WorldWideScience

Sample records for hospital-wide infection rate

  1. [Effectiveness of a hospital-wide educational programme for infection control to reduce the rate of health-care associated infections and related sepsis (ALERTS)--methods and interim results].

    Science.gov (United States)

    Hagel, S; Ludewig, K; Frosinski, J; Hutagalung, R; Porzelius, C; Gastmeier, P; Harbarth, S; Pletz, M W; Brunkhorst, F M

    2013-08-01

    Health care associated infections (HAIs) are one of the most frequent complications of hospital care, associated with increased morbidity, mortality and considerable extra costs for the health care system. The overarching objective of the ALERTS study is to demonstrate the feasibility of a hospitalwide programme to reduce the burden of HAIs and related sepsis of at least 20 %. Prospective, quasi-experimental study covering all acute care units (27 general wards, 4 ICUs, overall 809 beds) at Jena University Hospital. Surveillance for HAIs is performed by computerized antibiotic monitoring in patients with risk factors for HAIs (i. e. intravenous and urinary catheters, surgery) on a daily basis. Following the first surveillance period a multifaceted, pragmatic infection control programme, aimed at proper hand hygiene and bundles for the prevention of the four most common HAIs will be implemented. Subsequently, a second surveillance period lasting 18 months will be conducted to measure the effect of the infection control programme, starting in May 2013. Interim results for the first surveillance period (09/2011 to 08/2012) are presented. During this period, 30,631 patients were admitted to the participating departments. According to CDC definitions we identified 1,637 HAIs, resulting in an overall incidence of 5.3 %. Based on clinical evaluation only, irrespective of the CDC definitions, an additional 944 HAIs were detected (overall HAI rate, 8.4 % [n =2581]). A substantial proportion of patients had HAI associated severe sepsis or septic shock (lower respiratory tract infection, n = 279 [37 %]; surgical site infection, n = 114 [25 %]; primary sepsis, n = 110 [32 %]; urinary tract infection, n = 46 [8 %]; other, n = 87 [22 %]). Our numbers reveal that a high number of HAIs are missed using CDC-definitions and therefore the magnitude of the problem might be underestimated. Furthermore, a high percentage of HAIs progress from localized infection to severe sepsis or

  2. Impact of a hospital-wide hand hygiene promotion strategy on healthcare-associated infections

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    Ling Moi Lin

    2012-03-01

    Full Text Available Abstract Background During the Severe Acute Respiratory Syndrome (SARS outbreak, high compliance in healthcare workers to hand hygiene was primarily driven by fear. However, the post-SARS period confirmed that this practice was not sustainable. At the Singapore General Hospital, a 1,600-bedded acute tertiary care hospital, the hand hygiene program was revised in early 2007 following Singapore's signing of the pledge to the World Health Organization (WHO "Clean Care is Safer Care" program. Findings A multi-prong approach was used in designing the hand hygiene program. This included system change; training and education; evaluation and feedback; reminders in the workplace; and institutional safety climate. Hand hygiene compliance rate improved from 20% (in January 2007 to 61% (2010. Improvement was also seen annually in the compliance to each of the 5 moments as well as in all staff categories. Healthcare-associated MRSA infections were reduced from 0.6 (2007 to 0.3 (2010 per 1000 patient-days. Conclusions Leadership's support of the program evidenced through visible leadership presence, messaging and release of resources is the key factor in helping to make the program a true success. The hospital was recognised as a Global Hand Hygiene Expert Centre in January 2011. The WHO multi-prong interventions work in improving compliance and reducing healthcare associated infections.

  3. Microbial Characteristics of Nosocomial Infections and Their Association with the Utilization of Hand Hygiene Products: A Hospital-Wide Analysis of 78,344 Cases.

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    Liu, Song; Wang, Meng; Wang, Gefei; Wu, Xiuwen; Guan, Wenxian; Ren, Jianan

    Nosocomial infections are the main adverse events during health care delivery. Hand hygiene is the fundamental strategy for the prevention of nosocomial infections. Microbial characteristics of nosocomial infections in the Asia-Pacific region have not been investigated fully. Correlation between the use of hand hygiene products and the incidence of nosocomial infections is still unknown. This study investigates the microbial characteristics of nosocomial infections in the Asia-Pacific region and analyzes the association between the utilization of hand hygiene products and the incidence of nosocomial infections. A total of 78,344 patients were recruited from a major tertiary hospital in China. Microbial characteristics of major types of nosocomial infections were described. The association between the utilization of hand hygiene products and the incidence of nosocomial infections was analyzed using correlation and regression models. The overall incidence of nosocomial infections was 3.04%, in which the incidence of surgical site infection was 1%. Multi-drug resistance was found in 22.8% of all pathogens, in which multi-drug-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus were 56.6% and 54.9%, respectively. The utilization of hand hygiene products (including hand sanitizer, soap and paper towel) was associated negatively with the incidence of surgical site infection in surgical departments and the incidence of nosocomial infections in non-intensive care unit (ICU) departments (especially in surgical departments). Regression analysis further identified that higher utilization of hand hygiene products correlated with decreased incidence of major types of nosocomial infections. Multi-drug-resistant organisms are emerging in Asia-Pacific health care facilities. Utilization of hand hygiene products is associated with the incidence of nosocomial infections.

  4. A multifaceted hospital-wide intervention increases hand hygiene ...

    African Journals Online (AJOL)

    Hospital-acquired infections remain a global concern, with prevalence rates in the USA ranging from 3.5% to 9.9%,[1] almost one-third of infections being preventable. In South Africa (SA), about one in seven patients entering health facilities may be at risk of developing a hospital- acquired infection. This results in significant ...

  5. SIS Epidemic Spreading with Heterogeneous Infection Rates

    CERN Document Server

    Qu, Bo

    2015-01-01

    In this work, we aim to understand the influence of the heterogeneity of infection rates on the Susceptible-Infected-Susceptible (SIS) epidemic spreading. Specifically, we keep the recovery rates the same for all nodes and study the influence of the moments of the independently identically distributed (i.i.d.) infection rates on the average fraction $y_\\infty$ of infected nodes in the meta-stable state, which indicates the severity of the overall infection. Motivated by real-world datasets, we consider the log-normal and gamma distributions for the infection rates and we design as well a symmetric distribution so that we have a systematic view of the influence of various distributions. By continuous-time simulations on several types of networks, theoretical proofs and physical interpretations, we conclude that: 1) the heterogeneity of infection rates on average retards the virus spread, and 2) a larger even-order moment of the infection rates leads to a smaller average fraction of infected nodes, but the odd-...

