative stage where it was needed to perform additional and/or repeated interventions in the arteries of the hepatopancreatobilliary area. Intraoperative fl owmetry with assessment of the volume blood circulation (VBC in the hepatic artery (HA was carried out in the both studied groups. Reference value of VBC was 100 ml/min and higher. Before and after reperfusion in the liver biopsy material we performed immunohistochemical study with the use of endothelial marker CD 31 with subsequent morphometric estimation of the specifi c square of the microvascular bloodstream.Results. In both groups there was no change in the specifi c square in the areas of portal tract and central vein before and after restoring blood fl ow. In the second group, an 8 times increase of the specifi c square of sinusoids was observed after restoring blood fl ow (р < 0,01.Conclusion. Intraoperative fl owmetric control of the blood fl ow allows in due time to perform surgical correction of the graft arterial blood supply during OLT, and it reduces the risk of thrombosis up to 0%. The value of VBC in the hepatic artery (HA has reliable dependence upon the state of microcirculatory bloodstream of cadaveric donor’s liver after reperfusion.

  15. Detection of mcr-1 encoding plasmid-mediated colistin-resistant Escherichia coli isolates from human bloodstream infection and imported chicken meat, Denmark 2015

    DEFF Research Database (Denmark)

    Hasman, H.; Hammerum, A. M.; Hansen, F.;

    2015-01-01

    The plasmid-mediated colistin resistance gene, mcr-1, was detected in an Escherichia coli isolate from a Danish patient with bloodstream infection and in five E. coli isolates from imported chicken meat. One isolate from chicken meat belonged to the epidemic spreading sequence type ST131....... In addition to IncI2*, an incX4 replicon was found to be linked to mcr-1. This report follows a recent detection of mcr-1 in E. coli from animals, food and humans in China....

  16. Long-term, low-dose tigecycline to treat relapsing bloodstream infection due to KPC-producing Klebsiella pneumoniae after major hepatic surgery.

    Science.gov (United States)

    Morelli, Luca; Tartaglia, Dario; Furbetta, Niccolò; Palmeri, Matteo; Ferranti, Simone; Tagliaferri, Enrico; Di Candio, Giulio; Mosca, Franco

    2015-07-01

    A 68-year-old male underwent a right hepatectomy, resection of the biliary convergence, and a left hepatic jejunostomy for a Klatskin tumour. The postoperative course was complicated by biliary abscesses with relapsing bloodstream infections due to Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp). A 2-week course of combination antibiotic therapy failed to provide source control and the bacteraemia relapsed. Success was obtained with a regimen of tigecycline 100mg daily for 2 months, followed by tigecycline 50mg daily for 6 months, then 50mg every 48h for 3 months. No side effects were reported. PMID:25975648

  17. Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    M Kaur

    2015-01-01

    Full Text Available Purpose : Central venous catheters (CVCs though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC-BSI in the intensive care unit (ICU patients and studied the formation of biofilm in CVCs. Materials and Methods: The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO and Gram staining methods. Biofilm production in catheters was detected by ′tissue culture plate′ (TCP method. The results were analysed using the computer-based program statistical package for the social sciences (SPSS. Results : In 25/115 patients, definite diagnosis of CVC-BSI was made. The mean age was 48.44 ± 17.34 years (cases vs 40.10 ± 18.24 years (controls and the mean duration of catheterisation was 25.72 ± 8.73 days (cases vs 11.89 ± 6.38 days (controls. Local signs of infection (erythema, tenderness and oozing were found more significantly in CVC-BSI cases. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Staphylococcus aureus followed by Pseudomonas aeruginosa and non-albicans Candida were common CVC-BSI pathogens. Multidrug-resistant (MDR strains were isolated in bacterial agents of CVC-BSI. Non-albicans Candida and Enterococcus faecalis showed strong biofilm production. Conclusion : The incidence of CVC-BSI was 21.73% and the rate was 14.59 per 1000 catheter days. Prolonged ICU stay and longer catheterisation were major risk factors. S. aureus was isolated most commonly in CVC-BSI cases. The menace of multidrug resistance and

  18. Characterization and Clinical Impact of Bloodstream Infection Caused by Carbapenemase-Producing Enterobacteriaceae in Seven Latin American Countries

    Science.gov (United States)

    Villegas, Maria Virginia; Pallares, Christian J.; Hernández-Gómez, Cristhian; Correa, Adriana; Álvarez, Carlos; Rosso, Fernando; Matta, Lorena; Luna, Carlos; Zurita, Jeannete; Mejía-Villatoro, Carlos; Rodríguez-Noriega, Eduardo; Seas, Carlos; Cortesía, Manuel; Guzmán-Suárez, Alfonso; Guzmán-Blanco, Manuel

    2016-01-01

    Introduction Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE bloodstream infection (BSI) from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy. Methods Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela). Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information. Results A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p < 0.001). The most common regimen was carbapenem + colistin or polymyxin B. The overall mortality was 37% (94/255). Overall and attributable mortality were significantly higher in patients with CPE BSI (p < 0.001); however, we found that patients with CPE BSI who received combination therapy and those who received monotherapy had similar mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7–9.5; p = 0.002) and critical illness (aOR 6.5; 95% CI 3.1–13.7; p < 0

  19. Use of the Tego needlefree connector is associated with reduced incidence of catheter-related bloodstream infections in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Brunelli SM

    2014-04-01

    Full Text Available Steven M Brunelli,1 Levi Njord,2 Abigail E Hunt,1 Scott P Sibbel1 1DaVita Clinical Research®, Minneapolis, MN, USA; 2DaVita HealthCare Partners, Inc, Denver, CO, USA Background and objectives: Catheter-related bloodstream infections (CRBSIs are common in hemodialysis patients using central venous catheters, and catheter occlusion also occurs frequently. The Tego needlefree connector was developed to reduce the incidence of these complications; however, existing studies of its effectiveness and safety are limited. Materials and methods: This retrospective analysis compared outcomes among patients of a large dialysis organization receiving in-center hemodialysis using a central venous catheter with either the Tego connector or standard catheter caps between October 1 and June 30, 2013. Incidence rates for intravenous (IV antibiotic starts, receipt of an IV antibiotic course, positive blood cultures, mortality, and missed dialysis treatments were calculated, and incidence-rate ratios (IRRs were estimated using Poisson regression models. Utilization of erythropoiesis-stimulating agents (ESAs and thrombolytics was described for each patient-month and compared using mixed linear models. Models were run without adjustment, adjusted for covariates that were imbalanced between cohorts, or fully adjusted for all potential confounders. Results: The analysis comprised 10,652 Tego patients and 6,493 controls. Tego use was independently associated with decreased risk of CRBSI, defined by initiation of IV antibiotics (adjusted IRR 0.92, 95% confidence interval [CI] 0.87–0.97 or initiation of IV antibiotic course (adjusted IRR 0.89, 95% CI 0.84–0.95. Tego use was independently associated with decreased rate of missed dialysis treatments (adjusted IRR 0.98, 95% CI 0.97–1.00; no significant difference between Tego and control cohorts was observed with respect to mortality. Tego use was associated with decreased likelihood of thrombolytic use (adjusted per

  20. Defining Clinical Exposures of Cefepime for Gram-Negative Bloodstream Infections That Are Associated with Improved Survival.

    Science.gov (United States)

    Rhodes, Nathaniel J; Kuti, Joseph L; Nicolau, David P; Van Wart, Scott; Nicasio, Anthony M; Liu, Jiajun; Lee, Benjamin J; Neely, Michael N; Scheetz, Marc H

    2016-03-01

    The percentage of time that free drug concentrations remain above the MIC (fT>MIC) that is necessary to prevent mortality among cefepime-treated patients with Gram-negative bloodstream infections (GNBSI) is poorly defined. We conducted a retrospective study of adult patients with GNBSI. Eligible cases were frequency matched to ensure categorical representation from all MICs. Organism, MIC, infection source, gender, age, serum creatinine, weight, antibiotic history, and modified APACHE II score were collected from hospital records. Two population pharmacokinetic models (models 1 and 2) were used to impute exposures over the first 24 h in each patient from mean model parameters, covariates, and dosing history. From the imputed exposures, survival thresholds for fT>MIC were identified using classification and regression tree (CART) analysis and analyzed as nominal variables for univariate and multivariate regressions. A total of 180 patients were included in the analysis, of whom 13.9% died and 86.1% survived. Many patients (46.7% [n = 84/180]) received combination therapy with cefepime. Survivors had higher mean (standard deviation [SD]) fT>MIC than those who died (model 1, 74.2% [29.6%] versus 52.1% [33.8%], P MIC threshold values for greater survival according to models 1 and 2 at >68% and >74%, respectively. Survival was improved for those with fT>MIC of >68% (model 1 adjusted odds ratio [aOR], 7.12; 95% confidence interval [CI], 1.90 to 26.7; P = 0.004) and >74% (model 2 aOR, 6.48; 95% CI, 1.90 to 22.1) after controlling for clinical covariates. Similarly, each 1% increase in cefepime fT>MIC resulted in a 2% improvement in multivariate survival probability (P = 0.015). Achieving a cefepime fT>MIC of 68 to 74% was associated with a higher odds of survival for patients with GNBSI. Regimens targeting this exposure should be aggressively pursued. PMID:26666929

  1. Analysis of bloodstream infection in children with severe hematopathy%重症血液病患儿血流感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    张家源; 陈玉梅; 邹尧; 张丽; 阮敏; 陈晓娟; 刘晓明; 竺晓凡

    2014-01-01

    目的:探讨重症血液病患儿治疗过程中发生血流感染的原因、感染部位、病原菌分析及治疗对策。方法选择2007年1月-2009年9月住院治疗的血液病患儿2368例,对血液病患儿血流感染的发生率、感染部位与病原菌分布及相关因素进行分析,数据采用SPSS16.0统计软件进行处理,样本率的比较采用χ2检验。结果2368例住院治疗患儿中167例患儿发生血流感染,发生率7.1%;其中发生血流感染的急性淋巴细胞白血病患儿95例、急性髓性白血病患儿61例、重型再生障碍性贫血患儿9例、恶性淋巴瘤患儿2例,分别占56.9%、36.5%、5.4%、1.2%;感染部位以口腔黏膜与呼吸道为主,分别占12.6%与10.2%;经血培养检测,共分离出病原菌167株,其中革兰阴性杆菌90株占53.9%,革兰阳性球菌71株占42.5%,革兰阳性杆菌、真菌各3株,各占1.8%;急性淋巴细胞白血病患儿中应用糖皮质激素>2周及中性粒细胞绝对值<100/mm3与血流感染高度相关。结论急性髓性白血病较急性淋巴细胞白血病患儿易发生血流感染,血液病患儿中性粒细胞绝对值<100/mm3与血流感染的发生高度相关。%OBJECTIVE To explore the causes ,sites and pathogens of bloodstream infection in children with severe hematopathy and the method to decrease the mortality of bloodstream infection .METHODS Totally 2368 children with hematopathy were selected .The incidence rate ,infected sites ,pathogen distribution and related factors for bloodstream infection in children with hematopathy were analyzed . Data were processed by SPSS16 .0 , the comparison of sample rate was conducted with χ2 test .RESULTS There were 167 cases of bloodstream infection in the 2368 hospitalized children ,indicating the incidence was 7 .1% .The children who experienced bloodstream infection included 95 children with acute lymphoblastic

  2. 恶性肿瘤患者血流感染的危险因素分析%Risk factors for bloodstream infections in patients with malignant tumors

    Institute of Scientific and Technical Information of China (English)

    徐海燕; 王延风; 冯沙娜; 朱宇; 刘姗; 吴熙; 吴晓明; 于雷

    2016-01-01

    OBJECTIVE To explore the characteristics of bloodstream infections in patients with malignant tumors and analyze the risk factors so as to provide guidance for reasonable prevention and treatment of the bloodstream infections .METHODS A total of 150 malignant tumor patients who were positive for blood culture from Mar 2013 to Mar 2015 were recruited as the study objects ,then the univariate analysis and multivariate logistic regression a-nalysis were carried out ,and the statistical analysis of data was performed with the use of SPSS 16 .0 software . RESULTS Of 150 patients whose blood specimens were cultured positive for pathogens ,83 (52 .2% ) were positive for gram-negative bacteria ,55 (42 .8% ) were positive for gram-positive bacteria ,and 8 (5 .0% ) were positive for fungi.The Escherichiacoli,Staphylococcus epidermidis,and Klebsiella pneumoniae were the common species of pathogens .The univariate analysis indicated that the risk factors for the bloodstream infections included the neu-tropenia ,mechanical ventilation ,central venous catheter indwelling ,Charlson complication index ,and time of use of antibiotics no less than 7 days (P<0 .05);the multivariate logistic analysis showed that the intravenous cathe-ter indwelling and time of use of antibiotics no less than 7 days were the independent risk factors for the blood-stream infections .CONCLUSION It is an effective way to reduce the invasive operations and strictly control the time of use of antibiotics so as to reduce the incidence of the bloodstream infections .%目的 探讨恶性肿瘤患者发生血流感染的特点及其危险因素,为合理地预防和治疗血流感染提供临床依据.方法 选取医院2013年3月-2015年3月150例恶性肿瘤血培养阳性患者为研究对象,对其进行单因素分析及多因素logistic回归分析,筛选出与发生血流感染相关的危险因素,采用SPSS 16.0对数据进行统计分析.结果 150例血培养阳性患者共检出革兰阴性菌83

  3. Cosmic Forms

    CERN Document Server

    Kleman, Maurice

    2011-01-01

    The continuous 1D defects of an isotropic homogeneous material in an Euclidean 3D space are classified by a construction method, the Volterra process (VP). We employ the same method to classify the continuous 2D defects (which we call \\textit{cosmic forms}) of a vacuum in a 4D maximally symmetric spacetime. These defects fall into three different classes: i)- $m$-forms, akin to 3D space disclinations, related to ordinary rotations and analogous to Kibble's global cosmic strings (except that being continuous any deficit angle is allowed); ii)- $t$-forms, related to Lorentz boosts (hyperbolic rotations); iii)- $r$-forms, never been considered so far, related to null rotations. A detailed account of their metrics is presented. Their inner structure in many cases appears as a non-singular \\textit{core} separated from the outer part by a timelike hypersurface with distributional curvature and/or torsion, yielding new types of geometrical interactions with cosmic dislocations and other cosmic disclinations. Whereas...

  4. The current understanding of arterial-catheter related bloodstream infection%当前对动脉导管相关性血流感染的认识

    Institute of Scientific and Technical Information of China (English)

    王斌; 安友仲

    2016-01-01

    导管相关性血流感染(CRBSI)是重症加强治疗病房(ICU)中常见的严重感染之一,可增加患者的病死率,延长住院时间,增加住院费用.在CRBSI中,动脉导管相关性血流感染(AC-BSI)常被忽视或低估,目前的报道显示,AC-BSI的发生率接近甚至不低于中心静脉导管相关性血流感染(CVC-BSI).一旦怀疑AC-BSI,应在留取相关培养物培养后立即拔出动脉导管,并根据患者的情况实施抗感染治疗;预防是减少AC-BSI的关键.本文作者从AC-BSI的流行病学、病原学及发病机制、危险因素、诊断、治疗和预防等方面的进展进行综述,以期为临床处理提供帮助.%Catheter-related bloodstream infection (CRBSI) is one of the common severe infections in intensive care unit (ICU),which tends to increase the mortality of patients,the length of hospital stay and the cost of hospitalization.Arterial catheter-related bloodstream infection (AC-BSI) is often overlooked or underestimated.Some studies pointed out that the incidence of AC-BSI is close to or even higher than central venous catheter related bloodstream infection (CVC-BSI),which plays an important role in catheter-related infections.Once AC-BSI is suspected,arterial catheter should be removed immediately after bacterial culture and antibiotics should be prescribed according to severities of patients.Prevention is the key to reduce AC-BSI.The research progress of epidemiology,etiology,pathogenesis,risk factors,diagnosis,treatment and prevention of AC-BSI was reviewed to facilitate the clinical decision.

  5. 肿瘤重症患者合并血液感染后死亡的相关危险因素分析%Risk Factor Analysis of Mortality Following Bloodstream Infections of Cancer Patients in Intensive Care Unit

    Institute of Scientific and Technical Information of China (English)

    张青; 张文芳; 郑珊; 李丁; 张鹏

    2012-01-01

    Objective: The present study aims to analyze the bloodstream infection profiles and assess the risk factors associated with mortality of cancer patients in the intensive care unit ( ICU ) with bloodstream infections. Methods: Medical records of cancer patients with bloodstream infections, admitted to the Tianjin Medical University Cancer Institute and Hospital during January 2010 and June 2011, were retrospectively analyzed. Results: Microbiological data of 88 cases with bloodstream infections were recorded in our study ( 56 males, 32 females; 65.8 ± 24.2 years old ). Of the total patients, 45 survived and 43 died. The most commonly seen etiological agents of bloodstream infections were coagulase-negative staphylococci in 42 cases ( 37.8% ), Escherichia coli in 15 cases (13.5% ), and Candida albicans in 9 cases ( 8.1% ). Univariate analysis showed that risk factors included mechanical ventilation for more than 7 days and duration of central venous catheterization and higher APACHE II scores, of which, mechanical ventilation of more than 7 days was the independent mortality risk factor ( odds ratio: 6.8, 95%; CI: 2.5–18.4; P 7 d、中心静脉插管以及较高的APACHE Ⅱ评分是重症肿瘤患者合并血液感染后死亡的重要危险因子,其中机械通气>7 d为独立的死亡风险因子(OR=6.8,95%CI:2.5~18.4,P<0.001).结论:凝固酶阴性葡萄球菌是引起肿瘤患者血液感染的主要病原菌,临床应据此采取相应的预防控制措施,以减少重症肿瘤患者血液感染的发生发展.

  6. Editorial on low-dose acetylsalicylic acid treatment and impact on short-term mortality in Staphylococcus aureus bloodstream infection: a propensity score-matched cohort study

    Science.gov (United States)

    Schoergenhofer, Christian; Schwameis, Michael; Lagler, Heimo

    2016-01-01

    The manuscript “Low-Dose Acetylsalicylic Acid Treatment and Impact on Short-Term Mortality in Staphylococcus aureus (S. aureus) Bloodstream Infection: A propensity Score-Matched Cohort Study” published in Critical Care Medicine by Osthoff et al. reported an association of aspirin intake with a reduced short-term mortality. Direct anti-microbial effects of aspirin and its metabolite salicylate were suggested in preclinical studies. Especially intriguing is the inclusion of a control group with Escherichia coli (E. coli) blood stream infections in this study, in which aspirin was not associated with an improved outcome. However, as other observational studies also reported benefits of aspirin in critically ill patients, randomized trials are needed to confirm the effects of low-dose aspirin. PMID:27294095

  7. Editorial on low-dose acetylsalicylic acid treatment and impact on short-term mortality in Staphylococcus aureus bloodstream infection: a propensity score-matched cohort study.

    Science.gov (United States)

    Schoergenhofer, Christian; Schwameis, Michael; Lagler, Heimo; Jilma, Bernd

    2016-05-01

    The manuscript "Low-Dose Acetylsalicylic Acid Treatment and Impact on Short-Term Mortality in Staphylococcus aureus (S. aureus) Bloodstream Infection: A propensity Score-Matched Cohort Study" published in Critical Care Medicine by Osthoff et al. reported an association of aspirin intake with a reduced short-term mortality. Direct anti-microbial effects of aspirin and its metabolite salicylate were suggested in preclinical studies. Especially intriguing is the inclusion of a control group with Escherichia coli (E. coli) blood stream infections in this study, in which aspirin was not associated with an improved outcome. However, as other observational studies also reported benefits of aspirin in critically ill patients, randomized trials are needed to confirm the effects of low-dose aspirin. PMID:27294095

  8. Long-term, low-dose tigecycline to treat relapsing bloodstream infection due to KPC-producing Klebsiella pneumoniae after major hepatic surgery

    Directory of Open Access Journals (Sweden)

    Luca Morelli

    2015-07-01

    Full Text Available A 68-year-old male underwent a right hepatectomy, resection of the biliary convergence, and a left hepatic jejunostomy for a Klatskin tumour. The postoperative course was complicated by biliary abscesses with relapsing bloodstream infections due to Klebsiella pneumoniae carbapenemase (KPC-producing Klebsiella pneumoniae (KPC-Kp. A 2-week course of combination antibiotic therapy failed to provide source control and the bacteraemia relapsed. Success was obtained with a regimen of tigecycline 100 mg daily for 2 months, followed by tigecycline 50 mg daily for 6 months, then 50 mg every 48 h for 3 months. No side effects were reported.

  9. Use of PCR coupled with electrospray ionization mass spectrometry for rapid identification of bacterial and yeast bloodstream pathogens from blood culture bottles.

    Science.gov (United States)

    Kaleta, Erin J; Clark, Andrew E; Johnson, Desiree R; Gamage, Dulini C; Wysocki, Vicki H; Cherkaoui, Abdessalam; Schrenzel, Jacques; Wolk, Donna M

    2011-01-01

    Sepsis is among the top 10 causes of mortality in the United States. Rapid administration of antibiotics is one of the most important contributors to patient survival, yet only a limited number of methods exist for rapid identification of microbes cultivated from bloodstream infections, which can lead to sepsis. While traditional single-target molecular methods have been shown to greatly improve survival for septic patients by enabling rapid deescalation of broad-spectrum antibiotics, multiplex methods offer even greater possibilities. A novel multiplex method, PCR coupled to electrospray ionization mass spectrometry (PCR/ESI-MS), was used to identify the genus and species of microorganisms found to cause human bloodstream infections. DNA was directly extracted from 234 BacT-Alert blood culture bottles, and results were compared to those obtained by clinical reference standard methods. The study results demonstrated 98.7% and 96.6% concordance at the genus and species levels, respectively. Mixtures of microbes were identified in 29 blood culture bottles, including mixed species of the same genus, as well as mixtures containing Gram-positive and Gram-negative organisms, exemplifying the PCR/ESI-MS capability to identify multiple organisms simultaneously without the need for cultivation. This study demonstrates high analytical accuracy in comparison to routine subculture of blood culture bottles and phenotypic identification of microbes. Without foreknowledge of the microorganisms potentially present, the PCR/ESI-MS methods can deliver accurate results in as little as 5 to 6 h after a positive alarm from the automated blood culture system; however, current batch mode testing limits the method's clinical utility at this time.

  10. 铜绿假单胞菌血流感染27例临床分析%Clinical analysis of bloodstream infections caused by Pseudomonas aeruginosa

    Institute of Scientific and Technical Information of China (English)

    丁艳苓; 姚婉贞; 宁永忠

    2013-01-01

    Objective To analyze the clinical characteristics and antimicrobial resistance of blood stream infections caused by P. aeruginosa. Methods The clinical data were retrospectively reviewed for the patients with P. aeruginosa bloodstream infection who were treated in Peking University Third Hospital from January 2006 to December 2009. Results A total of 27 patients were found with P. aeruginosa bloodstream infection. The Charlson scores of the patients were 4. 48 ± 2. 10. All patients had fever and increased or decreased white blood cell counts when their bloodstream infection was identified. Six patients were infected by multidrug-resistant (MDR) strains. Compared with the patients with non-MDR P. aeruginosa infection, the patients infected by MDR strains had significantly higher APACHE TJ scores and Sequential Organ Failure Assessment (SOFA) scores at admission, longer stay in Intensive Care Unit (RICU and SICU), higher prevalence of multiple (two or more) antibiotics use before positive blood culture after admission, and lower proprotion of patients with appropriate antibiotic therapy after blood culture. The Charlson scores, clinical manifestation, APACHE TJ scores and SOFA scores at the time of bloodstream infection, and in-hospital mortality were similar between the two groups of patients. Conclusions The patients with P. aeruginosa bloodstream infection showed severe clinical status and high mortality rate. The MDR strains-infected patients had more severe conditions than those infected by non-MDR strains, but their clinical manifestations were similar. Patients with bloodstream infection should subject to microbiological testing and be treated with appropriate active agents as soon as possible to reduce fatality rate.%目的 探讨铜绿假单胞菌血流感染的临床特点及细菌耐药性.方法 回顾性分析北京大学第三医院2006年1月-2009年12月铜绿假单胞菌血流感染患者的临床及微生物学资料.结果 27例患者纳入分

  11. Automorphic Forms

    DEFF Research Database (Denmark)

    von Essen, Flemming Brændgaard

    -functions for Hecke characters in the points 4 and 6. It is well known, that all zeros of the Eisenstein series Ek wrt. SL2(Z) in the standard fundamental domain has modulus 1. We show that this is also true for #n Ek, where # is a certain differential operator. We then proceed to study logarithms of multiplier...... systems. For automorphic forms wrt. Hecke triangle groups and Fuchsian groups with no elliptic elements and genus 0, we show that some logarithms of multiplier systems can be interpreted as a linking number. Finally we show a "twisted" version of the prime geodesics theorem, and logarithms of multiplier...

  12. Bloodstream Infections among AIDS Patients%艾滋病并发血流感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    励峰; 朱翠云; 黄琴; 孙洪清

    2012-01-01

    Objective To analyze the bloodstream infections( BSI) among AIDS patients,and study its peripheral blood routine test,its pathogens distribution, and its influence to prognosis. Methods A retrospective cohort study was conducted among 144 AIDS inpa-tients from January 2011 to March 2012 in Shanghai Public health center of Fudan University. Results All of 144 cases, the incidence rate of BSI was 19.4% (28/144). The blood cultures contained 33 different pathogens, with 8 staphylococcus strains (24.2% ) ,6 fungi strains ( 18. 2% ) ,6 salmonella strains( 18. 2% ). The peripheral red blood cell count and haematoglobin were 3. 223 × 1012/L,98. 89g/L in patients with BSI and were 3.678 × 1012/L, 109. 94g/L in patients without BSI(f =0.016 and 0.049). The peripheral blood CD4 + lymphocyte counts were 78. 3 × 106/L in patients with BSI and were 98. 75 × 106/L in patients without BS1( P = 0. 422) . The mortality of BSI and non - BSI was 32. 1% and 12. 1% (X2 =6.772, P =0.009). Conclusion The AIDS patients with BSI had a lower red blood cell count and haematoglobin than non - BSI. The common pathogens of BSI were staphylococcus among AIDS patients in our hospital. AIDS patients with BSI had a high rate of mortality. It is necessary to prevent the happening of BSI.%目的 探讨艾滋病患者血流感染的病原菌分布,与外周血细胞的相关性及其对预后的影响.方法 回顾性分析2011年1月~2012年3月在上海市公共卫生临床中心感染科住院的艾滋病并发血流感染的发病率、病原菌分布、与外周血细胞、外周血淋巴细胞计数的相关性以及病死率.结果 144例艾滋病患者中确诊血流感染(血流感染组)有19.4% (28/144),无血流感染(无血流感染组)有80.6%(116/144).培养出33株病原菌,主要是葡萄球菌8株(24.2%);真菌6株(18.2%);沙门菌6株(18.2%).血流感染组平均红细胞计数及血红蛋白分别为3.223×1012/L、98.89g/L,无血流感染组分别为3.678×1012

  13. 金黄色葡萄球菌血流感染的临床特征分析%Clinical features of bloodstream infection caused by staphylococcus aureus

    Institute of Scientific and Technical Information of China (English)

    路明; 姚婉贞; 王筱宏; 刘振英

    2011-01-01

    OBJECTIVE To study the clinical characteristics and antimicrobial resistance of bloodstream infections caused by Staphylococcus aureus (SAU). METHODS Patients with bloodstream infections of SAU in our hospital from 2004 to 2008 were retrospectively reviewed. RESULTS All 28 patients had fever and 60. 7% with rigor. 18 cases had metastatic infection and lung was the most common metastasizing site. 85.7% of the patients had variety of vulnerable factors. 39% complicated by septic shock and the total mortality rate was 32.0%. 6 episodes were community acquired and 50. 0% of the primary infection site were from skin or soft tissues. All the six community-acquired SAU isolates were methicillin sensitive S. aureus (MSSA). The other 22 episodes were nosocomial infections, 45. 5% were related with central venous catheters, and 72. 0% of the SAU isolates were methicillin resistant S. aureus (MRSA). All the SAU isolates acquired from community and hospital were resistant to penicillin. CONCLUSION High fever with rigor and metastatic infection are common features of SAU bloodstream infection. MRSA isolates increased gradually with high mortality rate.%目的 了解金黄色葡萄球菌血流感染的临床特征及细菌耐药情况.方法 回顾分析医院2004-2008年由金黄色葡萄球菌所致血流感染患者的临床和微生物学资料.结果 共28例患者入选,均有发热,60.7%伴寒颤,18例有迁徙灶,肺受累最常见;85.7%的患者存在易感因素,39.0%合并感染性休克,死亡率32.0%;社区感染6例,多以皮肤为原发感染灶(50.0%),均为甲氧西林敏感金黄色葡萄球菌;医院内感染22例,多与中心静脉导管相关(45.5%),72.0%为耐甲氧西林金黄色葡萄球菌(MRSA);社区和医院内感染金黄色葡萄球菌株对青霉素100.0%耐药.结论 金黄色葡萄球菌血流感染多有高热、寒颤伴有迁徙灶,MRSA逐渐增多,导致很高的死亡率.

  14. 抗感染中心静脉导管预防导管相关性血流感染的效果%Effect in prevention of catheter-related bloodstream infection using antiseptic impregnated central venous catheter

    Institute of Scientific and Technical Information of China (English)

    罗蕾; 秦英; 向亚娟

    2011-01-01

    Objective To evaluate the clinical effect in prevention of catheter-related bloodstream infection(CRBSI) using antiseptic impregnated central venous catheter. Methods The incidence of catheterrelated bloodstream infection was compared between 420 cases performed with antiseptic impregnated central venous catheter ( experimental group ) and 430 cases performed with general central venous catheter (control).Besides, the categories and characteristics of pathogenic bacteria which resulted in catheter-related bloodstream infection were analyzed. Results There were 66 cases of CRBSI in 850 cases, 25 cases were inserted antiseptic impregnated central venous catheter and 41 cases inserted general central venous catheter. No significant difference in the incidence between the two groups was found during 7 days(χ2 = 0. 06 ,P > 0. 05), however, the incidence of CRBSI was lower in the experimental group than of the control group after 7 days( χ2 = 3.91,4.30 ;P 0.05),7 d后实验组CRBSI感染率较对照组低,差异有统计学意义(χ2分别为3.91,4.30,P<0.05).实验组减少导管相关性血流感染的病原体主要为革兰阳性菌.结论 抗感染中心静脉导管可明显减少导管相关性血流感染的发生,有很大的临床价值.

  15. Procalcitonin and procalcitonin kinetics for diagnosis and prognosis of intravascular catheter-related bloodstream infections in selected critically ill patients: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Theodorou Vasiliki P

    2012-10-01

    Full Text Available Abstract Background Procalcitonin (PCT has emerged as a valuable marker of sepsis. The potential role of PCT in diagnosis and therapy monitoring of intravascular catheter-related bloodstream infections (CRBSI in intensive care unit (ICU is still unclear and was evaluated. Methods Forty-six patients were included in the study, provided they were free of infection upon admission and presented the first episode of suspected CRBSI during their ICU stay. Patients who had developed any other infection were excluded. PCT was measured daily during the ICU hospitalization. Primary endpoint was proven CRBSI. Therapy monitoring as according to infection control was also evaluated. Results Among the 46 patients, 26 were diagnosed with CRBSI. Median PCT on the day of infection suspicion (D0 was 7.70 and 0.10 ng/ml for patients with and without proven CRBSI, respectively (p 0.20 ng/ml of PCT between the D0 and any of the 4 preceding days was associated with a positive predictive value exceeding 96%. PCT concentrations from the D2 to D6 after suspected infection tended to decrease in controlled patients, whereas remained stable in non-controlled subjects. A PCT concentration exceeding 1.5 ng/ml during D3 was associated with lack of responsiveness to therapy (p = 0.028. Conclusions We suggest that PCT could be a helpful diagnostic and prognostic marker of CRBSI in critically ill patients. Both absolute values and variations should be considered.

  16. Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment.

    Science.gov (United States)

    Zarkotou, O; Pournaras, S; Tselioti, P; Dragoumanos, V; Pitiriga, V; Ranellou, K; Prekates, A; Themeli-Digalaki, K; Tsakris, A

    2011-12-01

    Bloodstream infections (BSIs) caused by Klebsiella pneumoniae carbapenemases (KPC)-producing K. pneumoniae (KPC-KP) are associated with high mortality rates. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with BSIs caused by molecularly confirmed KPC-KP. All consecutive patients with KPC-KP BSIs between May 2008 and May 2010 were included in the study and followed-up until their discharge or death. Potential risk factors for infection mortality were examined by a case-control study. Case-patients were those who died from the BSI and control-patients those who survived. Appropriate antimicrobial therapy was defined as treatment with in vitro active antimicrobials for at least 48 h. A total of 53 patients were identified. Overall mortality was 52.8% and infection mortality was 34%. Appropriate antimicrobial therapy was administered to 35 patients; mortality due to infection occurred in 20%. All 20 patients that received combination schemes had favourable infection outcome; in contrast, seven of 15 patients given appropriate monotherapy died (p 0.001). In univariate analysis, risk factors for mortality were age (p catheter-related bacteraemia (p 0.04), prior surgery (p 0.014) and other therapeutic interventions (p 0.015) were significantly associated with survival. Independent predictors of mortality were age, APACHE II score at infection onset and inappropriate antimicrobial treatment. Among them, appropriate treatment is the only modifiable independent predictor of infection outcome.

  17. Comparison of E,E-Farnesol Secretion and the Clinical Characteristics of Candida albicans Bloodstream Isolates from Different Multilocus Sequence Typing Clades.

    Science.gov (United States)

    Jung, Sook-In; Shin, Jong Hee; Kim, Soo Hyun; Kim, Jin; Kim, Joo Hee; Choi, Min Ji; Chung, Eun-Kyung; Lee, Kyungwon; Koo, Sun Hoe; Chang, Hyun Ha; Bougnoux, Marie-Elisabeth; d'Enfert, Christophe

    2016-01-01

    Using multilocus sequence typing (MLST), Candida albicans can be subdivided into 18 different clades. Farnesol, a quorum-sensing molecule secreted by C. albicans, is thought to play an important role in the development of C. albicans biofilms and is also a virulence factor. This study evaluated whether C. albicans bloodstream infection (BSI) strains belonging to different MLST clades secrete different levels of E,E-farnesol (FOH) and whether they have different clinical characteristics. In total, 149 C. albicans BSI isolates from ten Korean hospitals belonging to clades 18 (n = 28), 4 (n = 23), 1 (n = 22), 12 (n = 17), and other clades (n = 59) were assessed. For each isolate, the FOH level in 24-hour biofilms was determined in filtered (0.45 μm) culture supernatant using high-performance liquid chromatography. Marked differences in FOH secretion from biofilms (0.10-6.99 μM) were observed among the 149 BSI isolates. Clade 18 isolates secreted significantly more FOH than did non-clade 18 isolates (mean ± SEM; 2.66 ± 0.22 vs. 1.69 ± 0.10 μM; P albicans BSI isolates belonging to the most prevalent MLST clade (clade 18) in Korea are characterized by increased levels of FOH secretion and less severe illness.

  18. A collaborative, systems-level approach to eliminating healthcare-associated MRSA, central-line-associated bloodstream infections, ventilator-associated pneumonia, and respiratory virus infections.

    Science.gov (United States)

    Henderson, Donna M; Staiger, Thomas O; Peterson, Gene N; Sinanan, Mika N; Angiulo, Cindy L; Makarewicz, Vanessa A; Wild, Lorie M; Whimbey, Estella E

    2012-01-01

    To achieve sustainable reductions in healthcare-associated infections (HAIs), the University of Washington Medical Center (UWMC) deployed a collaborative, systems-level initiative. With the sponsorship of senior leadership, multidisciplinary teams were established to address healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and respiratory virus infections. The goal of the initiative was to eliminate these four HAIs among medical center inpatients by 2012. In the first 24 months of the project, the number of healthcare-associated MRSA cases decreased 58%; CLABSI cases decreased 54%. Staff and provider compliance with infection prevention measures improved and remained strong, for example, 96% compliance with hand hygiene, 98% compliance with the recommended influenza vaccination program, and 100% compliance with the VAP bundle. Achieving these results required an array of coordinated, systems-level interventions. Critical project success factors were believed to include creating organizational alignment by declaring eliminating HAIs as an organizational breakthrough goal, having the organization's executive leadership highly engaged in the project, coordination by an experienced and effective project leader and manager, collaboration by multidisciplinary project teams, and promoting transparency of results across the organization.

  19. Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

    Directory of Open Access Journals (Sweden)

    Daiane Silva Resende

    2011-12-01

    Full Text Available INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7% CA-BSIs were observed. There were 46 (32% episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]. Neonates in the group after implementation of the intervention had 21 (19.6% episodes of CA-BSI (14.9 per 1,000 CVC days. The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04. In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

  20. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

    Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  1. 艾滋病患者血流感染的研究%Study of bloodstream infection in HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    杨宗兴; 吴南屏

    2012-01-01

    血流感染(BSI)对艾滋病患者的预后有重要意义,即使在HAART时代,BSI在艾滋病患者的死亡原因中仍排在前三位.国外有较多针对艾滋病患者BSI的研究,而国内这方面的研究较少.此文就艾滋病患者BSI的发病率、病原体、诊断、预后和防治等问题作了综述.%Bloodstream infection(BSI) is of great importance to the prognosis of HIV/AIDS patients,which ranks among the first three causes of death of HIV/AIDS patients even in HAART(highly active antiretroviral therapy)era.Many studies of BSI aiming at HIV/AIDS patients have been conducted abroad,but there are few in China.Now,the studies of BSI of HIV/AIDS patients,the topics involving incidence,pathogens,diagnosis,prognosis,prevention and cure are reviewed in this article.

  2. Impact of ESKAPE bloodstream infection on prognosis of acute necrotizing pancreatitis%ESKAPE血流感染对急性坏死型胰腺炎预后的影响

    Institute of Scientific and Technical Information of China (English)

    杨双汇; 杨慧明; 黄耿文; 李宜雄

    2015-01-01

    目的:探讨ESKAPE血流感染对急性坏死性胰腺炎(ANP)患者预后及并发症的影响。  方法:回顾性分析2003年1月—2014年7月收治的有血培养结果的87例ANP患者,其中血培养阴性49例,阳性38例,分析血流感染,尤其是ESKAPE血流感染对ANP患者治疗结果的影响。  结果:在38例血培养阳性ANP患者的69份的病原学结果中,40.6%为ESKAPE,其中鲍曼不动杆菌占比50.0%,其余依次为屎肠球菌(14.3%)、肺炎克雷伯菌(10.7%),肠杆菌属(10.7%),金黄色葡萄球菌(7.1%)和铜绿假单胞菌(7.1%)。血流感染患者休克、呼吸衰竭、肾功能衰竭与消化道出血等并发症的发生率、病死率、住院费用及ICU住院天数均较非血流感染患者明显增高(均P  结论:血流感染明显增加ANP患者的并发症和病死率。ESKAPE是导致ANP患者血流感染的主要病原体,其与患者休克的发生密切相关。%Objective:To investigate the impact of ESAKPE bloodstream infection on the prognosis and complications in patients with acute necrotizing pancreatitis (ANP). Methods:Eighty-seven ANP patients admitted from January 2003 to July 2014 with blood culture results were retrospectively studied. Of the patients, 49 cases had negative and 38 cases had positive blood culture. hTe impact of bloodstream infection, especially ESKAPE bloodstream infection on therapeutic outcomes of these ANP patients was analyzed. Results:In the 69 pathogen test results from the 38 ANP patients with positive blood culture, 40.6%were ESAKPE pathogens that included Acinetobacter baumanni (50.0%), Enterococcus faecium (14.3%), Klebsiella pneumonia (10.7%), Enterobacter species (10.7%), Staphylococcus aureus (7.1%) and Pseudomonas aeruginosa (7.1%). Patients with bloodstream infection had significantly increased incidence of shock, respiratory failure, renal failure and digestive tract bleeding and mortality, as well as

  3. Densified waste form and method for forming

    Energy Technology Data Exchange (ETDEWEB)

    Garino, Terry J.; Nenoff, Tina M.; Sava Gallis, Dorina Florentina

    2015-08-25

    Materials and methods of making densified waste forms for temperature sensitive waste material, such as nuclear waste, formed with low temperature processing using metallic powder that forms the matrix that encapsulates the temperature sensitive waste material. The densified waste form includes a temperature sensitive waste material in a physically densified matrix, the matrix is a compacted metallic powder. The method for forming the densified waste form includes mixing a metallic powder and a temperature sensitive waste material to form a waste form precursor. The waste form precursor is compacted with sufficient pressure to densify the waste precursor and encapsulate the temperature sensitive waste material in a physically densified matrix.

  4. Densified waste form and method for forming

    Energy Technology Data Exchange (ETDEWEB)

    Garino, Terry J.; Nenoff, Tina M.; Sava Gallis, Dorina Florentina

    2016-05-17

    Materials and methods of making densified waste forms for temperature sensitive waste material, such as nuclear waste, formed with low temperature processing using metallic powder that forms the matrix that encapsulates the temperature sensitive waste material. The densified waste form includes a temperature sensitive waste material in a physically densified matrix, the matrix is a compacted metallic powder. The method for forming the densified waste form includes mixing a metallic powder and a temperature sensitive waste material to form a waste form precursor. The waste form precursor is compacted with sufficient pressure to densify the waste precursor and encapsulate the temperature sensitive waste material in a physically densified matrix.

  5. Late onset sepsis in newborn babies: epidemiology and effect of a bundle to prevent central line associated bloodstream infections in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Daiane Silva Resende

    2015-02-01

    Full Text Available Aim:We assessed late onset sepsis (LOS rates of neonates in a neonatal intensive care unit (NICU before and after implementing an evidence-based bundle to prevent these infections in a country with poor resources.Methods:We evaluate trends of LOS between October 2010 and August 2012 in a large tertiary hospital in Brazil. We designed a protocol based of CDC guidelines for insertion of maintenance of central venous catheter targeted to reduction of bloodstream infections. During this period two major events occurred: a great increase of LOS rates in January months and relocation of the unit to a provisory place. Additionally we evaluated the risk factors and etiology of these infections.Results:A total of 112 (20.3% cases defined as LOS were found. The overall incidence rate of LOS in the study was 16.1/1000 patient/days and 23.0/1000 CVC-days. Our monthly rates data of LOS/1000 patient-day reveal fluctuations over the studied period, with incidence rates of these infections in staff vacation period (January 2011 and 2012 significantly higher (59.6/1000 patients-days than compared with the other months rates (16.6/1000 patients-days (IRR = 3.59; p< 0.001. As opposite, the incidence rates of LOS during relocation period was lower (10.3/1000 patients-days when compared with baseline period 26.7/1000 patients-days (IRR = 2.59; p= 0.007. After the intervention period, these rates decreased in the post intervention period, when compared with preintervention 14.7/1000 patients-days and 23.4/1000 patients-days, respectively (IRR = 1.59; p= 0.04.Conclusion:Through simple infection control measures, LOS can be successfully controlled especially in NICUs of limited resources countries such as ours.

  6. Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment.

    Science.gov (United States)

    Zarkotou, O; Pournaras, S; Tselioti, P; Dragoumanos, V; Pitiriga, V; Ranellou, K; Prekates, A; Themeli-Digalaki, K; Tsakris, A

    2011-12-01

    Bloodstream infections (BSIs) caused by Klebsiella pneumoniae carbapenemases (KPC)-producing K. pneumoniae (KPC-KP) are associated with high mortality rates. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with BSIs caused by molecularly confirmed KPC-KP. All consecutive patients with KPC-KP BSIs between May 2008 and May 2010 were included in the study and followed-up until their discharge or death. Potential risk factors for infection mortality were examined by a case-control study. Case-patients were those who died from the BSI and control-patients those who survived. Appropriate antimicrobial therapy was defined as treatment with in vitro active antimicrobials for at least 48 h. A total of 53 patients were identified. Overall mortality was 52.8% and infection mortality was 34%. Appropriate antimicrobial therapy was administered to 35 patients; mortality due to infection occurred in 20%. All 20 patients that received combination schemes had favourable infection outcome; in contrast, seven of 15 patients given appropriate monotherapy died (p 0.001). In univariate analysis, risk factors for mortality were age (p infection onset (p appropriate antimicrobial treatment (p 0.003), combinations of active antimicrobials (p 0.001), catheter-related bacteraemia (p 0.04), prior surgery (p 0.014) and other therapeutic interventions (p 0.015) were significantly associated with survival. Independent predictors of mortality were age, APACHE II score at infection onset and inappropriate antimicrobial treatment. Among them, appropriate treatment is the only modifiable independent predictor of infection outcome. PMID:21595793

  7. Prevention of Catheter-related Bloodstream Infection in ICU%ICU患者中心静脉导管相关性血流感染的预防

    Institute of Scientific and Technical Information of China (English)

    徐文

    2011-01-01

    Central venous catheter( CVC )is one of the most common technique for monitoring and treatment in ICU. But There is a risk of catheter-related bloodstream infection causing prolonged hospital stay and increased mortality. Positioning the CVC through the subclavian vein and using a antibiotic catheter can help to reduce the incidence of CRBSI. A bundle stratige is of a crucial role in CRBSI provention.It should include strict hand hygiene, sterilizing with mixture of 70% ethano and 2% chlorhexidine, maximal sterile barrier and regular dressing change. The efficiency of regular CVC replacement and of antibiotic based catheter lock solution are not clear, and are not recommended as a routine.%留置中心静脉导管是ICU中最常用的监测和治疗措施,但其同时存在发生导管相关性血流感染(CRBSI)的风险,从而导致患者住院时间延长和病死率升高.选择锁骨下穿刺径路、使用抗生素导管可减少CRBSI的发生.应用集束化预防措施进行置管及日常护理是预防CRBSI发生的重要措施,包括严格的手卫生、应用2%氯己定和70%乙醇混合液消毒皮肤、最大消毒屏障以及定期更换辅料.定期更换导管及使用抗生素封管对预防CRBSI效果不明确,不作为常规推荐.

  8. Clinical and microbiological features of community-acquired and nosocomial bloodstream infections in the surgical department of a tertiary-care hospital in Beijing

    Institute of Scientific and Technical Information of China (English)

    L(U) You; GUO Peng; YE Ying-jiang; WANG Hui; SHEN Zhan-long; WANG Qi; ZHAO Chun-jiang

    2013-01-01

    Background Bloodstream infections (BSls) remain a major cause of morbidity and mortality in patients undergoing surgery.This study aimed at elucidating the clinical characteristics of community-acquired BSls (CABs) and nosocomial BSls (nBSls) in patients admitted to the surgical wards of a teaching hospital in Beijing,China.Methods This cross-sectional study compared 191 episodes of BSls in 4074 patients admitted to the surgical wards between January 2008 and December 2011.Cases of BSls were classified as CABs or nBSls,and the characteristics,relevant treatments,and outcomes of CABs and nBSls were compared.Results Of the 191 BSls,52 (27.2%) and 139 (72.8%) were CABs and nBSls,respectively.Eschedchia coli,coagulasenegative staphylococci,and Klebsiella spp,were the most frequently isolated microorganisms.There were significant differences between CABs and nBSls with respect to the use of hormonal drugs,ventilation,acute physiology and chronic health evaluation (APACHE) Ⅱ and American Society of Anesthesiologists scores,and prevalence of cancer (P <0.05).Empirical antibacterial therapy did not decrease the crude mortality,but multivariate analysis showed that high APACHE Ⅱ was independently associated with a risk of mortality (odds ratio =0.97,95% confidence interval:0.93-1.02 for APACHE Ⅱ).Conclusions We found significant differences in the clinical characteristics of surgical patients with CABs and nBSls.The outcome of patients seems to be related to high APACHE Ⅱ scores.

  9. Case-case-control study of patients with carbapenem-resistant and third-generation-cephalosporin-resistant Klebsiella pneumoniae bloodstream infections.