  6. A Viral Infection Model with a Nonlinear Infection Rate

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    Nieto JuanJ

    2009-01-01

    Full Text Available A viral infection model with a nonlinear infection rate is constructed based on empirical evidences. Qualitative analysis shows that there is a degenerate singular infection equilibrium. Furthermore, bifurcation of cusp-type with codimension two (i.e., Bogdanov-Takens bifurcation is confirmed under appropriate conditions. As a result, the rich dynamical behaviors indicate that the model can display an Allee effect and fluctuation effect, which are important for making strategies for controlling the invasion of virus.

  7. The Seasonal Variation of TKR Infection Rates

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    Parkinson, Ben; Armit, Drew; Reid, Michael; Lorimer, Michelle; Harris, Ian

    2017-01-01

    Introduction: A seasonal variation in the incidence of surgical site infections has been described following a number of common surgical procedures. However in the setting of elective Total Knee Replacement (TKR), the role of environmental factors is an area of research that is currently lacking from the literature. Data recently presented from our institution demonstrates a possible trend toward higher infection rates during periods of increased temperature and humidity. The aim of this study was to investigate if seasonal and geographical factors influence the rate of TKR infection within Australia. Methods: Data from the AOA National Joint Registry for all primary TKRs performed within the last 5 years was analysed to determine the revision rates for early (<12 months) post-operative infection. The infection rates for tropical regions (Darwin, Cairns, Townsville, Mackay) were compared to the remainder of the country. A month-by-month analysis was performed to determine if there was a seasonal variation within the 2 study groups. Results: During the study period a total of 207,540 primary TKRs were performed (6,514 tropical vs 201,026 non-tropical regions). Overall, the rate of revision for infection was significantly higher for the tropical regions of Australia (0.80% vs 0.39%). In non-tropical regions, there was no observed seasonal variation of infection rates. In tropical regions, there was a clear seasonal variation found, with the winter months being associated with a significantly lower rate of infection than the remainder of the year (0.37% vs 0.94%). The infection rates were not significantly different between tropical (0.37%) and non- tropical (0.38%) regions during the winter period. Conclusion: To the best of our knowledge, this is the first study to investigate and demonstrate a significant influence from seasonal variation on primary TKR infection rates. This phenomenon is evident only within tropical regions, with the periods of warmer and humid

  8. A multifaceted hospital-wide intervention increases hand hygiene compliance.

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    Patel, B; Engelbrecht, H; McDonald, H; Morris, V; Smythe, W

    2016-03-07

    Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. To show an improvement in hand hygiene compliance using a multifaceted approach. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with non-intervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

  9. Hospital-wide education committees and high-quality residency training : A qualitative study

    NARCIS (Netherlands)

    Silkens, Milou E. W. M.; Slootweg, Irene A.; Scherpbier, Albert J. J. A.; Heineman, Maas Jan; Lombarts, Kiki M. J. M. H.

    2017-01-01

    High-quality residency training is of utmost importance for residents to become competent medical specialists. Hospital-wide education committees have been adopted by several healthcare systems to govern postgraduate medical education and to support continuous quality improvement of residency

  10. Effects of hospital-wide interventions to improve care for frail older inpatients: a systematic review

    NARCIS (Netherlands)

    Bakker, F.C.; Robben, S.H.M.; Olde Rikkert, M.G.M.

    2011-01-01

    BACKGROUND: Although it is widely recognised that frail older persons need adaptation of healthcare services, it is unclear how hospital care in general can best be tailored to their frailty. OBJECTIVE: To systematically review the evidence for hospital-wide interventions for older patients.

  11. Hospital-wide PACS with a digital image intensifier TV system.

    Science.gov (United States)

    Okaniwa, H; Tsuneyoshi, H; Kabata, S; Satoh, K; Yokouchi, H; Okabe, T

    1994-05-01

    Tokyo Hitachi Hospital, Hitachi Ltd., has used a hospital-wide PACS for over 1 year. The system runs a 100 Mb/s optical fiber network over the whole hospital including wards and outpatient clinic rooms, with 11 image workstations. The network links digital imaging modalities such as X-CT, MRI, computed radiography (CR) and digital radiography (DR) with a 2048 x 2048 (2k x 2k) matrix image intensifier television (I.I.-TV) system. These modalities generate about 200 images/day. The system has managed over 300,000 images of about 8000 patients so far. Although being still under improvement, the system has really been used for routine work. The hospital-wide PACS of a small hospital has been proved to be very useful for both image diagnosis and image management.

  12. Infection Rates in Arthroscopic Versus Open Rotator Cuff Repair.

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    Hughes, Jonathan D; Hughes, Jessica L; Bartley, Justin H; Hamilton, William P; Brennan, Kindyle L

    2017-07-01

    The prevalence of rotator cuff repair continues to rise, with a noted transition from open to arthroscopic techniques in recent years. One reported advantage of arthroscopic repair is a lower infection rate. However, to date, the infection rates of these 2 techniques have not been directly compared with large samples at a single institution with fully integrated medical records. To retrospectively compare postoperative infection rates between arthroscopic and open rotator cuff repair. Cohort study; Level of evidence, 3. From January 2003 until May 2011, a total of 1556 patients underwent rotator cuff repair at a single institution. These patients were divided into an arthroscopic repair group and an open group. A Pearson chi-square test and Fisher exact test were used, with a subgroup analysis to segment the open repair group into mini-open and open procedures. The odds ratio and 95% CI of developing a postoperative infection was calculated for the 2 groups. A multiple-regressions model was then utilized to identify predictors of the presence of infection. Infection was defined as only those treated with surgical intervention, thus excluding superficial infections treated with antibiotics alone. A total of 903 patients had an arthroscopic repair, while 653 had open repairs (600 mini-open, 53 open). There were 4 confirmed infections in the arthroscopic group and 16 in the open group (15 mini-open, 1 open), resulting in postoperative infection rates of 0.44% and 2.45%, respectively. Subgroup analysis of the mini-open and open groups demonstrated a postoperative infection rate of 2.50% and 1.89%, respectively. The open group had an odds ratio of 5.645 (95% CI, 1.9-17.0) to develop a postoperative infection compared with the arthroscopic group. Patients undergoing open rotator cuff repair had a significantly higher rate of postoperative infection compared with those undergoing arthroscopic rotator cuff repair.

  13. SIS Epidemic Spreading with Correlated Heterogeneous Infection Rates

    CERN Document Server

    Qu, Bo

    2016-01-01

    The epidemic spreading has been widely studied when each node may get infected by an infected neighbor with the same rate. However, the infection rate between a pair of nodes is usually heterogeneous and even correlated with their nodal degrees in the contact network. We aim to understand how such correlated heterogeneous infection rates influence the spreading on different network topologies. Motivated by real-world datasets, we propose a correlated heterogeneous Susceptible-Infected-Susceptible model which assumes that the infection rate $\\beta_{ij}(=\\beta_{ji})$ between node $i$ and $j$ is correlated with the degree of the two end nodes: $\\beta_{ij}=c(d_id_j)^\\alpha$, where $\\alpha$ indicates the strength of the correlation and $c$ is selected so that the average infection rate is $1$. In order to understand the effect of such correlation on epidemic spreading, we consider as well the corresponding uncorrected but still heterogeneous infection rate scenario as a reference, where the original correlated inf...

  14. Nosocomial urinary tract infection. Risk factors, rates and trends.

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    Al-Asmary, Saeed M; Al-Helali, Nabil S; Abdel-Fattah, Moataz M; Al-Jabban, Tawfiq M; Al-Bamri, Abdellatif M

    2004-07-01

    This report aims at both estimation of the rates of overall nosocomial and urinary tract infection (UTI) and their linear trends as well as studying the potential risk factors of patients admitted to Al-Hada, Rehab and Prince Sultan military hospitals and developed nosocomial UTIs (NUTIs). A case-control study on 206 discharged patients with confirmed UTI and 618 controls without UTI was carried out between August 2001 through to July 2003 to study risk factors for nosocomial UTI as well as hospital records during the period (1998-2002) were reviewed for calculation of the overall annual nosocomial infection and nosocomial UTI rates. Multiple logistic regression analysis showed that duration of hospital stay, unit of admission, history of diabetes mellitus or debilitating diseases, and duration and number of urinary catheters were independently associated with increased risk of NUTIs. The mean incidence rate of overall nosocomial infection along the study period (1998-2002) was 2.82, while the mean incidence rate of UTI nosocomial infection was 0.85 per 100 discharged patients. Urinary tract infection represents approximately 31.7% of overall nosocomial infection throughout the study period. Urinary tract infections comprise approximately one third of nosocomial infections. The results, thus, indicated that to reduce the incidence of UTI nosocomial infection, it was important to take factors that can be managed into consideration. Therefore, the involved persons should pay more attention and set practical and effective guidelines for the hospital.

  15. Estimating infectivity rates and attack windows for two viruses.

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    Zhang, J; Noe, D A; Wu, J; Bailer, A J; Wright, S E

    2012-12-01

    Cells exist in an environment in which they are simultaneously exposed to a number of viral challenges. In some cases, infection by one virus may preclude infection by other viruses. Under the assumption of independent times until infection by two viruses, a procedure is presented to estimate the infectivity rates along with the time window during which a cell might be susceptible to infection by multiple viruses. A test for equal infectivity rates is proposed and interval estimates of parameters are derived. Additional hypothesis tests of potential interest are also presented. The operating characteristics of these tests and the estimation procedure are explored in simulation studies. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Reduction of seclusion on a hospital-wide level: successful implementation of a less restrictive policy.

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    Jungfer, Hermann-Alexander; Schneeberger, Andres R; Borgwardt, Stefan; Walter, Marc; Vogel, Marc; Gairing, Stefanie K; Lang, Undine E; Huber, Christian G

    2014-07-01

    Change of treatment policy from closed to open ward settings has been shown to reduce coercive measures. The aim of the current study was to examine the effects of the change from closed to open wards on the frequency of seclusion and forced medication in a hospital-wide setting. 2-year, longitudinal observational study with 2838 inpatient cases. On a hospital-wide level, the percentage of patients with at least one seclusion was decreased significantly (χ(2)(1) = 5.8; p = .016), while there was no significant change in forced medication (χ(2)(1) = .08; p = .775). The frequency of seclusions and forced medication decreased significantly on newly opened wards, and there were no significant changes regarding seclusion on permanently closed or open wards, while the number of forced medications increased significantly on closed wards. The decrease in seclusions on newly opened wards remained statistically significant after controlling for diagnoses and severity of illness. Our results indicate that a reduction of overall seclusion can be successfully attained, and that, in particular, the frequency of seclusion and forced medication on newly opened wards was decreased significantly. These changes were not accompanied by a significant increase in seclusion on other wards. Open ward treatment was successfully implemented and was associated with a significant decrease of coercive measures in our study. It might therefore provide a good care model, strengthening the patient's right to autonomy and leading to a reduction of coercive measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Central Line Associated Blood Stream Infection Rate after ...

    African Journals Online (AJOL)

    CLABSI) rates remains a problem in developing countries due to the variations in surveillance practices and/or infection risk as non.availability of national data. Aim: The aim of the following study was to find out the CLABSI rate before and after ...