    Science.gov (United States)

    Gallagher, Jason C; Kuriakose, Safia; Haynes, Kevin; Axelrod, Peter

    2014-10-01

    Strains of third-generation-cephalosporin-resistant Klebsiella pneumoniae (3GCRKP) and carbapenem-resistant K. pneumoniae (CRKP) are rapidly spreading. Evidence is needed to establish whether differences exist between patients at risk for 3GCRKP and those at risk for CRKP bloodstream infections (BSIs); thus, this retrospective case-case-control study was conducted to determine if the risk factors for these two infections differ. The inclusion criteria for cases were positive blood cultures for K. pneumoniae, first episode of BSI, age of ≥18 years, and susceptibility results indicating resistance to either third-generation cephalosporins (3GCRKP group) or carbapenems and cephalosporins (CRKP group). Controls were patients admitted for ≥72 h and were matched to cases by month/year and medical unit. Variables of interest were analyzed by univariate analysis, and those of significance were analyzed by logistic regression. In total, 111 patients with 3GCRKP BSIs and 43 patients with CRKP BSIs were matched to 154 controls. Multivariate analyses of 3GCRKP case and control groups demonstrated that a length of stay (LOS) of >40 days (odds ratio [OR], 17.7; 95% confidence interval [CI], 3.7 to 84.3), the use of antibiotics in the past 90 days (OR, 4.3; 95% CI, 1.5 to 11.9), and the presence of a central venous catheter (OR, 4.1; 95% CI, 1.3 to 13.4) were independent risk factors. Multivariate analyses of the CRKP case and control groups demonstrated that a LOS of >40 days (OR, 13.5; 95% CI, 2.9 to 62.8) and the use of antibiotics in the past 90 days (OR, 5.9; 95% CI, 1.3 to 26.5) were independent risk factors. Similar factors put patients at risk for these two types of K. pneumoniae BSIs.

  10. Clinical impact of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay related to methicillin-resistant Staphylococcus aureus bloodstream infections.

    LENUS (Irish Health Repository)

    de Kraker, Marlieke E A

    2011-04-01

    Antimicrobial resistance is threatening the successful management of nosocomial infections worldwide. Despite the therapeutic limitations imposed by methicillin-resistant Staphylococcus aureus (MRSA), its clinical impact is still debated. The objective of this study was to estimate the excess mortality and length of hospital stay (LOS) associated with MRSA bloodstream infections (BSI) in European hospitals. Between July 2007 and June 2008, a multicenter, prospective, parallel matched-cohort study was carried out in 13 tertiary care hospitals in as many European countries. Cohort I consisted of patients with MRSA BSI and cohort II of patients with methicillin-susceptible S. aureus (MSSA) BSI. The patients in both cohorts were matched for LOS prior to the onset of BSI with patients free of the respective BSI. Cohort I consisted of 248 MRSA patients and 453 controls and cohort II of 618 MSSA patients and 1,170 controls. Compared to the controls, MRSA patients had higher 30-day mortality (adjusted odds ratio [aOR] = 4.4) and higher hospital mortality (adjusted hazard ratio [aHR] = 3.5). Their excess LOS was 9.2 days. MSSA patients also had higher 30-day (aOR = 2.4) and hospital (aHR = 3.1) mortality and an excess LOS of 8.6 days. When the outcomes from the two cohorts were compared, an effect attributable to methicillin resistance was found for 30-day mortality (OR = 1.8; P = 0.04), but not for hospital mortality (HR = 1.1; P = 0.63) or LOS (difference = 0.6 days; P = 0.96). Irrespective of methicillin susceptibility, S. aureus BSI has a significant impact on morbidity and mortality. In addition, MRSA BSI leads to a fatal outcome more frequently than MSSA BSI. Infection control efforts in hospitals should aim to contain infections caused by both resistant and susceptible S. aureus.

  11. Significance of mannose-binding lectin deficiency and nucleotide-binding oligomerization domain 2 polymorphisms in Staphylococcus aureus bloodstream infections: a case-control study.

    Directory of Open Access Journals (Sweden)

    Michael Osthoff

    Full Text Available BACKGROUND: Pathways coordinated by innate pattern recognition receptors like mannose-binding lectin (MBL and nucleotide-binding oligomerization domain 2 (NOD2 are among the first immune responses to Staphylococcus aureus (S. aureus bloodstream infections (BSI in animal models, but human data are limited. Here, we investigated the role of MBL deficiency and NOD2 mutations in the predisposition to and severity of S. aureus BSI. PATIENTS AND METHODS: A matched case-control study was undertaken involving 70 patients with S. aureus BSI and 70 age- and sex-matched hospitalized controls. MBL levels, MBL2 and NOD2 polymorphisms were analyzed. RESULTS: After adjusting for potential confounders, MBL deficiency (<0.5 µg/ml was found less frequently in cases than controls (26 vs. 41%, OR 0.4, 95% confidence interval (CI 0.20-0.95, p=0.04 as were low producing MBL genotypes (11 vs. 23%, OR 0.2, 95% CI 0.08-0.75, p=0.01, whereas NOD2 polymorphisms were similarly distributed. Cases with NOD2 polymorphisms had less organ dysfunction as shown by a lower SOFA score (median 2.5 vs. 4.5, p=0.02, whereas only severe MBL deficiency (<0.1 µg/ml was associated with life-threatening S. aureus BSI (OR 5.6, 95% CI 1.25-24.85, p=0.02. CONCLUSIONS: Contrary to animal model data, our study suggests MBL deficiency may confer protection against acquiring S. aureus BSI. NOD2 mutations were less frequently associated with multi-organ dysfunction. Further human studies of the innate immune response in S. aureus BSI are needed to identify suitable host targets in sepsis treatment.

  12. Differential association of fluconazole dose and dose/MIC ratio with mortality in patients with Candida albicans and non-albicans bloodstream infection.

    Science.gov (United States)

    Brosh-Nissimov, T; Ben-Ami, R

    2015-11-01

    Targeting fluconazole therapy to achieve predefined pharmacodynamic goals has been suggested as a means of optimizing the treatment of patients with candidaemia. However, data regarding species-specific dosing targets are inconclusive. We retrospectively analysed a cohort of 75 adult patients with Candida bloodstream infection (BSI) who received initial treatment with fluconazole for ≥48 h (36 Candida albicans and 39 non-albicans Candida (NAC)). Fluconazole dose, the dose/MIC ratio and the 24-h area under the concentration-time curve (AUC24)/MIC ratio were determined for each patient, and classification and regression tree analysis was used to determine breakpoints for significant interactions with 30-day survival. Both fluconazole exposure parameters and patient-related and disease-related variables were assessed in univariable and multivariable survival models. The crude 30-day mortality rate was 32% (44% and 21% for C. albicans and NAC, respectively). An average fluconazole dose of >200 mg/day, a dose/MIC ratio of >400 and an AUC24/MIC ratio of >400 were associated with a higher 30-day survival rate and better microbiological response in patients with C. albicans BSI but not in those with NAC BSI. Baseline chronic kidney disease was a risk factor for fluconazole underdosing and mortality. Severity of sepsis (Sequential Organ Failure Assessment score) was the only significant predictor of death in patients with NAC BSI. We conclude that, although pharmacodynamic target-directed fluconazole dosing may help to optimize outcomes for patients with C. albicans BSI, additional studies are needed to define the role of fluconazole in the treatment of NAC BSI.

  13. Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections: A Multicenter retrospective analysis

    Directory of Open Access Journals (Sweden)

    Ilker Inanc Balkan

    2015-01-01

    Full Text Available Objectives: To compare the efficacy of colistin (COL monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs due to multidrug resistant Acinetobacter spp.(MDR-A . Materials and Methods: Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. Primary End-Point: 14-day mortality. Secondary End-Points: Microbial eradication and clinical improvement. Results: Thirty-six patients in the COL monotherapy (CM group and 71 in the non-COL based combinations (NCC group were included in the study. Mean age was 59.98 ± 20 years (range: 18-89 and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297. The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36. Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13. Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001, Charlson comorbidity index (P = 0.03, duration of hospital stay before MDR-A BSI (P = 0.04, Pitt bacteremia score (P = 0.043 and Acute Physiology and Chronic Health Evaluation II score (P = 0.05 were significant in terms of 14-day mortality. Advanced age (P = 0.01 and duration of hospital stay before MDR-A BSI (P = 0.04 were independently associated with 14-day mortality in multivariate analysis. Conclusion: No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.

  14. Trends in Susceptibility Rates and Extended-Spectrum β-Lactamase Production of Klebsiella pneumoniae in Bloodstream Infections Across the United States Veterans Affairs Healthcare System.

    Science.gov (United States)

    Gentry, Chris A; Williams, Riley J

    2015-12-01

    Klebsiella pneumoniae is an important pathogen, increasingly notorious for its ability to become resistant to antimicrobial agents. This study sought to characterize trends in antimicrobial susceptibility rates for K. pneumoniae causing bacteremias across the United States (U.S.) Veterans Healthcare Administration (VHA) from 2007 through 2013 utilizing a national clinical database. K. pneumoniae grew in 9,235 blood cultures from 8,414 patients. Nationally, ampicillin-sulbactam, ceftazidime, cefepime, ertapenem, fluoroquinolones, and amikacin demonstrated statistically significant susceptibility rate increases against K. pneumoniae in the 2010-2013 period versus the 2007-2009 period. No antimicrobial agent had a statistically significant nationwide susceptibility rate decrease. Of the 126 antibiotic-organism pairs tested among 9 U.S. regions, 18 demonstrated statistically significant susceptibility rate increases while 6 demonstrated statistically significant susceptibility rate decreases. The East North Central (eight agents), Mid-Atlantic (five agents), and South Atlantic (four agents) regions demonstrated statistically significant susceptibility rate increases for multiple antimicrobial agents. Of the 70 antibiotic-organism pairs tested among 5 different medical center complexity levels, 11 antibiotics demonstrated statistically significant susceptibility rate increases and 1 demonstrated a statistically significant rate decrease. Extended-spectrum β-lactamase production did not significantly change over the study period across an available nationwide representation of 31 facilities (10.6% in 2007-2009 vs. 9.21% in 2010-2013, p=0.17). The South Atlantic and Mid-Atlantic regions had the highest prevalence of extended-spectrum ß-lactamase production in the two periods, respectively. The recent trend of generally increasing susceptibility rates for K. pneumoniae bloodstream isolates in this nationwide U.S. VHA study contrasts from other U.S. health system reports

  15. Differences in characteristics between healthcare-associated and community-acquired infection in community-onset Klebsiella pneumoniae bloodstream infection in Korea

    Directory of Open Access Journals (Sweden)

    Jung Younghee

    2012-10-01

    Full Text Available Abstract Background Healthcare-associated (HCA infection has emerged as a new epidemiological category. The aim of this study was to evaluate the impact of HCA infection on mortality in community-onset Klebsiella pneumoniae bloodstream infection (KpBSI. Methods We conducted a retrospective study in two tertiary-care hospitals over a 6-year period. All adult patients with KpBSI within 48 hours of admission were enrolled. We compared the clinical characteristics of HCA and community-acquired (CA infection, and analyzed risk factors for mortality in patients with community-onset KpBSI. Results Of 553 patients with community-onset KpBSI, 313 (57% were classified as HCA- KpBSI and 240 (43% as CA-KpBSI. In patients with HCA-KpBSI, the severity of the underlying diseases was higher than in patients with CA-KpBSI. Overall the most common site of infection was the pancreatobiliary tract. Liver abscess was more common in CA-KpBSI, whereas peritonitis and primary bacteremia were more common in HCA-KpBSI. Isolates not susceptible to extended-spectrum cephalosporin were more common in HCA- KpBSI than in CA-KpBSI (9% [29/313] vs. 3% [8/240]; p = 0.006. Overall 30-day mortality rate was significantly higher in HCA-KpBSI than in CA-KpBSI (22% [70/313] vs. 11% [27/240]; p = 0.001. In multivariate analysis, high Charlson’s weighted index of co-morbidity, high Pitt bacteremia score, neutropenia, polymicrobial infection and inappropriate empirical antimicrobial therapy were significant risk factors for 30-day mortality. Conclusions HCA-KpBSI in community-onset KpBSI has distinctive characteristics and has a poorer prognosis than CA-KpBSI, but HCA infection was not an independent risk factor for 30-day mortality.

  16. Catheter related bloodstream infection (CR-BSI in ICU patients: making the decision to remove or not to remove the central venous catheter.

    Directory of Open Access Journals (Sweden)

    Rodrigo Octávio Deliberato

    Full Text Available BACKGROUND: Approximately 150 million central venous catheters (CVC are used each year in the United States. Catheter-related bloodstream infections (CR-BSI are one of the most important complications of the central venous catheters (CVCs. Our objective was to compare the in-hospital mortality when the catheter is removed or not removed in patients with CR-BSI. METHODS: We reviewed all episodes of CR-BSI that occurred in our intensive care unit (ICU from January 2000 to December 2008. The standard method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and a positive semi quantitative (>15 CFU culture of a catheter segment from where the same organism was isolated. The conservative method was defined as a patient with a CVC and at least one positive blood culture obtained from a peripheral vein and one of the following: (1 differential time period of CVC culture versus peripheral culture positivity of more than 2 hours, or (2 simultaneous quantitative blood culture with ≥ 5:1 ratio (CVC versus peripheral. RESULTS: 53 CR-BSI (37 diagnosed by the standard method and 16 by the conservative method were diagnosed during the study period. There was a no statistically significant difference in the in-hospital mortality for the standard versus the conservative method (57% vs. 75%, p = 0.208 in ICU patients. CONCLUSION: In our study there was a no statistically significant difference between the standard and conservative methods in-hospital mortality.

  17. Implementation of central venous catheter bundle in an intensive care unit in Kuwait: Effect on central line-associated bloodstream infections.

    Science.gov (United States)

    Salama, Mona F; Jamal, Wafaa; Al Mousa, Haifa; Rotimi, Vincent

    2016-01-01

    Central line-associated bloodstream infection (CLABSIs) is an important healthcare-associated infection in the critical care units. It causes substantial morbidity, mortality and incurs high costs. The use of central venous line (CVL) insertion bundle has been shown to decrease the incidence of CLABSIs. Our aim was to study the impact of CVL insertion bundle on incidence of CLABSI and study the causative microbial agents in an intensive care unit in Kuwait. Surveillance for CLABSI was conducted by trained infection control team using National Health Safety Network (NHSN) case definitions and device days measurement methods. During the intervention period, nursing staff used central line care bundle consisting of (1) hand hygiene by inserter (2) maximal barrier precautions upon insertion by the physician inserting the catheter and sterile drape from head to toe to the patient (3) use of a 2% chlorohexidine gluconate (CHG) in 70% ethanol scrub for the insertion site (4) optimum catheter site selection. (5) Examination of the daily necessity of the central line. During the pre-intervention period, there were 5367 documented catheter-days and 80 CLABSIs, for an incidence density of 14.9 CLABSIs per 1000 catheter-days. After implementation of the interventions, there were 5052 catheter-days and 56 CLABSIs, for an incidence density of 11.08 per 1000 catheter-days. The reduction in the CLABSI/1000 catheter days was not statistically significant (P=0.0859). This study demonstrates that implementation of a central venous catheter post-insertion care bundle was associated with a reduction in CLABSI in an intensive care area setting.

  18. Are ciprofloxacin dosage regimens adequate for antimicrobial efficacy and prevention of resistance? Pseudomonas aeruginosa bloodstream infection in elderly patients as a simulation case study.

    Science.gov (United States)

    Cazaubon, Yoann; Bourguignon, Laurent; Goutelle, Sylvain; Martin, Olivier; Maire, Pascal; Ducher, Michel

    2015-12-01

    The aim of this work was to define the optimal dosage (OD) of ciprofloxacin in order to prevent the emergence of bacterial resistance of Pseudomonas aeruginosa in a geriatric population with a bloodstream infection. A thousand pharmacokinetic profiles were simulated with a ciprofloxacin pharmacokinetic model from the literature. Three dosing regimens were tested for five days: once daily (QD), twice daily (BID), and thrice daily (TID). First of all, effective dosages (ED) of ciprofloxacin were defined as those achieving a target AUC24 /MIC ≥ 125. Then, these ED were simulated in order to calculate the percentage of time spent within the mutant selection window (TMSW ) and to select optimal dosage (OD) defined as those achieving TMSW ≤ 20%. Based on the AUC24 /MIC, for low MICs (0.125 μg/mL), all dosing regimens recommended by French guidelines were effective. For intermediate MICs (0.25 and 0.5 μg/mL), simulated doses higher than those recommended were needed to achieve the efficacy target. About prevention of resistance for low MICs, dosages recommended were only effective in patients with creatinine clearance (CLCR ) ≥ 60 mL/min. For intermediate MICs, dosages higher than recommended were needed to achieve the optimality target. This study shows that current ciprofloxacin dosing guidelines have not been optimized to prevent the emergence of bacterial resistance, especially in geriatric patients with mild to severe renal impairment. To achieve both efficacy and prevention of resistance, ciprofloxacin dosages greater than those recommended would be needed. Tolerance of such higher doses needs to be evaluated in clinical studies.

  19. Differential association of fluconazole dose and dose/MIC ratio with mortality in patients with Candida albicans and non-albicans bloodstream infection.

    Science.gov (United States)

    Brosh-Nissimov, T; Ben-Ami, R

    2015-11-01

    Targeting fluconazole therapy to achieve predefined pharmacodynamic goals has been suggested as a means of optimizing the treatment of patients with candidaemia. However, data regarding species-specific dosing targets are inconclusive. We retrospectively analysed a cohort of 75 adult patients with Candida bloodstream infection (BSI) who received initial treatment with fluconazole for ≥48 h (36 Candida albicans and 39 non-albicans Candida (NAC)). Fluconazole dose, the dose/MIC ratio and the 24-h area under the concentration-time curve (AUC24)/MIC ratio were determined for each patient, and classification and regression tree analysis was used to determine breakpoints for significant interactions with 30-day survival. Both fluconazole exposure parameters and patient-related and disease-related variables were assessed in univariable and multivariable survival models. The crude 30-day mortality rate was 32% (44% and 21% for C. albicans and NAC, respectively). An average fluconazole dose of >200 mg/day, a dose/MIC ratio of >400 and an AUC24/MIC ratio of >400 were associated with a higher 30-day survival rate and better microbiological response in patients with C. albicans BSI but not in those with NAC BSI. Baseline chronic kidney disease was a risk factor for fluconazole underdosing and mortality. Severity of sepsis (Sequential Organ Failure Assessment score) was the only significant predictor of death in patients with NAC BSI. We conclude that, although pharmacodynamic target-directed fluconazole dosing may help to optimize outcomes for patients with C. albicans BSI, additional studies are needed to define the role of fluconazole in the treatment of NAC BSI. PMID:26183300

  20. Molecular epidemiology of CTX-M producing Enterobacteriaceae isolated from bloodstream infections in Rio de Janeiro, Brazil: emergence of CTX-M-15

    Directory of Open Access Journals (Sweden)

    Liliane Miyuki Seki

    2013-12-01

    Full Text Available OBJECTIVE: The present studywas designed to evaluate the molecular epidemiology of CTX-M producing Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli isolated from bloodstream infections at tertiary care hospitals in the State of Rio de Janeiro, Brazil. MATERIAL AND METHODS: A total of 231 nonduplicate Enterobacteriaceae were isolated from five Brazilian hospitals between September 2007 and September 2008. The antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical Laboratory Standard Institute. Isolates showing resistance to third-generation cephalosporins were screened for ESBL activity by the double-disk synergy test. The presence of blaCTX-M , blaCTX-M-15 and blaKPC genes was determined by Polymerase Chain Reaction (PCR amplification andDNA sequencing. The molecular typing of CTX-M producing isolateswas performed by pulsed-field gel electrophoresis (PFGE. RESULTS AND DISCUSSION: Ninety-three isolates were screened as ESBL positive and 85 (91% were found to carry CTX-M-type, as follows: K. pneumoniae 59 (49%, E. cloacae 15 (42%, and E. coli 11 (15%. Ten isolates resistant for carbapenems in K. pneumoniae were blaKPC-2 gene positive. Among CTX-M type isolates, CTX-M-15 was predominant in more than 50% of isolates for K. pneumoniae, E. coli, and E. cloacae. PFGE analysis of CTX-M producing isolates showed the predominance of CTX-M-15 in 10 of 24 pulsotypes in K. pneumoniae, 6 of 13 in E. cloacae and 3 of 6 in E. coli. CTX-M-15 was also predominant among KPC producing isolates. In conclusion, this study showed that CTX-M-15 was circulating in Rio de Janeiro state in 2007-2008. This data reinforce the need for continuing surveillance because this scenario may have changed over the years.

  1. 恶性肿瘤患者铜绿假单胞菌血流感染的临床分析%Clinical analysis of cancer patients with Pseudomonas aeruginosa bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    白长森; 李丁; 张文芳; 张青; 郑珊; 张鹏

    2014-01-01

    目的:分析恶性肿瘤患者合并铜绿假单胞菌血流感染的相关危险因素及耐药性情况。方法:回顾性分析天津医科大学肿瘤医院2010年1月至2012年12月30例合并铜绿假单胞菌血流感染及90例无铜绿假单胞菌血流感染的恶性肿瘤患者的临床资料;采用Whonet 5.6软件和SPSS 19.0对数据进行统计学分析。结果:感染组患者男20例,女10例,平均年龄(60.9±11.2)岁;对照组患者男60例,女30例,平均年龄(51.3±15.9)岁;多因素Logistic回归分析显示住院次数、合并其他部位感染和应用≥2种类型抗生素为恶性肿瘤患者合并铜绿假单胞菌血流感染的独立危险因素(P80%)。合并铜绿假单胞菌血流感染的恶性肿瘤患者的死亡率为60%。结论:恶性肿瘤患者合并铜绿假单胞菌血流感染死亡率高,在临床工作中必须采取综合防治的措施,减少铜绿假单胞菌血流感染的发生。%Objective:To analyze risk factors of cancer patients with Pseudomonas aeruginosa bloodstream infections and drug resistance. Methods:Clinical data of 30 cancer patients with P. aeruginosa bloodstream infection and 90 without infection who were ad-mitted in the Tianjin Medical University Cancer Institute and Hospital between January 2010 and December 2012 were retrospectively analyzed. Whonet 5.6 and SPSS19.0 software were used for statistical analysis of the data. Results:The infection group consisted of 20 male and 10 female patients with a mean age of 60.9±11.2 years. The control group consisted of 60 males and 30 females with a mean age of 51.3 ± 15.9 years. Multivariate logistic regression analysis showed that the number of hospitalization, combined with infection of other sites, and more than two types of antibiotics were independent risk factors of cancer patients with P. aeruginosa bloodstream infec-tions. P. aeruginosa showed high sensitivity(>80%) to carbapenems, ceftazidime, cefepime

  2. Integrity of lipid nanocarriers in bloodstream and tumor quantified by near-infrared ratiometric FRET imaging in living mice.

    Science.gov (United States)

    Bouchaala, Redouane; Mercier, Luc; Andreiuk, Bohdan; Mély, Yves; Vandamme, Thierry; Anton, Nicolas; Goetz, Jacky G; Klymchenko, Andrey S

    2016-08-28

    Lipid nanocarriers are considered as promising candidates for drug delivery and cancer targeting because of their low toxicity, biodegradability and capacity to encapsulate drugs and/or contrasting agents. However, their biomedical applications are currently limited because of a poor understanding of their integrity in vivo. To address this problem, we report on fluorescent nano-emulsion droplets of 100nm size encapsulating lipophilic near-infrared cyanine 5.5 and 7.5 dyes with a help of bulky hydrophobic counterion tetraphenylborate. Excellent brightness and efficient Förster Resonance Energy Transfer (FRET) inside lipid NCs enabled for the first time quantitative fluorescence ratiometric imaging of NCs integrity directly in the blood circulation, liver and tumor xenografts of living mice using a whole-animal imaging set-up. This unique methodology revealed that the integrity of our FRET NCs in the blood circulation of healthy mice is preserved at 93% at 6h of post-administration, while it drops to 66% in the liver (half-life is 8.2h). Moreover, these NCs show fast and efficient accumulation in tumors, where they enter in nearly intact form (77% integrity at 2h) before losing their integrity to 40% at 6h (half-life is 4.4h). Thus, we propose a simple and robust methodology based on ratiometric FRET imaging in vivo to evaluate quantitatively nanocarrier integrity in small animals. We also demonstrate that nano-emulsion droplets are remarkably stable nano-objects that remain nearly intact in the blood circulation and release their content mainly after entering tumors. PMID:27327767

  3. Factores de riesgo de infecciones del tracto sanguíneo asociadas a alimentación parenteral en pacientes pediátricos Risk factors of bloodstream infections associated with parenteral nutrition in pediatric patients

    Directory of Open Access Journals (Sweden)

    P. Balboa Cardemil

    2011-12-01

    Full Text Available Introducción: Una de las complicaciones de la nutrición parenteral (NP es la infección sanguínea (IS asociada a catéter, se desconoce los factores de riesgo más importantes en nuestro medio. Objetivo: Determinar los factores de riesgo de las IS asociadas a NP en pacientes pediátricos en hospitales de Santiago de Chile. Pacientes y métodos: En 2 hospitales públicos se analizaron retrospectivamente todos los recién nacidos (RN y niños que recibieron NP entre enero del 2002 y diciembre del 2005. El grupo estudio (GE son todos aquellos con hemocultivos (+ durante la administración de NP. El grupo control (GC correspondió a 2 controles por cada caso, niños con NP y hemocultivos (-. Para el análisis estadístico se usaron pruebas paramétricas, no paramétricas y regresión logística. Resultados: Se obtuvieron 58 casos y 130 controles. Los niños del GE recibieron NP por más tiempo que GC: 24 (7-934 vs 10 días (7-152 (p Introduction: One of the complications of parenteral nutrition (PN is bloodstream infection (BSI associated with catheter, unknown the most important risk factors in our country. Objective: To determine risk factors of BSI associated with PN in pediatric patients in public hospitals of Santiago, Chile. Patients and methods: In two public hospitals all newborns and children receiving PN were analyzed retrospectively, from January 2002 to December 2005. The study group (SG was formed by all those with blood cultures (+ during the administration of PN. We selected two controls for each case, children with PN and blood cultures (- (control group, CG. We used parametric, nonparametric and logistic regression to analyze data. Results: There were 58 cases and 130 controls. Children of the SG received PN for longer days than CG: 24 (7-934 vs. 10 days (7-152 (p < 0.001, presented a higher rate of malnutrition (44.4% vs. 31%, chi2, p < 0.05 and received more frequently PN by central venous catheter than peripheral catheter (GE

  4. A Multinational, Preregistered Cohort Study of β-Lactam/β-Lactamase Inhibitor Combinations for Treatment of Bloodstream Infections Due to Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae.

    Science.gov (United States)

    Gutiérrez-Gutiérrez, Belén; Pérez-Galera, Salvador; Salamanca, Elena; de Cueto, Marina; Calbo, Esther; Almirante, Benito; Viale, Pierluigi; Oliver, Antonio; Pintado, Vicente; Gasch, Oriol; Martínez-Martínez, Luis; Pitout, Johann; Akova, Murat; Peña, Carmen; Molina, José; Hernández, Alicia; Venditti, Mario; Prim, Nuria; Origüen, Julia; Bou, German; Tacconelli, Evelina; Tumbarello, Mario; Hamprecht, Axel; Giamarellou, Helen; Almela, Manel; Pérez, Federico; Schwaber, Mitchell J; Bermejo, Joaquín; Lowman, Warren; Hsueh, Po-Ren; Mora-Rillo, Marta; Natera, Clara; Souli, Maria; Bonomo, Robert A; Carmeli, Yehuda; Paterson, David L; Pascual, Alvaro; Rodríguez-Baño, Jesús

    2016-07-01

    The spread of extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) is leading to increased carbapenem consumption. Alternatives to carbapenems need to be investigated. We investigated whether β-lactam/β-lactamase inhibitor (BLBLI) combinations are as effective as carbapenems in the treatment of bloodstream infections (BSI) due to ESBL-E. A multinational, retrospective cohort study was performed. Patients with monomicrobial BSI due to ESBL-E were studied; specific criteria were applied for inclusion of patients in the empirical-therapy (ET) cohort (ETC; 365 patients), targeted-therapy (TT) cohort (TTC; 601 patients), and global cohort (GC; 627 patients). The main outcome variables were cure/improvement rate at day 14 and all-cause 30-day mortality. Multivariate analysis, propensity scores (PS), and sensitivity analyses were used to control for confounding. The cure/improvement rates with BLBLIs and carbapenems were 80.0% and 78.9% in the ETC and 90.2% and 85.5% in the TTC, respectively. The 30-day mortality rates were 17.6% and 20% in the ETC and 9.8% and 13.9% in the TTC, respectively. The adjusted odds ratio (OR) (95% confidence interval [CI]) values for cure/improvement rate with ET with BLBLIs were 1.37 (0.69 to 2.76); for TT, they were 1.61 (0.58 to 4.86). Regarding 30-day mortality, the adjusted OR (95% CI) values were 0.55 (0.25 to 1.18) for ET and 0.59 (0.19 to 1.71) for TT. The results were consistent in all subgroups studied, in a stratified analysis according to quartiles of PS, in PS-matched cases, and in the GC. BLBLIs, if active in vitro, appear to be as effective as carbapenems for ET and TT of BSI due to ESLB-E regardless of the source and specific species. These data may help to avoid the overuse of carbapenems. (This study has been registered at ClinicalTrials.gov under registration no. NCT01764490.). PMID:27139473

  5. Klebsiella variicola is a frequent cause of bloodstream infection in the stockholm area, and associated with higher mortality compared to K. pneumoniae.

    Science.gov (United States)

    Maatallah, Makaoui; Vading, Malin; Kabir, Muhammad Humaun; Bakhrouf, Amina; Kalin, Mats; Nauclér, Pontus; Brisse, Sylvain; Giske, Christian G

    2014-01-01

    Clinical isolates of Klebsiella pneumoniae are divided into three phylogroups and differ in their virulence factor contents. The aim of this study was to determine an association between phylogroup, virulence factors and mortality following bloodstream infection (BSI) caused by Klebsiella pneumoniae. Isolates from all adult patients with BSI caused by K. pneumoniae admitted to Karolinska University Hospital, Solna between 2007 and 2009 (n = 139) were included in the study. Phylogenetic analysis was performed based on multilocus sequence typing (MLST) data. Testing for mucoid phenotype, multiplex PCR determining serotypes K1, K2, K5, K20, K54 and K57, and testing for virulence factors connected to more severe disease in previous studies, was also performed. Data was retrieved from medical records including age, sex, comorbidity, central and urinary catheters, time to adequate treatment, hospital-acquired infection, and mortality, to identify risk factors. The primary end-point was 30- day mortality. The three K. pneumoniae phylogroups were represented: KpI (n = 96), KpII (corresponding to K. quasipneumoniae, n = 9) and KpIII (corresponding to K. variicola, n = 34). Phylogroups were not significantly different in baseline characteristics. Overall, the 30-day mortality was 24/139 (17.3%). Isolates belonging to KpIII were associated with the highest 30-day mortality (10/34 cases, 29.4%), whereas KpI isolates were associated with mortality in 13/96 cases (13.5%). This difference was significant both in univariate statistical analysis (P = 0.037) and in multivariate analysis adjusting for age and comorbidity (OR 3.03 (95% CI: 1.10-8.36). Only three of the isolates causing mortality within 30 days belonged to any of the virulent serotypes (K54, n = 1), had a mucoid phenotype (n = 1) and/or contained virulence genes (wcaG n = 1 and wcaG/allS n = 1). In conclusion, the results indicate higher mortality among patients infected with

  6. Impact of cefepime therapy on mortality among patients with bloodstream infections caused by extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli.

    Science.gov (United States)

    Chopra, Teena; Marchaim, Dror; Veltman, Jennifer; Johnson, Paul; Zhao, Jing J; Tansek, Ryan; Hatahet, Dania; Chaudhry, Khawar; Pogue, Jason M; Rahbar, Hiro; Chen, Ting-Yi; Truong, Thientu; Rodriguez, Victor; Ellsworth, Joseph; Bernabela, Luigino; Bhargava, Ashish; Yousuf, Adnan; Alangaden, George; Kaye, Keith S

    2012-07-01

    Extended-spectrum-β-lactamase (ESBL)-producing pathogens are associated with extensive morbidity and mortality and rising health care costs. Scant data exist on the impact of antimicrobial therapy on clinical outcomes in patients with ESBL bloodstream infections (BSI), and no large studies have examined the impact of cefepime therapy. A retrospective 3-year study was performed at the Detroit Medical Center on adult patients with BSI due to ESBL-producing Klebsiella pneumoniae or Escherichia coli. Data were collected from the medical records of study patients at five hospitals between January 2005 and December 2007. Multivariate analysis was performed using logistic regression. One hundred forty-five patients with BSI due to ESBL-producing pathogens, including K. pneumoniae (83%) and E. coli (16.5%), were studied. The mean age of the patients was 66 years. Fifty-one percent of the patients were female, and 79.3% were African-American. Fifty-three patients (37%) died in the hospital, and 92 survived to discharge. In bivariate analysis, the variables associated with mortality (P catheter. In multivariate analysis, the predictors of in-hospital mortality included stay in the intensive care unit (odds ratio [OR], 2.17; 95% confidence interval [CI], 0.98 to 4.78), presence of a central-line catheter prior to positive culture (OR, 2.33; 95% CI, 0.77 to 7.03), presence of a rapidly fatal condition at the time of admission (OR, 5.13; 95% CI, 2.13 to 12.39), and recent prior hospitalization (OR, 1.92; 95% CI, 0.83 to 4.09). When carbapenems were added as empirical therapy to the predictor model, there was a trend between empirical carbapenem therapy and decreased mortality (OR, 0.61; 95% CI, 0.26 to 1.50). When added to the model, receipt of empirical cefepime alone (n = 43) was associated with increased mortality, although this association did not reach statistical significance (OR, 1.66; 95% CI, 0.71 to 3.87). The median length of hospital stay was shorter for patients

  7. 导管相关性血流感染的病原菌分析%Pathogens of catheter-related bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    孙敏霞; 董梅; 雷红; 杨昌梅; 朱蕾; 匡铁吉

    2011-01-01

    Objective To provide the reference for the diagnosis and treatment of catheter-related bloodstream infection(CRBSI) by analyzing the distribution of pathogens in CRBSI. Methods One hundred and eighty patients with positive central vein culture of CRBSI admitted to our hospital from September 2008 to December 2010 were retrospectively analyzed. Results Of the 180 patients, 56(31.1%) were diagnosed as CRBSI, including 29 in Intensive Care Unit, 8 in Tuberculosis Department, 6 in Department of Kidney Medicine, 4 in Department of Respiratory Medicine, 8 in other departments. Of the 56 pathogens, 24(42.8%) were Gram-negative bacilli(mainly Acinetobacter baumannii and Klebsiella pneumoniae), 22(393%) were Gram-positive cocci(mainly coagulase-negative staphylococci and S.aureus), and 10(17.9%) were Candida. Conclusion Great importance should be attached to the multi-drug resistant Acinetobacter baumannii and fungi which are present in CRBSI.%目的 分析导管相关性血流感染(CRBSI)的病原菌分布,为临床诊治提供参考.方法 对本院2008年9月-2010年12月中心静脉导管培养阳性的180例病例进行回顾性分析.结果 180例中56例(31.1%)为CRBSI确诊病例.来源于重症监护病房29例,结核病区8例,肾内科6例,呼吸科4例,其他科室9例;56株病原菌中革兰阴性杆菌24株(42.8%),主要为鲍曼不动杆菌和肺炎克雷伯菌;革兰阳性球菌22株(39.3%),以凝固酶阴性葡萄球菌和金黄色葡萄球菌为主;假丝酵母菌属10株(17.9%).结论多耐药鲍曼不动杆菌和真菌在CRBSI中出现,应引起临床高度重视.

  8. Laboratory-based surveillance of hospital-acquired catheter-related bloodstream infections in Catalonia. Results of the VINCat Program (2007-2010).

    Science.gov (United States)

    Almirante, Benito; Limón, Enric; Freixas, Núria; Gudiol, F

    2012-06-01

    The VINCat Program is an institutional surveillance program for hospital-acquired infections developed in the healthcare institutions of Catalonia, Spain. The program includes the monitoring of various components of hospital-acquired infection, among which is catheter-related bloodstream infection (CRBSI). The aim of this study was to describe the frequency of CRBSI in hospitals participating in the VINCat Program over a period of 4 years (2007-2010). The monitoring of the CRBSI component is carried out continuously in all inpatient units by performing a daily assessment of all blood culture results issued by the Microbiology Laboratories. Precise definitions are used for CRBSI, and adjusted rates are expressed per 1,000 days of hospitalization, hospital size and type of catheter. The rates of CRBSI in catheters used for parenteral nutrition are adjusted and expressed per 1,000 days of device use. The aggregate data of the total period are shown in percentiles (10%, 25%, 50% or median, 75%, and 90%). From 2007 to 2010, a total of 2977 episodes of CRBSI were reported in 40 hospitals participating in the VINCat Program. The cumulative incidence of CRBSI has been 0.26 episodes per 1,000 days of hospitalization (CI95% 0.2 to 0.3). The overall incidence varied depending on hospital size: 0.36 ‰ for hospitals in Group I (>500 beds), 0.17 ‰ for Group II (200-500 beds), and 0.09 ‰ for Group III (catheters (CVC), 19% of the episodes with peripheral venous catheters (PVC), and the remaining 5% with peripherally inserted CVCs (PICC). The most common organisms causing CRBSI were staphylococci, the group Klebsiella, Serratia and Enterobacter, Candida spp., and Pseudomonas aeruginosa. There are important differences in the etiology of CRBSI in relation to these variables. During the reporting period, a significant reduction (38.1%, CI95%, 29.0-46.0%) of CRBSI rates have been observed in Group I hospitals. CRBSI surveillance is an important element of the VINCat Program

  9. Epidemiology and Burden of Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae in a Pediatric Hospital in Senegal.

    Directory of Open Access Journals (Sweden)

    Awa Ndir

    Full Text Available Severe bacterial infections are not considered as a leading cause of death in young children in sub-Saharan Africa. The worldwide emergence of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E could change the paradigm, especially in neonates who are at high risk of developing healthcare-associated infections.To evaluate the epidemiology and the burden of ESBL-E bloodstream infections (BSI.A case-case-control study was conducted in patients admitted in a pediatric hospital during two consecutive years. Cases were patients with Enterobacteriaceae BSI and included ESBL-positive (cases 1 and ESBL-negative BSI (cases 2. Controls were patients with no BSI. Multivariate analysis using a stepwise logistic regression was performed to identify risk factors for ESBL acquisition and for fatal outcomes. A multistate model was used to estimate the excess length of hospital stay (LOS attributable to ESBL production while accounting for time of infection. Cox proportional hazards models were performed to assess the independent effect of ESBL-positive and negative BSI on LOS.The incidence rate of ESBL-E BSI was of 1.52 cases/1000 patient-days (95% CI: 1.2-5.6 cases per 1000 patient-days. Multivariate analysis showed that independent risk factors for ESBL-BSI acquisition were related to underlying comorbidities (sickle cell disease OR = 3.1 (95%CI: 2.3-4.9, malnutrition OR = 2.0 (95%CI: 1.7-2.6 and invasive procedures (mechanical ventilation OR = 3.5 (95%CI: 2.7-5.3. Neonates were also identified to be at risk for ESBL-E BSI. Inadequate initial antibiotic therapy was more frequent in ESBL-positive BSI than ESBL-negative BSI (94.2% versus 5.7%, p<0.0001. ESBL-positive BSI was associated with higher case-fatality rate than ESBL-negative BSI (54.8% versus 15.4%, p<0.001. Multistate modelling indicated an excess LOS attributable to ESBL production of 4.3 days. The adjusted end-of-LOS hazard ratio for ESBL-positive BSI was 0.07 (95%CI, 0

  10. Prevalence of Resistant Gram-Negative Bacilli in Bloodstream Infection in Febrile Neutropenia Patients Undergoing Hematopoietic Stem Cell Transplantation: A Single Center Retrospective Cohort Study.

    Science.gov (United States)

    Wang, Ling; Wang, Ying; Fan, Xing; Tang, Wei; Hu, Jiong

    2015-11-01

    Bloodstream infection (BSI) is an important cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). To evaluate the causative bacteria and identify risk factors for BSI associated mortality in febrile neutropenia patients undergoing HSCT, we collected the clinical and microbiological data from patients underwent HSCT between 2008 and 2014 and performed a retrospective analysis. Throughout the study period, among 348 episodes of neutropenic fever in patients underwent HSCT, 89 episodes in 85 patients had microbiological defined BSI with a total of 108 isolates. Gram-negative bacteria (GNB) were the most common isolates (76, 70.3%) followed by gram-positive bacteria (GPB, 29, 26.9%) and fungus (3, 2.8%). As to the drug resistance, 26 multiple drug resistance (MDR) isolates were identified. Resistant isolates (n = 23) were more common documented in GNB, mostly Escherichia coli (9/36, 25%) and Klebsiella pneumonia (6/24, 25%). A total of 12 isolated were resistant to carbapenem including 4 K pneumoniae (4/24, 16.7%), 3 Stenotrophomonas maltophilia, and 1 Pseudomonas aeruginosa and other 4 GNB isolates (Citrobacter freumdii, Pseudomonas stutzeri, Acinetobacter baumanii, and Chryseobacterium indologenes). As to the GPB, only 3 resistant isolates were documented including 2 methicillin-resistant isolates (Staphylococcus hominis and Arcanobacterium hemolysis) and 1 vancomycin-resistant Enterococcus faecium. Among these 85 patients with documented BSI, 11 patients died of BSI as primary or associated cause with a BSI-related mortality of 13.1 ± 3.7% and 90-day overall survival after transplantation at 80.0 ± 4.3%. Patients with high-risk disease undergoing allo-HSCT, prolonged neutropenia (≥15 days) and infection with carbapenem-resistant GNB were associated with BSI associated mortality in univariate and multivariate analyses. Our report revealed a prevalence of GNB in BSI of neutropenic patients undergoing

  11. Prevalence of Resistant Gram-Negative Bacilli in Bloodstream Infection in Febrile Neutropenia Patients Undergoing Hematopoietic Stem Cell Transplantation: A Single Center Retrospective Cohort Study.

    Science.gov (United States)

    Wang, Ling; Wang, Ying; Fan, Xing; Tang, Wei; Hu, Jiong

    2015-11-01

    Bloodstream infection (BSI) is an important cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). To evaluate the causative bacteria and identify risk factors for BSI associated mortality in febrile neutropenia patients undergoing HSCT, we collected the clinical and microbiological data from patients underwent HSCT between 2008 and 2014 and performed a retrospective analysis. Throughout the study period, among 348 episodes of neutropenic fever in patients underwent HSCT, 89 episodes in 85 patients had microbiological defined BSI with a total of 108 isolates. Gram-negative bacteria (GNB) were the most common isolates (76, 70.3%) followed by gram-positive bacteria (GPB, 29, 26.9%) and fungus (3, 2.8%). As to the drug resistance, 26 multiple drug resistance (MDR) isolates were identified. Resistant isolates (n = 23) were more common documented in GNB, mostly Escherichia coli (9/36, 25%) and Klebsiella pneumonia (6/24, 25%). A total of 12 isolated were resistant to carbapenem including 4 K pneumoniae (4/24, 16.7%), 3 Stenotrophomonas maltophilia, and 1 Pseudomonas aeruginosa and other 4 GNB isolates (Citrobacter freumdii, Pseudomonas stutzeri, Acinetobacter baumanii, and Chryseobacterium indologenes). As to the GPB, only 3 resistant isolates were documented including 2 methicillin-resistant isolates (Staphylococcus hominis and Arcanobacterium hemolysis) and 1 vancomycin-resistant Enterococcus faecium. Among these 85 patients with documented BSI, 11 patients died of BSI as primary or associated cause with a BSI-related mortality of 13.1 ± 3.7% and 90-day overall survival after transplantation at 80.0 ± 4.3%. Patients with high-risk disease undergoing allo-HSCT, prolonged neutropenia (≥15 days) and infection with carbapenem-resistant GNB were associated with BSI associated mortality in univariate and multivariate analyses. Our report revealed a prevalence of GNB in BSI of neutropenic patients undergoing

  12. Bloodstream infections in febrile neutropenic patients at a tertiary cancer institute in South India: A timeline of clinical and microbial trends through the years

    Directory of Open Access Journals (Sweden)

    K Govind Babu

    2016-01-01

    Full Text Available Introduction: Febrile neutropenia (FN is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. Methods: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. Objectives: The objectives of this study were as follows: (1 To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies. (2 As per the institutional protocol to periodically review the antibiotic policy and susceptibility pattern, and compare the findings with an earlier study done in our institute in 2010. This was a prospective study conducted from September 2012 to September 2014. Results: About 379 episodes of FN were documented among 300 patients. About 887 blood cultures were drawn. Of these, 137 (15% isolates were cultured. Isolates having identical antibiograms obtained from a single patient during the same hospitalization were considered as one. Hence, 128 isolates were analyzed. About 74 (58% cultures yielded Gram-negative bacilli, 51 (40% were positive for Gram-positive cocci, and 3 (2% grew fungi. Among Gram-negative organisms, Escherichia coli followed by Acinetobacter baumannii and Klebsiella pneumoniae accounted for 78% of the isolates. Among Gram-positive cocci, Staphylococcus species accounted for 84% of the isolates. We have noted a changing trend in the antibiotic sensitivity pattern over the years. Following the switch in empirical antibiotics, based on the results of the study done in 2010 (when the empirical antibiotics were ceftazidime + amikacin, the sensitivity to cefoperazone-sulbactam has plunged from about 80% to 60%%. Similar reduction in

  13. Klebsiella variicola is a frequent cause of bloodstream infection in the stockholm area, and associated with higher mortality compared to K. pneumoniae.

    Directory of Open Access Journals (Sweden)

    Makaoui Maatallah

    Full Text Available Clinical isolates of Klebsiella pneumoniae are divided into three phylogroups and differ in their virulence factor contents. The aim of this study was to determine an association between phylogroup, virulence factors and mortality following bloodstream infection (BSI caused by Klebsiella pneumoniae. Isolates from all adult patients with BSI caused by K. pneumoniae admitted to Karolinska University Hospital, Solna between 2007 and 2009 (n = 139 were included in the study. Phylogenetic analysis was performed based on multilocus sequence typing (MLST data. Testing for mucoid phenotype, multiplex PCR determining serotypes K1, K2, K5, K20, K54 and K57, and testing for virulence factors connected to more severe disease in previous studies, was also performed. Data was retrieved from medical records including age, sex, comorbidity, central and urinary catheters, time to adequate treatment, hospital-acquired infection, and mortality, to identify risk factors. The primary end-point was 30- day mortality. The three K. pneumoniae phylogroups were represented: KpI (n = 96, KpII (corresponding to K. quasipneumoniae, n = 9 and KpIII (corresponding to K. variicola, n = 34. Phylogroups were not significantly different in baseline characteristics. Overall, the 30-day mortality was 24/139 (17.3%. Isolates belonging to KpIII were associated with the highest 30-day mortality (10/34 cases, 29.4%, whereas KpI isolates were associated with mortality in 13/96 cases (13.5%. This difference was significant both in univariate statistical analysis (P = 0.037 and in multivariate analysis adjusting for age and comorbidity (OR 3.03 (95% CI: 1.10-8.36. Only three of the isolates causing mortality within 30 days belonged to any of the virulent serotypes (K54, n = 1, had a mucoid phenotype (n = 1 and/or contained virulence genes (wcaG n = 1 and wcaG/allS n = 1. In conclusion, the results indicate higher mortality among patients infected with

  14. Presence of Mycoplasma fermentans in the bloodstream of Mexican patients with rheumatoid arthritis and IgM and IgG antibodies against whole microorganism

    Directory of Open Access Journals (Sweden)

    Salinas Salvador

    2009-08-01

    Full Text Available Abstract Background Increasing evidence incriminates bacteria, especially Mycoplasma fermentans, as possible arthritogenic agents in humans. The purpose of this study was to investigate M. fermentans in the bloodstream of patients with rheumatoid arthritis. Methods Two hundred and nineteen blood samples from patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, and healthy individuals were screened by bacterial culture and direct PCR in order to detect mycoplasmas; IgM and IgG against M. fermentans PG18 were also detected by ELISA and Immunoblotting assays in patients with rheumatoid arthritis and healthy individuals. Results Blood samples from patients with antiphospholipid syndrome and healthy individuals were negative for mycoplasma by culture or direct PCR. In blood samples from patients with systemic lupus erythematosus were detected by direct PCR M. fermentans in 2/50 (2%, M. hominis in 2/50 (2% and U. urealyticum in 1/50 (0.5%. In patients with RA M. fermentans was detected by culture in 13/87 blood samples and in 13/87 by direct PCR, however, there was only concordance between culture and direct PCR in six samples, so M. fermentans was detected in 20/87(23% of the blood samples from patients with RA by either culture or PCR. Antibody-specific ELISA assay to M. fermentans PG18 was done, IgM was detected in sera from 40/87 patients with RA and in sera of 7/67 control individuals, IgG was detected in sera from 48/87 RA patients and in sera from 7/67 healthy individuals. Antibody-specific immunoblotting to M. fermentans PG18 showed IgM in sera from 35/87 patients with RA and in sera from 4/67 healthy individuals, IgG was detected in sera from 34/87 patients and in sera from 5/67 healthy individuals. Conclusion Our findings show that only M. fermentans produce bacteremia in a high percentage of patients with RA. This finding is similar to those reported in the literature. IgM and IgG against M

  15. Linkage, evaluation and analysis of national electronic healthcare data: application to providing enhanced blood-stream infection surveillance in paediatric intensive care.