  18. Monthly ambient sunlight, infections and relapse rates in multiple sclerosis.

    Science.gov (United States)

    Tremlett, Helen; van der Mei, Ingrid A F; Pittas, Fotini; Blizzard, Leigh; Paley, Glenys; Mesaros, Desiree; Woodbaker, Richard; Nunez, Manuel; Dwyer, Terence; Taylor, Bruce V; Ponsonby, Anne-Louise

    2008-01-01

    Monthly variation in multiple sclerosis (MS) relapses has been found. The relationship between seasonal environmental factors, infections, serum vitamin D [25(OH)D] and MS relapses is undetermined. We prospectively followed a population-based cohort of relapsing-remitting (RR) MS patients in Southern Tasmania for a mean 2.3 years (January 2002-April 2005). Associations between monthly ambient environmental factors, estimated serum 25(OH)D, upper respiratory tract (URT) infections and relapse rates were examined using weighted Pearson's correlation and linear regression. Of 199 definite MS patients, 142 had RRMS. The lowest relapse rate of 0.5 per 1,000 days (95% CI: 0.2-1.3) occurred in February (mid-late summer) versus the March-January RR of 1.1 per 1,000 days (95% CI: 0.9-1.3; p = 0.018, weighted regression). Monthly relapse rates correlated with: (1) prior erythemal ultraviolet radiation (EUV): lagged 1.5 months, r = -0.32, p = 0.046; (2) URT infection rate: no lag, r = 0.39, p = 0.014; (3) 25(OH)D: no lag, r = -0.31, p = 0.057. The association between URT infections and relapses was reduced after adjustment for monthly EUV. Relapse rates were inversely associated with EUV and serum 25(OH)D levels and positively associated with URT infections. The demonstrated lag between EUV but not 25(OH)D and relapse rates is consistent with a role for EUV-generated 25(OH)D in the alteration of relapse rates. Future work on the association between URT infections and relapses should be considered in the context of ultraviolet radiation and vitamin D. Copyright 2008 S. Karger AG, Basel.

  19. Sporozoite Infection Rate and Identification of the Infective and Refractory Species of Anopheles gambiae (Giles Complex

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    Music Temitope OBEMBE

    2014-12-01

    Full Text Available The ability of Anopheles gambiae complex mosquitoes to transmit Plasmodium infection is known to be variable within sibling species of the complex with strains that cannot transmit the parasite. High sporozoite infection rate recorded showed that A. gambiae mosquitoes are potent malaria vectors in southwestern Nigeria. The aim of this study was to identify the infective and refractory strains of A. gambiae mosquitoes and to determine the sporozoite infection rate in this area. The infective strains were A. gambiae (sensu stricto and A. arabiensis, while the refractory strains were A. gambiae (sensu stricto. However, ovarian polytene chromosome banding patterns could not be used to distinguish between the infective and refractory strains of A. gambiae (sensu stricto. This study showed that the refractory strains of Anopheles gambiae complex are present, but in low frequencies, in southwestern Nigeria, and that the sibling species of Anopheles gambiae (A. gambiae s.s. and A. arabiensis are potent malaria vectors.

  20. Declining Rate of Infection with Maternal Human Immunodeficiency ...

    African Journals Online (AJOL)

    Declining Rate of Infection with Maternal Human Immunodeficiency Virus at Delivery Units in North-Central Nigeria. GE Imade, AS Sagay, J Musa, AN Ocheke, DS Adeniyi, M Idighri, R Powl, A Sendeht, JP Ogwuche, M Elujoba, CO Egbodo, T Oyebode, PH Daru, O Agbaji, IC Pam, ST Meloni, P Okonkwo, PJ Kanki ...

  1. Infection rate after transoral approach for the upper cervical spine.

    Science.gov (United States)

    Shousha, Mootaz; Mosafer, Azim; Boehm, Heinrich

    2014-09-01

    A retrospective review of prospectively collected databases of 139 consecutive patients who underwent transoral surgery for lesions of the upper cervical spine. To analyze the incidence and risk factors of local infection after transoral surgery for the craniocervical junction in a single institution and to compare the findings with the literature. One of the primary risks associated with transoral approach for lesions in the upper cervical spine is postoperative surgical wound infection. From April 1994 to December 2012, 139 consecutive transoral surgical procedures were performed at a single referral center. The mean age at presentation was 53.6 years (range: 5-87 yr), and more than half of the patients were males (58.3%). The majority of cases were experiencing rheumatic diseases (43.9%), whereas tumor destruction was the indication for surgery in 23.7% of the cases. A total of 23% had fracture of the upper cervical spine and primary infection was found in 7 patients (5%). The mean follow-up period was 4.5 years. Infection of the pharyngeal wound occurred in 5 patients (3.6%), solely in the rheumatic and tumor groups. The presentation was mostly in the first 4 months. A single patient with cage reconstruction after giant cell tumor C2 presented with a late infection 5 years postoperatively. Debridement and primary closure was possible in 2 patients, whereas flap coverage of the pharyngeal wall was necessary in 3 patients. The presence of implant did not have a statistically significant effect on the occurrence of infection. However, infection in the presence of titanium cage mostly necessitated flap coverage of the pharyngeal wall after removal of the cage. The transoral route has proved to be an invaluable method of approaching pathological lesions in the upper cervical spine. The infection rate in this work was 3.6%. Patients with rheumatic diseases and patients presenting with tumors were more susceptible to postoperative surgical wound infection. 4.

  2. Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme.

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    Dennerlein, Jack T; O'Day, Elizabeth Tucker; Mulloy, Deborah F; Somerville, Jackie; Stoddard, Anne M; Kenwood, Christopher; Teeple, Erin; Boden, Leslie I; Sorensen, Glorian; Hashimoto, Dean

    2017-05-01

    With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans. Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital. Safe and unsafe patient handling practice scales at the study hospital improved significantly (psystems approach based on recommended best practices, including integration of these practices into the patient's plan for care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Fungal Infections Increase the Mortality Rate Three-Fold in Necrotizing Soft-Tissue Infections.