    Directory of Open Access Journals (Sweden)

    Katie Harron

    Full Text Available BACKGROUND: Linkage of risk-factor data for blood-stream infection (BSI in paediatric intensive care (PICU with bacteraemia surveillance data to monitor risk-adjusted infection rates in PICU is complicated by a lack of unique identifiers and under-ascertainment in the national surveillance system. We linked, evaluated and performed preliminary analyses on these data to provide a practical guide on the steps required to handle linkage of such complex data sources. METHODS: Data on PICU admissions in England and Wales for 2003-2010 were extracted from the Paediatric Intensive Care Audit Network. Records of all positive isolates from blood cultures taken for children <16 years and captured by the national voluntary laboratory surveillance system for 2003-2010 were extracted from the Public Health England database, LabBase2. "Gold-standard" datasets with unique identifiers were obtained directly from three laboratories, containing microbiology reports that were eligible for submission to LabBase2 (defined as "clinically significant" by laboratory microbiologists. Reports in the gold-standard datasets were compared to those in LabBase2 to estimate ascertainment in LabBase2. Linkage evaluated by comparing results from two classification methods (highest-weight classification of match weights and prior-informed imputation using match probabilities with linked records in the gold-standard data. BSI rate was estimated as the proportion of admissions associated with at least one BSI. RESULTS: Reporting gaps were identified in 548/2596 lab-months of LabBase2. Ascertainment of clinically significant BSI in the remaining months was approximately 80-95%. Prior-informed imputation provided the least biased estimate of BSI rate (5.8% of admissions. Adjusting for ascertainment, the estimated BSI rate was 6.1-7.3%. CONCLUSION: Linkage of PICU admission data with national BSI surveillance provides the opportunity for enhanced surveillance but analyses based on

  16. 血流感染病原菌分布及耐药特性分析%The distribution and resistance characteristics analysis of pathogens from bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    钟桥石; 胡龙华; 熊建球; 章白芩; 张黎明; 胡晓彦; 贾坤如

    2012-01-01

    目的 了解血流感染主要病原菌的分布特点及对常用抗菌药物的耐药情况,以指导临床合理用药.方法 对2006年1月—2011年6月期间本院临床各科室送检的血培养标本采用美国Bactec9120全自动血培养仪进行培养,Vitek-32型仪进行菌种鉴定,纸片扩散法测定菌株对抗菌药物的敏感性,头孢西丁法检测耐甲氧西林葡菌球菌,WHONET5.6软件分析数据.结果 共分离出598株病原菌,其中革兰阳性球菌282株,占47.2%;革兰阴性杆菌289株,占48.3%,真菌15株,占2.5%.最常见的感染菌分别为大肠埃希菌、表皮葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌及鲍曼不动杆菌.金黄色葡萄球菌和表皮葡萄球菌中耐甲氧西林葡萄球菌检出率分别为63.9%和87.9%,其对青霉素耐药率均>95.0%,均未发现对万古霉素和替考拉宁耐药株.大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗生素耐药率最低,对氨苄西林耐药率分别为93.8%和100%.铜绿假单胞菌对亚胺培南耐药率为16.7%,而鲍曼不动杆菌对亚胺培南耐药率高达63.6%,鲍曼不动杆菌对其他抗菌药物的耐药率均>60%.结论 本单位血流感染以大肠埃希菌和葡萄球菌为主.表皮葡萄球菌较金黄色葡萄球菌耐药性严重,非发酵菌比肠杆菌科细菌耐药性严重,尤其是鲍曼不动杆菌引起的血流感染无经验抗菌药物可选,必须在药敏试验指导下用药.%Objective To investigate bacteria distribution characteristic and antimicrobial drug resistance of main pathogens of bloodstream infection in our hospital, and to guide the clinical treatment. Methods Various clinical departments blood cultures samples which were collected from January 2006 to June 2011 in the Second Affiliated Hospital of Nanchang University were incubated by Bactec9120 automated blood culture and identified by Vitek-32 automated microbial identified. Antimicrobial

  17. 氯己定醇皮肤消毒液在预防导管相关血流感染中的效果研究%Effect of chlorhexidine skin disinfectant on prevention of catheter-related bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    吴晓琴; 李兰云; 郭晶; 何金; 李琳; 徐莉; 杜永川

    2014-01-01

    目的:探讨2%葡萄糖酸氯己定(CHG)醇皮肤消毒液对预防经外周静脉导入中心静脉置管(PICC)导管相关血流感染(CRBSI)的消毒效果。方法对2013年1-12月行PICC置管的肿瘤患者进行前瞻性随机对照研究,将64例PICC置管的患者进行随机分组,观察组34例使用2% CHG醇进行皮肤消毒,对照组30例使用5%聚维酮碘进行皮肤消毒,分别于各组患者进行PICC置管前及置管后48 h对置管周围部位的皮肤采样,进行细菌监测并比较两组间的差异。结果观察组在 PICC置管前和置管后较对照组48h皮肤菌落数低、干燥时间短(P<0.05),观察组总置管日2356 d ,无CRBSI发生;对照组总置管日1970 d ,CRBSI 4例,2% CHG醇消毒液能降低CRBSI的发生率(P<0.05)。结论2% CHG醇皮肤消毒液可降低PICC导管相关血流感染的发生率,并可减少皮肤表面的暂居菌,抑制其生长从而降低CRBSI风险。%OBJECTIVE To explore the effect of 2% chlorhexidine gluconate (CHG) on prevention of peripherally inserted central venous catheter-related bloodstream infections .METHODS The prospective randomized control study was conducted for the tumor patients who underwent PICC from Jan 2013 to Dec 2013;the 64 PICC patients were randomly divided into the observation group with 34 cases and the control group with 30 cases , the observation group was treated with 2% CHG for skin disinfection ,while the control group was given 5% povidone iodine for skin disinfection .The skins around the catheter insertion sites were respectively sampled before the PICC catheterization and at 48 hours after the PICC catheterization ;the bacterial species were monitored and compared between the two groups .RESULTS The bacterial colony counts in the skin were less in the observation group than in the control group before and after the PICC catheterization ,and the drying time of the observation group was shorter

  18. On good ETOL forms

    DEFF Research Database (Denmark)

    Skyum, Sven

    1978-01-01

    This paper continues the study of ETOL forms and good EOL forms done by Maurer, Salomaa and Wood. It is proven that binary very complete ETOL forms exist, good synchronized ETOL forms exist and that no propagating or synchronized ETOL form can be very complete....

  19. Modular Forms and Weierstrass Mock Modular Forms

    Directory of Open Access Journals (Sweden)

    Amanda Clemm

    2016-02-01

    Full Text Available Alfes, Griffin, Ono, and Rolen have shown that the harmonic Maass forms arising from Weierstrass ζ-functions associated to modular elliptic curves “encode” the vanishing and nonvanishing for central values and derivatives of twisted Hasse-Weil L-functions for elliptic curves. Previously, Martin and Ono proved that there are exactly five weight 2 newforms with complex multiplication that are eta-quotients. In this paper, we construct a canonical harmonic Maass form for these five curves with complex multiplication. The holomorphic part of this harmonic Maass form arises from the Weierstrass ζ-function and is referred to as the Weierstrass mock modular form. We prove that the Weierstrass mock modular form for these five curves is itself an eta-quotient or a twist of one. Using this construction, we also obtain p-adic formulas for the corresponding weight 2 newform using Atkin’s U-operator.

  20. A 17-year study of bloodstream infection after liver transplantation: resistance rate, risk factor and mortality of enteroccal bloodstream infectious%肝移植术后肠球菌血行感染的耐药及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    邰强; 郭志勇; 黄洁夫; 何晓顺; 胡安斌; 巫林伟; 鞠卫强; 朱晓峰; 马毅; 王东平; 王国栋

    2010-01-01

    Objective To explore the resistance rate, risk factor and mortality of enteroccal bloodstream infections (BSI) after liver transplantation. Methods From January 1993 to May 2010, a retrospective analysis of enteroccus in liver transplants were conducted. Results Fifty-eight BSI occurred in 53 of 695 patients. And a total of 30 enterocci were isolated. Linezolid and glycopeptide antibiotics were the most consistently active against the Enterococcus. The resistance rates to Enterococcus for erythromycin,clindamycin, imipenem, ciprofloxacin, gentamycin and ampicillin-clavulanic acid were all over 70%. The univariate analysis identified the following variables as the risk factors for enterococcal bacteremia:retransplantion ( P = 0. 03 ) and biliary duct complications ( P = 0. 02 ). Enterococcal bloodstream infection increased the mortality at Day 15. No significant difference was found in the mortality rate at Day 30 and 1 year after enterococcal bacteremia. Conclusion Enterococcus after liver transplantion is resistant to multiple agents but active to linezolid and glycopeptide antibiotics. The risk factors commonly associated with enteroccal BSI are retransplantion and biliary duct complications. Enterococcal BSI can increase the mortality at Day 15 after liver transplantation.%目的 了解肝移植术后血行感染中肠球菌的耐药、临床结果及危险因素,对肝移植术后血行感染的治疗提供参考依据.方法 1993年1月至2010年5月,回顾分析中山大学附属第一医院肝移植术后血行感染中肠球菌患者资料.结果 695例肝移植患者中,53例(7.6%)出现革兰阳性球菌血行感染,共有革兰阳性菌58株,以肠球菌(30株)最为常见.肠球菌对糖肽类、利奈唑胺均为敏感,对克林霉素、红霉素、阿莫西林/克拉维酸、亚胺培南、利福平、庆大霉素、环丙沙星耐药率都在70%以上.针对肝移植术后肠球菌血行感染的危险因素分析发现,再次移植(P=0.03)

  1. Electroweak form factors

    International Nuclear Information System (INIS)

    The present status of electroweak nucleon form factors and the N - Δ transition form factors is reviewed. Particularly the determination of dipole mass MA in the axial vector form factor is discussed

  2. CRP和PCT检测对血流感染的诊断价值%Value of Diagnosis of CRP and PCT in the Differential Diagnosis of Bloodstream Infection

    Institute of Scientific and Technical Information of China (English)

    张佳夫; 李艳玲

    2016-01-01

    Objective To discuss the value of diagnosis of CRP and PCT in the differential diagnosis of bloodstream infection. Methods 217 cases of fever patients were put into positive group and negative group according to the blood culture. Detection of peripheral blood CRP and PCT levels in all patients. Based on the blood cultures were divided into gram positive and gram negative groups, and then detected the level of CRP and PCT. Results Positive group, the positive rate of PCT (99.16%) is higher than the negative group (30.61%) (P<0.05), positive group, the levels of CRP and PCT were higher than those of the negative group (P<0.05), leather gram positive serum PCT levels (3.48±1.15) ng/ml below the leather blue negative group (7.08±0.67) ng/ml (P<0.05). Conclusion CRP and PCT can be used as an indicator of blood flow infection, but PCT has high specificity, and the level of serum PCT in patients with gram positive bacterial infection was significantly lower than that of gram negative bacteria infection.%目的:探讨 C 反应蛋白(CRP)和降钙素原(PCT)对血流感染的诊断价值。方法对217例发热患者根据血培养分为阳性组和阴性组,对所有患者入院当天外周血 CRP 和 PCT 进行定量和定性检测,对血培养阳性患者根据病原菌革兰染色分为革兰染色阳性组和革兰染色阴性组,并进行 CRP 和 PCT 定量检测。结果阳性组 PCT 阳性率(99.16%)高于阴性组(30.61%)(P <0.05);阳性组 CRP 和 PCT水平均高于阴性组(P <0.05);革兰阳性组 PCT 水平(3.48±1.15) ng/ml 低于革兰阴性组(7.08±0.67)ng/ml(P <0.05)。结论 CRP 和PCT 均可作为初步判断血流感染的指标,但 PCT 具有较高的特异性,且革兰阳性菌感染患者血清 PCT 水平低于革兰阴性菌感染的患者。

  3. Bacteria form tellurium nanocrystals

    Science.gov (United States)

    Oremland, R.S.

    2007-01-01

    A team of researchers have found two bacterial species that produce tellurium oxyanions as respiratory electron acceptors for growth, leaving elemental tellurium in the form of nanoparticles. The crystals from the two organisms exhibit distinctively different structures. Bacillus selenitireducens initially forms nanorods that cluster together to form rosettes. Sulfurospirillum barnesii forms irregularly-shaped nanospheres that coalesce into larger composite aggregates.

  4. Generalized Maass Wave Forms

    OpenAIRE

    Mühlenbruch, Tobias; Raji, Wissam

    2012-01-01

    We initiate the study of generalized Maass wave forms, those Maass wave forms for which the multiplier system is not necessarily unitary. We then prove some basic theorems inherited from the classical theory of modular forms with a generalization of some examples from the classical theory of Maass forms.

  5. Adaptive municipal electronic forms

    NARCIS (Netherlands)

    Kuiper, Pieter; Dijk, van Betsy; Bondarouk, Tanya; Ruël, Huub; Guiderdoni-Jourdain, Karine; Oiry, Ewan

    2009-01-01

    Adaptation of electronic forms (e-forms) seems to be a step forward to reduce the burden for people who fill in forms. Municipalities more and more offer e-forms online that can be used by citizens to request a municipal product or service or by municipal employees to place a request on behalf of a

  6. Manufacturing processes 4 forming

    CERN Document Server

    Klocke, Fritz

    2013-01-01

    This book provides essential information on metal forming, utilizing a practical distinction between bulk and sheet metal forming. In the field of bulk forming, it examines processes of cold, warm and hot bulk forming, as well as rolling and a new addition, the process of thixoforming. As for the field of sheet metal working, on the one hand it deals with sheet metal forming processes (deep drawing, flange forming, stretch drawing, metal spinning and bending). In terms of special processes, the chapters on internal high-pressure forming and high rate forming have been revised and refined. On the other, the book elucidates and presents the state of the art in sheet metal separation processes (shearing and fineblanking). Furthermore, joining by forming has been added to the new edition as a new chapter describing mechanical methods for joining sheet metals. The new chapter “Basic Principles” addresses both sheet metal and bulk forming, in addition to metal physics, plastomechanics and computational basics; ...

  7. 血液病粒细胞缺乏患者医院血流感染的回顾性临床分析%Nosocomial bloodstream infections in neutropenic hematological patients:a retrospective clinical study

    Institute of Scientific and Technical Information of China (English)

    汤丽苑; 俞康

    2012-01-01

    OBJECTIVE To investigate the risk factors of nosocomial bloodstream infections in hematological patients with neutropenia, and analyze the distribution and antibiotic resistance of the pathogenic bacteria so as to provide basis for reduling the in cidence of blood stream infections and the mortality. METHODS A retrospective analysis of neutropenic patients with nosocomial bloodstream infections was performed from 2009 to 2011. RESULTS 1:2 matched case-control study showed the immunosuppressive therapy(OR = 6. 967),neutrophi<0. 2 ×109/L(OR = 28. 306), the duration of neutropenia<7 days(OR = 4. 383),MASCC risk index<21 scores (Multinational Association of Supportive Care of Cancer risk index score, OR — &9. 002) were important risk factors of nosocomial bloodstream infections in hematological patients with neutropenia; of totally 62 strains of pathogens isolated, gram-negative bacteria accounted for 64. 5%. gram-positive bacteria accounted for 27. 4%, and fungi accounted for 8. 1% , the most common pathogenic organisms identified were Escherichia coli(30. 6%) , Klebsiella pneumoniae (21. 0%) and Staphylococcus aureus (8. 1%) s the detection rates of ESBLs-producing strains of E.coli and K. pneumoniae were 47. 4% and 30. 8%, respectively. CONCLUSION It is critical to take effective measures and monitor the local bacterial epidemiology to control or decrease the morbidity and mortality of nosocomial bloodstream infections in hematological patients with neutropenia.%目的 分析血液病粒细胞缺乏患者血流感染的危险因素、病原菌分布及耐药性,为减少其血流感染的发病率及病死率提供依据.方法 对医院2009-2011年61例血液科粒细胞缺乏患者并发医院血流感染进行回顾性临床分析.结果 免疫抑制剂应用、中性粒细胞<0.2×109/L、中性粒细胞缺乏时间<7 d及癌症支持疗法多国学会风险指数<21分是血液病粒细胞缺乏患者医院血流感染的

  8. A subset of two adherence systems, acute pro-inflammatory pap genes and invasion coding dra, fim, or sfa, increases the risk of Escherichia coli translocation to the bloodstream.

    Science.gov (United States)

    Szemiako, K; Krawczyk, B; Samet, A; Śledzińska, A; Nowicki, B; Nowicki, S; Kur, J

    2013-12-01

    An analysis of the phylogenetic distribution and virulence genes of Escherichia coli isolates which predispose this bacteria to translocate from the urinary tract to the bloodstream is presented. One-dimensional analysis indicated that the occurrence of P fimbriae and α-hemolysin coding genes is more frequent among the E. coli which cause bacteremia. However, a two-dimensional analysis revealed that a combination of genes coding two adherence factors, namely, P + Dr, P + S, S + Dr, S + fim, and hemolysin + one adherence factor, were associated with bacteremia and, therefore, with the risk of translocation to the vascular system. The frequent and previously unrecognized co-existence of pro-inflammatory P fimbriae with the invasion promoting Dr adhesin in the same E. coli isolate may represent high-risk and potentially lethal pathogens.

  9. Maass Forms and Quantum Modular Forms

    Science.gov (United States)

    Rolen, Larry

    This thesis describes several new results in the theory of harmonic Maass forms and related objects. Maass forms have recently led to a flood of applications throughout number theory and combinatorics in recent years, especially following their development by the work of Bruinier and Funke the modern understanding Ramanujan's mock theta functions due to Zwegers. The first of three main theorems discussed in this thesis concerns the integrality properties of singular moduli. These are well-known to be algebraic integers, and they play a beautiful role in complex multiplication and explicit class field theory for imaginary quadratic fields. One can also study "singular moduli" for special non-holomorphic functions, which are algebraic but are not necessarily algebraic integers. Here we will explain the phenomenon of integrality properties and provide a sharp bound on denominators of symmetric functions in singular moduli. The second main theme of the thesis concerns Zagier's recent definition of a quantum modular form. Since their definition in 2010 by Zagier, quantum modular forms have been connected to numerous different topics such as strongly unimodal sequences, ranks, cranks, and asymptotics for mock theta functions. Motivated by Zagier's example of the quantum modularity of Kontsevich's "strange" function F(q), we revisit work of Andrews, Jimenez-Urroz, and Ono to construct a natural vector-valued quantum modular form whose components. The final chapter of this thesis is devoted to a study of asymptotics of mock theta functions near roots of unity. In his famous deathbed letter, Ramanujan introduced the notion of a mock theta function, and he offered some alleged examples. The theory of mock theta functions has been brought to fruition using the framework of harmonic Maass forms, thanks to Zwegers. Despite this understanding, little attention has been given to Ramanujan's original definition. Here we prove that Ramanujan's examples do indeed satisfy his

  10. Risk Factors and interventions for bloodstream infections after cardiac interventional therapy%心脏介入术后血管相关性血流感染因素分析及干预对策

    Institute of Scientific and Technical Information of China (English)

    赵雪芳; 狄韵漫

    2012-01-01

    目的 探讨心脏介入手术后发生中心静脉相关性血流感染因素及干预对策.方法 对心脏介入手术患者进行目标性临测及导管室的管理监控,分析、干预和总结感染因素.结果 通过开展目标性监测及干预对策,中心静脉导管相关性血流感染的感染率由开展前的1.9%下降为0,差异有统计学意义(P<0.01).结论 加强导管室管理,对介入手术进行监测和感染因素的干预,是预防心脏介入手术发生中心静脉导管相关性血流感染的有效方法.%OBJECTIVE To explore risk factors and intervention countermeasures for central venous catheter-related bloodstream infections after cardiac interventional therapy. METHODS By carrying out targeted surveillance in cardiac interventional therapy and monitoring of catheterization lab, the risk factors for the infections were analyzed, intervened, and summarized. RESULTS The incidence of the central venous catheter-related infections dropped from 1. 9% to 0 after the targeted surveillance and intervention countermeasures, and the difference was statistically significant (P<0. 01). CONCLUSION To strengthen the management of cauterization lab, monitor the interventional surgery, and intervene in the risk factors are effective ways to prevent central venous catheter-related bloodstream infections after cardiac interventional therapy.

  11. Clinical analysis of 74 cases of bloodstream infections caused by multidrug-resist-ant Acinetobacter%多重耐药不动杆菌属血流感染74例临床分析

    Institute of Scientific and Technical Information of China (English)

    邹颖; 徐晓刚; 郭庆兰; 李光辉

    2014-01-01

    Objective To study the clinical characteristics,antimicrobial restistance of bloodstream infections (bacteremia) caused by multidrug-resistant Acinetobacter and analyze the outcomes of antibacterial therapy.Methods The clinical data were reviewed retrospectively for 74 patients with bloodstream infection caused by multidrug-resistant Acinetobacter who were trea-ted in HuaShan hospital from January 2005 to December 2011 .Results During the 6-year period,74 patients were diagnosed with multidrug-resistant Acinetobacter bacteremia,73 of which were nosocomial infections.The remaining one was community-acquired. Primary bloodstream infection accounted for 51 .4% (38/74),and secondary infection 48.6% (36/74), mainly secondary to pulmonary infections (23.0%,17/74). Solid tumor was the most common underlying disease (24.3%,18/74).Prior corticosteroid therapy,indwelling deep venous catheter,surgery and invasive procedures were predisposing factors of bacteremia. Acinetobacter-related bloodstream infections were associated with higher white blood cell count,increased neutrophil percentage,higher APACHE II score and lower serum albumin level.The bloodstream infection was caused by Acinetobacter baumannii in 65 pa-tients,Acinetobacter lwoffi in 7 patients,both Acinetobacter baumannii and Acinetobacter junii in one patient.The all-cause mortality rate was 27.0% (20/74).In vitro susceptibility testing showed that 20.0% (15/75 )of the Acinetobacter isolates were resistant to cefoperazone-sulbactam,which was the lowest among all the antibiotics tested.About 40.0% to 42.7% of the isolates were resistant to carbapenems.The outcome was related to the antimicrobial restistance.Carbapenem non-suscepti-ble Acinetobacter was associated with poorer outcome compared with carbapenem-susceptible Acinetobacter (mortality 46.9%vs 11 .9%,P <0.05 ).Cefoperazone-sulbactam non-susceptible Acinetobacter was also associated with poorer outcome com-pared with cefoperazone-sulbactam susceptible

  12. 肿瘤医院ICU血流感染病原菌致炎症反应的比较%Comparison of inflammatory reaction between pathogenic bacteria bloodstream infections in ICU of tumor hospital

    Institute of Scientific and Technical Information of China (English)

    吴莉; 方敏峰; 许华; 杨峰

    2013-01-01

    目的 比较肿瘤医院ICU血流感染病原菌炎症反应指标及引起的临床表现与炎症反应程度,以此指导ICU严重感染患者的早期经验性抗菌药物选择.方法 回顾性分析入住ICU 48 h后血培养阳性患者60例,根据血培养结果,分为革兰阳性菌血流感染组及革兰阴性菌血流感染组,比较两组患者的一般资料及临床炎症反应的各项指标.结果 两组患者体温、心率、白细胞计数、中性粒细胞计数、C反应蛋白及降钙素原比较,差异均无统计学意义;革兰阳性菌血流感染组与革兰阴性菌血流感染组严重脓毒症或脓毒症休克发生率分别为4.1%与22.0%(P<0.05),血清脑肽素值分别为(112.0±15.2)pg/ml与(812.0±25.3) pg/ml(P<0.05),行机械通气感染率分别为75.0%与94.4% (P=0.016);两组肾脏替代治疗例数、ICU住院时间、临床死亡率分别为10例与12例、(34.3±16.5)与(26.0±27.1)d及12.50%与22.20%,两组比较差异无统计学意义;共分离出病原菌60株,其中革兰阴性菌36株占60.0%,以大肠埃希菌、肺炎克雷伯菌为主,分别占25.0%、11.7%,革兰阳性菌24株占40.0%,以金黄色葡萄球菌、肠球菌属为主,分别占16.7%、13.3%.结论 肿瘤医院ICU血流感染中革兰阴性菌的发生率偏高,与革兰阳性菌血流感染患者相比较,革兰阴性菌血流感染患者的炎症反应较重,临床表现严重,预后差.%OBJECTIVE To compare the clinical manifestations and the inflammatory reaction degrees caused by the pathogens causing bloodstream infections in the ICU of a tumor hospital so as to guide the empirical use of antibiotics for the ICU patient with severe infections.METHODS A total of 60 blood culture-positive patients,who have been hospitalized in the ICU for 48 hours,were enrolled in the study and divided into two groups(the gram-negative bacteria bloodstream infection patients and gram-positive bacteria bloodstream infection

  13. Forms of Arthritis

    Science.gov (United States)

    ... this page please turn Javascript on. Forms of Arthritis Past Issues / Fall 2006 Table of Contents Today, ... of Linda Saisselin Osteoarthritis (OA) — the form of arthritis typically occurring during middle or old age, this ...

  14. FORMS OF YOUTH TRAVEL

    OpenAIRE

    Moisã Claudia Olimpia

    2011-01-01

    Taking into account the suite of motivation that youth has when practicing tourism, it can be said that the youth travel takes highly diverse forms. These forms are educational tourism, volunteer programs and “work and travel”, cultural exchanges or sports tourism and adventure travel. In this article, we identified and analyzed in detail the main forms of youth travel both internationally and in Romania. We also illustrated for each form of tourism the specific tourism products targeting you...

  15. Method for forming ammonia

    Science.gov (United States)

    Kong, Peter C.; Pink, Robert J.; Zuck, Larry D.

    2008-08-19

    A method for forming ammonia is disclosed and which includes the steps of forming a plasma; providing a source of metal particles, and supplying the metal particles to the plasma to form metal nitride particles; and providing a substance, and reacting the metal nitride particles with the substance to produce ammonia, and an oxide byproduct.

  16. 导管相关血流感染临床分析%Clinical analysis of cathetei-related bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    卓婕; 孙永昌; 李莉; 李然

    2011-01-01

    目的 分析我院2008年1月至2010年12月重症监护病房(ICU)和普通病房导管相关血流感染(CRBSI)的发生情况,为CRBSI的预防和治疗提供依据.方法 将我院131例CRBSI病例分为ICU组和普通病房组,对临床资料、病原菌、导管位置、预后等进行回顾性分析.结果 ICU组(88例)和普通病房组(43例)在年龄和性别构成上差异无统计学意义(P>0.05).ICU组患者APACHE Ⅱ评分高于普通病房组(P=0.039).CRBSI在股静脉置管的患者中发生率最高.两组患者共培养出致病菌株152株.ICU组106株,其中革兰阳性球菌43株(40.6%),革兰阴性杆菌41株(38.7%),真菌22株(20.7%);普通病房组46株,其中革兰阳性球菌29株(63.0%).革兰阴性杆菌13株(28.3%),真菌4株(8.7%).因CRBSI导致死亡病例ICU组16例(18.2%),普通病房组4例(9.3%)(P>0.05).混合感染患者死亡率显著高于单一菌株感染(P=0.004).死亡病例感染病原菌前三位分别为真菌(12株)、肠球菌(6株)、铜绿假单胞菌(3株).结论 CRBSI在ICU和普通病房患者中病原菌分布存在差异,是抗菌药物选择和预后判断中需要考虑的因素.%Objective To study the incidence and pathogenic etiology of catheter-related bloodstream infection (CRBSI) in intensive care unit (ICU) and general ward, and to provide basis for the prevention and therapy of CRBSI. Methods 131 cases of CRBSI were divided into ICU group and general ward group. The clinical data, pathogens, catheter location, and prognosis were analyzed retrospectively. Results There was no statistical significance on age and gender between ICU group (88 cases) and general ward group (43 cases) ( P >0. 05). APACHE Ⅱ score in ICU group was higher than that in general ward group ( P =0.039). The incidence of CRBSI in the femoral vein was the highest. There were 152 pathogenic strains isolated from the two groups. There were 106 strains in ICU group, in which 43 strains (40.6%) were gram-positive cocci, 41

  17. Micro metal forming

    CERN Document Server

    2013-01-01

    Micro Metal Forming, i. e. forming of parts and features with dimensions below 1 mm, is a young area of research in the wide field of metal forming technologies, expanding the limits for applying metal forming towards micro technology. The essential challenges arise from the reduced geometrical size and the increased lot size. In order to enable potential users to apply micro metal forming in production, information about the following topics are given: tribological behavior: friction between tool and work piece as well as tool wear mechanical behavior: strength and formability of the work piece material, durability of the work pieces size effects: basic description of effects occurring due to the fact, that the quantitative relation between different features changes with decreasing size process windows and limits for forming processes tool making methods numerical modeling of processes and process chains quality assurance and metrology All topics are discussed with respect to the questions relevant to micro...

  18. Unified form language

    DEFF Research Database (Denmark)

    Alnæs, Martin S.; Logg, Anders; Ølgaard, Kristian Breum;

    2014-01-01

    We present the Unied Form Language (UFL), which is a domain-specic language for representing weak formulations of partial dierential equations with a view to numerical approximation. Features of UFL include support for variational forms and functionals, automatic dierentiation of forms and expres......We present the Unied Form Language (UFL), which is a domain-specic language for representing weak formulations of partial dierential equations with a view to numerical approximation. Features of UFL include support for variational forms and functionals, automatic dierentiation of forms...... and expressions, arbitrary function space hierarchies for multi-eld problems, general dierential operators and exible tensor algebra. With these features, UFL has been used to eortlessly express nite element methods for complex systems of partial dierential equations in near-mathematical notation, resulting...

  19. Regarding proton form factors

    OpenAIRE

    Bloch, J. C. R.; Krassnigg, A.; Roberts, C. D.

    2003-01-01

    The proton's elastic electromagnetic form factors are calculated using an Ansatz for the nucleon's Poincare' covariant Faddeev amplitude that only retains scalar diquark correlations. A spectator approximation is employed for the current. On the domain of q^2 accessible in modern precision experiments these form factors are a sensitive probe of nonperturbative strong interaction dynamics. The ratio of Pauli and Dirac form factors can provide realistic constraints on models of the nucleon and ...

  20. FLOW FORMING OF AEROENGINEMATERIALS

    OpenAIRE

    Kubilay, Ceylan

    2014-01-01

    Flow forming is a fairly new technique used for the production of dimensionallyaccurate near net shaped hollow components. The process has many advantagessuch as cost effectiveness and eliminating further operations like welding, machin-ing, etc. This study focuses on the characterization of flow formed componentsto understand the process. Flow formed components are composed of differentreductions and characterization techniques are applied to reveal the resulting mi-crostructural differences...

  1. Fractional Differential Forms

    OpenAIRE

    Cotrill-Shepherd, Kathleen; NAber, Mark

    2003-01-01

    A generalization of exterior calculus is considered by allowing the partial derivatives in the exterior derivative to assume fractional orders. That is, a fractional exterior derivative is defined. This is found to generate new vector spaces of finite and infinite dimension, fractional differential form spaces. The definitions of closed and exact forms are extended to the new fractional form spaces with closure and integrability conditions worked out for a special case. Coordinate transformat...

  2. Cooperative Station History Forms

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Various forms, photographs and correspondence documenting the history of Cooperative station instrumentation, location changes, inspections, and...

  3. PowerForms

    DEFF Research Database (Denmark)

    Brabrand, Claus; Møller, Anders; Ricky, Mikkel;

    2000-01-01

    such validation. Today, CGI programmers often use Perl libraries for simple server-side validation or program customized JavaScript solutions for client-side validation. We present PowerForms, which is an add-on to HTML forms that allows a purely declarative specification of input formats and sophisticated...... interdependencies of form fields. While our work may be seen as inspiration for a future extension of HTML, it is also available for CGI programmers today through a preprocessor that translates a PowerForms document into a combination of standard HTML and JavaScript that works on all combinations of platforms...

  4. 医院获得性铜绿假单胞菌血流感染的临床分析%Clinical analysis of hospital-acquired bloodstream infections due to Pseudomonas aeruginosa

    Institute of Scientific and Technical Information of China (English)

    文亚坤; 曹萌; 邹琳; 俞森洋; 孙宝君

    2013-01-01

    目的 分析医院获得性铜绿假单胞菌血流感染的临床特征及死亡相关因素,为临床诊治提供参考依据.方法 回顾性分析医院2010年1月-2011年12月由铜绿假单胞菌引起的医院获得性血流感染患者临床资料,根据是否暴露于危险因素进行死亡相关单因素及多因素分析,单因素分析分别比较不同危险因素之间死亡率的差异,多因素分析采用logistic回归分析.结果 51例血流感染患者98.0%出现发热,72.5%伴寒颤;31.4%有血液系统疾病,白细胞、中性粒细胞低于正常值,余患者中97.1%白细胞或(和)中性粒细胞升高;37.3%为导管相关性血流感染,35.3%发生感染性休克;病死率为29.4%,死亡相关单因素分析显示,年龄≥70岁、糖尿病、心脏疾病、肺部感染、血白蛋白< 30 g/L、血红蛋白<90 g/L、有创机械通气、血液透析、入住ICU与死亡相关;logistic回归分析显示,糖尿病、血红蛋白<90 g/L是死亡相关因素.结论 医院获得性铜绿假单胞菌血流感染多伴有发热、寒颤、白细胞或(和)中性粒细胞升高,糖尿病、血红蛋白<90 g/L为死亡相关因素.%OBJECTIVE To study the clinical characteristics and factors associated with mortality of nosocomial bloodstream infections due to Pseudomonas aeruginosa so as to provide reference for the clinical diagnosis and treatment. METHODS The clinical data of the patients with bloodstream infections caused by P. aeruginosa from Jan 2010 to Dec 2011 were analyzed retrospectively. According to the exposure to the risk factors, both the univariate factor analysis and the multivariate analysis were performed for the risk factors associated with the mortality. The univariate analysis was performed by comparing the mortality due to the various risk factors between the two groups, and logistic regression analysis was performed to analyze the multiple factors. RESULTS Of totally 51 patients with

  5. Early diagnostic value of combined inflammatory cytokines in bloodstream infection with different organisms%早期联合测定炎症因子对不同病原菌血流感染的鉴别诊断价值

    Institute of Scientific and Technical Information of China (English)

    陈炜; 牛素平; 臧学峰; 赵磊; 盛博

    2015-01-01

    Objective To investigate the expression of procalcitonin (PCT) and C-reactive protein (CRP),and endotoxin in bloodstream infection with different microorganisms,so as to assess the value of these inflammatory cytokines in early diagnosis of sepsis in bloodstream infections patients.Methods Data of 152 septic bloodstream infected patients with 90 male and 62 female aged from 62 to 102 years and 79.2 ± 16.3 years in average admitted from January 2012 to December 2013 were analyzed retrospectively.According to the results of blood culture,the microorganisms could be categorized into gram-negative bacteria,gram-positive bacteria and fungus groups,and the levels of serum CRP,PCT,and endotoxin were compared among these groups of bloodstream infections patients within 24 hours after admission.Results (1) A total of 152 strains of microorganisms were surveyed including 92 gram-negative strains (61.18%),43 gram-positive strains (28.29%),and 16 fungal strains (10.53%).In the gram-negative strains,Klebsiella pneumoniae (n =29),Acinetobacter baumannii (n =24),Escherichia coli (n =23),Burkholderia cepacia (n =9) and Pseudomonas aeruginosa (n =4) were the most common isolates.In the Gram-positive strains,13 strains of Staphylococcus aureus were isolated.(2) In the gram-negative bacterial bloodstream infections group,there were 60 (64.52%) patients with endotoxin positive,and there were no endotoxin positive cases with detected gram-positive bacteria and fungal bloodstream infections.The median levels of PCT were significantly different among the three groups [gram-negative strains group:7.760 (3.365,28.585) ng/mL,gram-positive strains group:0.705 (0.265,3.225) ng/mL,fungal infection group:1.245 (0.543,1.998) ng/mL].In the fungal bloodstream infection group,the mean level of CRP was higher than that in other two groups [gram-negative strains group:(126.01 ± 66.53) mg/L,gram-positive strains group:(77.58 ±54.21) mg/L,fungal infection group:(140.14 ±71.21) mg/L].(3) The

  6. Method of forming nanodielectrics

    Science.gov (United States)

    Tuncer, Enis [Knoxville, TN; Polyzos, Georgios [Oak Ridge, TN

    2014-01-07

    A method of making a nanoparticle filled dielectric material. The method includes mixing nanoparticle precursors with a polymer material and reacting the nanoparticle mixed with the polymer material to form nanoparticles dispersed within the polymer material to form a dielectric composite.

  7. Mastering HTML5 forms

    CERN Document Server

    Gupta, Gaurav

    2013-01-01

    This tutorial will show you how to create stylish forms, not only visually appealing, but interactive and customized, in order to gather valuable user inputs and information.Enhance your skills in building responsive and dynamic web forms using HTML5, CSS3, and related technologies. All you need is a basic understanding of HTML and PHP.

  8. Baryon form factors

    CERN Document Server

    Kubis, B; Meißner, Ulf G; Mei{\\ss}ner, Ulf-G.

    1999-01-01

    We calculate the form factors of the baryon octet in the framework of heavy baryon chiral perturbation theory. The calculated charge radius of the show that kaon loop effects can play a significant role in the neutron electric form factor. Furthermore. we derive generalized Caldi-Pagels relations between various charge radii which are free of chiral loop effects.

  9. Forming of Laminates

    NARCIS (Netherlands)

    De Jong, T.W.

    2004-01-01

    Fibre-Metal-Laminates have excellent properties for aerospace applications, with GLARE as an example. The metal layers inside the laminate provide permanent plastic deformations for the whole laminate; in principle Fibre-Metal-Laminates can be formed with common sheet metal forming processes. The d

  10. 血管内导管相关性血流感染的病原菌分布及耐药分析%Distribution and drug resistance of pathogens causing intravascular catheter-related bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    王晓峰; 蔡福景; 孙庆丰; 吴杨荷; 李克诚; 丁继光

    2012-01-01

    OBJECTIVE To analyze the distribution and drug resistance of the pathogens causing intravascular catheter-related bloodstream infections, so as to direct the treatment of intravascular catheter-related infections. METHODS A total of 35 patients diagnosed as intravascular catheter-related infections were retrospectively analyzed, the distribution and drug resistance of the pathogens were statistically significant. RESULTS A total of 41 strains of pathogens were isolated from 35 patients, gram-positive bacteria accounted for 56. 10% , 43. 90% of which were Staphylococcus, gram-negative bacteria accounted for 39. 02%, 12. 20% of which were Acinetobacter and Klebsiella, fungi accounted for 4. 88% ; the drug resistance rates of gram-positive bacteria to teicoplanin and vancornycin were 0, the resistance rates to rifampicin and tetracycline were 18. 18% and 13. 64%; the drug resistance rates of gram-negative bacteria to amikacin, cefoperazone/sulbactam, meropenem and imipenem were 25.00%; no strains of fungi resistant to fluconazole, itraconazole, amphotericin B and 5-fluorocytosine. CONCLUSION It's very important for the treatment of intravascular catheter-related bloodstream infections to learn about the distribution and drug resistance of the pathogens causing intravascular catheter-related bloodstream infections.%目的 分析血管内导管相关性血流感染的病原菌分布及耐药性,指导血管内导管相关性血流感染的治疗.方法 对医院确诊为血管内导管相关性血流感染的35例患者进行回顾性分析病原菌分布及其耐药性.结果 35例患者共检出41株病原菌,其中革兰阳性菌占56.10%,以葡萄球菌属为主,占43.90%,革兰阴性菌占39.02%,以不动杆菌属、克雷伯菌属为主,均占12.20%,真菌占4.88%;革兰阳性菌对替考拉宁、万古霉素耐药率均为0,对利福平、四环素耐药率为18.18%、13.64%;革兰阴性菌对阿米卡星、头孢哌酮/舒巴坦、亚

  11. 严重肝病伴糖尿病患者大肠埃希菌血流感染临床分析%Clinical analysis of bloodstream infections caused by Escherichia coli in severe liver diseases compared with diabetes

    Institute of Scientific and Technical Information of China (English)

    何卫平; 崔恩博; 蔡少平; 鲍春梅; 张文瑾; 范振平; 曲芬

    2014-01-01

    Objective To investigate the clinical characteristic and drug resistance of bloodstream infections caused by Escherichia coli (E.coli)in patients with severe liver diseases and diabetes,and to provide evidence for optimal therapy of antibiotics in clinical practice. Methods The clinical features and drug susceptibility of E.coli-caused bloodstream infections among inpatients with severe liver diseases and diabetes from 2009 to 2012 were analyzed retrospectively. Results A total of 47 strains of E. coli were isolated from those inpatients,among which 22 strains of extended-spectrumβ-lactamases (ESBLs)(46.81% )were positive. The overwhelming majority patients were liver cirrhosis with infection resulting from spontaneous bacterial peritonitis. The drug resistance of ESBLs-positive strains was higher than that of ESBLs-negative strains,with no statistical differences existed in age,sex,basic disease,infection source,peak temperature,white blood cell count and the percentage of neutrophils between ESBLs-positive strains and negative strains. Mortality rate in patients accompanied with septic shock was higher than that in patients without shock. Conclusion Due to the severity and bad prognosis of bloodstream infection,early identification and comprehensive treatment should be taken to reduce mortality.%目的:分析严重肝病伴糖尿病患者大肠埃希菌血流感染的临床特点及耐药性,为临床合理应用抗菌药物提供依据。方法回顾性分析2009年至2012年住院的严重肝病合并糖尿病血流感染大肠埃希菌患者的临床特点及药敏结果。结果严重肝病合并糖尿病血流感染大肠埃希菌患者共47例,基础疾病以肝硬化为主,感染来源以自发性细菌性腹膜炎为主,ESBL阳性22株,阳性率46.81%。ESBL阳性大肠埃希菌耐药性高于 ESBL 阴性大肠埃希菌,但两者在年龄、性别、基础疾病、原发病灶、体温峰值、白细胞计数及中性粒细胞百分比

  12. 重症急性胰腺炎患者肠屏障功能障碍与血流感染的关系研究%Relationship between intestinal barrier dysfunction and bloodstream infection of patients with severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    陈力; 卢燕

    2015-01-01

    目的:研究重症急性胰腺炎患者肠屏障功能障碍与血流感染的关系。方法统计分析2012年5月至2015年5月本院收治的重症急性胰腺炎患者80例的临床资料。结果合并血流感染组患者的 APACHE Ⅱ评分显著高于非血流感染组(P<0.05),住 ICU 时间显著长于非血流感染组(P<0.05),4周病死率15.0%(6/40)显著低于非血流感染组5.0%(2/40)(P<0.05);合并血流感染组和非血流感染组患者入院后第1、3、7d 的 L/M 、ET 、累及器官数之间的差异均显著(P<0.05);合并血流感染组患者入院后第1、3、7d 的 L /M 、ET 均逐渐升高,非血流感染组患者入院后第1、3、7d 的 L/M 、ET 均逐渐降低,L /M 、ET 呈显著的正相关关系(P<0.05)。结论重症急性胰腺炎患者肠屏障功能障碍与血流感染密切相关,值得临床充分重视。%Objective To study the relationship between intestinal barrier dysfunction and bloodstream infec‐tion of patients with severe acute pancreatitis .Methods The clinical data of 80 cases of patients with severe acute pancreatitis in our hospital from May 2012 to May 2015 were statistically analyzed .Results The APACHE Ⅱ score of combined bloodstream infections group was significantly higher (P< 0 .05) ,the duration of ICU stay was signifi‐cantly longer (P< 0 .05) ,the 4‐week mortality rate 15 .0% (6 / 40) was significantly lower than non bloodstream in‐fection group 5 .0% (2/40) (P< 0 .05) ;The differences of L / M ,ET ,involving the number of organs after admis‐sion 1 ,3 ,7 d between the combined bloodstream infections group and non bloodstream infection group were signifi‐cant (P< 0 .05) ;The L / M ,ET after admission 1 ,3 ,7 d of the combined bloodstream infections group were gradual‐ly increased ,The L / M ,ET after admission 1 ,3 ,7d of the non bloodstream infection group decreased gradually ,L /M ,ET showed

  13. Impact of Cluster of Intervention Strategies on CRRT Central Venous Catheter-related Bloodstream Infections%集束化干预策略对CRRT中心静脉导管相关性血行感染的影响

    Institute of Scientific and Technical Information of China (English)

    陈刚; 黄晓铭; 陈鑫鑫

    2014-01-01

    Objective To explore the cluster intervention strategies for CRRT central venous catheter related bloodstream infections (hereinafter referred to as CRBIS). Methods Retrospective analysis of our department in August 2012-February 2013 lines of central venous catheter and conventional CRRT infection intervention measures of patients 150 cases (control group) and March 2013-September 2013 lines of central venous catheter and CRRT in 196 patients with cluster intervention strategies (observation group), compared two groups of patients the incidence of CRBIS, ICU hospitalization days and hospitalization expenses, etc. Results Cluster intervention strategies significantly reduce the rate of catheter-related bloodstream infection, which reduces the patients in ICU time, reduced the cost of patients. Conclusion Cluster intervention strategy can decrease the CRRT CRBIS rate of femoral vein, but need to improve the clinical compliance.%目的:探讨集束化干预策略对CRRT中心静脉导管相关性血流感染(以下简称 CRBIS)的影响。方法回顾性对比分析我科2012年8月~2013年2月行CRRT中心静脉导管并按常规实施感染干预措施的患者150例(对照组)与2013年3月~9月行CRRT中心静脉导管并按集束化干预策略患者196例(观察组),比较两组患者的CRBIS发生率、ICU 住院天数、住院费用等。结果集束化干预策略明显降低导管相关性血行感染,从而降低了患者入住 ICU时间,减少了患者费用。结论集束化干预策略可降低CRRT股静脉的CRBIS率,但需提高临床的依从性。

  14. Prevenção da infecção da corrente sanguínea relacionada ao cateter venoso central: Uma revisão integrativa | Prevention of bloodstream infection related to central venous catheter: An integrative review

    Directory of Open Access Journals (Sweden)

    Alanna Gomes da Silva

    2016-05-01

    Full Text Available Objetivo: Analisar as produções científicas nacionais e internacionais sobre a adoção aos bundles para prevenção de infecção da corrente sanguínea relacionada ao cateter venoso central em unidade de terapia intensiva adulto. Métodos: Foi realizada uma revisão integrativa da literatura nas bases de dados Pubmed, Cinahl e Science Direct, publicados de 2011 a 2014. Resultados: Foram encontrados 11 artigos e em 100% deles as principais medidas adotadas foram antes da inserção do cateter, sendo: antissepsia da pele, uso de barreira máxima de precaução, preferência pela veia subclávia, higienização prévia das mãos e educação e treinamento dos profissionais de saúde. Conclusões: Os bundles estão sendo utilizados na prática clínica como estratégias para redução das infecções, contudo, as infecções da corrente sanguínea relacionadas a cateter continuam a ocorrer de forma alarmante e com grande impacto no cuidado a saúde. Desse modo, estratégias que apontem subsídios para melhoria da prática clínica e segurança do paciente devem ser incentivadas, sobretudo aquelas voltadas para o período crítico da inserção e manutenção do cateter. -----------------------------------------------------------------------------------------------Objective: To analyze the national and international scientific production on the adoption of bundles to prevent bloodstream infection related to central venous catheters in adult intensive care unit. Methods: An integrative literature review of studies published from 2011 to 2014 was conducted in the databases Pubmed, CINAHL and Science Direct. Results: 11 articles were found. In all of them the principal measures adopted before catheter insertion were: skin antisepsis, use of maximum barrier precaution, preference by the subclavian vein, previous hand hygiene, and education and training of health professionals. Conclusions: The bundles are being used in clinical practice as

  15. The clinical significance of procalcitonin in patients with bacterial bloodstream infection%降钙素原在细菌性血流感染患者中的临床意义

    Institute of Scientific and Technical Information of China (English)

    冷凌涵; 王平; 张丽涓

    2014-01-01

    Objective To investigate the clinical significance of serum procalcitonin (PCT) levels in distinguishing growth of Gram-positive and gram negative bacteria in blood culture.Methods icU patients with positive blood culture were divided into Gram-negative bacteria group and Gram-positive bacteria group, with 25 cases in each group. the serum procalcitonin in two groups were detected by quantitative determination, results of which were compared in statistics. Results the Pct level in blood culture results of growth of Gram-negative bacteria patients was (60.556 ± 38.816) ng / ml, which was significantly higher than (15.397 ± 15.657) ng / ml in Gram-positive bacteria group. The difference was statistically significant (P <0.05 ). Conclusion The procalcitonin level in patients with bloodstream Gram-negative bacteria infections was significantly higher than that in patients with bloodstream Gram-positive bacteria infections. determination of Pct was in favor of judging early bacterial infection category and guiding the early antibacterial agent selection.%目的:探讨患者血清降钙素原(Pct)水平对区别血培养生长革兰阳性菌及阴性菌的临床意义。方法对 icU 患者血培养阳性者分为革兰阴性菌组及革兰阳性菌组,每组患者各25例,对两组患者血清降钙素原进行定量测定,并对定量测定结果进行统计学比较。结果血培养生长革兰阴性菌患者 Pct 定量为(60.556±38.816)ng/ml,显著高于革兰阳性菌组 Pct(15.397±15.657)ng/ml,差异有统计学意义(P <0.05)。结论革兰阴性菌血流感染患者的降钙素原水平明显高于革兰阳性菌血流感染患者,Pct 测定有利于早期判断细菌感染的类别,指导早期抗菌药物选择。

  16. Clinical effectiveness and cost-effectiveness of central venous catheters treated with Minocycline and Rifampicin in preventing bloodstream infections in intensive care patients [Medizinische Wirksamkeit und Kosteneffektivität von Minocyclin/Rifampicin-beschichteten zentralvenösen Kathetern zur Prävention von Blutbahninfektionen bei Patienten in intensivmedizinischer Betreuung

    OpenAIRE

    Neusser, Silke; Bitzer, Eva Maria; Mieth, Ingeborg; Krauth, Christian

    2012-01-01

    [english] The use of central venous catheters coated with antibiotics can avoid bloodstream infections with intensive care patients. This is the result of a scientific examination which has been published by the DIMDI. Costs could be also saved in this way. However, according to the authors, the underlying studies do not allow absolutely valid statements.[german] Der Einsatz bestimmter Antibiotika-beschichteter Venenkatheter kann bei Intensivpatienten Blutbahninfektionen vermeiden. So das Erg...

  17. FormCalc 7

    CERN Document Server

    Agrawal, S; Mirabella, E

    2011-01-01

    We present additions and improvements in Version 7 of FormCalc, most notably analytic tensor reduction, choice of OPP methods, and MSSM initialization via FeynHiggs, as well as a parallelized Cuba library for numerical integration.

  18. Nucleon Form Factors

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis de Jager

    2004-09-01

    The experimental and theoretical status of elastic electron scattering from the nucleon is reviewed. As a consequence of new experimental facilities, data of unprecedented precision have recently become available for the electromagnetic and the strange form factors of the nucleon.

  19. VMS forms Output Tables

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These output tables contain parsed and format validated data from the various VMS forms that are sent from any given vessel, while at sea, from the VMS devices on...

  20. Getting in-formed

    DEFF Research Database (Denmark)

    Hansbøl, Mikala

    det vi undersøger på form gennem vores beskrivelser. Paperet tager afsæt i empiriske eksempler fra et postdoc projekt om et såkaldt 'serious game' - Mingoville. Projektet følger circuleringer og etableringer af Mingoville 'på en global markedsplads'. I paperet diskuteres hvordan vi som forskere samler....../performer de fænomener vi forsker i. Aktør-Netværks-Teoretiker Bruno Latour (2005) pointerer at enhver beskrivelse også er en form for forklaring. En form for forklaring, der putter ting ind i et skript og dermed også putter ting på form. Paperet diskuterer to tilgange til at gøre serious games og derved skabe viden om...... engagementer med disse fænomener i serious games forskning: experimentel og etnografisk....

  1. NOAA Form 370 Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The data set contains information from submitted NOAA Form 370s, also known as the Fisheries Certificate of Origin, for imported shipments of frozen and/or...

  2. FORM, Diagrams and Topologies

    CERN Document Server

    Herzog, Franz; Ueda, Takahiro; Vermaseren, J A M; Vogt, Andreas

    2016-01-01

    We discuss a number of FORM features that are essential in the automatic processing of very large numbers of diagrams as used in the Forcer program for 4-loop massless propagator diagrams. Most of these features are new.

  3. MAPS Appraisal Report Form

    CERN Multimedia

    HR Department

    2005-01-01

    As announced in Weekly Bulletin 48/2004, from now onwards, the paper MAPS appraisal report form has been replaced by an electronic form, which is available via EDH (on the EDH desktop under Other Tasks / HR & Training) No changes have been made to the contents of the form. Practical information will be available on the web page http://cern.ch/ais/projs/forms/maps/info.htm, and information meetings will be held on the following dates: 18 January 2005: MAIN AUDITORIUM (500-1-001) from 14:00 to 15:30. 20 January 2005: AB AUDITORIUM II (864-1-D02) from14:00 to 15:30. 24 January 2005: AT AUDITORIUM (30-7-018) from 10:00 to 11:30. Human Resources Department Tel. 73566

  4. Access Customized Forms

    OpenAIRE

    Cosma Emil; Jeflea Victor

    2010-01-01

    By using Word, Excel or PowerPoint one can automate routine operations using the VBA language (Visual Basic for Applications). This language is also used in Access, allowing access to data stored in tables or queries. Thus, Access and VBA resources can be used together. Access is designed for programming forms and reports (among other things), so there won’t be found any of the VBA editor’s specific forms.

  5. Electromagetic proton form factors

    OpenAIRE

    Hussein, M Y

    2006-01-01

    The electromagnetic form factors are crucial to our understanding of the proton internal structure, and thus provide a strong constraint of the distributions of the charge and magnetization current within the proton. We adopted the quark-parton model for calculating and understanding the charge structure of the proton interms of the electromagnetic form factors. A remarkable agreement with the available experimental evidence is found.

  6. The Literary Form

    OpenAIRE

    Compagnon, Antoine

    2015-01-01

    Wondering if there was anything new that could be said about literary forms, styles and genres, I was pleasantly surprised to notice that automated word processing, with its iterative review and algorithmic method, suggests the possibility of statistically surveying literary styles and genres. Digital Humanities, which are poorly developed in France, could contribute to the analysis of literary forms and the renewal of the theory of genres. As is often the case, it was while seeking to reso...

  7. FormFlavor Manual

    CERN Document Server

    Evans, Jared A

    2016-01-01

    This manual describes the usage and structure of FormFlavor, a Mathematica-based tool for computing a broad list of flavor and CP observables in general new physics models. Based on the powerful machinery of FeynArts and FormCalc, FormFlavor calculates the one-loop Wilson coefficients of the dimension 5 and 6 Standard Model effective Lagrangian entirely from scratch. These Wilson coefficients are then evolved down to the low scale using one-loop QCD RGEs, where they are transformed into flavor and CP observables. The last step is accomplished using a model-independent, largely stand-alone package called FFObservables that is included with FormFlavor. The SM predictions in FFObservables include up-to-date references and accurate current predictions. Using the functions and modular structure provided by FormFlavor, it is straightforward to add new observables. Currently, FormFlavor is set up to perform these calculations for the general, non-MFV MSSM, but in principle it can be generalized to arbitrary FeynArts...

  8. 鲍曼不动杆菌血流感染预后的危险因素分析%Analysis of risk factors on prognosis of Acinetobacter baumannii bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    乔莉; 张劲松; 梅亚宁; 张华忠; 苏成磊

    2013-01-01

    Objective To explore the risk factors on prognosis of Acinetobacter baumannii bloodstream infection.Methods Clinical data from 78 patients with Acinetobacter baumannii bloodstream infection hospitalized in First Affiliated Hospital of Nanjing Medical University from January 2010 to November 2012 were analyzed retrospectively.According to the 28-day prognosis after admission,the patients were divided into non-survivors (n=40) and survivors (n=38).Data on demographic and clinical characteristics,wards,underlying diseases,treatments,invasive medical procedures,bacterial resistance to antibiotics,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the beginning were collected.The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis.The predictor value was concluded by comparing area under the receiver operating characteristic curve (ROC curve) of each index.Results Risk factors of mortality of Acinetobacter baumannii bloodstream infection goes as following,including intensive care unit admission [ICU,odds ratio (OR)=12.9,95% confidence interval (95% CI) 2.4-63.5,P=0.001],trachea intubationor tracheostomy (OR =6.2,95% CI 1.5-30.4,P=0.023),invasive mechanical ventilation (OR =5.1,95% CI 1.4-22.6,P=0.042),invasive medical procedure besides central venous catheter (including thoracentesis,bone marrow puncture,lumbar puncture,catheterization,bronchoalveolar lavage with bronchofibroscope,arteriovenous fistula plastic operation,OR =8.4,95%CI 1.7-37.8,P=0.011),APACHE Ⅱ score ≥ 19 in the beginning (OR=35.4,95%CI 3.8-318.6,P=0.001).With respect to APACHE Ⅱ score ≥ 19 as mortality cut-off point,an area under the receiver operating curve of 0.938 was statistically significant (P<0.05),with sensitivity 76.2% and specificity 94.1%.The relationship between prognosis and antibiotic resistance did not have statistically significance.Conclusion Invasive medical procedures and

  9. 鲍曼不动杆菌血流感染临床特征和死亡危险因素分析%Analysis of clinical manifestations and risk factors of mortality in Acinetobacter baumannii bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    张银维; 周华; 蔡洪流; 杨青; 沈茜; 沈毅弘; 周建英

    2016-01-01

    Objective To explore the clinical manifestations,antimicrobial therapy,and risk factors of mortality in patients with Acinetobacter baumannii bloodstream infection.Methods Clinical data of 153 patients with Acinetobacter baumannii bloodstream infection hospitalized in First Affiliated Hospital of Zhejiang University from January 2013 to September 2014 were analyzed retrospectively.According to the 28-day survival after diagnosis,the patients were divided into death group (n =76) and survival group (n =77).Data related to demographic and clinical characteristics,underlying diseases,treatment,invasive procedures,bacterial resistance to antibiotics,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)scores at onset,and antimicrobial therapy were collected.The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis.Results This study included 153 patients with Acinetobacter baumannii bloodstream infection.The 28-day mortality was 49.7%.The independent risk factors of mortality were APACHE Ⅱ score ≥22 at onset (OR =15.7,95% CI 5.1-48.1,P < 0.001),septic shock (OR =6.3,95 % CI 1.9-21.3,P =0.003),and administration of steroids (OR =3.6,95% CI 1.0-12.3,P =0.043).Compared with subjects treated with non-cefoperazone-sulbactam-based regimen,those treated with cefoperazone-sulbactam for multidrug-resistant Acinetobacter baumannii (MDR-AB) had significantly lower mortality on day7,day14 and day28 (8.9% vs 59.2%,31.1% vs 65.8%,44.4% vs 72.4% respectively).Conclusions The patients with Acinetobacter baumannii bloodstream infection have high mortality within one month.Administration of steroids and septic shock are associated with poor prognosis.APACHE Ⅱ score ≥ 22 at onset predicts adverse outcome.Cefoperazone-sulbactam-based antimicrobial therapy improves patients' survival.%目的 探讨鲍曼不动杆菌血流感染患者的临床特征、抗菌药物治疗

  10. 失代偿期肝硬化患者大肠埃希菌血流感染临床及预后分析%Clinical and prognostic analysis of decompensated cirrhosis patients Escherichia coil bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    何卫平; 杨柳; 鲍春梅; 张文瑾; 崔恩博; 蔡少平; 范振平; 曲芬

    2015-01-01

    Objective To investigate the clinical characteristic and drug resistance of decompensated cirrhosis patients bloodstream infections causing by Escherichia coli,and determine risk factors for mortality among patients with bloodstream infections.Methods The clinical data and drug susceptibility of decompensated cirrhosis patients Escherichia coli bloodstream infections from 2009 to 2012 in 302 hospital of PLA were retrospectively analyzed.Univariable and multivariable Logistic regression was used to identify independent risk factors for all-cause mortality.Results A total 211 strains of E.coli were isolated from decompensated cirrhosis inpatients,80 strains ESBLs detecting were positive,positive rate was 37.9%.Most of infection source were uncertain.The drug resistance of ESBLs positive strains was higher than ESBLs negative strains,but no statistical difference existed in age,sex,basic disease,infection source,peak temperature,white blood cell count,the percentage of neutrophils between ESBLs positive strains and negative strains.154 patients were survived and 57 patients were died after treatment,with a mortality of 27.01%.On multivariate analysis,independent risk factors for in-hospital mortality were old age [odds ratio (OR) =2.429],abnormal pulse (OR =2.977),liver failure (OR =11.159),hepatic encephalopathy(OR =2.524),septic shock (OR =8.837),acute kidney injury (OR =3.758),gastrointestinal bleeding(OR =4.118).Body temperature of > 39 ℃ (OR =0.301) had protective effect to lower mortality.A Logistic probobility model was created by adding points for each independent risk factor,and had a c-statistic of 0.898.Conclusions Due to decompensated cirrhosis patients Escherichia coli bloodstream infection severity and bad prognosis,early effective antimicrobial therapy and severe complication prevention should be taken to reduce mortality.%目的 分析失代偿期肝硬化患者大肠埃希菌血流感染的临床特点及耐药性,探讨影响疾

  11. Constitute and antifungal susceptibility of Candida spp . causing blood-stream infection%血流感染假丝酵母菌菌种构成及其药物敏感性

    Institute of Scientific and Technical Information of China (English)

    徐鸣皋; 丁进亚; 徐娟; 孙洁

    2016-01-01

    Objective To analyze the constitute and antifungal susceptibility of Candida spp . causing bloodstream infection in a hospital,so as to provide evidence for the prevention and treatment of bloodstream infection caused by Candida spp .Methods Candida spp . isolated from blood specimens of clinical patients in a hospital between 2009 and 2013 were analyzed retrospectively,the high risk factors for Candida bloodstream infection were analyzed. Results A total of 42 isolates of Candida spp . were isolated from blood specimens of 42 patients between 2009 and 2013,the major was Candida parapsilosis (C.parapsilosis ,n =20,47.62%),followed by C.albicans (n =16, 38.10%),C.tropicalis (n=4,9.52%),and C.glabrata(n=2,4.76%).Candida spp .were mainly distributed in emergency intensive care unit(n=11),departments of urologic surgery (n=9)and cardiothoracic surgery(n=8). The venous catheters of 37 patients(88.10%)were isolated the same Candida spp . as blood culture,the average time from indwelling venous catheters to positive culture of blood and catheters were 31 .47 and 33.18 days respec-tively;the percentage of positive culture for blood and catheters both increased with the prolongation of catheteriza-tion (both P < 0.001 ).Susceptibility rates of Candida spp . to fluconazole and voriconazole were 75.00% -100.00%,to amphotericin B were all 100.00%,to itraconazole varied significantly with different species (0 -87.50%).Conclusion The major Candida strains causing bloodstream infection in this hospital is C.parapsilosis , and is related to the use of intravenous catheters,susceptibility rates to fluconazole,amphotericin B,and voricon-azole are all high.%目的:分析某院假丝酵母菌血流感染菌种构成及其对抗真菌药物的敏感性,为临床预防和治疗假丝酵母菌血流感染提供依据。方法回顾性分析2009—2013年该院临床科室送检血标本中检出的假丝酵母菌,并对假丝酵母菌血流感染的高

  12. Methods for forming particles

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Robert V.; Zhang, Fengyan; Rodriguez, Rene G.; Pak, Joshua J.; Sun, Chivin

    2016-06-21

    Single source precursors or pre-copolymers of single source precursors are subjected to microwave radiation to form particles of a I-III-VI.sub.2 material. Such particles may be formed in a wurtzite phase and may be converted to a chalcopyrite phase by, for example, exposure to heat. The particles in the wurtzite phase may have a substantially hexagonal shape that enables stacking into ordered layers. The particles in the wurtzite phase may be mixed with particles in the chalcopyrite phase (i.e., chalcopyrite nanoparticles) that may fill voids within the ordered layers of the particles in the wurtzite phase thus produce films with good coverage. In some embodiments, the methods are used to form layers of semiconductor materials comprising a I-III-VI.sub.2 material. Devices such as, for example, thin-film solar cells may be fabricated using such methods.

  13. How Do Friendships Form?

    OpenAIRE

    Bruce Sacerdote; David Marmaros

    2005-01-01

    We examine how people form social networks among their peers. We use a unique dataset that tells us the volume of email between any two people in the sample. The data are from students and recent graduates of Dartmouth College. First year students interact with peers in their immediate proximity and form long term friendships with a subset of these people. This result is consistent with a model in which the expected value of interacting with an unknown person is low (making traveling solely t...

  14. Sixth form pure mathematics

    CERN Document Server

    Plumpton, C

    1968-01-01

    Sixth Form Pure Mathematics, Volume 1, Second Edition, is the first of a series of volumes on Pure Mathematics and Theoretical Mechanics for Sixth Form students whose aim is entrance into British and Commonwealth Universities or Technical Colleges. A knowledge of Pure Mathematics up to G.C.E. O-level is assumed and the subject is developed by a concentric treatment in which each new topic is used to illustrate ideas already treated. The major topics of Algebra, Calculus, Coordinate Geometry, and Trigonometry are developed together. This volume covers most of the Pure Mathematics required for t

  15. Analysis of clinical distribution and drug resistance of bloodstream infections caused by Klebsiella pneumoniae%肺炎克雷伯菌血流感染的临床分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    查翔远; 宋有良; 林建; 崔小玲; 潘晓龙; 倪世峰

    2015-01-01

    Objective To study the clinical distribution and antimicrobial resistance of bloodstream infections caused by Klebsiella pneumoniae .Methods Patients with bloodstream infection caused by Klebsiella pneumoniae in Tongling People's Hospital in Anhui province from January 2008 to December 2013 were retrospectively reviewed.Results A total of 71 cases were found with bloodstream infection caused by Klebsiella pneumoniae, the top three clinical distribution departments were infectious diseases department, ICU and oncology de-partment, and the top three complications were pulmonary infection, malignant tumor, biliary tract infection as well as diabetes mellitus. There were 24 strains of ESBLs-producing Klebsiella pneumoniae, accounting for 33.8%among 71 strains of Klebsiella pneumoniae isolated from the blood samples, in which 18 (52.9%) strains of ESBLs-producing Klebsiella pneumoniae among 34 hospital acquired infection cases and 6 ( 1 6 .2%) strains of ESBLs-producing Klebsiella pneumoniae among 3 7 community acquired infection cases;the positive rate of ESBLs-producing Klebsiella pneumoniae strains among hospital acquired infection cases was significantly higher than that of community acquired in-fection cases(χ2 =10.680, P=0.05).Among 71 strains of Klebsiella pneumoniae, no imipenem or meropenem-resistant isolate was found, and the resistance rates to amikacin, levofloxacin, ciprofIoxacin, cefoxitin, cefepime, cefoperazone/sulbactam and piperacillin/tazobactam were low(<20%) .The resistance rates of stains isolated from hospital acquired infection cases to piperaeillin, amoxicillin/clavulanate, cef-operazone/sulbactam, ampicillin/sulbactam, ticareillin/clavulanate, piperacillin/tazobactam, cefazolin, cefoperazone, cefuroxime, ceftazi-dime, ceftriaxone, cefotaxime and aztreonam were significantly higher than those of stains isolated from community acquired infection cases. The resistance rates of ESBLs-producing Klebsiella pneumoniae strains to 20 antimicrobial

  16. On Quadratic Differential Forms

    NARCIS (Netherlands)

    Willems, J.C.; Trentelman, H.L.

    1998-01-01

    This paper develops a theory around the notion of quadratic differential forms in the context of linear differential systems. In many applications, we need to not only understand the behavior of the system variables but also the behavior of certain functionals of these variables. The obvious cases w

  17. Metal forming and lubrication

    DEFF Research Database (Denmark)

    Bay, Niels

    2000-01-01

    Lubrication is essential in most metal forming processes. The lubricant film has two basic functions, [1]: i. to separate the work piece and tool surfaces and ii. to cool the workpiece and the tool. Separation of the two surfaces implies lower friction facilitating deformation and lowering the tool...

  18. Incentive to Form

    DEFF Research Database (Denmark)

    Thomsen, Bente Dahl; Madsen, Klaus

    2011-01-01

    Projektet ’Incitament til Form' har identificeret en række tematiske angreb på formstudier - i stærkt papir – som skaber nye former, hvor af en eller flere ofte indeholder stærkere kvaliteter end udgangspunktet. Incitamenter er, i denne sammenhæng, former skabt ved foldning over variationer af li...

  19. Many Forms of Culture

    Science.gov (United States)

    Cohen, Adam B.

    2009-01-01

    Psychologists interested in culture have focused primarily on East-West differences in individualism-collectivism, or independent-interdependent self-construal. As important as this dimension is, there are many other forms of culture with many dimensions of cultural variability. Selecting from among the many understudied cultures in psychology,…

  20. Measuring urban form

    NARCIS (Netherlands)

    Berghauser Pont, M.Y.

    2011-01-01

    For many, the notion of ‘measuring urban form’ will sound disturbing. Urban form is about visual images of cities, experiences, feelings, memories of place, thoughts and intellectual constructs anchored in the realm of the arts and the humanities. Anne Vernez Moudon however gives in the paper Urbani

  1. Nucleon Form Factors

    Energy Technology Data Exchange (ETDEWEB)

    Kees de Jager

    2002-10-01

    A review of data on the nucleon electro-weak form factors in the space-like region is presented. Recent results from experiments using polarized beams and either polarized targets or nucleon recoil polarimeters have yielded a significant improvement on the precision of the electromagnetic data obtained with the traditional Rosenbluth separation. An outlook is presented of planned experiments.

  2. Image forming apparatus

    DEFF Research Database (Denmark)

    2005-01-01

    An image H(x, y) for displaying a target image G(x, y) is displayed on a liquid-crystal display panel and illumination light from an illumination light source is made to pass therethrough to form an image on a PALSLM. Read light hv is radiated to the PALSLM and a phase-modulated light image alpha...

  3. Comparison of inflammatory reaction between gram-negative and gram-positive bloodstream infections in critical patients%革兰阴性菌和革兰阳性菌血流感染危重患者中致炎症反应的比较

    Institute of Scientific and Technical Information of China (English)

    吴志恒; 郭玉霞; 卜婧; 郭翠翠; 谢佳; 穆玉

    2012-01-01

    Objective To investigate the extent of inflammatory reaction induced by nosocomial gram-negative or gram-positive bloodstream infections through comparing some clinical indicators and levels of inflammatory mediators. Methods Prospective analysis was conducted in patients with positive blood culture obtained 48 h after admission to ICU, in terms of patient gender, age, APACHE Ⅱ and Sequential organ failure assessment (SOFA) scores, underlying diseases, severity of infection, total parenteral nutrition, receiving operation or surgical procedure, mechanical ventilation, blood purification therapy, mixed bacterial bloodstream infection, length of ICU stay and in hospital mortality. The parameters such as temperature, heart rate, WBC count, neutrophils, lymphocytes, levels of C-reactive protein, calcitonin, tumor necrosis factor-α (TNF-α), interleukin-lβ (IL-lβ) and interleukin-6 (IL-6) were also compared between the patients with gram-positive bloodstream infection and those with gram-negative bloodstream infection. Results The incidence of severe sepsis and septic shock was significantly higher in the patients with gram-negative bloodstream infection than in those with gram-positive bloodstream infection (88.9% vs. 73% , P= 0. 003). Blood levels of TNF-α (0. 97 ± 0. 54 vs. 0.75 ± 0. 32, P = 0.029), IL-1β (7.03 + 0.12 vs. 2.21 ± 0. 09, P = 0. 006) and IL-6 (10. 59 ± 2. 48 vs. 2.55 ± 0. 75, P= 0. 005) increased more in the patients with gram-negative bloodstream infection than in the patients in gram-positive bloodstream infection. Conclusions The patients with gram-negative bloodstream infection show more severe clinical condition and inflammatory reaction than the patients with gram-positive bloodstream infection. The pathogenic mechanism and extent of the host inflammatory response should be considered when treating bloodstream infections in clinical practice.%目的 比较医院感染革兰阴性菌血流感染和革兰阳性菌血流感染的炎性

  4. Procalcitonin,C-reactive protein and interleukin-6 in differential diagnosis of gram-positive and gram-negative bacterial bloodstream infections%降钙素原及 C-反应蛋白与白细胞介素-6鉴别细菌血流感染的研究

    Institute of Scientific and Technical Information of China (English)

    谢尹晶; 兰亚婷; 徐舒敏; 陈文燕; 陈运霞; 杨继勇; 王成彬

    2015-01-01

    目的:探讨C‐反应蛋白(CRP)、降钙素原(PCT)和白细胞介素‐6(IL‐6)鉴别临床革兰阳性菌和革兰阴性菌血流感染的作用,以期更好地辅助临床早期鉴别诊断。方法选取2012年1月-2013年1月医院连续两次血培养阳性的细菌性血流感染患者223例,其中革兰阳性菌血流感染组共102例,革兰阴性菌血流感染组共121例,健康对照组100名,在血培养标本采集当天收集血液标本,检测各组的血清中 CRP、PCT 和 IL‐6浓度,采用Mann‐Whitney U检验比较3个指标在3组间的差异,用受试者工作特征曲线(ROC曲线)分析各指标鉴别革兰阳性菌和革兰阴性菌血流感染的作用。结果血流感染患者的CRP、PCT 和IL‐6浓度均较健康对照组明显升高(P<0.05),CRP、PCT和IL‐6中位数对照组分别为0.50 mg/dl、0.09 ng/ml、2.10 pg/ml;革兰阳性菌血流感染组分别为4.70 mg/dl、1.37 ng/ml、47.58 pg/ml;革兰阴性菌血流感染组分别为7.56 mg/dl、3.93 ng/ml、276.20 pg/ml;CRP和PCT的ROC曲线下面积在革兰阳性菌血流感染组(0.889和0.894)与革兰阴性菌血流感染组(0.963和9.952)之间差异无统计学意义,IL‐6的ROC曲线下面积在革兰阴性菌感染组(0.967)明显高于革兰阳性菌血流感染组(0.804)(P<0.05)。结论 CRP和PCT在革兰阳性菌和革兰阴性菌血流感染之间无差异,IL‐6在革兰阴性菌血流感染的升高水平明显高于革兰阳性菌。%OBJECTIVE To discuss the value of C‐reactive protein (CRP) ,procalcitonin (PCT ) and interleukin‐6 (IL‐6) in differential diagnosis of patients with bloodstream infections caused by gram‐positive and gram‐negative bacteria so as to better facilitate early clinical differential diagnosis .METHODS Totally 223 patients with blood‐stream infections whose two consecutive blood culture results

  5. 血流感染脓毒症患者炎症因子水平与疾病严重程度相关性研究%Correlation between levels of inflammatory cytokines in sepsis patients with bloodstream infections and severity of disease

    Institute of Scientific and Technical Information of China (English)

    赵磊; 盛博; 李丽娟; 陈炜

    2015-01-01

    OBJECTIVE To explore the correlation between the levels of inflammatory cytokines in the sepsis pa‐tients with bloodstream infections such as procalcitonin (PCT) ,C‐reactive protein (CRP) ,and endotoxin and the severity of disease so as to provide guidance for diagnosis of disease .METHODS A total of 134 sepsis patients who were positive for blood culture were retrospectively analyzed .The levels of the inflammatory cytokines within 24 hours were compared between the patients with bloodstream infections caused by gram‐negative bacteria and the patients with bloodstream infections caused by gram‐positive bacteria ,and the correlations with APACHE Ⅱscores were observed .RESULTS The levels of CRP ,PCT ,and endotoxin in all the patients with bloodstream in‐fections and the subgroup patients were significantly correlated with the APACHE Ⅱ score ,the correlation with PCT was the highest in the patients with bloodstream infections caused by the gram‐negative bacteria ,and the cor‐relation with CRP was the highest in the patients with bloodstream infections caused by the gram‐positive bacteria . The levels of PCT and CRP of the subgroup patients with severe sepsis or septic shock were significantly higher than those of the subgroup patients with sepsis (P<0 .01) .However ,the levels of PCT ,CRP ,and endotoxin of the subgroup patients with severe sepsis or septic shock in the gram‐negative bacteria group were significantly higher than those of the subgroup patients with severe sepsis or septic shock in the gram‐positive bacteria . CONCLUSION The levels of the blood inflammatory cytokines in the sepsis patients with bloodstream infections caused by both the gram‐negative bacteria and the gram‐positive bacteria are positively correlated with the severity of disease .%目的:探讨降钙素原(PCT )、C‐反应蛋白(CRP)、内毒素等炎症因子在细菌性血流感染脓毒症患者中的水平及与疾病严重程度的相关性,

  6. The Form of Gentrification

    CERN Document Server

    Venerandi, Alessandro; Romice, Ombretta; Porta, Sergio

    2014-01-01

    Many socioeconomic studies have been carried out to explain the phenomenon of gentrification. Although results of these works shed light on the process around this phenomenon, a perspective which focuses on the relationship between city form and gentrification is still missing. With this paper we try to address this gap by studying and comparing, through classic methods of mathematical statistics, morphological features of five London gentrified neighbourhoods. Outcomes confirm that areas which have undergone gentrification display similar and recognizable morphological patterns in terms of urban type and geographical location of main and local roads as well as businesses. These initial results confirm findings from previous research in urban sociology, and highlight the role of urban form in contributing to shape dynamics of non-spatial nature in cities.

  7. Texture and sheet forming

    Energy Technology Data Exchange (ETDEWEB)

    Canova, G.R.; Kocks, U.F.; Fressengeas, C.; Dudzinski, D.; Lequeu, Ph.; Sornberger, G.

    1987-01-01

    The classical Marciniak-Kuczynski (Defect) theory, which consists in calculating the behavior of an initial defect in the sheet, in the form of a thin groove, is applied together with a full-constraints or relaxed-constraints theory of polycrystal viscoplasticity. Purpose of this is to investigate the effect of the induced texture on the Forming Limit Diagram (FLD), and the effect of grain shape as well. An alternative fast way of deriving FLD's is also proposed using a perturbation method. Comparisons are made between the results obtained by both Defect and Perturbation theories, in the case of ideal fcc rolling texture components, and in the case of polycrystals. 13 refs., 7 figs.

  8. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Kester Diederik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-27

    The intent of this report is to document a procedure used at LANL for HIP bonding aluminum cladding to U-10Mo fuel foils using a formed HIP can for the Domestic Reactor Conversion program in the NNSA Office of Material, Management and Minimization, and provide some details that may not have been published elsewhere. The HIP process is based on the procedures that have been used to develop the formed HIP can process, including the baseline process developed at Idaho National Laboratory (INL). The HIP bonding cladding process development is summarized in the listed references. Further iterations with Babcock & Wilcox (B&W) to refine the process to meet production and facility requirements is expected.

  9. Low Temperature Sheet Forming

    Science.gov (United States)

    Voges-Schwieger, Kathrin; Hübner, Sven; Behrens, Bernd-Arno

    2011-05-01

    Metastable austenitic stainless steels change their lattice during forming operations by strain-induced alpha'-martensite formation. Temperatures below T = 20° C can accelerate the phase transformation while temperatures above T = 60° C may suppress the formation of martensite during the forming operation. In past investigations, the effect of high-strength martensitic regions in an austenitic ductile lattice was used in crash relevant parts for transportation vehicles. The local martensitic regions act as reinforcements leading to an increase in crash energy absorption. Moreover, they control the folding behavior as well as the force-distance-characteristic and increase the buckling resistance. This paper deals with a concerted thermomechanical drawing process to increase the local formation of alpha'-martensite caused by low temperatures.

  10. How semiconductor nanoplatelets form

    OpenAIRE

    Riedinger, Andreas; Ott, Florian D.; Mule, Aniket; Mazzotti, Sergio; Knuesel, Philippe N.; Kress, Stephan J. P.; Prins, Ferry; Erwin, Steven C.; Norris, David J.

    2016-01-01

    Colloidal nanoplatelets - quasi-two-dimensional sheets of semiconductor exhibiting efficient, spectrally pure fluorescence - form when liquid-phase syntheses of spherical quantum dots are modified. Despite intense interest in their properties, the mechanism behind their anisotropic shape and precise atomic-scale thickness remains unclear, and even counterintuitive when their crystal structure is isotropic. One commonly accepted explanation is that nanoclusters nucleate within molecular templa...

  11. Structure: form, beauty, space

    OpenAIRE

    O'Donovan, James

    2012-01-01

    non-peer-reviewed The objective of my thesis is to explore the various elements that make structure architecture. Through investigation into thinness, material, span, space and soundscape, I wish to create an architecture which can appeal to the senses and have value form many years to come. I propose to interrogate these qualities with the demanding programme of aircraft cargo and maintenance on the site of Shannon Airport, which is situated on the shannon estuary and to...

  12. 重症急性胰腺炎血行感染患者肠屏障功能障碍的研究%A study of intestinal barrier dysfunction in patients with severe acute pancreatitis and bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    余杨梓; 傅强; 华鹂鹂

    2012-01-01

    Objective To investigate the relationship between the bloodstream infection and intestinal barrier dysfunction in patients with severe acute pancreatitis (SAP) . Methods [''ifty-five cases of SAP patients were divided into confirmed bloodstream infection group(group A, IS cases) and suspicious bloodstream infection or without bloodstream infection group (group B, 37 cases) by the positive or negative results of bilateral upper extremity venous double flask culture. According to the guide, the patients were diagnosed and conventional integrated traditional Chinese medicine and western medicine was used to treat them systemically. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores were calculated on the entrance into the groups. The lactulose/mannitol (L/M) ratio and the level of peripheral blood endotoxin (ET) was detected on the 1st, 3rd, 7th day after entrance into the groups ; the enterobacterial repetitive intergenic consensus (ERIC) fingerprint which reflected the composition of intestinal microflora characteristics from total DNA extraction of feces was obtained. The endogenous creatinine clearance rate (CCr), the number of involved organs, the length of stay in surgical intensive care unit (SI.CU) and in the hospital and mortality in 28 days were recorded. Results The length of stay in S1CU in group A (days ; 11.75±4.83 vs. 7.68±3.33) and the mortality in 28 days (16.67% vs. 5.40%) were significantly higher than those in group B. The general conditions of two groups had no significant difference on the first day and so did L/M ratio, ET, the number of involved organs, endogenous CCr (all P>0.05). Within a week, the L/M ratio and ET levels in group A were significantly increased, while in group B those were decreased obviously, and at each time point, the above indexes in A group were higher than those in group B (L/M ratio on the 3rd day; 3.83 ± 1.67 vs. 1.33±0.56, on the 7th day; 4.37± 1.95 vs. 0.95 ± 0.30 ; ET (kEU/L) on the

  13. Advanced forming technology

    Directory of Open Access Journals (Sweden)

    J. Kliber

    2016-10-01

    Full Text Available Forming is usually the final stage of metallurgical production of steel (90 % of the 1,7 billion tons of total steel production in the world and traditionally also largely of the products made of non-ferrous metals. Many procedures and methods exist and we will focus only on some of them. The aim is usually to achieve ultra-fine grained structure, the proper microstructure and (mechanical / electrical properties in innovative materials. The presented article mentions only some examples.

  14. Do naked singularities form?

    CERN Document Server

    Vaz, C; Vaz, Cenalo; Witten, Louis

    1995-01-01

    A naked singularity is formed by the collapse of a Sine-Gordon soliton in 1+1 dimensional dilaton gravity with a negative cosmological constant. We examine the quantum stress tensor resulting from the formation of the singularity. Consistent boundary conditions require that the incoming soliton is accompanied by a flux of incoming radiation across past null infinity, but neglecting the back reaction of the spacetime leads to the absurd conclusion that the total energy entering the system by the time the observer is able to receive information from the singularity is infinite. We conclude that the back reaction must prevent the formation of the naked singularity.

  15. Form Some Words

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Hey! The flowerpot (花盆) is a puzzle. You can see some English capital letters on the petals (花瓣) and on the flowerpot. Er! If you count, there are ten English capital letters. Some are the same. They are A, I, U, Rs, Es, Ts and L. After enjoying the pic- ture, finish a task. Please form words as many as you can. The rules are: Letters can only be used once for each time. Plurals, proper names (专有名词) do not count. OK! Start your work at once, please. Have fun!

  16. [Adhesive cutaneous pharmaceutical forms].

    Science.gov (United States)

    Gafiţanu, E; Matei, I; Mungiu, O C; Pavelescu, M; Mîndreci, I; Apostol, I; Ionescu, G

    1989-01-01

    The adhesive cutaneous pharmaceutical forms aimed to local action release the drug substance in view of a dermatological, traumatological, antirheumatic, cosmetic action. Two such preparations were obtained and their stability, consistency and pH were determined. The "in vitro" tests of their bioavailability revealed the dynamics of calcium ions release according to the associations of each preparation. The bioavailability determined by evaluating the pharmacological response demonstrated the antiinflammatory action obtained by the association of calcium ions with the components extracted from poplar muds. The therapeutical efficiency of the studied preparations has proved in the treatment of some sport injuries.

  17. Risk factors for bloodstream infections in liver or kidney transplantation recipients%肝、肾移植患者并发血流感染的死亡危险因素分析

    Institute of Scientific and Technical Information of China (English)

    万齐全; 肖雪飞; 叶启发; 周建党

    2012-01-01

    Objective: To investigate the possible risk factors for death among liver or kidney recipients with bloodstream infections (BSIs).Methods: A retrospective study of 138 episodes of bloodstream infections documented in 103 patients was conducted to assess potential risk factors for mortality. The risk factors were identified by logistic regression analysis.Results: The mean age of the patients was 12-66 (42.3±12.7) years. The majority of infections were nosocomial (78.6%). The BSIs-related mortality rate was 39.8% (41/103). The following variables were identified as risk factors for BSIs-related mortality by univariate analysis: intra-abdominal/biliary focus (P=0.003), polymicrobial infection (P<0.00l), liver transplant (P<0.00l), platelet count < 50000/mm3 (P<0.00l), and septic shock (P<0.00l). Platelet count <50000/mm3 (P=0.002) and septic shock (P<0.00l) showed significantly difference between the mortality group and the survival groups in the multivariate logistic regression analysis. Conclusion: Decreased platelet count and septic shock are risk factors for increased mortality in liver or kidney tranplantation recipients with BSIs. The BSIs-related mortality rate is high. Attention should be paid to the prevention of BSIs in liver or kidney transplant patients.%目的:评价影响伴有血流感染的肝、肾移植患者生存率的可能危险因素.方法:回顾性研究103例肝、肾移植患者发生的138次血流感染,评估导致肝、肾移植术后患者死亡的危险因素.使用单变量分析和多元逻辑回归方法确定危险因素.结果:入选患者年龄12~66(42.3±12.7)岁.绝大多数为院内感染(78.6%),血流感染相关的死亡率为39.8%(41/103).单变量分析显示以下变量能预测血流感染相关的死亡:腹腔内或胆道感染(P=0.003),混合感染(P<0.001),肝移植(P<0.001),血小板计数<50000/mm3 (P<0.001),感染性休克(P<0.001).多元逻辑回归分析显示血小板计数<50000/mm3 (P=0

  18. The correlation study of procalcitonin and C- reactive protein with children's bloodstream infections%降钙素原、C-反应蛋白与儿童血流感染的相关性研究

    Institute of Scientific and Technical Information of China (English)

    余烈中; 彭伟媛; 何静文; 赖挺方

    2016-01-01

    Objective To study the correlation of procalcitonin with children's bloodstream infections. Methods 300 cases of suspected bloodstream infections children in author hospital were selected,where simultaneous blood cultures and procalcitonin detected as research subjects.Comparison of two groups of children of serum procalcitonin levels,C- reactive protein levels,serum procalcitonin levels Gram bacteria cases between yin and yang. Results Children with blood culture-negative serum procalcitonin group,C- reactive protein and blood mean level culture positive infants compared, they had significant differences(P 0.05). Conclusion The serum procalcitonin level cloud be used as an early auxiliary diagnosis in bacterial infection, which may be conducive to implement antibiotic therapy.Meanwhile,the serum procalcitonin level cloud provide evidence for antibiotic therapy to avoid abuse of antibiotics.%目的:分析血清降钙素原与儿童血流感染之间的相关性。方法选择笔者所在医院同时进行血培养和降钙素原检测的300例疑似血流感染患儿为研究对象。比较两组患儿的血清降钙素原水平、C-反应蛋白水平及革兰阴阳菌病例间的血清降钙素原水平。结果血培养阴性组患儿的血清降钙素原、C-反应蛋白的均值水平与血培养阳性组患儿相比,差异有统计学意义(P<0.05)。革兰阳性菌49株(74.24%),革兰阴性菌17株(25.76%);革兰阳性菌组患者血清降钙素原均值水平显著低于格兰阴性菌组。两组菌株、血清降钙素原水平比较差异有统计学意义(P<0.05);C-反应蛋白比较差异不显著,差异无统计学意义(P>0.05)。结论血清血降钙素原水平可作为临床早期诊断细菌感染的辅助指标,从而及时有效地实施抗菌药物治疗。同时,血清降钙素原水平还可为抗菌药物应用提供有效的参照标准,对避免抗菌药物滥用具有重要的现实意义。

  19. Application of real-time PCR in rapid detection of bloodstream infection pathogens%实时定量PC R在血流感染病原体快速检测中的应用

    Institute of Scientific and Technical Information of China (English)

    范世珍; 林松青; 莫莉

    2016-01-01

    Objective To investigate the clinical application value of real‐time PCR in the detection of bloodstream infection pathogens .Methods A total of 92 blood samples from 80 patients in our hospital were collected for conducting real time PCR de‐tection and conventional blood culture .The sensitivity and specificity were compared between the two methods .Results Among 92 samples ,66 samples (71 .7% ) were negative in both assays .Ten different pathogens were detected by either blood culture system or real‐time PCR or by both methods .Seven positive samples were detected by both assays .The consistence of the two methods was 79 .3% .The negative predictive value of real‐time PCR was 0 .94 ,the sensitivity was 0 .64 and the specificity was 0 .82 .Among them ,15 samples were positive in real‐time PCR ,while negative in blood culture system ,4 samples were positive in the blood cul‐ture ,whereas were negative in the real‐time PCR .The pathogens cultured in 2 samples were not in the detection range of real time PCR ,moreover real time pCR could not detect Candida glabrata .Conclusion Real time PCR is a valuable method for rapidly detec‐tion the sample of bloodstream infection ,but cannot completely replace the blood culture test .%目的:探讨实时定量PCR在血流感染病原体检测中的临床应用价值。方法选取收治的80例患者共92份血液标本进行实时定量PCR检测,同时进行血液培养,比较两种方法的特异度和敏感度。结果在92份标本当中,两种方法共同阴性标本66份(71.7%),两种方法共检测出病原体10种。实时定量 PCR和血培养共同检出阳性标本7例,两种方法的一致性为79.3%。实时定量PCR的阴性预测值是0.94,敏感度是0.64,特异度是0.82。其中15份标本实时定量 PCR阳性而血培养阴性,4份标本血培养阳性而实时定量PCR阴性。其中2份标本所培养出的病原体不在实时定量 PCR的检测范围

  20. 血流感染MRSA中的ST239克隆株快速检测与分析%Application of rapid detection of MRSA ST239 clones in bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    姚杰; 杨凯; 刘周; 陈礼文; 周强; 管世鹤

    2015-01-01

    目的 评价多重PCR法对耐甲氧西林金黄色葡萄球菌(MRSA) ST239克隆株的快速检测及合肥地区血流感染MRSA的分子流行现状.方法 收集2008年至2013年安徽医科大学第一附属医院及第二附属医院临床分离的血流感染金黄色葡萄球菌的106株MRSA进行相关耐药性分析,并采用多重PCR技术对ST239型克隆株进行快速检测,同时运用多位点序列分型(MLST)加以确认及葡萄球菌染色体mec基因盒(SCCmec)分型分析.结果 106株血流感染金黄色葡萄球菌中MRSA有51株,占48.1%,MRSA均为多耐药菌,对红霉素、氨基糖苷类和喹诺酮类耐药率明显高于甲氧西林敏感金黄色葡萄球菌(MSSA),MRSA和MSSA对磺胺甲噁唑/甲氧苄啶的敏感率分别为86.3%和 94.5%;51株MRSA中有47株为ST239快速检测阳性,阳性率高达92.2%;随机选取20株ST239初筛阳性的MRSA经MLST验证和SCCmec分型后确认为MRSA-ST239-SCCmecⅢ型.结论 合肥地区血流感染MRSA近半数为多重耐药克隆MRSA-ST239-SCCmecⅢ型,运用多重PCR技术能够快速检测ST239克隆株.%Objective To evaluation the method of rapid detection of Methicillin-resistant Stphylococcus aureus (MRSA) ST239 clones with multiplex PCR assay and investigation of the epidemic status of MRSA blood stream infections in Hefei area.Methods Antibiotic susceptibility testing were applied to MRSA isolates from bloodstream infection,rapid screening and confirmation of MRSA ST239 clones by using multiplex PCR,Multilocus Sequence typing (MLST) and Staphyloccoccal Cassette Chromosome mec(SCCmec) typing.Results 51 of 106 clinic isolates Staphylococcus aureus were identified as MRSA,accounting for 48.1%.The resistance rate of MRSA to erythromycin,aminoglycosides and quinolone were significantly higher than Methicillin Sensitive Staphylococcus aureus (MSSA).Both MRSA and MSSA had a high sensitivity to cotrimoxazole,the sensivity rates were 86.3% and 94.5%,respectively; 47 of 51

  1. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study.

    Science.gov (United States)

    Stewardson, Andrew J; Allignol, Arthur; Beyersmann, Jan; Graves, Nicholas; Schumacher, Martin; Meyer, Rodolphe; Tacconelli, Evelina; De Angelis, Giulia; Farina, Claudio; Pezzoli, Fabio; Bertrand, Xavier; Gbaguidi-Haore, Houssein; Edgeworth, Jonathan; Tosas, Olga; Martinez, Jose A; Ayala-Blanco, M Pilar; Pan, Angelo; Zoncada, Alessia; Marwick, Charis A; Nathwani, Dilip; Seifert, Harald; Hos, Nina; Hagel, Stefan; Pletz, Mathias; Harbarth, Stephan

    2016-08-18

    We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13-2.35), excess LOS (4.9 days; 95% CI: 1.1-8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae. PMID:27562950

  2. Successful Salvage of Central Venous Catheters in Patients with Catheter-Related or Central Line-Associated Bloodstream Infections by Using a Catheter Lock Solution Consisting of Minocycline, EDTA, and 25% Ethanol.