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    Horn, Christopher B; Wesp, Brendan M; Fiore, Nicholas B; Rasane, Rohit K; Torres, Marlon; Turnbull, Isaiah R; Ilahi, Obeid N; Punch, Laurie J; Bochicchio, Grant V

    2017-10-01

    Necrotizing soft-tissue infections (NSTIs) result in significant morbidity and mortality rates, with as many as 76% of patients dying during their index admission. Published data suggest NSTIs rarely involve fungal infections in immunocompetent patients. However, because of the recent recognition of fungal infections in our population, we hypothesized that such infections frequently complicate NSTIs and are associated with higher morbidity and mortality rates. A prospectively maintained Acute and Critical Care Surgery (ACCS) database spanning 2008-2015 and including more than 7,000 patients was queried for patients with NSTIs. Microbiologic data, demographics, and clinical outcomes were abstracted. Risk factors and outcomes associated with NSTI with positive intra-operative fungal cultures were determined. Frequencies were compared by χ2 and continuous variables by the Student t-test using SPSS. Because the study included only archived data, no patient permission was needed. A total of 230 patients were found to have NSTIs; 197 had intra-operative cultures, and 21 (10.7%) of these were positive for fungi. Fungal infection was more common in women, patients with higher body mass index (BMI), and patients who had had prior abdominal procedures. There were no significant differences in demographics, co-morbidities, or site of infection. The majority of patients (85.7%) had mixed bacterial and fungal infections; in the remaining patients, fungi were the only species isolated. Most fungal cultures were collected within 48 h of hospital admission, suggesting that the infections were not hospital acquired. Patients with positive fungal cultures required two more surgical interventions and had a three-fold greater mortality rate than patients without fungal infections. This is the largest series to date describing the impact of fungal infection in NSTIs. Our data demonstrate a three-fold increase in the mortality rate and the need for two additional operations

  4. Genotyping and infection rate of GBV-C among Iranian HCV- infected patients.

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    Ghanbari, Reza; Ravanshad, Mehrdad; Hosseini, Seyed Younes; Yaghobi, Ramin; Shahzamani, Kiana

    2010-01-01

    Hepatitis G virus/GB virus-C (HGV/GBV-C) is a newly identified member of the Flaviviridae family. Its clinical significance in chronic hepatitis C infection remains controversial. There is a geographical difference in the distribution of GBV-C in the world. The frequency of GBV-C infection among hepatitis C virus (HCV) infected patients varies. The aim of the current study was to determine the prevalence and genotypes of GBV-C among Iranian patients infected with chronic HCV. Infection with GBV-C was surveyed in 71 chronic confirmed hepatitis C infected patients. These samples were collected at the Digestive Disease Research Center (DDRC) of Shariati Hospital, Tehran, Iran from January to October 2007. The 5'-UTR region of GBV-C RNA was detected using a novel in-house touchdown nested reverse transcription polymerase chain reaction (RT-PCR), the products were sequenced and the results were aligned and phylogenically analyzed. Of the 71 HCV-infected patients, 31 (43.6%) were found positive for GBV-C RNA. Sequencing and phylogenic analysis showed that the samples were Genotype 2 of GBV-C. It seems that there is a high rate of GBV-C infection among Iranian patients infected with chronic HCV. In comparison with the six reference genotypes, it was observed that all the samples were categorized in Genotype 2 of GBV-C, prevalent in North America, Africa and in European countries.

  5. Global Dynamics and Optimal Control of a Viral Infection Model with Generic Nonlinear Infection Rate

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    Chenquan Gan

    2017-01-01

    Full Text Available This paper is devoted to exploring the combined impact of a generic nonlinear infection rate and infected removable storage media on viral spread. For that purpose, a novel dynamical model with an external compartment is proposed, and the explanations of the main model assumptions (especially the generic nonlinear infection rate are also examined. The existence and global stability of the unique equilibrium of the model are fully investigated, from which it can be seen that computer virus would persist. On this basis, a next-best approach to controlling the level of infected computers is suggested, and the theoretical analysis of optimal control of the model is also performed. Additionally, some numerical examples are given to illustrate the main results.

  6. Towards healthy learning climates in postgraduate medical education: exploring the role of hospital-wide education committees.

    Science.gov (United States)

    Silkens, Milou E W M; Lombarts, Kiki M J M H; Scherpbier, Albert J J A; Heineman, Maas Jan; Arah, Onyebuchi A

    2017-12-06

    Postgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality postgraduate medical education. In several countries, modernization of postgraduate medical education has resulted in hospital-wide responsibilities for monitoring learning climates. This study investigates the association between the actions undertaken by hospital-wide education committees and learning climates in postgraduate medical education. Research conducted in December 2010 invited 57 chairs of hospital-wide education committees to complete a questionnaire on their implemented level of quality improvement policies. We merged the survey data from 21 committees that oversaw training programs and used the Dutch Residency Educational Climate Test (D-RECT) instrument in 2012 to measure their training programs' learning climate. We used descriptive statistics and linear mixed models to analyse associations between the functioning of hospital-wide education committees and corresponding learning climates. In total, 812 resident evaluations for 99 training programs in 21 teaching hospitals were available for analysis. The implementation level of the internal quality management systems as adopted by the hospital-wide education committees varied from 1.6 to 2.6 on a 5 point Likert-scale (ranging from 1 (worst) to 5 (best)). No significant associations were found between the functioning of the committees and corresponding learning climates. The contribution of hospital-wide committees to creating healthy learning climates is yet to be demonstrated. The absence of such an association could be due to the lack of a Plan-Do-Check-Act cycle guiding the policy as implemented by the committees and the lack of involvement of departmental leadership. Insight into the impact of these strategies on

  7. High infection rate of zoonotic Eucoleus aerophilus infection in foxes from Serbia

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    Lalošević Vesna

    2013-01-01

    Full Text Available The respiratory capillariid nematode Eucoleus aerophilus (Creplin, 1839 infects wild and domestic carnivores and, occasionally, humans. Thus far, a dozen of human infections have been published in the literature but it cannot be ruled out that lung capillariosis is underdiagnosed in human medicine. Also, the apparent spreading of E. aerophilus in different geographic areas spurs new studies on the epidemiology of this nematode. After the recognition of the first human case of E. aerophilus infection in Serbia, there is a significant merit in enhancing knowledge on the distribution of the nematode. In the present work the infection rate of pulmonary capillariosis was investigated in 70 red foxes (Vulpes vulpes from the northern part of Serbia by autopsy. The estimated infection rate with Eucoleus aerophilus was 84%. In contrast, by copromicroscopic examination only 38% of foxes were positive. In addition, 10 foxes were investigated for the closely related species in nasal cavity, Eucoleus boehmi, and nine were positive. Our study demonstrates one of the highest infection rates of pulmonary capillariosis in foxes over the world.