    Science.gov (United States)

    Raad, Issam; Chaftari, Anne-Marie; Zakhour, Ramia; Jordan, Mary; Al Hamal, Zanaib; Jiang, Ying; Yousif, Ammar; Garoge, Kumait; Mulanovich, Victor; Viola, George M; Kanj, Soha; Pravinkumar, Egbert; Rosenblatt, Joel; Hachem, Ray

    2016-06-01

    In cancer patients with long-term central venous catheters (CVC), removal and reinsertion of a new CVC at a different site might be difficult because of the unavailability of accessible vascular sites. In vitro and animal studies showed that a minocycline-EDTA-ethanol (M-EDTA-EtOH) lock solution may eradicate microbial organisms in biofilms, hence enabling the treatment of central line-associated bloodstream infections (CLABSI) while retaining the catheter in situ Between April 2013 and July 2014, we enrolled 30 patients with CLABSI in a prospective study and compared them to a historical group of 60 patients with CLABSI who had their CVC removed and a new CVC inserted. Each catheter lumen was locked with an M-EDTA-EtOH solution for 2 h administered once daily, for a total of 7 doses. Patients who received locks had clinical characteristics that were comparable to those of the control group. The times to fever resolution and microbiological eradication were similar in the two groups. Patients with the lock intervention received a shorter duration of systemic antibiotic therapy than that of the control patients (median, 11 days versus 16 days, respectively; P < 0.0001), and they were able to retain their CVCs for a median of 74 days after the onset of bacteremia. The M-EDTA-EtOH lock was associated with a significantly decreased rate of mechanical and infectious complications compared to that of the CVC removal/reinsertion group, who received a longer duration of systemic antimicrobial therapy. (This study has been registered at ClinicalTrials.gov under registration no. NCT01539343.). PMID:27001822

  3. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

    Science.gov (United States)

    Stewardson, Andrew J; Allignol, Arthur; Beyersmann, Jan; Graves, Nicholas; Schumacher, Martin; Meyer, Rodolphe; Tacconelli, Evelina; De Angelis, Giulia; Farina, Claudio; Pezzoli, Fabio; Bertrand, Xavier; Gbaguidi-Haore, Houssein; Edgeworth, Jonathan; Tosas, Olga; Martinez, Jose A; Ayala-Blanco, M Pilar; Pan, Angelo; Zoncada, Alessia; Marwick, Charis A; Nathwani, Dilip; Seifert, Harald; Hos, Nina; Hagel, Stefan; Pletz, Mathias; Harbarth, Stephan

    2016-01-01

    We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34–2.42, HR = 1.81; 95% CI: 1.49–2.20 and HR = 2.42; 95% CI: 1.66–3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2–9.4, 11.5 days; 95% CI: 11.5–11.6 and 13.3 days; 95% CI: 13.2–13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8–5.9) but not hazard of death (1.16; 95% CI: 0.98–1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13–2.35), excess LOS (4.9 days; 95% CI: 1.1–8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae. PMID:27562950

  4. 儿科导管相关性血流感染的病原菌分布与耐药性分析%Distribution and drug resistance of pathogens causing catheter-related bloodstream infections in department of pediatrics

    Institute of Scientific and Technical Information of China (English)

    刘素品; 刘智; 丁朝鹏; 段玉龙; 刘瑞云; 岳慧芳

    2016-01-01

    OBJECTIVE To observe the distribution and drug resistance of pathogens causing catheter‐related blood‐stream infections in department of pediatrics so as to provide guidance for clinical prevention and control . METHODS A total of 211 children who were treated with central venous catheter indwelling in hospitals from Dec 2013 to Jan 2015 were recruited as the study objects .The incidence of catheter‐related bloodstream infections and distribution and drug resistance of the pathogens were observed .RESULTS Of the 211 children ,73 had the cathe‐ter‐related bloodstream infections ,with the infection rate 34 .60% .Totally 73 strains of pathogens were isolated , of which 28 (38 .36% ) were gram‐positive bacteria ,32 (43 .83% ) were gram‐negative bacteria ,and 13 (17 .81% ) were fungi .The drug resistance rates of the Staphylococcus epidermidis , Staphylococcus haemolyticus ,and Staphylococcus aureus to nitrofurantoin ,vancomycin ,and linezolid were 0 ;the drug resistance rate of the Acine‐tobacter baumannii to cefoperazone was the lowest (13 .33% );the drug resistance rate of the Klebsiella spp to imipenem was the lowest (0);the drug resistance rate of other species of gram‐negative bacteria to cefoperazone was the lowest (22 .22% );the drug resistance rates of the Candida albicans ,Candida tropicalis ,and Candida parapsilosis to amphotericin B and flucytosine were the highest (100 .00% ) .CONCLUSION The incidence of the catheter‐related bloodstream infections is relatively high in the children of the department of pediatrics .It is neces‐sary for the hospital to conduct targeted treatment based on the distribution and drug resistance of the pathogens .%目的:分析医院儿科患儿发生导管相关性血流感染病原菌分布及耐药性,为其临床预防控制提供参考依据。方法选取2013年12月-2015年1月医院儿科收治211例留置中心静脉导管患儿为研究对象,对其发生导管相关性血流感染率、病

  5. The clinical value of PCT levels in bacteria identification in ICU patients with bloodstream infection%血清降钙素原对ICU血流感染患者菌种鉴别中的应用研究

    Institute of Scientific and Technical Information of China (English)

    王建; 庄国华; 牛野; 李宏; 夏建萍

    2015-01-01

    目的 探讨血清降钙素原(PCT)水平测定在ICU血流感染患者菌种鉴别中的应用价值.方法 对本院ICU 2007年12月至2013年12月收治的540例血流感染患者的PCT水平进行检测并对患者标本分离的菌种进行鉴别,分析PCT水平在鉴别血流感染菌种的有效性.结果 540例血流感染患者中,G+菌感染患者比例最高(49.63%),G-菌感染患者比例次之(38.52%),真菌感染患者比例最低(11.85%),三者间差异有统计学意义(P<0.05).G-菌感染组PCT水平及阳性率均显著高于G+菌感染组和真菌感染组,差异有统计学意义(P<0.05),G+菌和真菌感染组之间差异无统计学意义(P>0.05).PCT界定为2.04 ng/ml时,血清PCT水平区分G-和G+的灵敏度和特异度分别为82.18%和76.09%;PCT界定为3.16 ng,/ml时,血清PCT水平鉴别血流感染G-菌与真菌种的灵敏度和特异度分别为59.42%和65.73%.结论 应用血清PCT水平鉴别G-菌与G+菌、真菌所致血流感染具有较高的临床价值,PCT水平≥2.04 ng/ml时,发生G-菌感染几率较大,PCT水平对G+菌与真菌的鉴别准确度较差.%Objective To investigate the clinical value of procalcitonin (PCT) levels in bacteria identification in intensive care unit (ICU) patients with bloodstream infection.Methods There were 540 cases of patients with bloodstream infection in our ICU between December 2007 and December 2013.The PCT levels and bacteria were identified.The application effectiveness of PCT levels in the bacteria identification was studied.Results The G+ bacteria infection rate was 49.63% (268/540),G-bacteria infection rate was 38.52% (208/540),and the fungal infection rate was 11.85% (64/540).The patients of G-bacteria had significant difference with G + bacteria and fungal infection (P < 0.05).The PCT average and positive rate of G-bacteria were significantly higher than G + bacteria and fungi group (P < 0.05),respectively.G+ bacteria and fungi infection did not

  6. Clinical analysis of bloodstream infections caused by Escherichia coli in elderly patients with hepatobiliary disease%老年肝胆疾病患者大肠埃希菌血流感染的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    王钱; 鲍春梅; 何卫平; 崔恩博; 张文瑾; 范振平; 曲芬

    2015-01-01

    Objective To investigate the clinical characteristics and drug resistance in elderly patients with hepatobiliary disease and blood-stream infections caused by Escherichia coli,and to provide a basis for clinical therapy.Methods A retrospective analysis was performed on the clinical characteristics and drug susceptibility of 57 elderly inpatients with hepatobiliary disease and bloodstream infections caused by Esch-erichia coli in our hospital from 2009 to 2012.Comparison of continuous data between the two groups was made by t test,and comparison of categorical data was made by chi -square test.Results The majority of patients had liver cirrhosis,and spontaneous bacterial peritonitis was the major infection source.A total of 57 strains of Escherichia coli were isolated from elderly patients with hepatobiliary disease,and 24 (42.1%)out of them were positive for extended -spectrum β-lactamase (ESBL).ESBL -positive strains had a significantly higher level of drug resistance than ESBL -negative strains (P 0.05).The case -fa-tality rate in patients with septic shock,hepatic encephalopathy,or acute kidney injury was significantly higher than that in patients with no com-plications (χ2 =9.541,7.622,9.733,respectively,P <0.05).Conclusion Elderly patients with hepatobiliary disease and bloodstream infections caused by ESBL -positive Escherichia coli had a high level of drug resistance and a poor prognosis for severe complications.Antibiotic therapy combined with prevention and control of severe complications should be taken as early as possible to reduce the case -fatality rate.%目的:分析老年肝胆疾病患者大肠埃希菌血流感染的临床特点及耐药性,为临床治疗提供依据。方法回顾性分析2009年-2012年于解放军三二医院住院的57例老年肝胆疾病患者血流感染大肠埃希菌的临床特点及药敏试验结果。计量资料组间比较采用 t 检验,计数资料组间比较采用χ2检验。结果57例老年肝

  7. Nucleon Electromagnetic Form Factors

    Energy Technology Data Exchange (ETDEWEB)

    Marc Vanderhaeghen; Charles Perdrisat; Vina Punjabi

    2007-10-01

    There has been much activity in the measurement of the elastic electromagnetic proton and neutron form factors in the last decade, and the quality of the data has greatly improved by performing double polarization experiments, in comparison with previous unpolarized data. Here we review the experimental data base in view of the new results for the proton, and neutron, obtained at JLab, MAMI, and MIT-Bates. The rapid evolution of phenomenological models triggered by these high-precision experiments will be discussed, including the recent progress in the determination of the valence quark generalized parton distributions of the nucleon, as well as the steady rate of improvements made in the lattice QCD calculations.

  8. The forms of prophecy

    Directory of Open Access Journals (Sweden)

    Rayco González

    2013-11-01

    Full Text Available The prophecy is a kind of text holding therefore its own textual marks, differing from other kinds of texts. In order to do a discursive analysis of it, we must bring a semiotic study of its own possible forms. It includes its intertextual connections, as well as the use of typical tropos and topoi. Our aim is to describe the features of a kind of text that seems to appear in every well-known culture. Our analysis is limited to religious prophecies, showing mainly several examples from Judeo-Christian tradition, but also from other cultures, according to our line of argument. Amongst its features we find the use of allusion, forcing to any addressee to expand all possible interpretations. Likewise the prophecy seems to fulfill the double function of threat/promise, depending on each addressee.

  9. Circle of Form

    DEFF Research Database (Denmark)

    Jaeger, Thomas Arvid

    2012-01-01

    Teaching aesthetics belongs to one of the most flourishing part in education. The variety of methods, terminology and tradition differs from country to country, school to school and from person to person. The ability to make aesthetic judgments which are coherent is difficult because, we don’t have...... a common professional language like in mathematics, colour and music. The result is a weaker professionalism in the aesthetic competences compared to the professionalism and competences in other areas. A research project [1] on contrasts or opposites in form investigated the phenomenon in the fields...... of architecture, design, art, art theory, and perception. It was then obvious in related areas to look for systems or models which organized opposites. The colour system has the same fundamental dualistic structure based on complementary colours, on light and dark (black and white), cold and warm. Inspired...

  10. Pion form factor

    Energy Technology Data Exchange (ETDEWEB)

    Ryong Ji, C.; Pang, A.; Szczepaniak, A. [North Carolina State Univ., Raleigh, NC (United States)

    1994-04-01

    It is pointed out that the correct criterion to define the legal PQCD contribution to the exclusive processes in the lightcone perturbative expansion should be based on the large off-shellness of the lightcone energy in the intermediate states. In the lightcone perturbative QCD calculation of the pion form factor, the authors find that the legal PQCD contribution defined by the lightcone energy cut saturates in the smaller Q{sup 2} region compared to that defined by the gluon four-momentum square cut. This is due to the contribution by the highly off-energy-shell gluons in the end point regions of the phase space, indicating that the gluon four-momentum-square cut may have cut too much to define the legal PQCD.

  11. 78 FR 58605 - Proposed Collection; Comment Request for Form 8453-EMP, Form 8453-F, Form 8453-FE, Form 8879-F...

    Science.gov (United States)

    2013-09-24

    ... Internal Revenue Service Proposed Collection; Comment Request for Form 8453-EMP, Form 8453-F, Form 8453-FE, Form 8879-F, and 8879-EMP. AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and request... comments concerning Form 8453-F, U.S. Estate of Trust Income Tax Declaration and Signature for...

  12. Weird past tense forms.

    Science.gov (United States)

    Xu, F; Pinker, S

    1995-10-01

    It is often assumed that children go through a stage in which they systematically overapply irregular past tense patterns to inappropriate verbs, as in wipe-wope, bring-brang, trick-truck, walk-has walken. Such errors have been interpreted both as reflecting over-use of minor grammatical rules (e.g. 'change i to a'), and as reflecting the operation of a connectionist pattern associator network that superimposes and blends patterns of various degrees of generality. But the actual rate, time course, and nature of these errors have never been documented. We analysed 20,000 past tense and participle usages from nine children in the CHILDES database, looking for overapplications of irregular vowel-change patterns, as in brang, blends, as in branged, productive suffixations of -en, as in walken, gross distortions, as in mail-membled, and double-suffixation, as in walkeded. These errors were collectively quite rare; children made them in about two tenths of one per cent of the opportunities, and with few stable patterns: the errors were not predominantly word-substitutions, did not occur predominantly with irregular stems, showed no consistency across verbs or ages, and showed no clear age trend. Most (though not all) of the errors were based closely on existing irregular verbs; gross distortions never occurred. We suggest that both rule-theories and connectionist theories have tended to overestimate the predominance of such errors. Children master irregular forms quite accurately, presumably because irregular forms are just a special case of the arbitrary sound-meaning pairings that define words, and because children are good at learning words.

  13. Forming Spirals From Shadows

    Science.gov (United States)

    Kohler, Susanna

    2016-07-01

    What causes the large-scale spiral structures found in some protoplanetary disks? Most models assume theyre created by newly-forming planets, but a new study suggests that planets might have nothing to do with it.Perturbations from Planets?In some transition disks protoplanetary disks with gaps in their inner regions weve directly imaged large-scale spiral arms. Many theories currently attribute the formation of these structures to young planets: either the direct perturbations of a planet embedded in the disk cause the spirals, or theyre indirectly caused by the orbit of a planetary body outside of the arms.Another example of spiral arms detected in a protoplanetary disk, MWC 758. [NASA/ESA/ESO/M. Benisty et al.]But what if you could get spirals without any planets? A team of scientists led by Matas Montesinos (University of Chile) have recently published a study in which they examine what happens to a shadowed protoplanetary disk.Casting Shadows with WarpsIn the teams setup, they envision a protoplanetary disk that is warped: the inner region is slightly tilted relative to the outer region. As the central star casts light out over its protoplanetary disk, this disk warping would cause some regions of the disk to be shaded in a way that isnt axially symmetric with potentially interesting implications.Montesinos and collaborators ran 2D hydrodynamics simulations to determine what happens to the motion of particles within the disk when they pass in and out of the shadowed regions. Since the shadowed regions are significantly colder than the illuminated disk, the pressure in these regions is much lower. Particles are therefore accelerated and decelerated as they pass through these regions, and the lack of axial symmetry causes spiral density waves to form in the disk as a result.Initial profile for the stellar heating rate per unit area for one of the authors simulations. The regions shadowed as a result of the disk warp subtend 0.5 radians each (shown on the left

  14. A 17-year study of bloodstream Escherichia coli infection after liver transplantation: resistance rate,risk factor and mortality%肝移植术后大肠埃希菌血行感染耐药及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    邰强; 郭志勇; 黄洁夫; 何晓顺; 胡安斌; 巫林伟; 鞠卫强; 朱晓峰; 王东平; 王国栋; 马毅

    2011-01-01

    Objective To explore the resistance rate,risk factors and mortality of Escherichia coli bloodstream infections (BSI) after liver transplantation.Methods From January 1993 to May 2010,a retrospective analysis of Escherichia coli in liver transplants were conducted.Results A total of 88 BSI occurred in 83/695 patients and Escherichia coli ( n =23 ) was most commonly found.Carbapenem and piperacillin-tazobactam were the most consistently active against Escherichia coli while the resistance rate to enterococcus for ciprofloxacin,gentamycin,ampicillin-clavulanic acid was over 60%.Univariate analysis identified the following variables as risk factors for Escherichia coli bacteremia:cholangioenterostomy ( P <0.001 ) and ductal complications ( P < 0.001 ).Escherichia coli bloodstream infection could increase the mortality at 15 days after bloodstream infection.No significant difference in mortality occurred at 30 days and 1 year after enterococcal bacteremia.Conclusion Escherichia coli after liver transplantation is resistant to agents but commonly active to carbapenem and piperacillin-tazobactam.The risk factor associated with Escherichia coli bloodstream infections are cholangioenterostomy and ductal complications.Escherichia coli bloodstream infection can increase the mortality at 15 days after bloodstream infection.%目的 探讨肝移植术后血行感染中大肠埃希菌的耐药、临床结果及危险因素.方法 回顾分析1993年1月至2010年5月,中山大学附属第一医院移植科肝移植术后血行感染中大肠埃希菌患者资料,对患者的资料(如:抗生素耐药、术式及危险因素)进行分类统计.结果 695例肝移植患者中,83例(7.6%)88次出现革兰阴性球菌血行感染,以大肠埃希菌(23例)最为常见.大肠埃希菌对碳青酶烯类抗生素均为100%敏感,对哌拉西林/他唑巴坦耐药率在5%以下,而对环丙沙星、庆大霉素、氨苄西林/克拉维酸耐药率基本都在60%以上.针

  15. Investigation and analysis of postoperative cardiac venous catheter-related bloodstream infections in children with congenital heart disease%先天性心脏病患儿术后中心静脉导管相关性血流感染的调查分析

    Institute of Scientific and Technical Information of China (English)

    贾鹏; 黄睿; 李刚; 刘斌

    2015-01-01

    OBJECTIVE To investigate postoperative central venous catheter‐related bloodstream infections in children with congenital heart disease as well as the distribution of pathogenic bacteria ,so as to provide the basis for reducing infection rates .METHODS A total of 617 children with congenital heart disease who underwent surgical treatment in the cardiology center during May 2011 to Mar .2013 were enrolled .The targeted monitoring of central venous catheter‐related bloodstream infections was performed , and the infection incidence and the pathogen distribution were investigated .RESULTS Among the 617 children who underwent cardiac surgery and had indwelling central venous catheters ,12 cases of related bloodstream infections occurred ,the incidence was 1 .94% .Three cases (25 .00% ) had related bloodstream infections occurring in 7 days ,7 cases (58 .33% ) in 8 - 15 days and 2 cases (16 .67% ) after 15 days .Totally 21 pathogens were detected ,including 12 gram‐negative bacteria accounting for 57 .14% and 9 gram‐positive bacteria accounting for 42 .86% ,among which Acinetobacter baumannii ,Pseudomonas aeruginosa ,Staphylococcus aureus accounted for the top three .CONCLUSION The rate of postoperative central venous catheter‐related bloodstream infections in children with congenital heart disease is relatively high .In the course of treatment ,health care workers should be strictly in accordance with the instruc‐tion manual ,implement proactive measures to prevent infection in children ,reduce central venous catheter‐related bloodstream infections ,shorten hospital stay in children and reduce mortality .%目的:探讨先天性心脏病患儿术后中心静脉导管(CVC)相关性血流感染以及病原菌分布,为临床降低其感染率提供依据。方法选取2011年5月-2013年3月心脏病治疗中心收治的617例实施手术治疗的先天性心脏病患儿,进行中心静脉导管相关血流感染目标性监测,调查研究感

  16. Group valued differential forms revisited

    DEFF Research Database (Denmark)

    Kock, Anders

    We study the relationship between combinatorial group valued differential forms, and classical differential forms with values in the corresponding Lie algebra. In particular, we compare simplicial coboundary and exterior derivative for 1-forms. The results represent strengthenings of results...

  17. Moon (Form-Origin)

    Science.gov (United States)

    Tsiapas, Elias

    2016-04-01

    When the Earth was formed, it was in a state of burning heat. As time went by, temperature on the planet's surface was falling due to radiation and heat transfer, and various components (crusts) began taking solid form at the Earth's poles. The formation of crusts took place at the Earth's poles, because the stirring of burning and fluid masses on the surface of the Earth was significantly slighter there than it was on the equator. Due to centrifugal force and Coriolis Effect, these solid masses headed towards the equator; those originating from the North Pole followed a south-western course, while those originating from the South Pole followed a north-western course and there they rotated from west to east at a lower speed than the underlying burning and liquid earth, because of their lower initial linear velocity, their solid state and inertia. Because inertia is proportional to mass, the initially larger solid body swept all new solid ones, incorporating them to its western side. The density of the new solid masses was higher, because the components on the surface would freeze and solidify first, before the underlying thicker components. As a result, the western side of the initial islet of solid rocks submerged, while the east side elevated. . As a result of the above, this initial islet began to spin in reverse, and after taking on the shape of a sphere, it formed the "heart" of the Moon. The Moon-sphere, rolling on the equator, would sink the solid rocks that continued to descend from the Earth's poles. The sinking rocks partially melted because of higher temperatures in the greater depths that the Moon descended to, while part of the rocks' mass bonded with the Moon and also served as a heat-insulating material, preventing the descended side of the sphere from melting. Combined with the Earth's liquid mass that covered its emerging eastern surface, new sphere-shaped shells were created, with increased density and very powerful structural cohesion. During the

  18. New education coalition formed

    Science.gov (United States)

    Watt Ireto, M. Frank

    The Coalition for Earth Science Education (CESE) was recently formed to promote Earth science education at all levels. Earth science is a diverse group of sciences and as a result, professional and academic organizations from the various areas, though united in their goal to stimulate student enthusiasm for the Earth sciences, have not had an effective way of reaching students or their precollege teachers. Over the past year, meetings sponsored by the National Academy of Science's Board on Earth Sciences and Resources and the National Science Foundation have paved the way for this coalition. Victor Mayer, Director of the Program for Leadership in Earth Systems Science (PLESE) project at the University of Ohio, has been the leader in initiating and promoting this effort for the last several years.The purpose of CESE is to promote communication among the member organizations and to coordinate projects in Earth science education. Individual organizations will continue to develop and run projects, but will be able to find out what types of projects others are working on or have completed through a coalition clearinghouse. The clearinghouse should aid organizations as they design projects and should afford opportunities for collaborative efforts. This will directly benefit teachers, who will be able to contact one source for information on the multitude of projects in the Earth and space sciences. The new coalition's steering committee is working on goals and guidelines, and will give a report at the next coalition meeting at the National Science Teachers Association annual convention in Boston.

  19. Image forming apparatus

    DEFF Research Database (Denmark)

    2005-01-01

    An image H(x, y) for displaying a target image G(x, y) is displayed on a liquid-crystal display panel and illumination light from an illumination light source is made to pass therethrough to form an image on a PALSLM. Read light hv is radiated to the PALSLM and a phase-modulated light image alpha...... (x, y) read out of the PALSLM is subjected to Fourier transform by a lens. A phase contrast filter gives a predetermined phase shift to only the zero-order light component of Fourier light image alpha f(x, y). The phase-shifted light image is subjected to inverse Fourier transform by a lens...... to project an output image O(x, y) to an output plane. A light image O'(x, y) branched by a beam sampler is picked up by a pickup device and an evaluation value calculating unit evaluates conformity between the image O(x, y) and the image G(x, y).; A control unit performs feedback control of optical...

  20. Impact of extended-spectrum β-lactamases production on mortality in Enterobacteriaceae bloodstream infection: a meta-analysis%产超广谱β内酰胺酶对肠杆菌科细菌血流感染病死率的影响:荟萃分析

    Institute of Scientific and Technical Information of China (English)

    张晓琳; 焦红梅; 刘新民

    2013-01-01

    Objective A meta-analysis was preformed to examine the impact of extended-spectrum p-lactamases (ESBLs) production on the mortality of Enterobacteriaceae bloodstream infections. Methods PubMed, CNKI and WanFangdata databases were searched with search terms "extended-spectrum beta-lactamase" or "ESBL" and "bacteremia", "bloodstream". Retrospective cohort studies were included, screened and the heterogeneity of studies was tested. Valid data were extracted and analyzed with Revman 5. 1 software. Results Nineteen studies met the inclusion criteria, a total of 3 218 subiects, including 994 patients and 2 224 controls. Meta-analysis of crude RRs demonstrated significantly increased mortality in ESBL-associated bloodstream infections (RR 1. 86, 95%CI 1. 50-2. 30, P<0. 001 ). Conclusions ESBL production is associated with increased mortality of Enterobacteriaceae bloodstream infections.%目的 通过荟萃分析,评价肠杆菌科细菌血流感染中产超广谱β内酰胺酶(ESBL)对病死率的影响.方法 检索PubMed、万方数据库、CNKI数据库,英文检索关键词为“ESBL”、“extended spectrum beta-lactamase”与“bacteremia”、“bloodstream”两组关键词一一组合,中文检索词为“超广谱β内酰胺酶”与“血流感染”、“菌血症”或“败血症”,获得比较ESBL及非ESBL肠杆菌科细菌血流感染预后的研究结果,对其进行筛选、异质性检验,纳入文献的研究设计均为回顾性队列研究,采用Revman5.1软件对提取的数据进行分析.结果 共有19篇文章符合标准,获得3 218例样本,其中病例组994例,对照组2 224例.荟萃分析结果显示,产ESBL肠杆菌科细菌血流感染病死率较非产ESBL的明显增高(RR 1.86,95% CI 1.50~2.30,P<0.001).结论 在肠杆菌科细菌血流感染中,产ESBL肠杆菌科细菌明显增加了病死率.

  1. Risk factors and prognosis of patients with bloodstream infection due to carbapenem-resistant Acinetobacter baumannii%耐碳青霉烯类鲍曼不动杆菌血流感染患者危险因素及预后

    Institute of Scientific and Technical Information of China (English)

    黄文治; 乔甫; 王妍潼; 尹维佳; 宗志勇

    2015-01-01

    Objective To explore the risk factors and prognosis of hospitalized patients with bloodstream infection due to carbapenem-resistant Acinetobacter baumannii (CRAB).Methods 163 patients with CRAB bloodstream in-fection from 2010 to 2013 were conducted retrospective case-control study,68 patients with bloodstream infection due to carbapenem-susceptible Acinetobacter baumannii (CSAB)during the same period were as control group. Results The independent risk factors for CRAB bloodstream infection were stay in intensive care unit(ICU)(OR, 1 .27[95%CI ,5.55-22.89])and emergency department(OR,3.57 [95%CI ,1 .67 -7.62])before infection.Pa-tients with CRAB bloodstream infection had lower 28-day survival rate than those with CSAB bloodstream infection (66.17% vs 96.95%,χ2 =15.71 ,P <0.001 ).The independent risk factors for influencing prognosis of Acineto-bacter baumannii bloodstream infection were infection of CRAB (HR 95% CI ,3.01 -67.28),blood disease(HR 95%CI ,3.77-25.97),cardiac insufficiency(HR 95%CI ,2.10-20.41),stay in ICU(HR 95%CI ,1 .01 -5.28), and age(HR 95%CI ,1 .01 -1 .04).Conclusion The independent risk factors for CRAB bloodstream infection are stay in ICU and emergency department before infection,CRAB bloodstream infection is risk factor for influencing prognosis of patients.%目的:探讨住院患者血流感染耐碳青霉烯类鲍曼不动杆菌(CRAB)的危险因素及预后。方法采用病例对照研究,回顾性收集某院2010—2013年 CRAB 血流感染患者163例,并以同期68例对碳青霉烯类敏感的鲍曼不动杆菌(CSAB)血流感染患者作为对照,进行危险因素及预后分析。结果 CRAB 血流感染的独立危险因素是感染前入住重症监护病房(ICU)[OR 及 OR95%CI :1.27(5.55~22.89)]及入住过急诊室[OR 及 OR95%CI :3.57(1.67~7.62)]。鲍曼不动杆菌(AB)血流感染患者28 d 生存率 CRAB 为66.17%,而 CSAB 为96.95%, CRAB

  2. Bloodstream infections among patients using central venous catheters in intensive care units Infección de corriente sanguínea en pacientes con catéter venosos central en unidades de cuidado intensivo Infecções da corrente sangüínea em pacientes em uso de cateter venoso central em unidades de terapia intensiva

    OpenAIRE

    Eni Rosa Aires Borba Mesiano; Edgar Merchán-Hamann

    2007-01-01

    Central Venous Catheters (CVC), widely used in Intensive Care Units (ICU) are important sources of bloodstream infections (BSI). This prospective cohort epidemiological analytical study, aimed to infer the incidence of BSI, the risk factors associated and evaluate the care actions related to the use of these catheters in seven ICU in the Federal District - Brasília, Brazil. From the 630 patients using CVC, 6.4% developed BSI (1.5% directly related to the catheter and 4.9% clinic BSI). The hos...

  3. Watching How Planets Form

    Science.gov (United States)

    2006-09-01

    Anatomy of a Planet-Forming Disc around a Star More Massive than the Sun With the VISIR instrument on ESO's Very Large Telescope, astronomers have mapped the disc around a star more massive than the Sun. The very extended and flared disc most likely contains enough gas and dust to spawn planets. It appears as a precursor of debris discs such as the one around Vega-like stars and thus provides the rare opportunity to witness the conditions prevailing prior to or during planet formation. "Planets form in massive, gaseous and dusty proto-planetary discs that surround nascent stars. This process must be rather ubiquitous as more than 200 planets have now been found around stars other than the Sun," said Pierre-Olivier Lagage, from CEA Saclay (France) and leader of the team that carried out the observations. "However, very little is known about these discs, especially those around stars more massive than the Sun. Such stars are much more luminous and could have a large influence on their disc, possibly quickly destroying the inner part." The astronomers used the VISIR instrument [1] on ESO's Very Large Telescope to map in the infrared the disc surrounding the young star HD 97048. With an age of a few million years [2], HD 97048 belongs to the Chameleon I dark cloud, a stellar nursery 600 light-years away. The star is 40 times more luminous than our Sun and is 2.5 times as massive. The astronomers could only have achieved such a detailed view due to the high angular resolution offered by an 8-metre size telescope in the infrared, reaching a resolution of 0.33 arcsecond. They discovered a very large disc, at least 12 times more extended than the orbit of the farthest planet in the Solar System, Neptune. The observations suggest the disc to be flared. "This is the first time such a structure, predicted by some theoretical models, is imaged around a massive star," said Lagage. ESO PR Photo 36/06 ESO PR Photo 36/06 A Flared Proto-Planetary Disc Such a geometry can only be

  4. Doing Focus-on-Form.

    Science.gov (United States)

    Ellis, Rod; Basturkmen, Helen; Loewen, Shawn

    2002-01-01

    Considers the rationale for using a focus on form approach to teaching form as opposed to the more traditional focus on forms approach where linguistic features are treated sequentially. Describes methodological options for attending to form in communication. (Author/VWL)

  5. 恶性血液病合并血流感染61例临床分析%Clinical Analysis of 61 Cases of Malignant Hematology with Bloodstream Infection

    Institute of Scientific and Technical Information of China (English)

    金凤波; 夏瑞祥; 金广霞; 吴炜; 刘飞

    2012-01-01

    的药物分别为亚胺培南、万古霉素及利奈唑胺.临床对该类患者及早正确使用敏感抗菌药物治疗,可有效控制感染,并可降低BSI导致恶性血液病患者的病死率.%Objective To study the characteristics,treatments and prognosis in the malignant hematology patients with bloodstream infection.Methods From January 2008 to December 2009,61 cases of malignant hematology with bloodstream infection patients,who were treated by department of blood transfusion in the First Affiliated Hospital of Anhui Medical University,were analyzed retrospectively.The antibiotic resistance rates and sensitivity rates of 72 non-duplicate pathogenic isolates were calculated,and the infection related factors and prognosis of malignant hematology with bloodstream infection patients were analyzed,through the issues of patients' neutrophil counts,days of hospitalization,age and initial antimicrobial treatment options.The x2 test was used to analyze the qualitative data,and the t-test was used to analyze the quantitative data.P<0.05 showed that the difference was statistically significant.Results The main pathogens of these 61 patients were Gram-negative bacterium.The total prevalence of extendedspectrum beta-lactamases (EBSLs)-producing strains in E.coli and Klebsiella isolates were 56.25% and 36.60%,respectively.The sensitive rates of ESBLs-producing strains of E.coli to Imipenem,Klebsiella to Imipenem,and Gram-positive cocci to Vancomycin and Linezolid were 100%.Compared with the patients whose neutrophils>0.5 × 109/L,the patients whose neutrophils<0.5 × 109/L were more susceptible to multiple infection (x2.455,P=0.02).Among the 60 patients,the multiple infection was significant different between hospitalization days <20 d and >20 d(x2 =7.576,P=0.006).The mortality was high in patients over the age of 60(x2=3.021,P=0.023).Before the blood culture results returning,the antimicrobial treatment average times of the 35 patients who had used

  6. Research on BD BACTEC 9120 blood culture instrument combined with serum PCT in diagnosis of bloodstream infections%BD BACTEC 9120血培养仪联合血清降钙素原在血流感染诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    郭盼; 马萍; 王海龙; 董彬; 尚晓泓

    2015-01-01

    目的:比较革兰阳性(G+)菌和革兰阴性(G-)菌血流感染(BSI)的血清降钙素原(PCT)水平,探讨血培养与PCT联合检测在临床诊断中的意义。方法:采用BD BACTEC9120型全自动血培养仪对199例住院发热患者的血液标本进行细菌培养,同时检测PCT水平,比较PCT浓度水平在血培养阳性与阴性之间以及革兰阳性细菌与阴性细菌之间的差异。结果:①筛选出检测PCT的99例血培养阳性标本中分别检出18种细菌,其中表皮葡萄球菌构成比最大(占17.2%);其余依次为大肠埃希菌(占16.2%)和鲍曼不动杆菌(占10.1%);②血培养阳性与血培养阴性标本PCT结果比较差异有统计学意义;③血培养革兰阳性菌与革兰阴性菌PCT结果比较无明显差异,但如果将革兰阳性菌组金黄色葡萄球菌的结果去除,再与革兰阴性菌相比差异有统计学意义。结论:PCT对革兰阴性菌与革兰阳性菌感染有一定的判别作用,配合血培养检测能辅助临床的快速诊断,提示临床初步抗生素的使用方向,减少用药的盲目性和耐药菌株的出现。%Objective: Compare gram-positive (G+)bacteria and gram-negative bacteria (G-) bloodstream infections of serum procalcitonin(PCT) original level, to explore the clinical significance of blood culture and PCT joint detection. Methods: One hundred and ninty nine cases were selected, by using BD BACTEC 9120 type automatic blood culture instrument to detect the bacterial culture and at the same time the PCT results, comparative PCT concentration in blood cultures between positive and negative results and gram-positive bacteria and gram-negative bacteria. Results:(1)Screening detection of PCT were detected in 99 cases of specimens of blood culture positive for 18 species of bacteria including staphylococcus epidermis form than most, by 17.2%;The second is the e. coli were 16.2%and 10.1%acinetobacter baumannii. (2)blood culture positive for

  7. 实体器官移植术后并发败血症96例临床分析%A clinical anylasis of 96 patients with bloodstream infections after solid organ transplantation

    Institute of Scientific and Technical Information of China (English)

    万齐全; 明英姿; 马颖

    2012-01-01

    目的:探讨实体器官移植术后并发败血症的临床表现、病原体、综合治疗及结果.方法:回顾性分析96例实体器官移植术后并发败血症患者的临床资料、病原体构成和来源、综合处理手段及成败原因.结果:96例患者共发生134次败血症,患者平均年龄42.4岁.实体器官移植术后并发败血症病原体种类繁多,病原体耐药性强,临床表现无特异性,抗感染效果差.经减量或停用免疫抑制剂、抗感染等处理,57例存活,败血症相关病死率为40.6%.结论:果断停用实体器官移植术后并发败血症患者的免疫抑制剂,及早使用敏感抗生素,以及强有力营养及器官功能支持是救治成功的关键,预防感染发生尤为关键.%Objective: To evaluate clinical characteristics, pathogens, treatment regimens and outcomes in patients with bloodstream infections (BSIs) after solid organ transplantation.Methods: Clinical data of ninety six cases of BSI were analyzed retrospectively to identify the pathogens and the origin of infection, and to evaluate comprehensive treatment and the causes of success or failure.Results: All 96 patients underwent the comprehensive treatments, including suspending administration of immunosuppressants and starting administration of approprite antibiotics. The clinical characteristics of patients with BSIs after solid organ transplantation were atypical. The pathogens were various and seriously multi-drug resistant, which led to a high mortality. Among them 57 cases recovered, but the BSI-related mortality rate was 40.6%.Conclusion: Stopping the administration of immunosuppressants, reasonable use of antibiotics,nutritional support and protecting the function of organs as soon as possible were of the greatest importance among of the various treatment plan. Avoidance of all kinds of infection in the first place is most important.

  8. 中心静脉导管相关性血流感染21例临床分析%Clinical analysis of intravascular catheter-related bloodstream infection in neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    赵方; 曾宾; 刘筱萍; 周于新; 张双船

    2010-01-01

    Objective To find out the clinical characteristics and morbility factors of intravascular catheterrelated bloodstream infection(CRBSI). Methods Totally 21 patients who had CRBSI in neonatal intensive care unit were investigated retrospectively. Results The distribution of CRBSI was higher in very low birthweight preterm infants, gestational age among 28 ~34week, whose intravascular catheter remaining time were obove three weeks. Principal clinical presentation of CRBSI were poor feeding, unaocountable tachycardia, temperature instability, stressed hyperglycemia,refractoriness metabolic acidosis. The most common pathogens were coagulase-negative staphylococci (35.7%), Klebsiella pneumonia, bacilli ( 11.9% ) Staphylococcus aureus (9.5 % ), Pseudomonas aeruginosa( 7. 1% )and Enterobacter cloacae(7.1% ). Conclusions The clinical manifestations of CRBSI were concealment,and reducing the time of inserted central catherization and total parenteral nutrition, strengthening the nutrition of body would provide effective prevention of CRBSI.%目的 探讨中心静脉导管相关性血流感染(CRBSI)的临床特征和发病因素.方法 对新生儿重症监护病房发生的21例CRBSI患儿的临床资料进行回顾性分析.结果 胎龄28~34周、出生体质量<1 500 g、导管留置时间在3周以上的早产儿是CRBSI的高发人群,以喂养不耐受、不明原因的心率加快、体温不稳、应激性血糖升高及顽固性代谢性酸中毒为主要临床表现.感染的病原以凝固酶阴性的葡萄球菌为主(35.7%),其次分别为肺炎克雷伯杆菌(11.9%)、金黄色葡萄球菌(9.5%)、铜绿假单胞菌(7.1%)及阴沟肠杆菌(7.1%).结论 CRBSI患儿临床表现隐匿,缩短导管留置时间及胃肠外营养时间、加强全身的营养支持是预防CRBSI的有效措施.

  9. 探讨ICU患者中心静脉导管相关性血流感染的集束化预防策略%Increase the bundle prevention strategies of central venous catheter-related bloodstream infection in patients of ICU

    Institute of Scientific and Technical Information of China (English)

    王艳菊; 陈奕文; 姜爱丽

    2014-01-01

    ICU收治急危重症患者,大多数患者需要使用中心静脉导管测压、输液等,但其同时存在发生导管相关性血流感染(CRBSI)的风险,从而导致患者住院时间延长和病死率升高等。选择最优的穿刺途径、严格的手卫生、消毒皮肤、最大消毒屏障以及定期更换辅料等,应用集束化预防措施进行置管及日常护理是预防导管相关性血流感染发生的重要措施。%In ICU,there are critically ill patients,and most patients require the use of central venous catheter manometer,infusion and so on.But at the same time,the occurrence of catheter-related bloodstream infection(CRBSI) risk,result in patients with prolonged hospitalization and mortality rate higher.The application of bundle preventive measures of catheter and daily care, including the selection of optimal puncture,strict hand hygiene,disinfection, the biggest disinfection and barrier regular replacement of accessories and so on,is an important measure to prevent occurrence of catheter-related bloodstream infection,.

  10. 血培养阳性时间在假丝酵母菌属血流感染中的诊断价值%Diagnostic value of positivity in candida bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    王凯飞; 陈荣; 沈定霞; 叶丽艳; 王磊利

    2011-01-01

    OBJECTIVE To analyze the clinical characteristics of patients with candidemia and to assess the clinical value of the time to positivity (TTP) of blood cultures in patients of Candida bloodstream infection. METHODS The correlation of TTP with clinical parameters of 82 patients with candidemia was analyzed retrospectively. All statistical calculations were performed by using SPSS statistical software. RESULTS The average TTP in patients of C. Tropicalis bloodstream infection was the shortest (17. 0 ± 4. 9h), C. Glabrata was the longest (43. 6± 18. 9h), C. Albicans and C. Parapsilosis were (26. 6 ± 14. 3)h and (33. 7 ± 7. 8)h .respectively. Among the clinical parameters of patients of blood stream infection:78% of patients received long-term antibiotic therapy and 35% of patients underwent abdominal surgery. Among the first diagnosis in patients. 'tumor amounted to the highest percentage (20. 7%) and 35. 4% of patients suffered from respiratory infection at the same time. TTP were no significantly difference between survival group and death group. In the 30 candidemic patients with multiple blood cultures, the mortality of the patients with extended TTP was 16. 7% , which was significantly lower than that of the patients with shortened TTP (66. 7%). CONCLUSION More attention should be paid to the infection of Candida for patients rececing long-term antibiotic therapy, abdominal surgery, or with tumor and respiratory infection. The change of TTP is related to the prognosis of the patient.%目的 分析假丝酵母菌属血流感染的临床特征,探讨血培养的阳性时间(TTP)在假丝酵母菌属血流感染中的临床意义.方法 采用回顾性分析的方法,收集82例假丝酵母菌血培养阳性患者的TTP及其相关临床资料,将30 d内死亡的分为死亡组,未死亡的为生存组,并应用SPSS统计学软件进行数据分析.结果 热带假丝酵母菌TTP平均值最短,为(17.0±4.9)h,光滑假丝酵母菌TTP平均值最长,为(43.6±18

  11. The epidemiology of bloodstream infections in Fuxing Hospital in 2012 in Beijing%首都医科大学附属复兴医院2012年住院患者血流感染分析

    Institute of Scientific and Technical Information of China (English)

    梁蓓; 姜利; 刘淑梅; 席修明

    2016-01-01

    目的 了解血流感染患者的临床特征、预后及病原菌种类.方法 收集首都医科大学附属复兴医院2012年1月1日至12月31日住院患者的阳性血培养结果,分析确诊为血流感染患者的临床资料和病原菌种类.结果 血流感染患者149例,占当年出院患者18 774例次的0.8%,即当年血流感染的发生率为0.8%.首次发生血流感染时,15例(10.1%)患者来自手术科室,83例(55.7%)患者来自非手术科室,51例(34.2%)患者来自ICU.33例(22.1%)患者表现为感染性休克.住院期间死亡68例,病死率为45.6%.共发生154例次血流感染,其中医院获得性血流感染125例次(81.2%),社区获得性血流感染29例次(18.8%).共分离出病原菌188株,其中革兰阴性菌106株(56.4%),革兰阳性菌67株(35.6%),真菌15株(8.0%).革兰阴性菌血流感染中,社区获得性血流感染更多为肠杆菌科细菌,而非发酵菌在医院获得性血流感染显著多于社区获得性血流感染.125例次医院获得性血流感染中分离出159株菌(84.6%).188株病原菌中,26株为中心静脉导管相关性血流感染.手术科室、非手术科室、ICU的非发酵菌和肠杆菌分布差异有统计学意义(P=0.049).结论 血流感染发生地点不同、患者所在科室不同,病原学分布差异较大.对本地区、本单位、本科室血流感染患者临床特征和病原菌分布及演变的及时了解,为临床医生经验性使用抗菌药物提供依据,以改善血流感染患者的预后.%Objective To investigate the etiology,clinical features and outcome of hospitalized patients with bloodstream infections (BSIs) in a tertiary hospital.Methods Positive blood cultures were obtained from the microbiological laboratory in Fuxing Hospital,Capital Medical University from January 1,2012 to December 31,2012.BSIS events were identified and the epidemiology data were collected.Results A total of 149 patients and 154 BSIs events were

  12. Advances in metal forming expert system for metal forming

    CERN Document Server

    Hingole, Rahulkumar Shivajirao

    2015-01-01

    This comprehensive book offers a clear account of the theory and applications of advanced metal forming. It provides a detailed discussion of specific forming processes, such as deep drawing, rolling, bending extrusion and stamping. The author highlights recent developments of metal forming technologies and explains sound, new and powerful expert system techniques for solving advanced engineering problems in metal forming. In addition, the basics of expert systems, their importance and applications to metal forming processes, computer-aided analysis of metalworking processes, formability analysis, mathematical modeling and case studies of individual processes are presented.

  13. Distribution of pathogens causing catheter-associated bloodstream infections in hemodialysis patients and analysis of risk factors%血液透析患者导管相关性血流感染病原菌分布与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    杨春琴; 黄敏; 翁明祥

    2015-01-01

    目的:探讨血液透析患者导管相关性血流感染的病原菌分布及相关危险因素,为制定相应的干预措施提供参考依据。方法回顾性分析286例行中心静脉留置透析导管透析患者的临床资料,记录透析患者的年龄、性别、基础疾病、置管种类及部位、导管留置时间、病原菌培养结果。结果286例留置中心静脉透析导管患者,发生CRBSI 28例,发生率为9.79%;共分离出病原菌28株,其中革兰阳性菌20株占71.44%,以表皮葡萄球菌、金黄色葡萄球菌为主,革兰阴性菌8株占28.56%,以铜绿假单胞菌、大肠埃希菌、褪色沙雷菌为主;年龄>60岁、原发病为糖尿病肾病、导管留置时间>2周、行股静脉置管与CRBSI的发生具有相关性(P<0.05)。结论 CRB‐SI感染病原菌以革兰阳性菌为主,高龄、糖尿病、导管留置时间长、股静脉置管为导管相关性血流感染的危险因素。%OBJECTIVE To explore the distribution of pathogens causing catheter‐associated bloodstream infections in the hemodialysis patients and analyze the related risk factors so as to put forward targeted interventions . METHODS The clinical data of 286 patients who underwent indwelling central venous catheter hemodialysis were retrospectively analyzed;the age ,genders ,underlying diseases ,types of indwelling catheter ,intubation sites , catheter indwelling time ,and result of cultures of pathogens were recorded and observed .RESULTS The catheter‐associated bloodstream infections occurred in 28 of 286 patients undergoing indwelling central venous catheter he‐modialysis ,with the incidence rate of 9 .79% .A total of 28 strains of pathogens have been isolated ,including 20 (71 .44% ) strains of gram‐positive bacteria and 8 (28 .56% ) strains of gram‐negative bacteria;the Staphylococcus epidermidis and Staphylococcus aureus were the predominant species of the gram‐positive bacteria

  14. Scaling of Hadronic Form Factors in Point Form Kinematics

    CERN Document Server

    Coester, F

    2003-01-01

    The general features of baryon form factors calculated with point form kinematics are derived. With point form kinematics and spectator currents hadronic form factors are functions of $\\eta:={1\\over 4}(v_{out}-v_{in})^2$ and, over a range of $\\eta$ values are insensitive to unitary scale transformations of the model wave functions when the extent of the wave function is small compared to the scale defined by the constituent mass, $ \\ll 1/m^2$. The form factors are sensitive to the shape of such compact wave functions. Simple 3-quark proton wave functions are employed to illustrate these features. Rational and algebraic model wave functions lead to a reasonable representation of the empirical form factors, while Gaussian wave functions fail. For large values of $\\eta$ point form kinematics with spectator currents leads to power law behavior of the wave functions.

  15. Visual perception of tree forms

    Energy Technology Data Exchange (ETDEWEB)

    Muederrisoglu, Haldun; Eroglu, Engin; OEzkan, Suekran; Ak, Kivanc [Department of Landscape Architecture, Faculty of Forestry, Abant Izzet Baysal University, 81000, Duzce (Turkey)

    2006-06-15

    This study, made in the cities of Adapazari, Duzce, and Bolu, has three fundamental goals. The first one is the evaluation of visual quality and strength of each tree form, second is the determination of visual quality and strength of different tree forms next to each other, and the third goal of this study is determining the effects of personal characteristics to the perception of tree forms. To reach these three goals the semantic differential method was used to evaluate graphical visions of tree forms. According to the findings, trees with pyramid forms have the most effective visual quality and strength. Pyramid-formed tree combinations have higher visual quality and strength than mixed combinations do. At the same time personal characteristics are effective on the visual perception of tree forms. A strong relationship between the amount of area per person in the cities the participants live in and their visual perception of tree forms has been found. (author)

  16. Candida Infection of the Bloodstream - Candidemia

    Science.gov (United States)

    Candida Infection of the Bloodstream– Candidemia Fungal Disease Series #4 Candida is the single most important cause of ... Where in my body can I get a Candida infection? Candida infection can happen in almost any part ...

  17. ParFORM: Recent development

    International Nuclear Information System (INIS)

    We report on the status of our project of parallelization of the symbolic manipulation program FORM. We have now parallel versions of FORM running on Cluster- or SMP-architecture. These versions can be used to run arbitrary FORM programs in parallel

  18. Investigating Form-Focused Instruction.

    Science.gov (United States)

    Ellis, Rod

    2001-01-01

    Provides an historical sketch of form-focused instruction research, defines what is meant by form-focused instruction, and discusses the main research methods that have been used to investigate form-focused instruction in terms of a broad distinction between confirmatory and interpretive research. (Author/VWL)

  19. ParFORM: recent development

    OpenAIRE

    Tentyukov, M.; Vermaseren, J. A. M.; Staudenmaier, H. M.

    2005-01-01

    We report on the status of our project of parallelization of the symbolic manipulation program FORM. We have now parallel versions of FORM running on Cluster- or SMP-architectures. These versions can be used to run arbitrary FORM programs in parallel.

  20. FormLink/FeynCalcFormLink : Embedding FORM in Mathematica and FeynCalc

    CERN Document Server

    Feng, Feng

    2012-01-01

    FORM, a symbolic manipulation system, has been widely used in a lot of calculations for High Energy Physics due to its high performance and fficient design. Mathematica, another computational software program, has also widely been used, but more for reasons of generality and user-friendliness than for speed. Especially calculations involving tensors and noncommutative operations like calculating Dirac traces can be rather slow in Mathematica, compared to FORM. In this article we describe FormLink and FeynCalcFormLink, two Mathematica packages to link Mathematica and FeynCalc with FORM. FormLink can be used without FeynCalc and FeynCalcFormLink, which is an extension loading FormLink and FeynCalc automatically. With these two packages the impressive speed and other special features of FORM get embedded into the generality of Mathematica and FeynCalc in a simple manner. FeynCalcFormLink provides a FORM-based turbo for FeynCalc, making it much more efficient. FormLink turns Mathematica into an editor and code or...

  1. 综合ICU导管相关性血流感染的危险因素分析%Research on risk factors for central venous catheter-related bloodstream infections in general ICU

    Institute of Scientific and Technical Information of China (English)

    许燕卿; 周立新; 罗盛鸿; 李杏崧; 李轶男; 莫韶妹; 吕春梅; 邵劲松

    2012-01-01

    目的 探讨ICU导管相关性血流感染(CRBSI)的感染率及危险因素.方法 采用前瞻性监测,对2009年7月-2010年11月入住ICU> 24 h、年龄>1月龄的置管患者进行监测,并对发生CRBSI的病例进行危险因素分析.结果 监测患者共1145例,其中接受血管内置管的患者890例,血管内导管使用率为77.7%,置管日为9189 d,发生CRBSI 26例,CRBSI感染率为2.9%,平均日感染率为2.8/千日;CRBSI感染率与置管时间、置管次数均呈正相关(x2=40.71,P=0.000;x2=28.6,P=0.000);留置天数(OR=2.415)与置管次数(OR=1.531)是综合ICU的CRBSI独立危险因素.结论 严格执行手卫生、无菌技术置管和维护、尽早拔除导管是预防CRBSI发生的关键.%OBJECTIVE To determine the incidence rate and risk factors for catheter-related bloodstream infections (CRBSI ) in general ICU. METHODS Prospective monitoring was carried out on patients aged over one month whose ICU length of stay was over 24 hours from Jul 2009 to Nov 2010. The risk factors for CRBSI were analyzed. RESULTS Among the 1145 cases surveyed,890 cases were under intravenous catheterization. The rate of intravenous catheterization was 77. 7% while the overall duration was 9189 days. A total of 26 cases of CRBSI were observed with the incidence rate of 2. 9% and the mean daily incidence rate of 2. 8 per 1,000 catheter-day; the incidence rate of CRBSI was positively correlated with the duration of catheterization (x2 =40. 71,P = 0. 000) and frequency of catheterization (x2 =28. 6, P=0. 000), respectively. The duration (OR=2. 415) and frequency (OR=l. 531) of the catheterization were the independent risk factors for CRBSI in general ICU patients with central intravenous catheter. CONCLUSION The incidence rate of CRBSI can be reduced by performing strict hand hygiene procedures, aseptic technique for insertion, care for intravascular catheters and the removal of catheters in a timely manner.

  2. Prognostic determinants of death of patients with bloodstream infections in emergency department%急诊病区血行感染患者的死亡危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李楠; 白传哲; 王静; 高燕

    2013-01-01

    目的 对急诊病区血行感染(BSI)患者的流行病学资料进行调查,探讨BSI患者死亡的危险因素.方法 对2009年1月-2010年12月沈阳军区总医院急诊科病区BSI患者进行回顾性调查,按照其病情转归将其分为生存组和死亡组,筛选BSI患者死亡危险因素.结果 52例患者被确诊为BSI,发生率为2.9%,28 d死亡率为30.8%;革兰阴性菌检出最高,占51.9%,BSI致患者的死亡率为56.3%;诊断BSI后的APACHEⅡ评分、器官功能障碍的数目、肾功能不全和凝血功能障碍均为BSI患者死亡的独立危险因素;及时正确使用抗菌药物可显著提高BSI患者生存率(P=0.038).结论 确诊BSI时的APACHEⅡ评分、器官功能障碍的数目、肾功不全和凝血功能障碍可以预测BSI患者病情的转归,及时正确使用抗菌药物是病情转归的关键因素.%OBJECTIVE To investigate the epidemiological data of the patients with bloodstream infections (BSD in emergency department and explore the risk factors associated with the death of the BSI patients. METHODS A retrospective study was performed to analyze the epidemic data of BSI in ED of General Hospital of Shenyang Military Region from Jan 2009 to Dec 2010. The patients were divided into the survival group and the death group according to the clinical outcomes, and the risk factors of the death of the BSI patients were screened. RESULTS Totally 52 cases were diagnosed as hospital-acquired BSI with the incidence rate of 2. 9% , and the 28-day mortality was 30. 8%. The gram-negative bacteria were the most frequently isolated pathogens, accounting for 51. 9%, an the mortality of the patients with BSI caused the pathogens was 56. 3%. The APACHE Ⅱ score, the number of involving organs of dysfunctions, renal dysfunction, and coagulation disorders at onset of the BSI were the independent predictors of mortality. Appropriate use of antimicrobial agents could significantly improve the survival rate of the BSI

  3. Central venous catheter-related bloodstream infections in blood purification department%血液净化中心静脉导管相关性血流感染调查分析

    Institute of Scientific and Technical Information of China (English)

    张祥文; 贾中尉; 滕廷波; 李丽华

    2012-01-01

    目的 了解血液净化患者中心静脉导管相关性血流感染(CRBSI)的病原菌分布特点及药敏,分析CRBSI的相关因素.方法 对三峡大学第一临床医学院肾病科血液净化室,2008年1月-2010年12月所有新增留置中心静脉导管的患者进行回顾性分析.结果 医院32例半永久留置、105例临时留置CRBSI患者发生率分别为1.09次/1000导管日、5.19次/1000导管日,两者比较差异有统计学意义(P<0.01);临时导管留置时间>45、<45 d患者的CRBSI发生率分别为6.73次/1000导管日、2.28次/1000导管日;颈内静脉、股静脉置管患者的CRBSI发生率分别为2.43次/1000导管日、6.95次/1000导管日,两者比较差异均有统计学意义(P<0.05);表面葡萄球菌、金黄色葡萄球菌、溶血性葡萄球菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌是常见病原菌.结论 置管方式、部位、留置时间是CRBSI的危险因素,留置导管的CRBSI应根据本中心的经验及药敏选择抗菌药物.%OBJECTIVE To investigate the isolated pathogens and their drug susceptibility of the pathogens causing central venous catheter-related blood stream infections (CRBSI) in patients in blood purification department, and analyze the risk factors for CRBSI. METHODS A retrospective analysis of central venous catheter-related bloodstream infection (CRBSI) in all the patients who were newly placed with CVCs in our hospital s hemodialysis room from Jan 2008 to Dec 2010 was performed. RESULTS The incidence of CRBSI were 1. 09 episodes per 1,000 catheter-days in 32 permanent CVC cases and 5. 19 episodes per 1,000 catheter-days in 105 temporary CVC cases, and there was statistically difference between them (P<0. 05). The incidence of CRBSI were 6. 73 episodes per 1, 000 catheter-days in cases with temporary catheter time more than 45 days, and 2. 28 in cases with temporary catheter time less than 45 days. There was statistical difference between them (P

  4. 批量重度烧伤患者中心静脉置管相关血流感染病例分析%Central venous catheter-related bloodstream infection in mass severe burn patients

    Institute of Scientific and Technical Information of China (English)

    黄慧敏; 徐晓莉; 尹湘毅; 方红梅; 聂牛燕; 沈小玥

    2015-01-01

    目的:了解批量重度烧伤患者中心静脉置管相关血流感染情况、危险因素及感染防控措施效果。方法某院2014年8月抢救了9例重度烧伤患者,对其行中心静脉置管术,置管全程对患者进行感染防控干预。结果9例患者共进行中心静脉置管30例次,置管总日数227 d,其中2例患者股静脉三腔置管细菌培养阳性,导管相关血流感染(CRBSI)发病率为8.81‰;其中1例患者培养出屎肠球菌,另1例患者培养出鲍曼不动杆菌和嗜麦芽窄食单胞菌。2例 CRBSI 患者均为股静脉置管,置管部位均为创面,置管时间均≥7 d,均为三腔置管,且患者Ⅲ°烧伤面积≥60%。经及时拔除导管和使用抗菌药物,2例感染患者均治愈。结论中心静脉置管有利于危重烧伤患者长期、安全、有效地补液,但其可导致 CRBSI;对中心静脉导管置管患者进行全程感染防控干预,选用少腔导管,有助于降低 CRBSI 的发生。%Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns

  5. 基层医院ICU中心静脉导管相关性血流感染的危险因素分析%Risk Factors of Catheter-Associated Bloodstream Infections in Intensive Care Unit of Primary Hospital

    Institute of Scientific and Technical Information of China (English)

    张细江

    2012-01-01

    Objective To explore the risk factors of catheter-associated bloodstream infections (CRBSI) in intensive care unit (ICU) of primary hospital. Methods A total of 623 patients with central venous catheters were recruited in the study. 60 of them suffered from CRBSI served as an observation group and other 563 cases without CRBSI served as control. Univariate analysis was used to scan possible risk factors. Then logistic regression analysis was used to exclude the confounding factors. Results The overall incidence rate of CRBSI was 9. 63% (60/623). There were significant differences in APACHE score, type of catheter,location of catheter,duration of central venous catheter,intravenous nutrition, use of steroid,times of intubation, urgent intubations, nutritional status, diabetes, and MODS between the two groups. Logistic regression analysis revealed that higher APACHE score, double-lumen catheter, femoral vein catheter, catheter indwelling more than two weeks, intravenous nutrition, intubation more than 2 times, and emergency intubation were risk factors of CRBSI. Conclusions Higher APACHE score,double-lumen catheter,femoral vein catheter,catheter indwelling more than two weeks,intravenous nutrition,intubation more than 2 times, and emergency intubation were major risk factors of CRBSI in ICU of primary hospital.%目的 探讨基层医院ICU中心静脉导管相关血流感染(CRBSI)的危险因素.方法 以台州市立医院ICU就诊的中心静脉导管留置患者为研究对象,根据是否发生CRBSI分成感染组(60例)和非感染组(563例),首先单因素分析初步筛查CRBSI的危险因素,然后以是否发生CRBSI(1=是,0=否)为因变量,以单因素分析有差别的危险因素为自变量,进行Logistic多因素回归分析,寻找CRBSI的危险因素.结果 CRBSI的发生率为9.63% (60/623);感染组与非感染组APACHE评分、导管类型、导管留置部位、留置时间、静脉营养、激素使用、插管次数、紧急插管、营

  6. Risk factors for catheter-related bloodstream infection in an intensive care unit%ICU 导管相关血流感染危险因素分析

    Institute of Scientific and Technical Information of China (English)

    刘银梅; 余红; 杨惠英

    2014-01-01

    目的:了解重症监护室(ICU)导管相关血流感染(CRBSI)的危险因素,为其预防控制提供科学依据。方法选取2008年1月-2012年12月某院 ICU 行中心静脉置管(CVC)且时间>48 h 的住院患者1677例,分为CRBSI 组和非 CRBSI 组,对其进行危险因素分析。结果 CVC 使用率为92.88%(21041 d);发生 CRBSI 86例, CRBSI 发生率为5.13%,千导管日 CRBSI 发生率为4.02/1000,CRBSI 组患者病死率为58.14%(50/86),显著高于非CRBSI 组的36.83%(586/1591),差异有统计学意义(χ2=15.74,P <0.01)。多因素 logistic 回归分析结果显示,入住ICU 时间>5 d、CVC 时间>5 d、CVC 次数>1次是 CRBSI 的危险因素(均 P <0.01)。结论了解 ICU 住院患者CRBSI 状况及其危险因素,可为进一步开展目标性监测,实现 CRBSI“零宽容”的奋斗目标提供参考。%Objective To study the risk factors for catheter-related bloodstream infection (CRBSI)in an intensive care unit (ICU),and provide scientific evidence for CRBSI prevention and control.Methods 1 677 ICU patients with central venous catheterization (CVC)for>48 hours between January 2008 and December 2012 were divided in-to CRBSI group and non-CRBSI group,risk factors for CRBSI were analyzed.Results The utilization rate of CVC was 92.88% (21 041 d);86 (5.13%)patients developed CRBSI,the incidence of CRBSI per 1 000 catheterization-day was 4.02,the mortality of CRBSI group was significantly higher than non-CRBSI group (58.14% [50/86]vs 36.83%[586/1 591])(χ2 =15.74,P 5 days,CVC>5 days,the episode of CVC>1 (P <0.01).Conclusion Realizing the occur-rence status and risk factors of CRBSI in ICU patients can provide reference for further targeted monitor and implementation of zero tolerance goal of the CRBSI.

  7. Discussion on Form Focused Instruction

    Institute of Scientific and Technical Information of China (English)

    冯滢

    2007-01-01

    The pedagogy of language teaching has moved from one extreme-Grammar Translation Method to the other-Communicative Language Teaching.Today Form Focused Instruction(FFI)has emerged,intending to bring language forms instructionback to the communicative language classroom.Despite of the approval of this new approach,there is a hot dispute on its two types of application:Focus on Form or Focus on FormS.This article briefly analyzes FFI in recent research studies with focus on the choice between the two types of application.The tentative conclusion is FFI does show some explicit and reliable effects on accuracy and error elimination in language teaching;however,the investigation into its application is not simply either Focus on Form Or Focus on FormS,but focuses on the optimal combination of the two in teaching.

  8. Temporal form in interaction design

    DEFF Research Database (Denmark)

    Vallgårda, Anna; Winther, Morten Trøstrup; Mørch, Nina;

    2015-01-01

    Interaction design is distinguished from most other design disciplines through its temporal form. Temporal form is the computational structure that enables and demands a temporal expression in the resulting design. Temporal form is what enables poetry. In music, temporal form is the composition...... of tones, pauses, and timbre arranged into harmonies and rhythms. In interaction design it is, for instance, the behaviors of pixels on a screen or the movements in shape-changing interfaces. In this paper we show the power of working explicitly with temporal form in designing computational things. We give...... temporal forms by letting a series of expert designers reflect upon them. We borrow a framework from Boorstin’s film theory in which he distinguishes between the voyeuristic, the vicarious, and the visceral experience. We show how to use rhythms, complexity, gentle or forceful behavior, etc., to create...

  9. The semantics of biological forms.

    Science.gov (United States)

    Albertazzi, Liliana; Canal, Luisa; Dadam, James; Micciolo, Rocco

    2014-01-01

    This study analyses how certain qualitative perceptual appearances of biological forms are correlated with expressions of natural language. Making use of the Osgood semantic differential, we presented the subjects with 32 drawings of biological forms and a list of 10 pairs of connotative adjectives to be put in correlations with them merely by subjective judgments. The principal components analysis made it possible to group the semantics of forms according to two distinct axes of variability: harmony and dynamicity. Specifically, the nonspiculed, nonholed, and flat forms were perceived as harmonic and static; the rounded ones were harmonic and dynamic. The elongated forms were somewhat disharmonious and somewhat static. The results suggest the existence in the general population of a correspondence between perceptual and semantic processes, and of a nonsymbolic relation between visual forms and their adjectival expressions in natural language.

  10. Isometric Spacelike Immersions of Space Forms in Indefinite Space Forms

    Institute of Scientific and Technical Information of China (English)

    李海中; 吴岚

    2001-01-01

    Let M be a connected n-dimensional space form spacelike isometrically immersed in a (2n -1)-dimensional indefinite space form. If M is maximal, we prove that either M is totally geodesic or M is apiece of the n-dimensional hyperbolic cylinder in the (2n - 1)-dimensional pseudo-hyperbolic space.``

  11. Risk factors of bloodstream infection-related death after liver transplantation%肝移植术后血流感染死亡的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    万齐全; 谢建飞; 叶少军; 刘忠忠; 仲福顺; 周建党; 叶啟发

    2016-01-01

    发生≥3次的血流感染(最多发生了6次).41.12% (44/107)发生血流感染的肝移植受者接受了不恰当的抗感染处理.原发感染部位:腹腔内、肺、尿道、血管内导管、部位不明分别为40、39、3、1、24例.微生物感染类型:革兰氏阳性菌、革兰氏阴性菌、真菌、混合感染分别为28、24、4、51例.102例为院内感染.186株血液标本细菌培养结果显示:84株为革兰氏阳性菌是其主要的致病菌,其中又以肠球菌(31株)及金黄色葡萄球菌(23株)为优势菌株.血流感染病死率为37.38% (40/107),其中因感染性休克死亡35例.(2)影响肝移植受者术后血流感染相关死亡的危险因素分析指标:单因素分析结果显示:受者的性别、供肝来源、感染时体温、病原微生物类型、血清Cr水平、血清Alb水平、外周血WBC、外周血PLT、感染性休克是肝移植术后血流感染死亡的危险因素(x2=5.801,5.920,13.047,12.776,11.366,7.976,25.173,9.289,51.905,P<0.05).多因素分析结果表明:血清Alb水平<30 mg/L和感染性休克是肝移植术后血流感染相关死亡的独立危险因素(OR=5.839,44.983,95%可信区间:1.145~29.767,12.606~160.514,P <0.05).结论 肝移植术后易发生血流感染,血清Alb水平<30mg/L和感染性休克是肝移植术后血流感染相关死亡的独立危险因素.%Objective To investigate the risk factors of bloodstream infection-related death after liver transplantation.Methods The retrospective case-control study was adopted.The clinical data of the 107 patients with bloodstream infection from 365 liver transplantation patients who were admitted to the Third Xiangya Hospital of Central South University (220 patients) and South Central Hospital Affiliated to Wuhan University (145 patients) from January 1,2002 to December 31,2015 were collected.The patients received modified piggyback liver transplantation.The second or third generation celphalosporin or carbapenems antibiotics

  12. Analysis of resistance tendency of bloodstream-infecting pathogens in China%2004-2010年中国血标本中致病菌耐药趋势分析

    Institute of Scientific and Technical Information of China (English)

    吕媛; 李耘; 薛峰; 张秀珍; 胡云建; 金玉芬; 褚云卓; 胡志东; 赵建宏

    2013-01-01

    Objective To investigate the resistance profiles and the trend of bloodstream-infecting pathogens isolated from hospitalized patients during 2004-2010.Methods The bloodstream isolates were collected from 18 hospitals in 17 cities.Minimum inhibition concentrations (MIC) were determined using the agar dilution method recommended by CLSI (Clinical and Laboratory Standards Institute),and susceptibility results were analyzed according to the 2011 CLSI guideline.Results Among the 2004-2005,2007-2008 and 2009-2010 periods,the proportions of clinical isolates were similar; 43.1% (149 isolates),34.0% (151 isolates) and 47.5% (776 isolates) for Gram positive strains,56.9% (197 isolates),66.0% (293 isolates) and 52.5% (858 isolates) for Gram negative strains,respectively.The isolating rate of MRSA was 54.1% (20/37) in 2007-2008,which was the highest among the 3 periods during 2004 to 2010,while it decreased in 2009-2010 (36.5%,62/170).The MRCNS proportions were similar across the 3 periods.One (1.8%) vancomycin-resistant Enterococcus faecium and 1 linezolidresistant Enterococcus faecalis were found.Although the isolating rates of penicillin non-sensitive strains (oral) were similar between 2009-2010 and 2007-2008 [54.5% (6/11) and 53.9% (7/13),respectively],the resistant rates increased from 0% in 2007-2008 to 30.8% (4/13) in 2009-2010.The results were similar according to the non-meningitis criterion (Ⅳ),and the susceptibility rates decreased from 100.0% (11 isolates) in 2007-2008 to 84.6% (11/13) in 2009-2010.ESBL-harboring strains in E.coli were similar among the 3 periods during 2004 to 2010 [66.7% (30/45),73.2% (71/97) and 67.9% (233/343),respectively].ESBL-producing strains in Klebsilla pnuemoniae decreased year after year,72.4% (21/29),50.0% (18/36) and 41.1% (65/158) in 2004-2005,2007-2008 and 2009-2010,respectively.Except that the sensitive rate of Enterobacter cloacae to ertapenem was 80% (32/40),the sensitive rates of

  13. Supergravity Actions with Integral Forms

    OpenAIRE

    Castellani, L.; Catenacci, R.; Grassi, P. A.

    2014-01-01

    Integral forms provide a natural and powerful tool for the construction of supergravity actions. They are generalizations of usual differential forms and are needed for a consistent theory of integration on supermanifolds. The group geometrical approach to supergravity and its variational principle are reformulated and clarified in this language. Central in our analysis is the Poincare' dual of a bosonic manifold embedded into a supermanifold. Finally, using integral forms we provide a proof ...

  14. Laser forming and welding processes

    CERN Document Server

    Yilbas, Bekir Sami; Shuja, Shahzada Zaman

    2013-01-01

    This book introduces model studies and experimental results associated with laser forming and welding such as laser induced bending, welding of sheet metals, and related practical applications. The book provides insight into the physical processes involved with laser forming and welding. The analytical study covers the formulation of laser induced bending while the model study demonstrates the simulation of bending and welding processes using the finite element method. Analytical and numerical solutions for laser forming and welding problems are provided.

  15. A compiler for variational forms

    CERN Document Server

    Kirby, Robert C; 10.1145/1163641.1163644

    2011-01-01

    As a key step towards a complete automation of the finite element method, we present a new algorithm for automatic and efficient evaluation of multilinear variational forms. The algorithm has been implemented in the form of a compiler, the FEniCS Form Compiler FFC. We present benchmark results for a series of standard variational forms, including the incompressible Navier-Stokes equations and linear elasticity. The speedup compared to the standard quadrature-based approach is impressive; in some cases the speedup is as large as a factor 1000.

  16. Discussion on Form Focused Instruction

    Institute of Scientific and Technical Information of China (English)

    冯滢

    2007-01-01

    The pedagogy of language teaching has moved from one extreme-Grammar Translation Method to the other-Communicative Language Teaching.Today Form Focused Instruction(FFI) has emerged,intending to bring language forms instruction back to the communicative language classroom.Despite of the approval of this new approach,there is a hot dispute on its two types of application:Focus on Form or Focus on FormS.This article briefly analyzes FFI in recent research studies with focus on the choice between the two types ...

  17. INFORMATIONAL EFFECT OF A FORM

    Directory of Open Access Journals (Sweden)

    Kovalenko V.F.

    2016-02-01

    Full Text Available The study was conducted by method of light scattering of laser emission. The influence of the form field, mutual influence of mental informational and form torsional fields as well as the following exposure of water samples in the form field after the cease of informational influence on water structure were examined. Paper forms of a pyramid, a cylinder, and a prism were used. The experimental findings show that mechanism of mutual influence on water structure of the form and informational torsional fields depended on the initial conditions of spin restructuring process – the configuration of a form, the type of the form field (internal and external ones, and the initial water structure. The influence of the form field on informational aftereffect was determined, the character of which was defined by ratio of intensities of torsional form field and an informational soliton. The phenomenon of the abnormally large amplification of the informational aftereffect in the internal field of a pyramid demonstrating the attributes of positive reverse connection between the informational soliton and torsional field of water structure and selection of generated cluster sizes were discovered.

  18. Tectonics: The meaning of form

    DEFF Research Database (Denmark)

    Christiansen, Karl; Brandt, Per Aage

    Tectonics – The meaning of form deals with one of the core topics of architecture: the relationship between form and content. In the world of architecture, form is not only made from brick, glass and wood. Form means something. When a material is processed with sufficient technical skill...... perspectives. You can read the chapters in any order you like – from the beginning, end or the middle. There is no correct order. The project is methodologically inductive: the more essays you read, the broader your knowledge of tectonics get....

  19. 肝移植术后耐甲氧西林金黄色葡萄球菌血流感染危险因素的17年回顾性分析%A 17-year retrospective study of the risk factor of bloodstream infection with MRSA after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    邰强; 何晓顺; 巫林伟; 鞠卫强; 王东平; 王国栋; 马毅; 胡安斌; 郭志勇; 朱晓峰

    2011-01-01

    目的 探讨本院肝移植术后耐甲氧西林金黄色葡萄球菌(MRSA)血流感染的危险因素及临床结果.方法 回顾分析1993年1月至2010年5月肝移植术后血液MRSA阳性感染者的资料.结果 695例肝移植患者中,53例(7.6%)出现革兰氏阳性球菌血流感染,以肠球菌最为常见,7例病人发生7次MRSA血流感染.分析肝移植术后MRSA血流感染的危险因素发现,急性排斥(P=0.03)是出现MRSA血流感染的危险因素.肝移植术后MRSA血流感染与非MRSA血流感染的15d、30 d、1年病死率差异无统计学意义.结论 急性排斥是出现肝移植术后MRSA血流感染的危险因素,但肝移植术后MRSA血流感染后15d、30 d、1年的死亡率未明显增加.%Objective To define the risk factor and mortality of methicillin-resistant Staphylococcus aureus (MRSA) of bloodstream infections(BSI) after liver transplantation. Method From January 1993 to May 2010, a retrospective analysis of methicillin-resistant Staphylococcus aureus in liver transplants are conducted. Results S3 out of 695 patients had BSI, commonly infected with enterococcus. Postoperative acquisition of MRSA was detected in 7 patients. Univariate analysis identified acute rejection was the risk factor for methicillin-resistant Staphylococcus aureus bacteremia(P=0.03). No significant differences was found in mortality at 15 days,30 days and 1 year in methicillin-resistant Staphylococcus aureus bacteremia after liver transplantation. Conclusions Risk factor associated with methicillin-resistant Staphylococcus aureus of bloodstream infections was acute rejection. Methicillin-resistant Staphylococcus aureus bloodstream infection show no significance in mortality at 15 days, 30 days and 1 year after operation.

  20. Improving the forming capability of laser dynamic forming by using rubber as a forming medium

    Science.gov (United States)

    Shen, Zongbao; Liu, Huixia; Wang, Xiao; Wang, Cuntang

    2016-04-01

    Laser dynamic forming (LDF) is a novel high velocity forming technique, which employs laser-generated shock wave to load the sample. The forming velocity induced by the high energy laser pulse may exceed the critical forming velocity, resulting in the occurrence of premature fracture. To avoid the above premature fracture, rubber is introduced in LDF as a forming medium to prolong the loading duration in this paper. Laser induced shock wave energy is transferred to the sample in different forming stages, so the forming velocity can be kept below the critical forming velocity when the initial laser energy is high for fracture. Bulge forming experiments with and without rubber were performed to study the effect of rubber on loading duration. The experimental results show that, the shock wave energy attenuates during the propagation through the rubber layer, the rubber can avoid the premature fracture. So the plastic deformation can continue, the forming capability of LDF is improved. Due to the severe plastic deformation under rubber compression, adiabatic shear bands (ASB) occur in LDF with rubber. The material softening in ASB leads to the irregular fracture, which is different from the premature fracture pattern (regular fracture) in LDF without rubber. To better understand this deformation behavior, Johnson-Cook model is used to simulate the dynamic response and the evolution of ASB of copper sample. The simulation results also indicate the rubber can prolong the loading duration.

  1. Higher-order Maass forms

    NARCIS (Netherlands)

    Bruggeman, R.W.; Diamantis, N.

    2012-01-01

    The spaces of Maass forms of even weight and of arbitrary order are studied. It is shown that, if we allow exponential growth at the cusps, these spaces are as large as algebraic restrictions allow. These results also apply to higher-order holomorphic forms of even weight.

  2. Automated Test-Form Generation

    Science.gov (United States)

    van der Linden, Wim J.; Diao, Qi

    2011-01-01

    In automated test assembly (ATA), the methodology of mixed-integer programming is used to select test items from an item bank to meet the specifications for a desired test form and optimize its measurement accuracy. The same methodology can be used to automate the formatting of the set of selected items into the actual test form. Three different…

  3. Identities between Modular Graph Forms

    CERN Document Server

    D'Hoker, Eric

    2016-01-01

    This paper investigates the relations between modular graph forms, which are generalizations of the modular graph functions that were introduced in earlier papers motivated by the structure of the low energy expansion of genus-one Type II superstring amplitudes. These modular graph forms are multiple sums associated with decorated Feynman graphs on the world-sheet torus. The action of standard differential operators on these modular graph forms admits an algebraic representation on the decorations. First order differential operators are used to map general non-holomorphic modular graph functions to holomorphic modular forms. This map is used to provide proofs of the identities between modular graph functions for weight less than six conjectured in earlier work, by mapping these identities to relations between holomorphic modular forms which are proven by holomorphic methods. The map is further used to exhibit the structure of identities at arbitrary weight.

  4. Topics on the FORM software; Topicos do software FORM

    Energy Technology Data Exchange (ETDEWEB)

    Costa Jorge, Patricia M. da; Peres, Patricia Duarte [Universidade Catolica de Petropolis, RJ (Brazil). Dept. de Ciencia da Computacao

    1997-06-01

    These notes studies the compilation with FORM software as applied to high energy physics, covering the following topics: Command structures, statistics and numbers, Dirac matrices, optimization control, Gamma matrices, errors and polynomial substitution

  5. FormTracer - A Mathematica Tracing Package Using FORM

    CERN Document Server

    Cyrol, Anton K; Strodthoff, Nils

    2016-01-01

    We present FormTracer, a high-performance, general purpose, easy-to-use Mathematica tracing package which uses FORM. It supports arbitrary space and spinor dimensions as well as an arbitrary number of simple compact Lie groups. While keeping the usability of the Mathematica interface, it relies on the efficiency of FORM. An additional performance gain is achieved by a decomposition algorithm that avoids redundant traces in the product tensors spaces. FormTracer supports a wide range of syntaxes which endows it with a high flexibility. Mathematica notebooks that automatically install the package and guide the user through performing standard traces in space-time, spinor and gauge-group spaces are provided.

  6. Quantum modular forms, mock modular forms, and partial theta functions

    Science.gov (United States)

    Kimport, Susanna

    Defined by Zagier in 2010, quantum modular forms have been the subject of an explosion of recent research. Many of these results are aimed at discovering examples of these functions, which are defined on the rational numbers and have "nice" modularity properties. Though the subject is in its early stages, numerous results (including Zagier's original examples) show these objects naturally arising from many areas of mathematics as limits of other modular-like functions. One such family of examples is due to Folsom, Ono, and Rhoades, who connected these new objects to partial theta functions (introduced by Rogers in 1917) and mock modular forms (about which there is a rich theory, whose origins date back to Ramanujan in 1920). In this thesis, we build off of the work of Folsom, Ono, and Rhoades by providing an infinite family of quantum modular forms of arbitrary positive half-integral weight. Further, this family of quantum modular forms "glues" mock modular forms to partial theta functions and is constructed from a so-called "universal" mock theta function by extending a method of Eichler and Zagier (originally defined for holomorphic Jacobi forms) into a non-holomorphic setting. In addition to the infinite family, we explore the weight 1/2 and 3/2 functions in more depth. For both of these weights, we are able to explicitly write down the quantum modular form, as well as the corresponding "errors to modularity," which can be shown to be Mordell integrals of specific theta functions and, as a consequence, are real-analytic functions. Finally, we turn our attention to the partial theta functions associated with these low weight examples. Berndt and Kim provide asymptotic expansions for a certain class of partial theta functions as q approaches 1 radially within the unit disk. Here, we extend this work to not only obtain asymptotic expansions for this class of functions as q approaches any root of unity, but also for a certain class of derivatives of these functions

  7. Utilização de cateter central de inserção periférica e ocorrência da infecção da corrente sanguínea em uma Unidade de Terapia Intensiva Neonatal | Use of peripherally inserted central catheters and occurrence of bloodstream infections in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Márcia Yumi Yonekura

    2015-02-01

    Full Text Available Objetivo: Analisar a prevalência de infecção hospitalar primária da corrente sanguínea em uma Unidade de Terapia Intensiva Neonatal. Métodos: Estudo retrospectivo, com análise de prontuários de uma Unidade de Terapia Intensiva Neonatal, no período de janeiro a dezembro de 2010. Foi calculada a densidade de incidência de infecção de corrente sanguínea associada ao cateter por 1000 cateteres-dia. Resultados: Dos 192 recém-nascidos, 16 (8,3% apresentaram infecção da corrente sanguínea e todos estes utilizaram o cateter central de inserção periférica. A densidade de infecção confirmada por hemocultura foi de 5,9 e a baseada em critérios clínicos foi de 3,5 por 1000 pacientes com cateter vascular central-dia. A distribuição por faixa de peso foi de: 30,9 (750-999g; 11 (1000-1499g; 8,5 (1500-2499g e 6,8 (> 2500g por 1000 pacientes com cateter vascular dia. A média do tempo de uso do cateter foi de 11 dias. O sítio de inserção mais comum foi o acesso jugular (37,5% e a mortalidade associada à infecção da corrente sanguínea foi de 31%. Conclusões: A utilização do cateter central de inserção periférica é uma prática não isenta de riscos, considerando que este é um dispositivo invasivo e pode predispor à ocorrência de infecção. ------------------------------------------------------------------------------------------ Objective: To analyze the prevalence of hospital primary bloodstream infections in a neonatal intensive care unit (NICU. Methods: A retrospective study involving analyses of records of patients admitted to the NICU from January to December 2010 was conducted. The incidence density of catheter-associated bloodstream infections per 1000 catheter-days was calculated. Results: Among 192 newborns, 16 (8.3% who used peripherally inserted central catheters had bloodstream infections. The infection density confirmed by blood culture reached 5.9, while the density based on clinical criteria accounted for

  8. Clinical effectiveness and cost-effectiveness of central venous catheters treated with Minocycline and Rifampicin in preventing bloodstream infections in intensive care patients [Medizinische Wirksamkeit und Kosteneffektivität von Minocyclin/Rifampicin-beschichteten zentralvenösen Kathetern zur Prävention von Blutbahninfektionen bei Patienten in intensivmedizinischer Betreuung

    Directory of Open Access Journals (Sweden)

    Neusser, Silke

    2012-10-01

    Full Text Available [english] The use of central venous catheters coated with antibiotics can avoid bloodstream infections with intensive care patients. This is the result of a scientific examination which has been published by the DIMDI. Costs could be also saved in this way. However, according to the authors, the underlying studies do not allow absolutely valid statements.[german] Der Einsatz bestimmter Antibiotika-beschichteter Venenkatheter kann bei Intensivpatienten Blutbahninfektionen vermeiden. So das Ergebnis einer wissenschaftlichen Untersuchung, die das DIMDI veröffentlicht hat. Auch ließen sich damit Kosten einsparen. Allerdings erlauben, laut den Autoren, die zugrunde gelegten Studien keine uneingeschränkt gültigen Aussagen.

  9. Differential forms theory and practice

    CERN Document Server

    Weintraub, Steven H

    2014-01-01

    Differential forms are utilized as a mathematical technique to help students, researchers, and engineers analyze and interpret problems where abstract spaces and structures are concerned, and when questions of shape, size, and relative positions are involved. Differential Forms has gained high recognition in the mathematical and scientific community as a powerful computational tool in solving research problems and simplifying very abstract problems through mathematical analysis on a computer. Differential Forms, 2nd Edition, is a solid resource for students and professionals needing a solid g

  10. Cold-formed steel design

    CERN Document Server

    Yu, Wei-Wen

    2010-01-01

    The definitive text in the field, thoroughly updated and expanded Hailed by professionals around the world as the definitive text on the subject, Cold-Formed Steel Design is an indispensable resource for all who design for and work with cold-formed steel. No other book provides such exhaustive coverage of both the theory and practice of cold-formed steel construction. Updated and expanded to reflect all the important developments that have occurred in the field over the past decade, this Fourth Edition of the classic text provides you with more of the detailed, up-to-the-minute techni

  11. Quadratic minima and modular forms

    OpenAIRE

    Brent, Barry

    1998-01-01

    We give upper bounds on the size of the gap between the constant term and the next non-zero Fourier coefficient of an entire modular form of given weight for \\Gamma_0(2). Numerical evidence indicates that a sharper bound holds for the weights h \\equiv 2 . We derive upper bounds for the minimum positive integer represented by level two even positive-definite quadratic forms. Our data suggest that, for certain meromorphic modular forms and p=2,3, the p-order of the constant term is related to t...

  12. 短信及时报告阳性血培养对细菌性血流感染的诊治价值初探%Preliminary study on the value of short message service timely reporting of positive blood cultures for bacterial diagnosis and treatment of bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    蒋晓飞; 田月如; 刘红; 阮斐怡

    2012-01-01

    目的 寻找合理评价缩短报告阳性血培养结果时间的价值指标,了解短信及时报告阳性血培养结果的临床价值.方法 采用率的x2检验比较短信报告阳性血培养结果前、后2组血流感染患者年龄、血流感染病原菌、血培养阳性率及30 d死亡率.结果 短信报告阳性血培养结果前、后2组的年龄、血流感染病原菌构成及血培养阳性率差异无统计学意义,30 d死亡率差异有统计学意义(P<0.05).结论 短信及时报告阳性血培养结果对临床有一定价值.%Objective To find a reasonable indicator to evaluate the value of reducing the time to report the positive blood culture results, and understand the clinical value of timely reporting of positive blood culture results by short message service. Methods With the statistics method X2 test, the disparities in age, bloodstream infection pathogens, blood culture positive rate and 30 d mortality of 2 groups before and after the reporting positive blood culture results by short message service were compared. Results The disparities in age, bloodstream infection pathogens and blood culture positive rate of the 2 groups were not statistically significant, but the disparity in 30 d mortality of the 2 groups was statistically significant (P<0. 05). Conclusions Short message service timely reporting of positive blood culture results are valuable for clinic.

  13. NETWORK CODING BY BEAM FORMING

    DEFF Research Database (Denmark)

    2013-01-01

    Network coding by beam forming in networks, for example, in single frequency networks, can provide aid in increasing spectral efficiency. When network coding by beam forming and user cooperation are combined, spectral efficiency gains may be achieved. According to certain embodiments, a method...... includes operating a user equipment of a plurality of user equipment in a network comprising a plurality of access points. The method also includes the user equipment forming a beam. The method further receives processing received signals from at least one of the plurality of access points at the user...... equipment. The forming the beam is configured to let different user equipment of the plurality of user equipment to receive different signals from the plurality of access points to achieve diversity by using different beams amongst the plurality of user equipment. The method additionally includes...

  14. Distances to star forming regions

    CERN Document Server

    Loinard, Laurent

    2014-01-01

    The determination of accurate distances to star-forming regions are discussed in the broader historical context of astronomical distance measurements. We summarize recent results for regions within 1 kpc and present perspectives for the near and more distance future.

  15. Movement in aesthetic form creation

    DEFF Research Database (Denmark)

    Thomsen, Bente Dahl

    2015-01-01

    This paper presents the good practice based experiences found when movement is used to strengthen form creation and to create flow in the process of artistic education. Faced with the design engineering students’ problems with creating forms with aesthetic statements, the experiences with movement...... inspired the thesis that the design engineers’ training in aesthetic form creation can be improved by integrating the movement potential into their education. The paper documents the on-going work on developing a model for embodied creation of form called ‘Somatechne model’. The study also identifies...... a lens to assess the students’ development of mind-body skills, known as ‘The Three Soma’. The Somatechne model also helps to identify the activity that gives the students the opportunity to develop their sensibility and thus aesthetic attention....

  16. Fields and Forms on -Algebras

    Indian Academy of Sciences (India)

    Cătălin Ciupală

    2005-02-01

    In this paper we introduce non-commutative fields and forms on a new kind of non-commutative algebras: -algebras. We also define the Frölicher–Nijenhuis bracket in the non-commutative geometry on -algebras.

  17. Detection of Life Forms Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Gaia Genomics proposes to develop an instrument for the detection of earthborn and/or planetary life forms that are based on a nucleic acid paradigm. Highly...

  18. BILINEAR FORMS AND LINEAR CODES

    Institute of Scientific and Technical Information of China (English)

    高莹

    2004-01-01

    Abraham Lempel et al[1] made a connection between linear codes and systems of bilinear forms over finite fields. In this correspondence, a new simple proof of a theorem in [1] is presented; in addition, the encoding process and the decoding procedure of RS codes are simplified via circulant matrices. Finally, the results show that the correspondence between bilinear forms and linear codes is not unique.

  19. Programmed form generation in design

    OpenAIRE

    V F Koleichuk

    1980-01-01

    This article distinguishes design research that is concerned with further developments of existing formal systems from fundamental research in technical or geometrical fields that is capable of opening up new form-generating programmes. A historical discussion includes analysis of an early series of 'spatial compositions' by the pioneer Soviet Constructivist artist and designer Aleksandr Rodchenko. The general character of serial form is discussed, and its relationship to the concept and the ...

  20. Form 6 - gas balancing agreement

    International Nuclear Information System (INIS)

    In 1988, a special Committee of the Rocky Mountain Mineral Law Foundation undertook a project to draft a model from gas balancing agreement. This project was initiated at the request of a number of Foundation members who felt that a model form gas balancing agreement would facilitate the negotiation of operating agreement, since gas balancing issues had become sticking points in the process. The Committee was composed of attorneys representing a wide cross-section of the oil and gas industry including both major and independent oil companies, production companies with interstate pipeline affiliates, and private practitioners. The Committee attempted to address the more controversial issues in gas balancing with optional provisions in the Form. To facilitate the negotiation process, the number of optional provisions was minimized. This form may be used as an Appendix to the new A.A.P.L. Form 610-1989 Model Form Operating Agreement. This book includes provision of this Form which are: Ownership of gas production; Balancing of production accounts; Cash balancing upon depletion; Deliverability tests; Nominations; Statements; Payment of taxes; Operating expenses; Overproducing allowable; Payment of leasehold burdens; Operator's liability; Successors and assigns; Audits; Arbitration; and Operator's fees

  1. Conjoint Forming - Technologies for Simultaneous Forming and Joining

    Science.gov (United States)

    Groche, P.; Wohletz, S.; Mann, A.; Krech, M.; Monnerjahn, V.

    2016-03-01

    The market demand for new products optimized for e. g. lightweight applications or smart components leads to new challenges in production engineering. Hybrid structures represent one promising approach. They aim at higher product performance by using a suitable combination of different materials. The developments of hybrid structures stimulate the research on joining of dissimilar materials. Since they allow for joining dissimilar materials without external heating technologies based on joining by plastic deformation seem to be of special attractiveness. The paper at hand discusses the conjoint forming approach. This approach combines forming and joining in one process. Two or more workpieces are joined while at least one workpiece is plastically deformed. After presenting the fundamental joining mechanisms, the conjoint forming approach is discussed comprehensively. Examples of conjoint processes demonstrate the effectiveness and reveal the underlying phenomena.

  2. Characterization of polymorphic ampicillin forms.

    Science.gov (United States)

    Baraldi, C; Tinti, A; Ottani, S; Gamberini, M C

    2014-11-01

    In this work polymorphs of α-aminobenzylpenicillin (ampicillin), a β-lactamic antibiotic, were prepared and investigated by several experimental and theoretical methods. Amorphous monohydrate and three crystalline forms, the trihydrate, the crystal form I and the crystal form II, were investigated by FT-IR and micro-Raman. Also data obtained by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), X-ray powder diffraction (XRPD) and hot-stage Raman spectroscopy are reported. Finally, quantum mechanical calculations were performed by density functional theory (DFT) to assist the assignment of spectroscopic experimental bands. For the first time, the ampicillin molecule in its zwitterionic form was studied at the B3LYP/aug-cc-pVDZ level and the corresponding theoretical vibrational spectra were computed. In fact, ampicillin in the crystal is in zwitterionic form and concentrations of this same form are quite relevant in solutions at physiological pH. Experimental and theoretical results allowed identification of specific features for polymorph characterization. Bands typical of the different polymorphs are identified both in IR and Raman spectra: in particular in the NH stretching region (IR), in the amide I+δNH region (both techniques), in the 1520-1490cm(-1) region (IR), in the 1320-1300cm(-1) and 1280-1220cm(-1) (IR), in the 1200-1170cm(-1) (Raman), in the amide V region (IR), and, finally, in the 715-640cm(-1) and 220-200cm(-1) (Raman). Interconversion among different polymorphs was investigated by hot-stage Raman spectroscopy and thermal analysis, clarifying the complex pattern of transformations undergone as a function of temperature and heating rate. In particular, DSC scans show how the trihydrate crystals transform into anhydrous forms on heating. Finally, stability tests demonstrated, after a two years period, that no transformation or degradation of the polymorphs occurred.