  8. Seasonal changes of microfilarial infection and infectivity rates in mosquito populations within Makurdi, Benue State, Nigeria

    Directory of Open Access Journals (Sweden)

    Manyi, M. M

    2014-12-01

    Full Text Available Studies on the infection and infectivity rates of Wuchereria bancrofti in mosquito populations in Makurdi, Nigeria were carried out over a 12 month period in four localities. Adult female mosquitoes (4,320 were morphologically identified and dissected following standard keys and procedures. 1,040 (24.1% were Anopheles gambiae s.l.; 641 (14.8% were Anopheles funestus Giles and 2,418 (56.0% were Culex quinquefasciatus Say while 221 (5.1% were tagged ‘unidentified’ Anopheles species. The overall microfilarial infection and infectivity rates were 10.1% and 4.8% respectively. The microfilarial infection and infectivity rates differed significantly (ANOVA; χ2 test p<0.05across vector species, study months and the localities surveyed. The findings indicate that Makurdi is endemic for lymphatic filariasis, and that Anopheles gambiae s.l. and Anopheles funestus were potential vectors of lymphatic filariasis in Makurdi while Culex quinquefasciatus was the major vector. This work may provide an entomological baseline data required for evaluation and implementation of vector control interventions in the study area.

  9. Forced-air warming discontinued: periprosthetic joint infection rates drop

    Directory of Open Access Journals (Sweden)

    Scott D. Augustine

    2017-06-01

    Full Text Available Several studies have shown that the waste heat from forced-air warming (FAW escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW at three hospitals. Surgical and antibiotic protocols were held constant. The pooled multicenter data showed a decreased PJI rate of 78% following the discontinuation of FAW and a switch to air-free CFW (n=2034; P=0.002. The 78% reduction in joint implant infections observed when FAW was discontinued suggests that there is a link between the waste FAW heat and PJIs.

  10. Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle

    NARCIS (Netherlands)

    K. Helder MScN (Onno); R.F. Kornelisse (René); C. van der Starre (Cynthia); D. Tibboel (Dick); C.W.N. Looman (Caspar); R.M.H. Wijnen (René); M.J. Poley (Marten); E. Ista (Erwin)

    2013-01-01

    textabstractBackground: Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation

  11. Impact of nosocomial infections surveillance on nosocomial infection rates: A systematic review.

    Science.gov (United States)

    Li, Ye; Gong, Zhenyu; Lu, Ye; Hu, Guoqing; Cai, Ran; Chen, Zhiping

    2017-06-01

    According to previously studies, nosocomial infections (NIs) surveillance could effectively reduce infection rates. As NIs surveillance systems have been implemented in some hospitals for several years, their impact on NIs need to be explored. Therefore, the purpose of this review is to evaluate the tendency of NI rates during the surveillance period and the impact of surveillance on NI rates. A systematic literature search of the PubMed database to identify papers that evaluated effect of surveillance on NIs, all kinds of NIs occurred during hospitalization or discharged were included. Exclude articles investigated the surveillance combined with other infection control measures. Twenty-five articles were included. NI rates had different levels of reduction during surveillance period, the reduction were not limited by state, department, surveillance system, and NI type. Continuous surveillance had a positive impact on NI, OR/RR were ranged from 0.43 to 0.95. Participation in NI surveillance is associated with reducing infection rates, though RCTs need to further prove the effective role of surveillance. Hospitals may consider to perform NIs surveillance systems according to its own conditions. Copyright © 2017. Published by Elsevier Ltd.

  12. Prospective hospital-wide studies of 505 patients with nosocomial bacteraemia in 1997 and 2002.

    Science.gov (United States)

    Jerassy, Z; Yinnon, A M; Mazouz-Cohen, S; Benenson, S; Schlesinger, Y; Rudensky, B; Raveh, D

    2006-02-01

    We conducted surveys in 1997 and 2002 to determine the rate, underlying sources and outcome of nosocomial bacteraemia. Blood culture results were reviewed daily. All patients with positive cultures drawn >or=48 h after hospitalization were included in the study and their charts were reviewed. The underlying source of infection was determined by pre-defined clinical and/or microbiological criteria. Patients were followed until discharge or death. In 1997 and 2002, 851 and 857 patient-unique cases of bacteraemia were diagnosed, respectively, excluding contaminants; of these, 228 (27%) and 277 (32%) cases, respectively, were hospital acquired (P1997 and 2002, respectively, were: intravascular catheters (36% and 27%, P1997, Staphylococcus aureus was the most frequent isolate (26%), followed by coagulase-negative Staphylococcus (13%) and Klebsiella pneumoniae (11%). By 2002, the incidence of S. aureus had fallen to 11% (P<0.001), acinetobacter was the single most frequently isolated organism (increased from 6% to 17%) (P<0.001). In-hospital mortality associated with acinetobacter bacteraemia (57%) was significantly higher than that for other organisms (31-43%) (P<0.05). In conclusion, prospective surveys of nosocomial bacteraemias provide valuable information, facilitating the pursuit of successful interventions.

  13. Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46299 consecutive patients

    DEFF Research Database (Denmark)

    Johansen, Jens Brock; Jørgensen, Ole Dan; Møller, Mogens

    2011-01-01

    Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population....