  3. Distribution and Drug Resistance of Pathogenic Bacteria in 575 Cases of Bloodstream Infection%血流感染575例病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    李文利; 吴诗品; 陈洪涛; 吴劲松

    2009-01-01

    Objective To study the distribution and drug resistance of pathogenic bacteria in patients with bloodstream infection(BSI).Methods Five hundred and seventy-five BSI patients hospitalized from Jan.2004 to Nov.2008 were enrolled to perform a retrospective analysis on bacterial identification and drug sensitive test results.Results A total of 645 strains of pathogenic bacteria were isolated,including 338 gram-negative (52.4%),267 gram-positive(41.4%),40 fungi(6.2%).Mixed infection was found in 52 patients.The isolated pathogenic bacteria were mainly coagulase-negative staphylococci(27.6%),Escherichia coli(21.7%),klebsiella pneumoniae(12.6%),glucose non-fermentative bacteria(9.9%),enterococcus(3.9%).The detection rates of Escherichia coli and klebsiella pneumoniae producing superspectrum β-lactamases (ESBLs)were 46.4%,19.7%,respectively;those of methicillin resistant S.aureus(MRSA) and meticillin-resistant coagulase-negative staphylococci(MRCNS) were 54.8%,89.3%,respectively.Glucose non-fermentative bacteria,acinetobacter baumannii,pseudomonas aeruginosa and burkholderia cepacia were highly resistant to most antimicrobials;gram-positive cocci resistant to vancomycin were not found.Conclusion The pathogenic bacteria inducing BSI are mainly gram-negative,and the multiple drug resistance of BSI pathogenic bacteria,especially glucose non-fermentative,is increasing.Monitoring drug resistance of pathogenic bacteria is of importance in guiding clinical rational use of antimicrobial drugs and reducing drug resistance bacteria.%目的 探讨近年来血流感染的病原菌分布及其对抗菌药物的耐药状况.方法 选择2004年1月-2008年11月在我院住院的575例血流感染患者,对患者的细菌鉴定及药敏试验结果进行回顾性分析.结果 从575例血流感染患者中共分离出645株病原菌,其中革兰阴性菌338株(占52.4%)、革兰阳性菌267株(占41.4%)、真菌40株(占6.2%),52例患者发生混合感染.分离的病原菌中,主要

  4. Analysis of etiology and clinical features of hospital-acquired bloodstream infection in children%儿童医院获得性血流感染的临床特征和病原学分析

    Institute of Scientific and Technical Information of China (English)

    徐月波; 董琳; 刘琳; 蔡蓓蓓

    2013-01-01

    目的 分析儿童医院获得性血流感染(H ABSI)的病原菌分布及其耐药性,为临床抗感染治疗提供依据.方法 回顾性分析温州医学院附属育英儿童医院2004年1月至2011年12月收治的168例病原学阳性的HABSI患儿的临床和细菌药物敏感试验资料.结果 共从168例患儿中检出病原菌171株,以ICU最多见(73.7%),其次为血液科(22.6%).其中革兰阳性菌占53.8%,革兰阴性菌占34.5%,真菌占11.7%;居前6位的分别为表皮葡萄球菌(24株、14.1%),肺炎克雷伯菌(23株、13.5%),溶血葡萄球菌(13株、7.6%),金黄色葡萄球菌(11株、6.4%),屎肠球菌(11株、6.4%)及大肠埃希菌(11株、6.4%).检出耐甲氧西林金黄色葡萄球菌和耐甲氧西林表皮葡萄球菌分别为1株和22株,未发现耐万古霉素和耐利奈唑胺的葡萄球菌和肠球菌.肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶(ESBL)株分别有22株和8株.160例(95.2%)患儿原有基础疾病,以早产和低体质量最多见(60.7%),126例(75.0%)接受过侵入性操作.发病年龄以<3个月最多见(75.6%).结论 HABSI好发于3个月以下婴儿及有基础疾病的患儿,多数接受过侵入性操作;病原菌以革兰阳性球菌为主;极低出生体质量儿可发生罕见的奥默毕赤酵母菌HABSI,加强医院感染防控至关重要.%Objective To summarize the pathogenic spectrum and antimicrobial susceptibility of hospital-acquired bloodstream infections (HABSI) in children,and to provide evidence for clinical antiinfection treatment.Methods During January 2004 to December 2011,the clinical data and drug susceptibility results of 168 children who were diagnosed with HABSI based on positive results of pathogen tests were reviewed retrospectively in Yuying Children's Hospital affiliated to Wenzhou Medical College.Results A total of 171 strains were isolated from blood specimens of the 168 children.The majority of HABSI occurred in the

  5. Candidemia combined with bacterial bloodstream infection: analysis of clinical features and associated risk factors%念珠菌血症合并细菌血流感染的临床与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    刘涌; 孙永昌; 卓婕; 刘晓芳

    2014-01-01

    目的 回顾性分析念珠菌血症合并细菌血流感染的临床资料,探讨其临床特点及相关危险因素.方法 分析自2009年1月至2011年12月入住北京同仁医院并经血培养证实为念珠菌血症合并细菌血流感染病例的临床特征、微生物学检查及临床结局等,与同期收治的单一念珠菌血症病例进行对照分析,并应用logistic回归探讨相关危险因素.结果 共收集念珠菌血症患者42例,其中念珠菌血症合并细菌血流感染组14例,单一念珠菌血症组28例.14例念珠菌血症合并细菌血流感染患者中革兰阳性球菌感染者10例,革兰阴性杆菌感染者4例,白色念珠菌6例,光滑念珠菌4例,热带念珠菌3例,克柔念珠菌1例.单一念珠菌血症组28例中白色念珠菌12例,光滑念珠菌4例,热带念珠菌2例,克柔念珠菌1例,两组相比差异无达统计学意义(P值分别为1.000、0.266、0.178和0.608);但单一念珠菌血症组近平滑念珠菌感染者9例,念珠菌血症合并细菌血流感染组未检出.念珠菌血症合并细菌血流感染组12例出现脓毒性休克,单一念珠菌血症组为7例,差异有统计学意义(P=0.000);前者死亡10例,后者死亡15例.单因素分析结果显示,住院时间超过4周(P=o.oo1)、念珠菌血流感染前是否存在菌血症(P=0.005)、是否存在血液系统肿瘤(P=0.01)、是否存在腹腔感染(P=0.001)为念珠菌血症合并细菌血流感染的危险因素,但多因素回归分析显示仅住院时间超过4周为独立危险因素.结论 念珠菌血症合并细菌血流感染以革兰阳性球菌为主,易并发脓毒性休克;住院时间超过4周为念珠菌血症合并细菌血流感染的独立危险因素.%Objective To investigate the clinical characteristics of and risk factors for candidemia combined with bacterial bloodstream infection (BSI) by retrospective analysis of cases.Method The clinical data of cases diagnosed as candidemia combined with BSI

  6. Pre-exposure to moving form enhances static form sensitivity.

    Directory of Open Access Journals (Sweden)

    Thomas S A Wallis

    Full Text Available BACKGROUND: Motion-defined form can seem to persist briefly after motion ceases, before seeming to gradually disappear into the background. Here we investigate if this subjective persistence reflects a signal capable of improving objective measures of sensitivity to static form. METHODOLOGY/PRINCIPAL FINDINGS: We presented a sinusoidal modulation of luminance, masked by a background noise pattern. The sinusoidal luminance modulation was usually subjectively invisible when static, but visible when moving. We found that drifting then stopping the waveform resulted in a transient subjective persistence of the waveform in the static display. Observers' objective sensitivity to the position of the static waveform was also improved after viewing moving waveforms, compared to viewing static waveforms for a matched duration. This facilitation did not occur simply because movement provided more perspectives of the waveform, since performance following pre-exposure to scrambled animations did not match that following pre-exposure to smooth motion. Observers did not simply remember waveform positions at motion offset, since removing the waveform before testing reduced performance. CONCLUSIONS/SIGNIFICANCE: Motion processing therefore interacts with subsequent static visual inputs in a way that can improve performance in objective sensitivity measures. We suggest that the brief subjective persistence of motion-defined forms that can occur after motion offsets is a consequence of the decay of a static form signal that has been transiently enhanced by motion processing.

  7. Sixth-Form Colleges: An Endangered Organisational Form?

    Science.gov (United States)

    Stoten, David William

    2014-01-01

    The sixth-form college sector is often marginalised in policy and academic discourse, where the much larger school and further education sectors dominate. This paper sets out to describe the sector's key features, assess its position within the wider education system and consider its future in an increasingly competitive education market. The…

  8. Method of forming structural heliostat

    Science.gov (United States)

    Anderson, Alfred J.

    1984-06-26

    In forming a heliostat having a main support structure and pivoting and tilting motors and gears and a mirror module for reflecting solar energy onto a collector, the improvement characterized by a method of forming the mirror module in which the mirror is laid upon a solid rigid supporting bed in one or more sections, with or without focusing; a mirror backing sheet is applied by first applying respective thin layers of silicone grease and, thereafter, progressively rolling application to eliminate air bubbles; followed by affixing of a substrate assembly to the mirror backing sheet to form a mirror module that does not curve because of thermally induced stresses and differential thermal expansion or contraction effects. The silicone grease also serves to dampen fluttering of the mirror and protect the mirror backside against adverse effects of the weather. Also disclosed are specific details of preferred embodiments.

  9. Amorphous drugs and dosage forms

    DEFF Research Database (Denmark)

    Grohganz, Holger; Löbmann, K.; Priemel, P.;

    2013-01-01

    The transformation to an amorphous form is one of the most promising approaches to address the low solubility of drug compounds, the latter being an increasing challenge in the development of new drug candidates. However, amorphous forms are high energy solids and tend to recry stallize. New...... formulation principles are needed to ensure the stability of amorphous drug forms. The formation of solid dispersions is still the most investigated approach, but additional approaches are desirable to overcome the shortcomings of solid dispersions. Spatial separation by either coating or the use of micro......-containers has shown potential to prevent or delay recrystallization. Another recent approach is the formation of co-amorphous mixtures between either two drugs or one drug and one low molecular weight excipient. Molecular interactions between the two molecules provide an energy barrier that has to be overcome...

  10. Mono Digital Wordlist: Presentation Form

    Directory of Open Access Journals (Sweden)

    Kenneth S. Olson

    2009-01-01

    Full Text Available This paper presents a 204-item digital wordlist of Mono, an Ubangian language spoken in the Democratic Republic of the Congo. The wordlist includes orthographic and broad phonetic transcriptions of each word, French and English glosses, an individual WAV recording of each item, GIF images of the original field transcriptions, and metadata for resource discovery. An archival form of the wordlist was deposited into an institutional archive (the SIL Language and Culture Archives and includes the original WAV digital recording, descriptive markup encoding of the wordlist in XML employing Unicode 5.1 transcription, TIFF images of the original field transcriptions, and the metadata record. The presentation form was then generated directly from the archival form.

  11. Induction interview form in EDH

    CERN Multimedia

    Information technology Department, AIS (Administrative Information Services) Group

    2007-01-01

    As part of the efforts to rationalise administrative procedures, the IT and HR Departments have developed a new EDH form for induction interviews, which can be accessed using the link below. In accordance with Administrative Circular No. 2 ('Recruitment, Appointment and possible developments regarding the contractual position of Staff Members', Rev. 3), the work and training objectives to be achieved during the probation period shall be specified in writing to all new staff members during an induction interview. The interview shall take place between the new staff member and his supervisor within six weeks of his taking up his duties at the latest. https://edh.cern.ch/Document/MAPS/Induction1) (or from the EDH desktop, by clicking on 'Other Tasks' and going to the 'HR & Training' heading) Please note that this form is to be used exclusively for new staff members. A separate EDH form will be developed for fellows.Information technology Department, AIS (Administrative Information Services) Group Human Re...

  12. Induction interview form in EDH

    CERN Multimedia

    Information technology Department, AIS (Administrative Information Services) Group,

    2007-01-01

    As part of the efforts to rationalise administrative procedures, the IT and HR Departments have developed a new EDH form for induction interviews, which can be accessed using the link below. In accordance with Administrative Circular No. 2 ('Recruitment, Appointment and possible developments regarding the contractual position of Staff Members', Rev. 3), the work and training objectives to be achieved during the probation period shall be specified in writing to all new staff members during an induction interview. The interview shall take place between the new staff member and his supervisor within six weeks of him taking up his duties at the latest. https://edh.cern.ch/Document/MAPS/Induction (or from the EDH desktop, by clicking on 'Other Tasks' and going to the 'HR & Training' heading) Please note that this form is to be used exclusively for new staff members. A separate EDH form will be developed for fellows. Information technology Department, AIS (Administrative Information Services) Group Human...

  13. Tourism forms and social sustainability

    OpenAIRE

    Onni, Giuseppe

    2012-01-01

    Sardinia offers a field to study the evolution of the tourist politics, above all in comparison to the relationships between tourist and local society, because it has been, and it is still, one of the best destinations of trip both in the set of the international tourism and for the one who seeks niche forms, however the tourist politics, that have driven the development of the different forms, have been driven in meaningful way, in time, from what that can be defined the tourist ...

  14. Differential forms on electromagnetic networks

    CERN Document Server

    Balasubramanian, N V; Sen Gupta, D P

    2013-01-01

    Differential Forms on Electromagnetic Networks deals with the use of combinatorial techniques in electrical circuit, machine analysis, and the relationship between circuit quantities and electromagnetic fields. The monograph is also an introduction to the organization of field equations by the methods of differential forms. The book covers topics such as algebraic structural relations in an electric circuit; mesh and node-pair analysis; exterior differential structures; generalized Stoke's theorem and tensor analysis; and Maxwell's electromagnetic equation. Also covered in the book are the app

  15. Front-Form Chiral Multiplets

    CERN Document Server

    Gómez-Rocha, María

    2012-01-01

    In this article we point out that the unitary transformation that relates the chiral basis $\\{R; I J^{PC}\\}$ and the $\\{I; ^{2S+1}L_J \\}$ basis, which was already derived for canonical spin in instant form, is also applicable in light-cone representations. From the most general expression for the Clebsch-Gordan coefficients of the Poincar\\'e group one can see that the chiral limit brings the angular momentum coupling into a simple form that permits a clear relation in terms of SU(2) Clebsch-Gordan coefficients. It provides a tool of measurement of chiral symmetry in relativistic composite systems.

  16. 48 CFR 53.301 - Standard forms.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Standard forms. 53.301... AND FORMS FORMS Illustrations of Forms 53.301 Standard forms. This section illustrates the standard... order. The subsection numbers correspond with the standard form numbers (e.g., Standard Form 18...

  17. Education fees – New forms

    CERN Multimedia

    2015-01-01

    The application forms for the payment of education fees have been updated and are now available in the Admin e-guide (under the “Useful Documents” heading):   Payment of education fees (including language course fees) – AC12A (form to be used by staff members recruited before 1 January 2007, with the exception of former “local staff”).   Payment of education fees – AC12B (form to be used by staff members recruited on or after 1 January 2007, by fellows, scientific associates and guest professors and by former “local staff” whose contracts started before 1 January 2007). The Education Fees service will continue to accept the old forms until the end of the current academic year, i.e. until 31 August 2015. Members of the personnel are reminded that any false declaration or failure to declare information with a view to deceiving others or achieving a gain that would result in a financial loss for CERN or...

  18. Green Lubricants for Metal Forming

    DEFF Research Database (Denmark)

    Bay, Niels

    2010-01-01

    The increasing focus on legislation towards diminishing the impact on working environment as well as external environment has driven efforts to develop new, environmentally benign lubricants for metal forming. The present paper gives an overview of these efforts to substitute environmentally...

  19. Simerka - Quadratic Forms and Factorization

    OpenAIRE

    Lemmermeyer, Franz

    2011-01-01

    In this article we show that the Czech mathematician Vaclav Simerka discovered the factorization of (10^17-1)/9 using a method based on the class group of binary quadratic forms more than 120 years before Shanks and Schnorr developed similar algorithms. Simerka also gave the first examples of what later became known as Carmichael numbers.

  20. English Pidgins: Form and Function.

    Science.gov (United States)

    Mufwene, Salikoko S.

    1988-01-01

    Highlights similarities and variation in both form and function of English pidgins the world over. It is argued that English pidgins are related more by socio-historical conditions and directions of development than by details of their formal structure. Reference list includes 68 citations. (Author/DJD)

  1. Emerging Forms of Cultural Capital

    DEFF Research Database (Denmark)

    Prieur, Annick; Savage, Mike

    - the claims that there are forms of emotional, subcultural or national cultural capital at work - The claim about cosmopolitanism or an international orientation as a distinctive feature of the culturally privileged classes The paper responds to the first theme announced in the call for this conference...

  2. Polynomial Algebra in Form 4

    Science.gov (United States)

    Kuipers, J.

    2012-06-01

    New features of the symbolic algebra package Form 4 are discussed. Most importantly, these features include polynomial factorization and polynomial gcd computation. Examples of their use are shown. One of them is an exact version of Mincer which gives answers in terms of rational polynomials and 5 master integrals.

  3. Intersections: Form, Feeling, and Isomorphism

    Science.gov (United States)

    Reichling, Mary J.

    2004-01-01

    In this article, the author examines the intersections of three concepts, form, feeling, and isomorphism, in the work of Susanne Langer, as they are fundamental to an understanding of her aesthetic theory and to the construction of a philosophy of music and music education. These three concepts hold meanings that differ among musicians and…

  4. Technetium Immobilization Forms Literature Survey

    Energy Technology Data Exchange (ETDEWEB)

    Westsik, Joseph H.; Cantrell, Kirk J.; Serne, R. Jeffrey; Qafoku, Nikolla

    2014-05-01

    Of the many radionuclides and contaminants in the tank wastes stored at the Hanford site, technetium-99 (99Tc) is one of the most challenging to effectively immobilize in a waste form for ultimate disposal. Within the Hanford Tank Waste Treatment and Immobilization Plant (WTP), the Tc will partition between both the high-level waste (HLW) and low-activity waste (LAW) fractions of the tank waste. The HLW fraction will be converted to a glass waste form in the HLW vitrification facility and the LAW fraction will be converted to another glass waste form in the LAW vitrification facility. In both vitrification facilities, the Tc is incorporated into the glass waste form but a significant fraction of the Tc volatilizes at the high glass-melting temperatures and is captured in the off-gas treatment systems at both facilities. The aqueous off-gas condensate solution containing the volatilized Tc is recycled and is added to the LAW glass melter feed. This recycle process is effective in increasing the loading of Tc in the LAW glass but it also disproportionally increases the sulfur and halides in the LAW melter feed which increases both the amount of LAW glass and either the duration of the LAW vitrification mission or the required supplemental LAW treatment capacity.

  5. Form Filling with SCC in a Vertical Form

    DEFF Research Database (Denmark)

    Thrane, Lars Nyholm

    2004-01-01

    University of Denmark and the second largest ready-mix manufacturer in Denmark, 4K-Beton A/S. The aim is to identify the flow characteristic of SCC and the effect of concrete properties, casting technique, reinforcement configuration, and form geometry. A wall form of dimensions l = 3m, w = 0.3m, h =1m has....... Monitoring equipment has been produced and tested and is valuable as documentary evidence of the flow in combination with visual observations. In one experiment reinforcement gap sizes of 1.5 and 3⋅Dmax,agg have been applied and blocking occurred at 1.5⋅Dmax,agg. Pumping from the bottom corner at casting...... rate of 10 m/h resulted in hydrostatic pressure. Continuously shearing across the surface seems to have a positive effect on the surface quality (no blowholes)....

  6. Forms representing forms and linear spaces on hypersurfaces

    CERN Document Server

    Brandes, Julia

    2012-01-01

    A generalisation of Waring's problem, considered first by Arkhipov and Karatsuba, is the question of representing not an integer, but a given polynomial, as a sum of powers of linear polynomials. We investigate a related problem and prove a Hasse principle for the number of identical representations of a set of given forms by homogeneous polynomials of general shape. The result leads to sizeable improvements for estimates of the number of linear spaces on the intersection of hypersurfaces.

  7. NNWSI waste form testing program

    International Nuclear Information System (INIS)

    A waste form testing program has been developed to ensure that the release rate of radionuclides from the engineered barrier system will meet NRC and EPA regulatory requirements. Waste form performance testing will be done under unsaturated, low water availability conditions which represent the expected repository conditions. Testing will also be done under conditions of total immersion of the waste form in repository-type water to cover the possibility that localized portions of the repository might contain standing water. Testing of reprocesses waste forms for CHLW and DHLW will use reaction vessels fabricated from Topopah Spring tuff. Chemical elements which are expected to show the highest release rates in the mildly oxidizing environment of the Topopah Spring tuff horizon at Yucca Mountain are Np and Tc. To determine the effect of residual canister material and of corrosion products from the canister/overpack, waste form testing will be done in the presence of these materials. The release rate of all radionuclides which are subject to NRC and EPA regulations will be measured, and the interactive effects of the released radionuclide and the rock reaction vessels will be determined. The testing program for spent fuel will determine the release rate from bare spent fuel pellets and from Zircaloy clad spent fuel where the cladding contains minor defects. A metal testing program for Zircaloy will establish the expected lifetime of the cladding material. Estimation of the state of cladding for fuel presently in reactor pool storage will provide baseline data for Zircaloy containment credit. 9 references, 4 figures

  8. Electro-Hydraulic Forming of Sheet Metals: Free-forming vs. Conical-die Forming

    Energy Technology Data Exchange (ETDEWEB)

    Rohatgi, Aashish; Stephens, Elizabeth V.; Davies, Richard W.; Smith, Mark T.; Soulami, Ayoub; Ahzi, Said

    2012-05-01

    This work builds upon our recent advances in quantifying high-rate deformation behavior of sheet metals, during electro-hydraulic forming (EHF), using high-speed imaging and digital image correlation techniques. Following recent publication of an earlier manuscript, resulting from this project, in the Journal of Materials Processing Technology, this manuscript further details our results and compares forming behavior when the process is carried out inside an open-die or a conical die. It is anticipated that quantitative information of the sheet deformation history, made possible by the experimental technique developed in this work, will improve our understanding on the roles of strain-rate and sheet-die interactions in enhancing the sheet metal formability during high-rate forming. This knowledge will be beneficial to the automotive industry and enable them to fabricate light-weight sheet parts out of Al and advanced high strength steels.

  9. Terra firma-forme dermatosis

    Directory of Open Access Journals (Sweden)

    Emel Erkek

    2012-01-01

    Full Text Available Terra firma-forme dermatosis is characterized by ′dirty′ brown-grey cutaneous patches and plaques that can simply be eradicated by forceful swabbing with alcohol pads. The pathogenesis has been attributed to abnormal and delayed keratinization. Although affected patients present with typical lesions, the disorder is not well-known by dermatologists. In this report, we describe two patients with terra firma-forme dermatosis in the setting of xerosis cutis and atopic dermatitis. From a clinical point of view, we lay emphasis on its unique expression and diagnosis/treatment. From a histological perspective, we highlight its resemblance to dermatosis neglecta and speculate on the role of ′neglect′ in a patient with seemingly adequate hygiene. The role of urea containing emollients in the development of this disorder remains to be determined.

  10. Free-form illumination optics

    Science.gov (United States)

    Mohedano, Rubén; Chaves, Julio; Hernández, Maikel

    2016-04-01

    In many illumination problems, the beam pattern needed and/or some geometrical constraints lead to very asymmetric design conditions. These asymmetries have been solved in the past by means of arrangements of rotationally symmetric or linear lamps aimed in different directions whose patterns overlap to provide the asymmetric prescriptions or by splitting one single lamp into several sections, each one providing a part of the pattern. The development of new design methods yielding smooth continuous free-form optical surfaces to solve these challenging design problems, combined with the proper CAD modeling tools plus the development of multiple axes diamond turn machines, give birth to a new generation of optics. These are able to offer the performance and other advanced features, such as efficiency, compactness, or aesthetical advantages, and can be manufactured at low cost by injection molding. This paper presents two examples of devices with free-form optical surfaces, a camera flash, and a car headlamp.

  11. Cyclodextrin Inclusion Polymers Forming Hydrogels

    Science.gov (United States)

    Li, Jun

    This chapter reviews the advances in the developments of supramolecular hydrogels based on the polypseudorotaxanes and polyrotaxanes formed by inclusion complexes of cyclodextrins threading onto polymer chains. Both physical and chemical supramolecular hydrogels of many different types are discussed with respect to their preparation, structure, property, and gelation mechanism. A large number of physical supramolecular hydrogels were formed induced by self-assembly of densely packed cyclodextrin rings threaded on polymer or copolymer chains acting as physical crosslinking points. The thermo-reversible and thixotropic properties of these physical supramolecular hydrogels have inspired their applications as injectable drug delivery systems. Chemical supramolecular hydrogels synthesized from polypseudorotaxanes and polyrotaxanes were based on the chemical crosslinking of either the cyclodextrin molecules or the included polymer chains. The chemical supramolecular hydrogels were often made biodegradable through incorporation of hydrolyzable threading polymers, end caps, or crosslinkers, for their potential applications as biomaterials.

  12. The Integral Form of Supergravity

    OpenAIRE

    Castellani, L.; Catenacci, R.; Grassi, P. A.

    2016-01-01

    By using integral forms we derive the superspace action of D=3, N=1 supergravity as an integral on a supermanifold. The construction is based on target space picture changing operators, here playing the role of Poincare' duals to the lower-dimensional spacetime surfaces embedded into the supermanifold. We show how the group geometrical action based on the group manifold approach interpolates between the superspace and the component supergravity actions, thus providing another proof of their e...

  13. Characterising rag-forming solids

    OpenAIRE

    Kupai, MM; Yang, F.; Harbottle, D; Moran, K.; Masliyah, J; Xu, Z.

    2013-01-01

    In oil sands froth treatment, an undesirable intermediate layer, often accumulates during the separation of water-oil emulsions. The layer referred to as rag layer is a complex mixture of water, oil, solids and interfacially active components. The presence of a rag layer has a detrimental impact on the separation of water and fine solids from diluted bitumen. The current study focuses on characterisation of solids from a rag layer forming stream of a naphthenic froth treatment plant in an att...

  14. The faintest star forming galaxies

    CERN Document Server

    Ranalli, P

    2003-01-01

    I briefly report on the X-ray detection of 10 radio sub-mJy sources in the 2 Ms Chandra observation of the Hubble Deep Field North region. These sources follow the same radio/X-ray luminosities relation which holds for nearby galaxies. Making use of this relation, X-ray number counts from star forming galaxies are predicted from the deep radio Log N-Log S's.

  15. The Integral Form of Supergravity

    CERN Document Server

    Castellani, L; Grassi, P A

    2016-01-01

    By using integral forms we derive the superspace action of D=3, N=1 supergravity as an integral on a supermanifold. The construction is based on target space picture changing operators, here playing the role of Poincare' duals to the lower-dimensional spacetime surfaces embedded into the supermanifold. We show how the group geometrical action based on the group manifold approach interpolates between the superspace and the component supergravity actions, thus providing another proof of their equivalence.

  16. Ngbugu digital wordlist: Presentation form

    Directory of Open Access Journals (Sweden)

    Kenneth S. Olson

    2007-01-01

    Full Text Available This paper presents a 204-item digital wordlist of Ngbugu, an Ubangian language spoken in Central African Republic. The wordlist includes orthographic and broad phonetic transcriptions of the words, French and English glosses, an individual WAV recording of each word, GIF images of the original field transcriptions, and metadata for resource discovery. This presentation form of the wordlist was generated from an archived version (Olson 2006 following the procedure laid out in Simons, Olson and Frank (2007.

  17. Pion structure form lattice QCD

    OpenAIRE

    Javadi Motaghi, Narjes

    2015-01-01

    In this thesis we use lattice QCD to compute the second Mellin moments of pion generalized parton distributions and pion electromagnetic form factors. For our calculations we are able to analyze a large set of gauge configurations with 2 dynamical flavours using non-perturbatively the improved Wilson-Sheikholeslami-Wohlert fermionic action pion masses ranging down to 151 MeV. By employing improved smearing we were able to suppress excited state contamination. However, our data in the ph...

  18. Coated particle waste form development

    International Nuclear Information System (INIS)

    Coated particle waste forms have been developed as part of the multibarrier concept at Pacific Northwest Laboratory under the Alternative Waste Forms Program for the Department of Energy. Primary efforts were to coat simulated nuclear waste glass marbles and ceramic pellets with low-temperature pyrolytic carbon (LT-PyC) coatings via the process of chemical vapor deposition (CVD). Fluidized bed (FB) coaters, screw agitated coaters (SAC), and rotating tube coaters were used. Coating temperatures were reduced by using catalysts and plasma activation. In general, the LT-PyC coatings did not provide the expected high leach resistance as previously measured for carbon alone. The coatings were friable and often spalled off the substrate. A totally different concept, thermal spray coating, was investigated at PNL as an alternative to CVD coating. Flame spray, wire gun, and plasma gun systems were evaluated using glass, ceramic, and metallic coating materials. Metal plasma spray coatings (Al, Sn, Zn, Pb) provided a two to three orders-of-magnitude increase in chemical durability. Because the aluminum coatings were porous, the superior leach resistance must be due to either a chemical interaction or to a pH buffer effect. Because they are complex, coated waste form processes rank low in process feasibility. Of all the possible coated particle processes, plasma sprayed marbles have the best rating. Carbon coating of pellets by CVD ranked ninth when compared with ten other processes. The plasma-spray-coated marble process ranked sixth out of eleven processes

  19. Fuzzy logic of Aristotelian forms

    Energy Technology Data Exchange (ETDEWEB)

    Perlovsky, L.I. [Nichols Research Corp., Lexington, MA (United States)

    1996-12-31

    Model-based approaches to pattern recognition and machine vision have been proposed to overcome the exorbitant training requirements of earlier computational paradigms. However, uncertainties in data were found to lead to a combinatorial explosion of the computational complexity. This issue is related here to the roles of a priori knowledge vs. adaptive learning. What is the a-priori knowledge representation that supports learning? I introduce Modeling Field Theory (MFT), a model-based neural network whose adaptive learning is based on a priori models. These models combine deterministic, fuzzy, and statistical aspects to account for a priori knowledge, its fuzzy nature, and data uncertainties. In the process of learning, a priori fuzzy concepts converge to crisp or probabilistic concepts. The MFT is a convergent dynamical system of only linear computational complexity. Fuzzy logic turns out to be essential for reducing the combinatorial complexity to linear one. I will discuss the relationship of the new computational paradigm to two theories due to Aristotle: theory of Forms and logic. While theory of Forms argued that the mind cannot be based on ready-made a priori concepts, Aristotelian logic operated with just such concepts. I discuss an interpretation of MFT suggesting that its fuzzy logic, combining a-priority and adaptivity, implements Aristotelian theory of Forms (theory of mind). Thus, 2300 years after Aristotle, a logic is developed suitable for his theory of mind.

  20. The glycosylphosphatidylinositol-PLC in Trypanosoma brucei forms a linear array on the exterior of the flagellar membrane before and after activation.

    Science.gov (United States)

    Hanrahan, Orla; Webb, Helena; O'Byrne, Robert; Brabazon, Elaine; Treumann, Achim; Sunter, Jack D; Carrington, Mark; Voorheis, H Paul

    2009-06-01

    Bloodstream forms of Trypanosoma brucei contain a glycosylphosphatidylinositol-specific phospholipase C (GPI-PLC) that cleaves the GPI-anchor of the variable surface glycoprotein (VSG). Its location in trypanosomes has been controversial. Here, using confocal microscopy and surface labelling techniques, we show that the GPI-PLC is located exclusively in a linear array on the outside of the flagellar membrane, close to the flagellar attachment zone, but does not co-localize with the flagellar attachment zone protein, FAZ1. Consequently, the GPI-PLC and the VSG occupy the same plasma membrane leaflet, which resolves the topological problem associated with the cleavage reaction if the VSG and the GPI-PLC were on opposite sides of the membrane. The exterior location requires the enzyme to be tightly regulated to prevent VSG release under basal conditions. During stimulated VSG release in intact cells, the GPI-PLC did not change location, suggesting that the release mechanism involves lateral diffusion of the VSG in the plane of the membrane to the fixed position of the GPI-PLC.

  1. Candida bloodstream infection: data from a teaching hospital in Mato Grosso do Sul, Brazil Infecção na corrente sangüínea por Candida spp. dados de um hospital universitário em Mato Grosso do Sul, Brasil

    Directory of Open Access Journals (Sweden)

    Marilene Rodrigues Chang

    2008-10-01

    Full Text Available The incidence of Candida bloodstream infection has increased over the past years. In the Center-West region of Brazil, data on candidemia are scarce. This paper reports a retrospective analysis of 96 cases of Candida bloodstream infection at a Brazilian tertiary-care teaching hospital in the state of Mato Grosso do Sul, from January 1998 to December 2006. Demographic, clinical and laboratory data were collected from medical records and from the hospital's laboratory database. Patients' ages ranged from three days to 92 years, with 53 (55.2% adults and 43 (44.8% children. Of the latter, 25 (58.1% were newborns. The risk conditions most often found were: long period of hospitalization, utilization of venous central catheter, and previous use of antibiotics. Fifty-eight (60.4% patients died during the hospitalization period and eight (13.7% of them died 30 days after the diagnosis of candidemia. Candida albicans (45.8% was the most prevalent species, followed by C. parapsilosis (34.4%, C. tropicalis (14.6% and C. glabrata (5.2%. This is the first report of Candida bloodstream infection in the state of Mato Grosso do Sul and it highlights the importance of considering the possibility of invasive Candida infection in patients exposed to risk factors, particularly among neonates and the elderly.RESUMO A incidência de infecções na corrente sangüínea causada por Candida spp. tem aumentado nos últimos anos. Na região Centro-Oeste do Brasil, os dados sobre candidemia são escassos. Realizamos uma análise retrospectiva de casos de infecção na corrente sangüínea por Candida em um hospital terciário de ensino de Mato Grosso do Sul. Noventa e seis episódios diagnosticados de janeiro de 1998 a dezembro de 2006 foram incluídos no estudo. Os dados demográficos e clínicos foram obtidos de prontuários; os dados laboratoriais provieram de registros do laboratório hospitalar. Dos pacientes, 43 (44,8% eram crianças e 53 (55,2% adultos, com idades

  2. 重症监护病房呼吸机相关肺炎患者血流感染病原菌分布及耐药性分析%The distribution and drug resistance of pathogenic bacteria related to bloodstream infection in patients with ventilator-associated pneumonia at intensive care unit

    Institute of Scientific and Technical Information of China (English)

    陈聪

    2015-01-01

    Objective To analyze the distributions and drug resistance of pathogenic bacteria related to bloodstream infection in patients with ventilator-associated pneumonia ( VAP) at intensive care unit ( ICU) in order to provide the information for reasonable use of antibacterial agents and guide the control and prevention of hospital infection.Methods The pathogenic bacterial identification and drug sensitive test of bacteria were carried out by using an automatic microbial analysis system (VITEK2 COMPACT).WHO-NET5.6 software was used for statistical analysis.Results There were 194 cases with bloodstream infection in 275 patients.The main pathogens were gram negative bacteria,accounting for 50.52%,followed by gram positive bacteria (39.18%) and fungi (10.30%).In gram-negative bacilli,Klebsiella pneumoniae and Escherichia coli were still the main pathogens causing bloodstream infections and highly sensitive to imipenem,meropenem and amikacin.In gram-positive cocci mainly were Staphylococcus epidermidis and Staphylo-coccus aureus and highly sensitive to vancomycin,linezolid and teicoplanin.Conclusion Pathogenic bacteria and multiple drug resist-ant bacteria are detected by ICU.The distribution of pathogenic bacteria and drug resistance of VAP in ICU patients are mastered which is of great significance for rational use of antibiotics.%目的:探讨重症监护病房( ICU)呼吸机相关肺炎( ventilator-associated pneumo-nia,VAP)患者血流感染病原菌分布及耐药情况,为指导医院感染的预防控制和临床合理使用抗生素提供依据。方法使用全自动微生物分析系统( VITEK2 COMPACT)对我院ICU 275例VAP患者的血液标本进行细菌鉴定和药敏试验,运用WHONET5.6软件对微生物检测结果进行统计分析。结果275例VAP患者中有194例发生血流感染,病原菌主要以革兰阴性菌为主,占50.52%;其次为革兰阳性菌(39.18%)和真菌(10.30%)。在革兰阴性杆菌中,

  3. CERAMIC WASTE FORM DATA PACKAGE

    Energy Technology Data Exchange (ETDEWEB)

    Amoroso, J.; Marra, J.

    2014-06-13

    The purpose of this data package is to provide information about simulated crystalline waste forms that can be used to select an appropriate composition for a Cold Crucible Induction Melter (CCIM) proof of principle demonstration. Melt processing, viscosity, electrical conductivity, and thermal analysis information was collected to assess the ability of two potential candidate ceramic compositions to be processed in the Idaho National Laboratory (INL) CCIM and to guide processing parameters for the CCIM operation. Given uncertainties in the CCIM capabilities to reach certain temperatures throughout the system, one waste form designated 'Fe-MP' was designed towards enabling processing and another, designated 'CAF-5%TM-MP' was designed towards optimized microstructure. Melt processing studies confirmed both compositions could be poured from a crucible at 1600{degrees}C although the CAF-5%TM-MP composition froze before pouring was complete due to rapid crystallization (upon cooling). X-ray diffraction measurements confirmed the crystalline nature and phase assemblages of the compositions. The kinetics of melting and crystallization appeared to vary significantly between the compositions. Impedance spectroscopy results indicated the electrical conductivity is acceptable with respect to processing in the CCIM. The success of processing either ceramic composition will depend on the thermal profiles throughout the CCIM. In particular, the working temperature of the pour spout relative to the bulk melter which can approach 1700{degrees}C. The Fe-MP composition is recommended to demonstrate proof of principle for crystalline simulated waste forms considering the current configuration of INL's CCIM. If proposed modifications to the CCIM can maintain a nominal temperature of 1600{degrees}C throughout the melter, drain, and pour spout, then the CAF-5%TM-MP composition should be considered for a proof of principle demonstration.

  4. Development of unconventional forming methods

    Directory of Open Access Journals (Sweden)

    S. Rusz

    2012-10-01

    Full Text Available Purpose: Paper presents results of progress ECAP processing method for UFG structure reached (gained.The properties and microstructure are influenced by technological factors during application ECAP method.Design/methodology/approach: Summary of methods studied on Department of technology at Machining faculty of VŠB-TU Ostrava through of co-operation with Institute of Engineering Materials and Biomaterials, Silesian University of Technology is presented.Findings: Achievement of ultra-fine grained structure in initial material leads to substantial increase of plasticity and makes it possible to form materials in conditions of „superplastic state“. Achievement of the required structure depends namely of the tool geometry, number of passes through the matrix, obtained deformation magnitude and strain rate, process temperature and lubrication conditions. High deformation at comparatively low homologous temperatures is an efficient method of production of ultra-fine grained solid materials.The new technologies, which use severe plastic deformation, comprise namely these techniques: High Pressure Torsion, Equal Channel Angular Pressing = ECAP, Cyclic Channel Die Compression = CCDC, Cyclic Extrusion Compression = CEC, Continuous Extrusion Forming = CONFORM, Accumulative Roll Bonding, Constrained Groove Pressing.Research limitations/implications: Achieved hardness and microstructure characteristics will be determined by new research.Practical implications: The results may be utilized for a relation between structure and properties of the investigated materials in future process of manufacturing.Originality/value: These results contribute to complex evaluation of properties new metals after application unconventional forming methods. The results of this paper are determined for research workers deal by the process severe plastic deformation.

  5. [Adult form of Pompe disease].

    Science.gov (United States)

    Ziółkowska-Graca, Bozena; Kania, Aleksander; Zwolińska, Grazyna; Nizankowska-Mogilnicka, Ewa

    2008-01-01

    Pompe disease (glycogen-storage disease type II) is an autosomal recessive disorder caused by a deficiency of lysosomal acid alpha-glucosidase (GAA), leading to the accumulation of glycogen in the lysosomes primarily in muscle cells. In the adult form of the disease, proximal muscle weakness is noted and muscle volume is decreased. The infantile form is usually fatal. In the adult form of the disease the prognosis is relatively good. Muscle weakness may, however, interfere with normal daily activities, and respiratory insufficiency may be associated with obstructive sleep apnea. Death usually results from respiratory failure. Effective specific treatment is not available. Enzyme replacement therapy with recombinant human GAA (rh-GAA) still remains a research area. We report the case of a 24-year-old student admitted to the Department of Pulmonary Diseases because of severe respiratory insufficiency. Clinical symptoms such as dyspnea, muscular weakness and increased daytime sleepiness had been progressing for 2 years. Clinical examination and increased blood levels of CK suggested muscle pathology. Histopathological analysis of muscle biopsy, performed under electron microscope, confirmed the presence of vacuoles containing glycogen. Specific enzymatic activity of alpha-glucosidase was analyzed confirming Pompe disease. The only effective method to treat respiratory insufficiency was bi-level positive pressure ventilation. Respiratory rehabilitation was instituted and is still continued by the patient at home. A high-protein, low-sugar diet was proposed for the patient. Because of poliglobulia low molecular weight heparin was prescribed. The patient is eligible for experimental replacement therapy with rh-GAA. PMID:19003770

  6. Capillary flows with forming interfaces

    CERN Document Server

    Shikhmurzaev, Yulii D

    2007-01-01

    PREFACEINTRODUCTION Free-surface flows in nature and industryScope of the bookFUNDAMENTALS OF FLUID MECHANICS Main concepts Governing equations Elements of thermodynamics Classical boundary conditions Physically meaningful solutions and paradoxes of modelingMOVING CONTACT LINES: AN OVERVIEW Essence of the problem Experimental observations Molecular dynamics simulations Review of theoriesThe key to the moving contact-line problemBOUNDARY CONDITIONS ON FORMING INTERFACES Modeling of interfacesConservation lawsLiquid-gas and liquid-solid interfacesLiquid-liquid interfaces SummaryOpen questions an

  7. Instructions & Forms for Authors

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Journal of Materials Sciences & Technology is a monthly journal for the rapid dissemination of new, impor- tant results in material and related fields. Submission Electronic files of MS Word and PDF are acceptable. Please visit http://www.jmst.org and submit online. Submission of a manuscript must be the original work of the author(s) and has not been published elsewhere or under consideration for another publication, or a substantially similar form in any language. Authors are encouraged to recommend three to five individuals (including their research fields, e-mail, phone numbers and addresses) who are qualified to serve as referees for their paper.

  8. Two forms of reactive arthritis?

    OpenAIRE

    Toivanen, P; Toivanen, A

    1999-01-01

    Inflammatory arthritides developing after a distant infection have so far been called reactive or postinfectious, quite often depending on the microbial trigger and/or HLA-B27 status of the patient. For clarity, it is proposed that they all should be called reactive arthritis, which, according to the trigger, occurs as an HLA-B27 associated or non-associated form. In addition to the causative agents and HLA-B27, these two categories are also distinguished by other characteristics. Most import...

  9. Screening three-form fields

    CERN Document Server

    Barreiro, Tiago; Nunes, Nelson J

    2016-01-01

    Screening mechanisms for a three-form field around a dense source such as the Sun are investigated. Working with the dual vector, we can obtain a thin-shell where field interactions are short range. The field outside the source adopts the configuration of a dipole which is a manifestly distinct behaviour from the one obtained with a scalar field or even a previously proposed vector field model. We identify the region of parameter space where this model satisfies present solar system tests.

  10. Baryon Form Factors at Threshold

    Energy Technology Data Exchange (ETDEWEB)

    Baldini Ferroli, Rinaldo [Museo Storico della Fisica e Centro Studi e Ricerche ' E. Fermi' , Rome (Italy); INFN, Laboratori Nazionali di Frascati, Frascati (Italy); Pacetti, Simone [INFN and Dipartimento di Fisica, Universita di Perugia, Perugia (Italy)

    2012-04-15

    An extensive study of the e{sup +}e{sup -}{yields}pp{sup Macron }BABAR cross section data is presented. Two unexpected outcomes have been found: the modulus of the proton form factor is normalized to one at threshold, i.e.: |G{sup p}(4M{sub p}{sup 2})|=1, as a pointlike fermion, and the resummation factor in the Sommerfeld formula is not needed. Other e{sup +}e{sup -} {yields} baryon-antibaryon cross sections show a similar behavior near threshold.

  11. Numerical Simulation of Peen Forming

    Institute of Scientific and Technical Information of China (English)

    Kang Xiaoming; Ma Zeen; Gu Lin; Chen ming

    2004-01-01

    Peen forming is the most important process for the manufacturing of integral wing skin panels. In order to determine peening parameters, an equivalent deformation theory was proposed in which peening parameters are transformed into equivalent nodal forces. In this study, a linear elastic shell finite element method is adopted. Other related problems such as wing skin panel modeling and peening scheme analysis were also outlined. The method has been applied to manufacturing panels of a certain Chinese aircraft and was proved to be effective in reducing peening experimental tests and improving products quality.

  12. Theoretical mechanics for sixth forms

    CERN Document Server

    Plumpton, C

    1971-01-01

    Theoretical Mechanics for Sixth Forms, Second Edition is a 14-chapter book that begins by elucidating the nature of theoretical mechanics. The book then describes the statics of a particle in illustration of the techniques of handling vector quantities. Subsequent chapters focus on the principle of moments, parallel forces and centers of gravity; and the application of Newton's second law to the dynamics of a particle and the ideas of work and energy, impulse and momentum, and power. The concept of friction is also explained. This volume concludes with chapters concerning motion in a circle an

  13. Terra Firma-forme Dermatosis

    Directory of Open Access Journals (Sweden)

    Anagha Ramesh Babu

    2013-01-01

    Full Text Available Terra firma-forme dermatosis is a cutaneous discoloration. ‘Dirty’ brown grey cutaneous patches and plaques that can be rid off by forceful swabbing with alcohol pads characterize it. The pathogenesis has been attributed to abnormal and delayed keratinization. It poses no medical threat. A 40-year-old male patient presented to the Department of Dermatology with a 2-3 month history of persistent pigmented patches on both upper arms. The lesions were not associated with itching or burning sensation. He gives no history of exacerbation on exposure to the sun.

  14. Strange chiral nucleon form factors

    CERN Document Server

    Hemmert, T R; Meißner, Ulf G; Hemmert, Thomas R.; Kubis, Bastian; Meissner, Ulf-G.

    1999-01-01

    We investigate the strange electric and magnetic form factors of the nucleon in the framework of heavy baryon chiral perturbation theory to third order in the chiral expansion. All counterterms can be fixed from data. In particular, the two unknown singlet couplings can be deduced from the parity-violating electron scattering experiments performed by the SAMPLE and the HAPPEX collaborations. Within the given uncertainties, our analysis leads to a small and positive electric strangeness radius, $ = (0.05 \\pm 0.16) fm^2$. We also deduce the consequences for the upcoming MAMI A4 experiment.

  15. Forms of creativity in translation

    Directory of Open Access Journals (Sweden)

    Lucia V Aranda

    2009-12-01

    Full Text Available http://dx.doi.org/10.5007/2175-7968.2009v1n23p23This paper explores the creative constructs utilized by translators in the reformulation of texts. As translation studies realigns the definition of translation vis-à-vis the original, a number of factors inform translations: the agency and subjectivity of the translator, as well as questions of form, and the more obvious social factors. This discussion addresses the articulation of creativity as a response to specific cases and repositions translation as part of a greater creative project.

  16. Prevenção de infecções de corrente sanguínea relacionadas a cateter em pacientes em hemodiálise Prevención de infecciones del torrente sanguíneo relacionadas al catéter de pacientes en hemodiálisis Prevention of Catheter-Related Bloodstream Infections in Patients on Hemodialysis

    Directory of Open Access Journals (Sweden)

    Dayana Souza Fram

    2009-01-01

    Full Text Available OBJETIVO: Realizar uma revisão sistemática sobre medidas padronizadas para prevenção de infecções relacionadas a cateter em pacientes em hemodiálise. MÉTODOS: Foi realizada uma revisão sobre a prevenção de infecções em hemodiálise nas bases de dados Medline, Embase, SciElo, Lilacs e Cochrane Library de estudos publicados entre os anos de 1990 e 2008. RESULTADOS: Foram encontrados 293 artigos e destes 12 foram incluídos no estudo. CONCLUSÃO: Foi evidenciada a importância da aplicação de um conjunto de medidas de controle de infecções pelos profissionais da saúde para prevenir a infecção nesta população de pacientes.OBJETIVO: Realizar una revisión sistemática sobre las medidas patronizadas para la prevención de infecciones relacionadas al catéter de pacientes en hemodiálisis. MÉTODOS: Fue realizada una revisión sobre la prevención de infecciones en hemodiálisis en las bases de datos Medline, Embase, SciElo, Lilacs y Cochrane Library de estudios publicados entre los años de 1990 al 2008. RESULTADOS: Fueron encontrados 293 artículos y de éstos 12 fueron incluidos en el estudio. CONCLUSIÓN: Se evidenció la importancia de la aplicación de un conjunto de medidas de control de infecciones por los profesionales de la salud para prevenir la infección en esta población de pacientes.OBJECTIVE: To conduct a systematic review of the literature on the prevention of catheter-related bloodstream infections in patients on hemodialysis. METHODS: A literature search was performed in Medline, Embase, Scielo, Lilacs, and Cochrane databases for articles published from 1990 to 2008. RESULTS: Two hundred ninety- three articles were retrieved. However, only 12 studies were included in this review. CONCLUSIONS: Findings suggest that health care providers use several infection control measures to prevent bloodstream infections in this patient population.

  17. On Quasi-Modular Forms, Almost Holomorphic Modular Forms, and the Vector-Valued Modular Forms of Shimura

    OpenAIRE

    Zemel, Shaul

    2013-01-01

    We extend the relation between quasi-modular forms and modular forms to a wider class of functions. We then relate both forms to vector-valued modular forms with symmetric power representations, and prove a general structure theorem for these vector-valued forms.

  18. AMERICAN QUARTER HORSES’ BEHAVIORAL FORMS

    Directory of Open Access Journals (Sweden)

    Iryna Olexandrivna Suprun

    2016-02-01

    Full Text Available The review of basic literary sources is made out of behavior of horse. On the basis of the field researches (visual supervisions after three different aged groups of mares it is built ethograms. An ethogram of behavioral forms among mares was developed. They represent the different forms of mares’ behavior in a dynamics. The reaction of mares of the different age-related and physiology groups on appearance of extraneous objects on a pasture, their activity, hierarchy, socialization is analyzed in groups. Several main studies on equines were reviewed in ethogram. Four objects were placed into the pasture with the mares and foals including a mat, cone, halter, and mounting block. Initial interest of mares in objects was high. Herd mentality highly evident. When one horse spooked at object the whole herd followed. After 5 minutes, majority of mares and foals lose interest in objects. The major general behavior categories observed include: locomotion, comfort, and harem social. Dominance was demonstrated while looking at the objects. Dominance was also demonstrated when a mare wanted to be in a specific place or play with a specific toy, she would pin her ears back, bite, or kick at the other mare. 