  14. Post-discharge surveillance and infection rates in obstetric patients.

    Science.gov (United States)

    Couto, R C; Pedrosa, T M; Nogueira, J M; Gomes, D L; Neto, M F; Rezende, N A

    1998-06-01

    To study the impact of post-discharge surveillance on the detection of nosocomial surgical site infection (SSI) after cesarean section and vaginal delivery. During a 21-month period, all patients attending the obstetrics service in labor were recruited for a observational study on the incidence of SSI. Examinations to detect SSI were performed daily during the hospitalization period and up to 30 days after hospital discharge in an outpatient clinic supervised by the Infection Control Committee. The stratification of risk-factors and the criteria for the diagnosis of SSI were done in accordance with the methods described by the Centers for Disease Control and Prevention. The rates of surgical site infection detected during the hospitalization period were compared with those reported by the Centers for Disease Control and Prevention's National (United States) Nosocomial Infection Surveillance System (CDCNNIS) 'benchmarks'. The incidence of SSI detected by post-discharge outpatient surveillance was compared with that from in-hospital surveillance, for both cesarean section and vaginal delivery. A total of 4463 deliveries were performed during the study period, 2431 (54.5%) by the vaginal route and 2032 (45.5%) by cesarean section. In-hospital surveillance was done on all patients. Post-discharge examinations were done on 951 (46.8%) of the 2032 cesarean section patients. The incidence of SSI in cesarean section detected by in-hospital surveillance was 1.6% (32 cases) and lower than the 3.6% mean rate reported by the CDCNNIS. When SSIs detected by post-discharge surveillance were included, the total number of SSI was 196 cases (9.6%), a value much higher than that for the SSI detected by in-hospital surveillance alone. Only 5 cases (0.21%) of SSI were detected among the 2431 vaginal deliveries. The results of our study demonstrate that most of SSI following cesarean section were detected only after patient's discharge from the hospital and seems to indicate that

  15. Mortality rate associated with hospital acquired infections among burn patients

    Directory of Open Access Journals (Sweden)

    Saima Aslam Bharwana

    2016-09-01

    Full Text Available Hospital acquired infections (HAIs are the major contributors of mortality associated with burn injuries. The aim of this research was to document the antecedents affiliated with major burn injuries, hospitalization and mortality in burn patients. We performed a single center prospective study of patients admitted during 3 months period (April-June 2014 in burn wards of government hospital. There were 100 patients in this investigation which were observed weekly. The inclusion criterion was based on the shifting of patients from emergency to the wards after initial treatment of more than 24 h. Variables included were age and gender of the patient, the percent total body surface area (%TBSA burn, the cause of the burn. Mean age of patients was 30.29 years. More females (55.67% were admitted than males (44.32%. The total body surface area (%TBSA burnt were from 15%- 95% respectively moreover children were more sensitive to hospital acquired infections (HAIs and mortality rate was 34% in children with mean age of 5 years and disability of body parts were 42% among 75% were females. Whereas the most common (HAIs were primary blood stream (PBS with mean value of 30.50, wound infections (WIS were at second prevalence with mean value of 27.50, followed by sepsis (S and pneumonia (P 10.33, eye infections (EIs 4.833 and urinary tract infections (UTIs 2.667. Factors significantly (p-value= 0.000 associated with increased duration of hospitalization caught HAIs mortality include the age and gender of the patient, the cause of burn, inhalation injury, the region affected and %TBSA burnt. It concluded that the mortality was very much dependent on age and gender of the patient, burn causes, affected area as well as %TBSA burnt are considerable factors in determining the relationship of HAIs and whether the patients will survive or knuckle to injuries. Better compliance techniques, stricter control over disinfection and sterilization practices and usage of

  16. High readmission rates and mental distress after infective endocarditis

    DEFF Research Database (Denmark)

    Rasmussen, Trine Bernholdt; Zwisler, Ann-Dorthe; Thygesen, Lau Caspar

    2017-01-01

    BACKGROUND: Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge,......-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR). CONCLUSIONS: After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management....... in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated. RESULTS: Patients discharged after treatment for IE had a mortality...

  17. Central venous catheter placement by advanced practice nurses demonstrates low procedural complication and infection rates--a report from 13 years of service*.

    Science.gov (United States)

    Alexandrou, Evan; Spencer, Timothy R; Frost, Steven A; Mifflin, Nicholas; Davidson, Patricia M; Hillman, Ken M

    2014-03-01

    To report procedural characteristics and outcomes from a central venous catheter placement service operated by advanced practice nurses. Single-center observational study. A tertiary care university hospital in Sydney, Australia. Adult patients from the general wards and from critical care areas receiving a central venous catheter, peripherally inserted central catheter, high-flow dialysis catheter, or midline catheter for parenteral therapy between November 1996 and December 2009. None. Prevalence rates by indication, site, and catheter type were assessed. Nonparametric tests were used to calculate differences in outcomes for categorical data. Catheter infection rates were determined per 1,000 catheter days after derivation of the denominator. A total of 4,560 catheters were placed in 3,447 patients. The most common catheters inserted were single-lumen peripherally inserted central catheters (n = 1,653; 36.3%) and single-lumen central venous catheters (n = 1,233; 27.0%). A small proportion of high-flow dialysis catheters were also inserted over the reporting period (n = 150; 3.5%). Sixty-one percent of all catheters placed were for antibiotic administration. The median device dwell time (in d) differed across cannulation sites (p catheter placement had the longest dwell time with a median of 16 days (interquartile range, 8-26 d). Overall catheter dwell was reported at a cumulative 63,071 catheter days. The overall catheter-related bloodstream infection rate was 0.2 per 1,000 catheter days. The prevalence rate of pneumothorax recorded was 0.4%, and accidental arterial puncture (simple puncture-with no dilation or cannulation) was 1.3% using the subclavian vein. This report has demonstrated low complication rates for a hospital-wide service delivered by advance practice nurses. The results suggest that a centrally based service with specifically trained operators can be beneficial by potentially improving patient safety and promoting organizational efficiencies.

  18. Tuberculosis-HIV Co-infection Rate among Smear Positive ...

    African Journals Online (AJOL)

    Drinking alcohol was significantly associated with increased risk of HIV infection among smear positive pulmonary TB patients in univariable logistic regression but that ... Other factors significantly associated with HIV infection among the study population were previous anti-TB treatment, being resident in urban area and ...

  19. Surgical Site Infection Rate Drops to 0% Using a Vacuum-Assisted Closure in Contaminated/Dirty Infected Laparotomy Wounds.