  19. Gravity, light and plant form.

    Science.gov (United States)

    Hangarter, R P

    1997-06-01

    Plants have evolved highly sensitive and selective mechanisms that detect and respond to various aspects of their environment. As a plant develops, it integrates the environmental information perceived by all of its sensory systems and adapts its growth to the prevailing environmental conditions. Light is of critical importance because plants depend on it for energy and, thus, survival. The quantity, quality and direction of light are perceived by several different photosensory systems that together regulate nearly all stages of plant development, presumably in order to maintain photosynthetic efficiency. Gravity provides an almost constant stimulus that is the source of critical spatial information about its surroundings and provides important cues for orientating plant growth. Gravity plays a particularly important role during the early stages of seedling growth by stimulating a negative gravitropic response in the primary shoot that orientates it towards the source of light, and a positive gravitropic response in the primary root that causes it to grow down into the soil, providing support and nutrient acquisition. Gravity also influences plant form during later stages of development through its effect on lateral organs and supporting structures. Thus, the final form of a plant depends on the cumulative effects of light, gravity and other environmental sensory inputs on endogenous developmental programs. This article is focused on developmental interactions modulated by light and gravity.

  20. Friction-formed liquid droplets

    Energy Technology Data Exchange (ETDEWEB)

    Lockwood, A J; Inkson, B J [NanoLAB Centre, Department of Materials Science and Engineering, University of Sheffield, Sheffield S1 3JD (United Kingdom); Anantheshwara, K; Bobji, M S, E-mail: a.lockwood@sheffield.ac.uk, E-mail: beverley.inkson@sheffield.ac.uk [Department of Mechanical Engineering, Indian Institute of Science (IISc), Bangalore 560012 (India)

    2011-03-11

    The formation of nanoscale liquid droplets by friction of a solid is observed in real-time. This is achieved using a newly developed in situ transmission electron microscope (TEM) triboprobe capable of applying multiple reciprocating wear cycles to a nanoscale surface. Dynamical imaging of the nanoscale cyclic rubbing of a focused-ion-beam (FIB) processed Al alloy by diamond shows that the generation of nanoscale wear particles is followed by a phase separation to form liquid Ga nanodroplets and liquid bridges. The transformation of a two-body system to a four-body solid-liquid system within the reciprocating wear track significantly alters the local dynamical friction and wear processes. Moving liquid bridges are observed in situ to play a key role at the sliding nanocontact, interacting strongly with the highly mobile nanoparticle debris. In situ imaging demonstrates that both static and moving liquid droplets exhibit asymmetric menisci due to nanoscale surface roughness. Nanodroplet kinetics are furthermore dependent on local frictional temperature, with solid-like surface nanofilaments forming on cooling. TEM nanotribology opens up new avenues for the real-time quantification of cyclic friction, wear and dynamic solid-liquid nanomechanics, which will have widespread applications in many areas of nanoscience and nanotechnology.

  1. Friction-formed liquid droplets

    Science.gov (United States)

    Lockwood, A. J.; Anantheshwara, K.; Bobji, M. S.; Inkson, B. J.

    2011-03-01

    The formation of nanoscale liquid droplets by friction of a solid is observed in real-time. This is achieved using a newly developed in situ transmission electron microscope (TEM) triboprobe capable of applying multiple reciprocating wear cycles to a nanoscale surface. Dynamical imaging of the nanoscale cyclic rubbing of a focused-ion-beam (FIB) processed Al alloy by diamond shows that the generation of nanoscale wear particles is followed by a phase separation to form liquid Ga nanodroplets and liquid bridges. The transformation of a two-body system to a four-body solid-liquid system within the reciprocating wear track significantly alters the local dynamical friction and wear processes. Moving liquid bridges are observed in situ to play a key role at the sliding nanocontact, interacting strongly with the highly mobile nanoparticle debris. In situ imaging demonstrates that both static and moving liquid droplets exhibit asymmetric menisci due to nanoscale surface roughness. Nanodroplet kinetics are furthermore dependent on local frictional temperature, with solid-like surface nanofilaments forming on cooling. TEM nanotribology opens up new avenues for the real-time quantification of cyclic friction, wear and dynamic solid-liquid nanomechanics, which will have widespread applications in many areas of nanoscience and nanotechnology.

  2. CR-Submanifolds of Generalized -Space Forms

    OpenAIRE

    Mahmood Jaafari Matehkolaee

    2013-01-01

    We study sectional curvature, Ricci tensor, and scalar curvature of submanifolds of generalized -space forms. Then we give an upper bound for foliate -horizontal (and vertical) CR-submanifold of a generalized -space form and an upper bound for minimal -horizontal (and vertical) CR-submanifold of a generalized -space form. Finally, we give the same results for special cases of generalized -space forms such as -space forms, generalized Sasakian space forms, Sasakian space forms, Kenmotsu space ...

  3. Do atmospheric aerosols form glasses?

    Directory of Open Access Journals (Sweden)

    D. A. Pedernera

    2008-09-01

    Full Text Available A new process is presented by which water soluble organics might influence ice nucleation, ice growth, chemical reactions and water uptake of aerosols in the upper troposphere: the formation of glassy aerosol particles. Glasses are disordered amorphous (non-crystalline solids that form when a liquid is cooled without crystallization until the viscosity increases exponentially and molecular diffusion practically ceases. The glass transition temperatures, Tg, homogeneous ice nucleation temperatures, Thom, and ice melting temperatures, Tm, of various aqueous inorganic, organic and multi-component solutions are investigated with a differential scanning calorimeter. The investigated solutes are: various polyols, glucose, raffinose, levoglucosan, an aromatic compound, sulfuric acid, ammonium bisulfate and mixtures of dicarboxylic acids (M5, of dicarboxylic acids and ammonium sulfate (M5AS, of two polyols, of glucose and ammonium nitrate, and of raffinose and M5AS. The results indicate that aqueous solutions of the investigated inorganic solutes show Tg values that are too low to be of atmospheric importance. In contrast, aqueous organic and multi-component solutions readily form glasses at low but atmospherically relevant temperatures (≤230 K. To apply the laboratory data to the atmospheric situation, the measured phase transition temperatures were transformed from a concentration to a water activity scale by extrapolating water activities determined between 252 K and 313 K to lower temperatures. The obtained state diagrams reveal that the higher the molar mass of the aqueous organic or multi-component solutes, the higher Tg of their respective solutions at a given water activity. To a lesser extent, Tg also depends on the hydrophilicity of the organic solutes. Therefore, aerosol particles containing larger (≳150 g mol−1 and

  4. Interação entre Trypanosoma cruzi e macrófagos: diferenças entre tripomastigotas sangüí-colas e de cultivo de tecidos Trypanosoma cruzi interaction with macrophages: differences between tissue culture and bloodstream forms

    OpenAIRE

    Judith K. Kloetzel; Regina V. Milder; Umezawa, Eufrosina S.

    1984-01-01

    Macrófagos obtidos do peritoneo de camundongos após estímulo, com peptona, foram cultivados em lamínulas, infectados com tripomastigotas das cepas F e Y de T. cruzi, obtidos de cultivo de tecidos ou do sangue de camundongos infectados. Os parasitas, obtidos de cultivo de tecidos, tanto da cepa Y como os da cepa F, são interiorizados por macrófagos em proporção muito mais elevada do que os sanguícolas. Parasitas de cultivo de tecidos incubados com soro de camundongos normais, ou soro híperimun...

  5. Forming impressions from incongruent traits.

    Science.gov (United States)

    Casselden, P A; Hampson, S E

    1990-08-01

    The factors that affect the ease with which impressions are formed from incongruent trait pairs are investigated. In Experiments 1 and 2, trait pairs that were both descriptively and evaluatively congruent, as well as ones that were only evaluatively congruent, were found to be more imaginable and to be perceived as more frequently co-occurring than incongruent trait pairs. In Experiment 3, response latency provided a converging measure of ease of imaginability. Experiment 4 examined written descriptions of targets described by these trait pairs, and found more attempts to integrate the congruent than the incongruent pairs. These findings are discussed in terms of the relation between laypersons' impressions of personality and formal personality assessment.

  6. ACUTE PANCREATITIS - THE SEVERE FORM

    Directory of Open Access Journals (Sweden)

    Ioana Grigoras

    2005-01-01

    Full Text Available Acute pancreatitis is an acute inflammatory disease. Frequently it is a challenging condition for the surgeon and for the intensive care physician, taking into account that etiology is sometimes obscure, the pathophysiology is complex and incompletely understood, the timing of surgical treatment is still under debate and the general treatment is mostly supportive. The incidence is about 30 – 50 / 100.000 / year. In 80% of cases the disease is associated with interstitial edema, mild infiltration with inflammatory cells and intra- or peripancreatic fat necrosis. Evolution is benign and self-limited with proper treatment. The severe form occurs less frequent (15 - 20%, results in long lasting hospitalization and is associated with high mortality (30 - 40%, due to infected necrosis and multiple organ failure. Alcoholism and biliary disease account for 80% of cases. Rare etiologies of disease include metabolic factors (hypercalcemia, hyperlipoproteinemia, drug ingestion, obstructive factors (abdominal tumors, trauma, endoscopic retrograde cholecistopancreatography, and s.o., infections (viral, parasitic and hemodynamic factors. Postoperative pancreatitis is a complication after major abdominal surgery (abdominal aorta aneurism repair, extensive upper abdominal surgery, hepatic or cardiac transplant, so.. The common pathophysiological mechanism is pancreatic hypoperfusion. Acute pancreatitis is not a stable disease, being characterized by time-dependent stages with specific morphologic and clinical patterns. The terminology used to designate these stages is stated in the Ulm classification. Since the consensus Conference in Atlanta (1992 the severe form of acute pancreatitis is defined by the presence of organ dysfunction/failure or by the presence of local complications. The initiating event is the premature zymogene activation and the impairment of the exocytosis process with local consequences (ongoing tissue necrosis and general consequences

  7. Fabrication Aware Form-finding

    DEFF Research Database (Denmark)

    Egholm Pedersen, Ole; Larsen, Niels Martin; Pigram, Dave;

    2014-01-01

    This paper describes a design and construction method that combines two distinct material systems with fabrication aware form-finding and file-to-factory workflows. The method enables the fluent creation of complex materially efficient structures comprising high populations of geometrically unique...... parts. The first material system employs a novel rotated joint design to allow the structural tuning of quasi-reciprocal timber frame elements fabricated from multi-axis machined plywood sheet stock. The second em-loys discontinuous post-tensioning to assemble unique precast concrete components...... into load-bearing structures, significantly reducing or eliminating false work during as-embly. The method is tested with the construction of a research pavilion....

  8. Waste form development/test

    International Nuclear Information System (INIS)

    The main objective of this study is to investigate new solidification agents relative to their potential application to wastes generated by advanced high volume reduction technologies, e.g., incinerator ash, dry solids, and ion exchange resins. Candidate materials selected for the solidification of these wastes include a modified sulfur cement and low-density polyethylene, neither of which are currently employed commerically for the solidification of low-level waste (LLW). As both the modified sulfur cement and the polyethylene are thermoplastic materials, a heated screw type extruder is utilized in the production of waste form samples for testing and evaluation. In this regard, work is being conducted to determine the range of conditions under which these solidification agents can be satisfactorily applied to the specific LLW streams and to provide information relevant to operating parameters and process control

  9. Mycoplasmas: small but perfectly formed

    Directory of Open Access Journals (Sweden)

    Robin NICHOLAS

    2015-07-01

    Full Text Available Interest in mycoplasmas stems from their importance as serious animal and human pathogens, their frequent contamination of cell lines and, because of their small size, for their use as models of the minimal cell concept.They have traditionally been seen as highly host specific but this is being reviewed in view of recent detections of animal mycoplasmas in unlikely hosts including humans. Some highlights include:Mycoplasmas, containing as few as 450 genes, are the smallest free-living organisms on the planetThey were the first synthetically created life formsWhile the majority of mycoplasmas are harmless, the World Organisation for Animal Health (OIE have listed 4 mycoplasma diseases because of their serious socio-economic impacts10-15% of cell lines used for virus research are contaminated with mycoplasma Are they the real the causes of TSEs and other undiagnosed human conditions?

  10. The Textile Form of Sound

    DEFF Research Database (Denmark)

    Bendixen, Cecilie

    of sound. This issue is a part of a Ph.D. study at The Danish Design School in Copenhagen. Sound diffusion in architecture is a complex phenomenon. From the sound source the sound spreads in all directions as a sphere of wave fronts. When the sound is reflected from room boundaries or furniture, complex...... experiments were carried out. One experiment was done in a laboratory with a sound measure instrument and textiles arranged in different positions and shapes. Here the high energy spots were located. The other experiment is ongoing and is an investigation of how textiles can take the shape of the sound......Sound is a part of architecture, and sound is complex. Upon this, sound is invisible. How is it then possible to design visual objects that interact with the sound? This paper addresses the problem of how to get access to the complexity of sound and how to make textile material revealing the form...

  11. The Form of HWID Theory

    DEFF Research Database (Denmark)

    Clemmensen, Torkil

    2015-01-01

    The aim of activities within the Human-Computer Interaction (HCI) area named Human Work Interaction Design (HWID) is to establish relationships between empirical work-domain studies and recent developments in interaction design. Recent areas of research within HWID include design sketches for work......, usability in context, work analysis for HCI, and integration of work analysis and interaction design methods for pervasive and smart workplaces. Across these areas, the question emerges what form of theory may HWID research produce? The aim with this paper is to investigate the requirements of different...... research purposes to a common framework. We take the position that we should approach HWID with a lightweight, medium-level framework that is useful to guide the application of other theories to study the relation between work analysis and interaction design. We analyse the requirements to theory found...

  12. Forming impressions from incongruent traits.

    Science.gov (United States)

    Casselden, P A; Hampson, S E

    1990-08-01

    The factors that affect the ease with which impressions are formed from incongruent trait pairs are investigated. In Experiments 1 and 2, trait pairs that were both descriptively and evaluatively congruent, as well as ones that were only evaluatively congruent, were found to be more imaginable and to be perceived as more frequently co-occurring than incongruent trait pairs. In Experiment 3, response latency provided a converging measure of ease of imaginability. Experiment 4 examined written descriptions of targets described by these trait pairs, and found more attempts to integrate the congruent than the incongruent pairs. These findings are discussed in terms of the relation between laypersons' impressions of personality and formal personality assessment. PMID:2213498

  13. Simultaneous Assembly of Multiple Test Forms

    NARCIS (Netherlands)

    Linden, van der Wim J.; Adema, Jos J.

    1998-01-01

    An algorithm for the assembly of multiple test forms is proposed in which the multiple-form problem is reduced to a series of computationally less intensive two-form problems. At each step, one form is assembled to its true specifications; the other form is a dummy assembled only to maintain a balan

  14. 48 CFR 570.701 - Standard forms.

    Science.gov (United States)

    2010-10-01

    ... PROGRAMS ACQUIRING LEASEHOLD INTERESTS IN REAL PROPERTY Forms 570.701 Standard forms. Use Standard Form 2, U.S. Government Lease for Real Property, to award leases unless you use GSA Form 3626 (see 570.702). Delete the reference to the Standard Form 2-A in paragraph 7....

  15. 48 CFR 570.702 - GSA forms.

    Science.gov (United States)

    2010-10-01

    ... PROGRAMS ACQUIRING LEASEHOLD INTERESTS IN REAL PROPERTY Forms 570.702 GSA forms. (a) You may use GSA Form 3626, U.S. Government Lease for Real Property (Short Form), to award leases if you use the simplified leasing procedures in 570.2 or if you determine it advantageous to use. (b) You may use GSA Form...

  16. Are There Various Forms of Lupus?

    Science.gov (United States)

    ... lupus Understanding lupus Are there various forms of lupus? Systemic Lupus Erythematosus Systemic lupus is the most common form ... and tissues at “ Lupus and the Body ”. Cutaneous Lupus Erythematosus This form of lupus is limited to ...

  17. 48 CFR 3053.303 - Agency forms.

    Science.gov (United States)

    2010-10-01

    ... section illustrates agency-specified forms. To access these forms go to: http://www.dhs.gov (under “Business, Acquisition Information”) or https://dhsonline.dhs.gov/portal/jhtml/general/forms.jhtml....

  18. Distinct Phenotypes Caused by Mutation of MSH2 in Trypanosome Insect and Mammalian Life Cycle Forms Are Associated with Parasite Adaptation to Oxidative Stress.

    Directory of Open Access Journals (Sweden)

    Viviane Grazielle-Silva

    2015-06-01

    Full Text Available DNA repair mechanisms are crucial for maintenance of the genome in all organisms, including parasites where successful infection is dependent both on genomic stability and sequence variation. MSH2 is an early acting, central component of the Mismatch Repair (MMR pathway, which is responsible for the recognition and correction of base mismatches that occur during DNA replication and recombination. In addition, recent evidence suggests that MSH2 might also play an important, but poorly understood, role in responding to oxidative damage in both African and American trypanosomes.To investigate the involvement of MMR in the oxidative stress response, null mutants of MSH2 were generated in Trypanosoma brucei procyclic forms and in Trypanosoma cruzi epimastigote forms. Unexpectedly, the MSH2 null mutants showed increased resistance to H2O2 exposure when compared with wild type cells, a phenotype distinct from the previously observed increased sensitivity of T. brucei bloodstream forms MSH2 mutants. Complementation studies indicated that the increased oxidative resistance of procyclic T. brucei was due to adaptation to MSH2 loss. In both parasites, loss of MSH2 was shown to result in increased tolerance to alkylation by MNNG and increased accumulation of 8-oxo-guanine in the nuclear and mitochondrial genomes, indicating impaired MMR. In T. cruzi, loss of MSH2 also increases the parasite capacity to survive within host macrophages.Taken together, these results indicate MSH2 displays conserved, dual roles in MMR and in the response to oxidative stress. Loss of the latter function results in life cycle dependent differences in phenotypic outcomes in T. brucei MSH2 mutants, most likely because of the greater burden of oxidative stress in the insect stage of the parasite.

  19. Risk factors for hospital-acquired bloodstream infections caused by gram-positive cocci and analysis of prognosis%医院获得性革兰阳性球菌血流感染的危险因素及预后分析

    Institute of Scientific and Technical Information of China (English)

    温晓星; 李华茵; 周晴; 周春妹; 高晓东; 胡必杰

    2014-01-01

    OBJECTIVE To explore the risk factors for hospital-acquired bloodstream infections caused by gram-positive cocci and observe the prognosis so as to provide guidance for control of the infections and improve the prognosis .METHODS The clinical data were retrospectively collected from the patients with hospital-acquired bloodstream infections caused by gram-positive cocci who were treated in the hospital from Jan 2012 to Jun 2014 , then the distribution and drug resistance of pathogens were compared between the survival group and the death group;the mortality of the hospitalized patients and the related factors for death were analyzed .RESULTS The coagulase-negative Staphylococcus was the predominant species of gram-positive cocci causing the bloodstream infections ,accounting for 54 .26% ;25 patients died with the mortality rate of 24 .04% .The drug resistance rate of the coagulase-negative Staphylococcus to penicillin was the highest (97 .01% ) ,followed by erythromycin (88 .24% ) and oxacillin (85 .00% );the drug resistance rate of the coagulase-negative Staphylococcus of the death group was higher than that of the survival group except for penicillin ,there was statistically significant difference (P<0 .05) .The isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 100 .00% in the death group ,significantly higher than that of the survival group (P= 0 .045) .The multivariate logistic regression analysis indicated that the hospital-acquired bloodstream infections showed significant correlation with the medical device implanting duration ,catheter indwelling time ,highest body temperature during infection ,total protein before drug therapy ,multidrug-resistant bacteria infections ,and mortality .CONCLUSION The medical device implanting duration ,catheter indwelling time ,highest body temperature during infection ,and multidrug-resistant bacteria infections are the independent risk factors for the death .%目的:了解医院获得性革兰阳

  20. 综合重症监护病房肠杆菌科细菌致血流感染发生的危险因素%Risk factors of bloodstream infections caused by enterobacteriaceae and related prognostic factors in general intensive care unit

    Institute of Scientific and Technical Information of China (English)

    孙伏喜; 冯旰珠; 高天明; 张扬; 赵水娣

    2014-01-01

    目的 探讨综合监护病房医院获得性肠杆菌科细菌血流感染(BSI)的危险因素.方法回顾性分析南京医科大学第二附属医院重症医学科综合监护病房2007年1月至2012年12月间南京医科大学第二附属医院重症医学科获得性肠杆菌科及非肠杆菌科细菌BSI患者的临床资料,分析肠杆菌科细菌BSI发生的危险因素,并以是否存活作为预后判定的终点指标,对肠杆菌科细菌BSI分别进行单因素及多因素Logistic回归分析,探究影响其存活的相关因素.结果 在96例医院获得性血流感染患者中35例为肠杆菌科细菌BSI,35例肠杆菌科细菌BSI患者中15例死亡,病死率42.9%;就肠杆菌科与非肠杆菌科细菌BSI患者的基础及临床特征对比后发现,影响肠杆菌科细菌BSI发生的危险因素包括急性胰腺炎、接受腹部手术及使用制酸剂(17.1%比4.9%,31.4%比16.4%,77.1%比45.9%;P<0.05 或0.01).对肠杆菌科细菌BSI患者生存组和死亡组各项特征的单因素分析及多因素Logistic回归分析发现,对肠杆菌科细菌BSI患者存活的影响因素包括患者年龄、APACHEⅡ评分、气管插管或切开及ESBL阳性(P<0.05).结论 在入住综合监护病房的患者中,急性胰腺炎、接受腹部手术及使用制酸剂的患者更易罹患肠杆菌科细菌BSI;而一旦发生细菌BSI,患者的年龄、APACHEⅡ评分、气管插管或切开及ESBLs阳性是影响其预后的重要因素.%Objective To explore the risk factors and its related prognostic factors of hospital-acquired bloodstream infections caused by enterobacteriaceae in general intensive care unit(GICU). Methods The clinical data of hospital-acquired bloodstream infections caused by enterobacteriaceae in general intensive care unit from January 2007 to December 2012 were retrospectively analyzed to determine the risk factors and explore the related prognostic factors of bloodstream infections by mono-factor and Logistic regression

  1. 产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌的耐药性及其所致血流感染的危险因素%Antibiotic resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae isolates and risk factors for bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    丁月平; 陆军; 俞云松; 周志慧

    2015-01-01

    Objective To investigate the antibiotic resistance of extended-spectrum-β-1actamases (ESBLs)-producing Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) isolates and the risk factors of bloodstream infections caused by these strains.Methods Clinical data of 131 patients with E.coli or K.pneumoniae-induced bloodstream infections admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University during September 2009 and June 2014 were retrospectively analyzed.Species identification and antimicrobial susceptibility test were performed by Vitek 2 system,and ESBLs production was tested by standard disk diffusion method.Logistic regression analysis was performed to identify the risk factors of bloodstream infections induced by ESBLs-producing strains.Results Among 131 patients,65 were infected with ESBLs-producing strains,and 66 were infected with non-ESBLs-producing strains.The resistance rates of ESBLs-producing strains were above 50% for penicillin,aztreonam and third/fourth generation cephalosporins,which were significantly higher than those of non-ESBLs producing strains.The resistance rates of ESBLs-producing E.coli and K.pneumoniae to carbapenems and piperacillin/tazobactam were 0-2.0%,2.3% and 0-14.3%,26.7%,respectively.The univariate analysis revealed that patients with exposure to cephalosporins in recent 3 months (x2 =18.322,P < 0.01),prior infection with ESBLs-producing strains (x2=14.610,P<0.01),indwelling catheter in recent 3 months (x2 =13.016,P < 0.01),history of hospitalization in recent 3 months (x2 =11.269,P < 0.01),exposure to quinolones in recent 3 months (x2 =10.638,P < 0.01),nosocomial infection (x2 =8.205,P < 0.01),history of indwelling deep venous catheter or percutaneous central catheter in recent 3 months (x2 =4.817,P < 0.05) and exposure to glucocorticoid hormone in recent 3 months (x2 =4.265,P < 0.05) were associated with infection of ESBLs-producing strains.Multivariate Logistic

  2. 儿童中心静脉置管相关性血流感染病原菌分布及耐药性分析%Analysis of the distribution and drug resistance of pathogenic bacteria of children′s PICC related bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    李智英; 罗学群; 余慕雪

    2014-01-01

    OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in peripherally insert‐ed central catheter (PICC) related bloodstream infection on children ,and to provide the foundation for the clinical prevention and treatment .METHODS The clinical data of 72 children with PICC related bloodstream infection were chosen in our hospital from Jan .2009 to Jan .2014 ,the distribution and drug resistance of pathogenic bacte‐ria were analyzed .SPSS13 .0 was adopted for a statistic analysis .RESULTS Totally 98 strains of pathogenic bacte‐ria were isolated and identified ,including 48 strains of gram‐positive bacteria (48 .98% ) ,37 strains of gram‐nega‐tive bacteria (37 .75% ) and 13 strains of fungi (13 .27% ) .The main gram‐positive bacteria were with high resist‐ance to penicillin ,erythromycin and ampicillin G ,and the resistance rate was 61 .11% ~100 .00% .The gram‐neg‐ative bacteria were with high resistance to ceftazidime ,cefepime ,cefuroxime and ampicillint ,and the resistance rate was 58 .30% ~88 .89% .Fungi were sensitive to itraconazole ,amphotericin B ,fluconazole and flucytosine , and the resistance rate was less than 20 .00% ;The children with the PICC indwelling time less than 7 days accaunted for 6 .9% ,while the children with the indwelling time more than 21days accounted for 50 .00% ;with the increase of the indwelling time ,the proportion of the chlidren with blooclstream infections was increased . CONCLUSION To strengthen the monitoring of pathogenic bacteria in PICC related bloodstream infections can help us better understand the dynamic changes of pathogenic bacteria in bloodstream infection .It′s benefit for guiding the clinical rational use of antimicrobial drugs and improving the clinical effect to master the drug resistance of pathogenic bacteria .%目的:分析儿童中心静脉置管(PICC )相关性血流感染的感染病原菌分布及其耐药性,为临床防治奠

  3. Miscellaneous Waste-Form FEPs

    Energy Technology Data Exchange (ETDEWEB)

    A. Schenker

    2000-12-08

    The US DOE must provide a reasonable assurance that the performance objectives for the Yucca Mountain Project (YMP) potential radioactive-waste repository can be achieved for a 10,000-year post-closure period. The guidance that mandates this direction is under the provisions of 10 CFR Part 63 and the US Department of Energy's ''Revised Interim Guidance Pending Issuance of New US Nuclear Regulatory Commission (NRC) Regulations (Revision 01, July 22, 1999), for Yucca Mountain, Nevada'' (Dyer 1999 and herein referred to as DOE's Interim Guidance). This assurance must be demonstrated in the form of a performance assessment that: (1) identifies the features, events, and processes (FEPs) that might affect the performance of the potential geologic repository; (2) examines the effects of such FEPs on the performance of the potential geologic repository; (3) estimates the expected annual dose to a specified receptor group; and (4) provides the technical basis for inclusion or exclusion of specific FEPs.

  4. Uniform-droplet spray forming

    Energy Technology Data Exchange (ETDEWEB)

    Blue, C.A.; Sikka, V.K. [Oak Ridge National Lab., TN (United States); Chun, Jung-Hoon [Massachusetts Institute of Technology, Cambridge, MA (United States); Ando, T. [Tufts Univ., Medford, MA (United States)

    1997-04-01

    The uniform-droplet process is a new method of liquid-metal atomization that results in single droplets that can be used to produce mono-size powders or sprayed-on to substrates to produce near-net shapes with tailored microstructure. The mono-sized powder-production capability of the uniform-droplet process also has the potential of permitting engineered powder blends to produce components of controlled porosity. Metal and alloy powders are commercially produced by at least three different methods: gas atomization, water atomization, and rotating disk. All three methods produce powders of a broad range in size with a very small yield of fine powders with single-sized droplets that can be used to produce mono-size powders or sprayed-on substrates to produce near-net shapes with tailored microstructures. The economical analysis has shown the process to have the potential of reducing capital cost by 50% and operating cost by 37.5% when applied to powder making. For the spray-forming process, a 25% savings is expected in both the capital and operating costs. The project is jointly carried out at Massachusetts Institute of Technology (MIT), Tuffs University, and Oak Ridge National Laboratory (ORNL). Preliminary interactions with both finished parts and powder producers have shown a strong interest in the uniform-droplet process. Systematic studies are being conducted to optimize the process parameters, understand the solidification of droplets and spray deposits, and develop a uniform-droplet-system (UDS) apparatus appropriate for processing engineering alloys.

  5. A Framework for Interactively Helpful Web Forms

    DEFF Research Database (Denmark)

    Bohøj, Morten; Bouvin, Niels Olof; Gammelmark, Henrik

    2012-01-01

    AdapForms is a framework for adaptive forms, consisting of a form definition language designating structure and constraints upon acceptable input, and a software architecture that continuously validates and adapts the form presented to the user. The validation is performed server-side, which...

  6. 48 CFR 245.7101 - Forms.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Forms. 245.7101 Section 245.7101 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Plant Clearance Forms 245.7101 Forms. Use the forms...

  7. Siegel modular forms and their applications

    NARCIS (Netherlands)

    G. van der Geer

    2008-01-01

    These are the lecture notes of the lectures on Siegel modular forms at the Nordfjordeid Summer School on Modular Forms and their Applications. We give a survey of Siegel modular forms and explain the joint work with Carel Faber on vector-valued Siegel modular forms of genus 2 and present evidence fo

  8. E-Forms in E-Business

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The form-based application framework is proposed as a straightsolution for E-bu siness applications. A Rapid Application Development (RAD) tool FormNet is desi gned for developing complex enterprise network applications. Its main features and a comparison with Microsoft Windows Forms are presented in this paper. The tool can be also perfectly applied to the government form applications.

  9. New CERN Health Insurance Scheme (CHIS) forms

    CERN Multimedia

    HR Department

    2015-01-01

    New versions of the following forms for claims and requests to the CERN Health Insurance Scheme (CHIS) have been released:   form for claiming reimbursement of medical expenses,   form for requesting advance reimbursement, and   dental estimate form (for treatments foreseen to exceed 800 CHF).   The new forms are available in French and English. They can either be completed electronically before being printed and signed, or completed in paper form. New detailed instructions can be found at the back of the claim form; CHIS members are invited to read them carefully. The electronic versions (PDF) of all the forms are available on the CHIS website and on the UNIQA Member Portal. CHIS Members are requested to use these new forms forthwith and to discard any previous version. Questions regarding the above should be addressed directly to UNIQA (72730 or 022.718 63 00 or uniqa.assurances@cern.ch).

  10. Current assisted superplastic forming of titanium alloy

    Directory of Open Access Journals (Sweden)

    Wang Guofeng

    2015-01-01

    Full Text Available Current assisted superplastic forming combines electric heating technology and superplastic forming technology, and can overcome some shortcomings of traditional superplastic forming effectively, such as slow heating rate, large energy loss, low production efficiency, etc. Since formability of titanium alloy at room temperature is poor, current assisted superplastic forming is suitable for titanium alloy. This paper mainly introduces the application of current assisted superplastic forming in the field of titanium alloy, including forming technology of double-hemisphere structure and bellows.

  11. Impacto dos conectores sem agulhas na infecção da corrente sanguínea: revisão sistemática Impacto de los conectores sin agujas en la infección de la corriente sanguínea: revisión sistemática Impact of needleless connectors in the bloodstream infection: a systematic review

    Directory of Open Access Journals (Sweden)

    Silvia Helena Frota Mendonça

    2010-01-01

    Full Text Available Esta revisão sistemática buscou evidenciar o impacto do uso de conectores sem agulhas para sistema fechado de infusão na ocorrência de infecção da corrente sanguínea relacionada ao cateter venoso central. A amostra constitui-se de 14 estudos, os quais investigaram somente conectores sem agulhas. A infecção da corrente sanguínea relacionada ao cateter venoso central foi o desfecho de nove estudos. Seis apresentaram diferenças a favor do conector valvulado; quatro a favor do conector puncionável com cânula; um a favor do conector puncionável com agulha; um a favor do conector valvulado com pressão positiva e dois a favor do dispositivo usado antes da troca. A heterogeneidade dos estudos não permitiu a realização de metanálise.Esta revisión sistemática buscó evidenciar el impacto del uso de conectores sin agujas para sistemas cerrados de infusión en el caso de ocurrir una infección en la corriente sanguínea relacionada al catéter venoso central. La muestra fue constituida de 14 estudios, los cuales investigaron solamente conectores sin agujas. La infección de la corriente sanguínea relacionada al catéter venoso central fue el resultado de nueve estudios. Seis presentaron diferencias a favor del conector de válvula; cuatro a favor del conector para punción con cánula; uno a favor del conector para punción con aguja; uno a favor do conector de válvula con presión positiva y dos a favor del dispositivo usado antes del cambio. La heterogeneidad de los estudios no permitió la realización de una meta-análisis.This systematic review was intended to evaluate the impact of using needleless connectors in closed infusion systems in the event of a bloodstream infection related to central venous catheter. The sample consisted of 14 studies, which investigated only needleless connectors. The bloodstream infection related to central venous catheter was the result of nine studies. Six produced evidence in favor of the valve

  12. An analysis of catheter-related bloodstream infections in old hemodialysis patients with tunneled central venous catheterization%老年透析患者隧道式中心静脉置管相关血流感染临床分析

    Institute of Scientific and Technical Information of China (English)

    郑洁; 黄雯; 姜立萍

    2012-01-01

    Objective To study catheter-related bloodstream infections (CRBSI) in old hemodialysis patients with tunneled central venous catheterization. Methods Twenty-six old hemodialysis patients with tunneled central venous catheterization were observed and analyzed. Results The incidence of CRBSI in old hemodialysis patients with tunneled central venous catheterization was 1.36 times/1000 catheterization days. Nine strains bacteria were isolated. The bacteria included Staphylococcus epidermidis(33.3%), Staphylococcus aureus (22.2%), Staphylococcus hominis(ll.l%), extended spectrum beta -lactamases type Escherichia coli (11.1%), pseudomonas aeruginosa (11.1%), Klebsiella pneumoniae procalcitonin of patients with CRBSI were remarkablely increased. Catheter indwelling time was an independent risk factor for CRBSI (OR = 11.09, P < 0.05). Low albumin level was associated with CRBSI. The level of procalcitonin of patients with CRBSI was increased obviously. Conclusion Prolonged catheter indwelling time is an independent risk factor of CRBSI in old hemodialysis patients with tunneled central venous catheterization.%目的 探讨老年血液透析患者隧道式中心静脉置管所致导管相关血流感染(catheter-related bloodstream infections,CRBSI)的病原菌及相关因素.方法 选择北京同仁医院使用隧道式中心静脉置管的老年维持性血液透析患者26例,根据血培养结果分为感染组和非感染组,分析CRBSI患者血培养分离出的病原菌及相关因素.结果 老年血液透析患者隧道式中心静脉置管CRBSI的发生率为1.36次/1000导管日.CRBSI患者血培养阳性8例,分离出病原菌9株,包括表皮葡萄球菌3株(33.3%)、金黄色葡萄球菌2株(22.2%)、人葡萄球菌1株(11.1%)、超广谱β内酰胺酶阳性大肠埃希菌1株(11.1%)、绿脓杆菌1株(11.1%)、肺炎克雷伯杆菌1株(11.1%).导管留置时间是CRBSI的独立危险因素(OR值为11.09,P< 0.05).低白蛋白水平与CRBSI的

  13. Real time PCR与常规血培养在血流感染未知病原体鉴定中的比较研究%Comparative Study of Real-time PCR and Blood Culture in Characterization of Unknown Pathogen in Bloodstream Infection

    Institute of Scientific and Technical Information of China (English)

    焦巍; 彭莉

    2014-01-01

    目的:观察real time PCR在血流感染病原体检测中的敏感性和特异性,并与常规血培养对比,探讨其临床应用价值。方法以该院各临床科室收集的108份脓毒血症患者血液标本进行real time PCR检测,同时进行常规血培养,比较两种方法的特异性和敏感性。结果108份标本当中,两种方法检测出12种病原微生物。 Real time PCR共检测出阳性标本25份,阴性标本83份。其中与血培养共同阳性标本9份,共同阴性标本78份。两方法的一致性为80.6%。Real time PCR的阴性预测值是0.94,敏感性64%,特异性83%。16例标本real time PCR阳性而血培养阴性,5例标本血培养阳性而real time PCR阴性。同时,有2病标超出real time PCR的检测范围,而血培养阳性。此外,real time PCR无法检测光滑念珠菌。结论real time PCR虽然能快速检测血液感染中病原微生物,但依然不能完全替代血培养。%Objective To observe the sensitivity and specificity of real-time PCR in the detection of unknown pathogen in blood-stream infection, and compare that with conventional blood culture, and thus to investigate its clinic application value in pathogen detection. Methods A total of 108 blood samples of patients with sepsis from the clinic departments in our hospital were collected for real-time PCR detection and conventional blood culture. And the sensitivity and specificity of these two methods were compared. Results Of the 108 samples, 12 kinds of pathogens were detected. 25 positive and 83 negative samples were detected by real-time PCR. 9 samples were positive, and 78 samples were negative in both real-time PCR and blood culture assays. The agreement rate of blood culture system and real-time PCR was 80.6%. The negative predictive value of real-time PCR was 0.94, sensitivity was 64%, and specificity 83%. In 16 samples where a positive real-time PCR and a negative blood culture system result were obtained

  14. Analysis for bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli in patients with liver cirrhosis%肝硬化患者产超广谱β-内酰胺酶大肠埃希菌血液感染的分析

    Institute of Scientific and Technical Information of China (English)

    张思泉; 叶卫江; 朱明利; 王飞; 刘华锋

    2009-01-01

    目的 分析肝硬化患者产超广谱β-内酰胺酶(ESBLs)大肠埃希菌(大肠杆菌)血液感染的危险因素及其对常用抗菌药物的耐药性,为临床治疗提供参考.方法 对2001年9月-2008年12月我院30例产ESBLs的大肠埃希菌血液感染肝硬化患者(A组)与60例非产ESBLs的大肠埃希菌血液感染肝硬化患者(B组)进行病例-对照研究.结果 A组重型肝炎及继发性败血症发生率明显高于B组(P<0.05),既往三代头孢菌素、β-内酰胺酶抑制剂复合制剂或氟喹诺酮类抗菌药物使用率均高于对照组(P<0.05).产ESBLs大肠埃希菌除亚胺培南/西司他丁、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦外,对各类抗菌药物呈现了较为普遍的耐药性.结论 严重肝功能损伤、使用过三代头孢菌素、β-内酰胺酶抑制剂复合制剂或氟喹诺酮类抗菌药物是产ESBLs大肠埃希菌血液感染的危险因素.对有产ESBLs大肠埃希菌败血症的肝硬化高危患者,应首选亚胺培南/西司他丁、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦作为经验性治疗.%Objective To investigate the risk factors for bloodstream infections caused by extended-spectrum β-lactamases(ESBLs)-producing Escherichia coli in patients with liver cirrhosis,and provide reference for clinical therapy.Methods An exploratory case control study was used,in which 30 cases of liver cirrhosis with bacteraemia caused by ESBLs-producing E.coli(Group A)were compared with 60 cases of liver cirrhosis with bacteraemia caused by non-ESBLs-producing E.co1i(Group B).Results Previous use ratio of third generation cephalosporins,combinations of β-lactams and β-lactamase inhibitors or fluoroquinolones and the incidence of chronic severe hepatitis and secondary septicamia were higher in group A than in group B(P<0.05).In addition to imipenem-cilastatin,cefoperazone-sulbactam,piperacillin-tazobactam,ESBLs-producing E.coli was usually resistant to most antimicrobial

  15. Singularity conjecture and constructions of Jacobi forms

    Institute of Scientific and Technical Information of China (English)

    王巨平

    2002-01-01

    This paper verifies the singularity conjecture for Jacobi forms with higher degree in some typical cases, and gives constructions for the Jacobi cusp forms whose Fourier coefficients can be expressed by some kind of Rankin-type L-series.

  16. FormCalc 9 and Extensions

    CERN Document Server

    Hahn, T; Schappacher, C

    2016-01-01

    We present Version 9 of the Feynman-diagram calculator FormCalc and a flexible new suite of shell scripts and Mathematica packages based on FormCalc, which can be adapted and used as a template for calculations.

  17. Epidemiology and microbiology of nosocomial bloodstream infections:analysis of 482 cases from a retrospective surveillance study%医院获得性血流感染的流行病学和病原学特征分析:482例感染病例的回顾性调查

    Institute of Scientific and Technical Information of China (English)

    Jian-nong WU; Tie-er GAN; Yue-xian ZHU; Jun-min CAO; Cong-hua JI; Yi-hua WU; Bin LV

    2015-01-01

    分析某三级中医院医院获得性血流感染(nBSIs)的流行病学和病原学特征,探索影响28天病死率的相关危险因素。%In many traditional Chinese medicine (TCM) hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. A retrospective sur-veillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions. Escherichia coli (25.5%) was the most common Gram-negative and coagulase-negative staphylococcus (CoNS) (14.1%) was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsiella pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7%were resistant to methicillin. Carbapenems and glyco-peptide were the most frequently used for nBSI therapy. Only about one-third of patients (157/482) received appro-priate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score>4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.

  18. 乌司他丁治疗危重症血流感染患者全身炎性反应的临床研究%Clinical studies of ulinastatin in the treatment of systemic inflammatory response in patients with critical bloodstream infections

    Institute of Scientific and Technical Information of China (English)

    吕卫星; 许兆军; 何盛

    2015-01-01

    OBJECTIVE To investigate the clinical effect of ulinastatin in the treatment of systemic inflammatory re‐sponse in patients with critical bloodstream infections so as to provide reference for clinical treatments .METHODS Totally 74 cases of critical patients with systemic inflammatory response caused by bloodstream infections were se‐lected from Mar .2010 to Dec .2013 and they were randomly divided into two groups .Conventional treatment was adopted in the control group with 35 patients and another 39 patients were given ulinastatin intravenously on the basis of the control group .Indicators like temperature ,respiratory rate ,heart rate ,leukocyte numbers ,serum creatinine ,blood lactic acid ,C‐reactive protein and inflammatory cytokines were observed and recorded .Other in‐dicators like invasive mechanical ventilation ,hospital stays in ICU and fatality rate were recorded too .SPSS 13 .0 software was adopted for statistical analysis .RESULTS The invasive ventilation time ,ICU length of stay and mor‐tality rate in control group were respectively (16 .42 ± 1 .28) d ,(27 .72 ± 3 .17) d and 31 .43% .In the observation group ,they were (7 .33 ± 0 .52) d ,(15 .23 ± 1 .44 ) d and 5 .13% .The curative time and mortality rate in the ob‐servation group were significantly less than the control group (P<0 .05) .CONCLUSION Ulinastatin treatment for critical patients with systemic inflammatory response caused by bloodstream infections can significantly improve the patient's vital signs ,effectively protect the patient's liver and kidney function ,shorten treatment time and im‐prove patients prognosis ,and ease administration ,hence it can be used as a routine means of treatment to pro‐mote in clinic .%目的:探讨乌司他丁治疗危重症血流感染患者全身炎性反应的临床效果,为临床治疗提供参考依据。方法选取2010年3月-2013年12月危重症患者血流感染所致全身炎性反应的74例,随机分为两组,

  19. Comparison of Community-acquired and Nosocomial Bloodstream Infection in Hangzhou Area%杭州地区社区获得性血流感染与医院血流感染的临床及病原学研究

    Institute of Scientific and Technical Information of China (English)

    王淑颖; 黄美先; 董晓勤; 吴旻

    2011-01-01

    目的 比较近年来杭州地区社区获得性血流感染(CABSI)与医院血流感染(NBSI)的临床特点及病原菌分布.方法 调查2004~2008年入住杭州市第一人民医院、血培养阳性并确诊为血流感染的病例,对其临床特点及病原菌分布进行统计分析.结果 确诊为血流感染者共397例,获病原菌405株.其中CABSI 261例(65.7%),NBSI 136例(34.3%).CABSI的平均年龄39.87±31.41岁,病死率1.9%,合并基础疾病率65.1%;NBSI的平均年龄65.10±19.02岁,病死率14.0%,合并基础疾病率97.1%,P均<0.01.CABSI获病原菌263株,病原菌中以凝固酶阴性葡萄球菌(CNS)最常见,占27.4%,余依次为大肠杆菌、克雷伯菌属、阴沟肠杆菌、链球菌属等.NBSI病原菌142株,病原菌中以大肠杆菌最常见,占19.7%,余依次为凝固酶阴性葡萄球菌、白色念珠菌等念珠菌属、伯克霍尔德菌属、铜绿假单胞菌等.结论 CABSI患者与NBSI比较,发病年龄较轻、合并基础疾病较少、治愈率较高,病原菌以CNS居首位,NBSI则以大肠杆菌最常见.临床上应对CABSI抑或NBSI加以区分、分析可能的致病菌,对了解地区差异、判断预后、减少病死率甚为重要.%Objective To compare the clinical charactenstics and bacteriaJ distribution of community - acquired( CABSI) and nosocomial( NBSI) bloodstream infection in Hangzhou area. Methods Records with positive blood culture from 2004 to 2008 in Hangzhou First People's Hospital were examined. We analyzed the clinical characteristics and bacterial distribution of the cases diagnosed bloodstream infection. Results 397 episodes were diagnosed and 405 pathogenic isolates were collected. Of all the BSI episodes, 65. 7% BSI were CABSI and 34. 3% were NBSI. The average age was 39. 87 ±31.41 year for CABSI vs 65. 10 ± 19. 02 year for NBSI( P < 0. 01 ) . The mortality was 1. 9% for CABSI versus 14. 0% for NBSI ( P < 0. 01 ) . Underlying illnesses accompanying bloodstream infections

  20. 降钙素原在血液透析患者导管相关性血行感染中的应用价值%The value of procalcitonin for the evaluation of catheter-related bloodstream infection in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    王芳; 潘淼; 李大勇; 刘小华; 陈晶; 谢鸣部; 黄智敏; 郑佩兰; 韦永光

    2013-01-01

    目的 研究降钙素原(Procalcitonin,PCT)在血液透析患者导管相关性血行感染(catheter related bloodstream infection,CRBSI)中的应用价值.方法 62例行中心静脉临时置管后临床怀疑导管相关性血行感染的血液透析患者,采集血常规、C反应蛋白(CRP)、降钙素原血样后拔除导管,同时留取血培养及导管标本.62例患者根据诊断标准分为CRBSI组27例和非CRBSI组35例,比较2组患者的年龄、性别、导管类型、导管留置时间、血白细胞计数(WBC)值、CRP值及降钙素原值(PCT值),并对比CRBSI组治疗前后的PCT值. 结果 CRBSI组患者年龄、导管留置时间明显大于非CRBSI组,CRBSI组及非CRBSI组拔管时的血清PCT水平分别为7.16±5.84μ g/L和0.97±1.44 μ g/L(F =11.759,t=5.387,P<0.001),具有统计学意义,其WBC (109/L)分别为9.52±3.10及8.65±2.19 (F =0.860 t=1.291 P=0.202),CRP值分别为10.57±3.74mg/L及10.66±4.94mg/L(F=1.641,t=0.081 P=0.935),2组均无统计学意义.CRBSI组拔管前后的降钙素原值(PCT值)分别为7.16±5.84 μ g/L及0.63±0.43 μ g/L (t=5.904,P<0.001),具有统计学意义. 结论 PCT在早期诊断CRBSI方面具有较高的指导价值.%Objective To study the value of procalcitonin for the evaluation of catheter-related bloodstream infection (CRBSI) in hemodialysis patients. Methods Blood samples from 62 hemodialysis patients suspected to have catheter-related bloodstream infection were obtained for the assays of blood routine examinations, procalcitonin and C-reactive protein (CRP). Blood and the catheter taken from the patients were cultured for bacteria. Patients were assigned into CRBSI group (n=27 cases) or non-CRBSI group (n=35 cases) based on the diagnostic criteria. Age, gender, catheter type, catheter retention period, WBC, CRP and procalcitonin were compared between the two groups. Procalcitonin levels were also compared before and after treatment. Results Age and catheter retention period were