    Science.gov (United States)

    Lozano-Balderas, Gerardo; Ruiz-Velasco-Santacruz, Alejandro; Díaz-Elizondo, José Antonio; Gómez-Navarro, Juan Antonio; Flores-Villalba, Eduardo

    2017-05-01

    Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/infected wounds. Eighty-one laparotomized patients with Class III or IV surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G. C., & Plous, S., Version 4.0). Presence of infection was determined by a certified board physician according to Centers for Disease Control's Criteria for Defining a Surgical Site Infection. Twenty-seven patients received primary closure, 29 delayed primary closure, and 25 vacuum-assisted closure, with no exclusions for analysis. Surgical site infection was present in 10 (37%) patients treated with primary closure, 5 (17%) with primary delayed closure, and 0 (0%) patients receiving vacuum-assisted closure. Statistical significance was found between infection rates of the vacuum-assisted group and the other two groups. No significant difference was found between the primary and primary delayed closure groups. The infection rate in contaminated/dirty-infected laparotomy wounds decreases from 37 and 17 per cent with a primary and delayed primary closures, respectively, to 0 per cent with vacuum-assisted systems.

  20. The rate of TB-HIV co-infection depends on the prevalence of HIV infection in a community

    Directory of Open Access Journals (Sweden)

    Chekol Luelseged T

    2008-07-01

    Full Text Available Abstract Background A complex interaction exists between tuberculosis (TB and human immunodeficiency virus (HIV infection at an individual and community level. Limited knowledge about the rate of HIV infection in TB patients and the general population compromises the planning, resource allocation and prevention and control activities. The aim of this study was to determine the rate of HIV infection in TB patients and its correlation with the rate HIV infection in pregnant women attending antenatal care (ANC in Southern Ethiopia. Methods All TB patients and pregnant women attending health institutions for TB diagnosis and treatment and ANC were consecutively enrolled in 2004 – 2005. TB diagnosis, treatment and HIV testing were done according to the national guidelines. Blood samples were collected for anonymous HIV testing. We used univariate and multivariate logistic regression analysis to determine the risk factors for HIV infection and linear regression analysis to determine the correlation between HIV infection in TB patients and pregnant women. Results Of the 1308 TB patients enrolled, 226 (18% (95%CI: 15.8 – 20.0 were HIV positive. The rate of HIV infection was higher in TB patients from urban 25% (73/298 than rural areas 16% (149/945 [AOR = 1.78, 95%CI: 1.27–2.48]. Of the 4199 pregnant women attending ANC, 155 (3.8% [95%CI: 3.2–4.4] were HIV positive. The rate of HIV infection was higher in pregnant women from urban (7.5% (80/1066 than rural areas (2.5% (75/3025 [OR = 3.19, 95% CI: 2.31–4.41]. In the study participants attending the same health institutions, the rate of HIV infection in pregnant women correlated with the rate of HIV infection in TB patients (R2 = 0.732. Conclusion The rate of HIV infection in TB patients and pregnant women was higher in study participants from urban areas. The rate of HIV infection in TB patients was associated with the prevalence of HIV infection in pregnant women attending ANC.

  1. Comparison of Infection Rates Among Critically Ill Patients Per Their Route of Nutrition: A Retrospective Analysis

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    Esra Ozayar

    2013-10-01

    Full Text Available Aim: Infection is an important problem in intensive care units (ICU which is a complication of nutritional support. In our institution, we aimed to determine the differences in infection rates of patients who were supported with parenteral nutrition (PN and enteral + parenteral nutrition (EN+PN combination retrospectively. Material and Method: In this study, we enrolled 156 patients from January 1, 2011 to Agust 1, 2011. There were 88 patients in the parenteral nutrition group (Group 1 and 68 patients in the enteral+ parenteral nutrition group (Group 2. On all 156 patients, retrospective chart reviews were performed and biweekly culture results were recorded. Specifically, soft tissue infections, skin infections, catheter related blood stream infections, pneumonia and urinary tract infections were recorded. HI (hospital infection incidences and incidence densities were also calculated in both groups. Results: There were 16 recorded infections in 16 patients among Group 1. These were 4 cases of catheter related blood stream infections, 4 cases of pneumonia, 3 cases of urinary tract infections and 5 cases of soft tissue infections. In group 2, 8 patients showed signs of infection. These were, 4 cases catheter related blood stream infections, 2 cases of soft tissue infections and 2 cases of urinary tract infections. There were no reported pneumonia cases in group 2. Discussion: According to our results, with the exception of catheter related blood stream infections, infection numbers declined within the group of combination of enteral and parenteral nutrition group than parenteral nutrition group alone, but the results were not statistically significant. The intolerance to enteral nutrition can increase the cost of stay, mainly due to increased length of stay as a result of increased infection rates. We would recommend a combination nutrition regimen in such a similar situation, in order to decrease infection rates.

  2. Does Pelvic Embolization Increase Infection Rates in Patients Who Undergo Open Treatment of Acetabular Fractures?

    Science.gov (United States)

    Firoozabadi, Reza; Little, Milton; Alton, Timothy; Scoloro, John; Agel, Julie; Kogut, Mathew

    2017-04-01

    Evaluate the impact of pelvic embolization on postoperative infection rate after acetabular fracture fixation. Retrospective study of 3 separate cohorts. Level I Trauma Center. Identified patients who underwent angiography of the pelvis as well as required an open reduction internal fixation (ORIF) of an acetabular fracture. This group was compared to a control group of patients with an acetabular fracture, which did not undergo angiography, and underwent ORIF. ORIF of an aectabular fracture with angiography ± embolization. Deep infection rate. Seventy-two patients remained for final analysis; 25 patients underwent embolization, 16 patients underwent angiography without embolization, and 31 patients did not undergo angiography. Two out of 25 (8%) patients developed infections in the embolization group, one deep infection and one superficial infection. Five out of 16 (31%) patients developed deep infections in the nonembolization group. Control group of patients who did not undergo angiography had a deep infection rate of 9.6%. Despite previous reports of high infection rates after pelvic embolization, the deep infection rate was only 4% after embolization in our cohort. This suggests that concerns for higher rates of infection are not substantiated, and pelvic embolization should be performed when indicated. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  3. Hospital-wide implementation of an electronic-workflow solution aiming to make surgical practice improvement easy.

    Science.gov (United States)

    Sakowska, Magdalena M; Thomas, Megan V; Connor, Saxon; Roberts, Ross

    2017-03-01

    In measuring quality of health-care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital-wide workflow system that collected data prospectively as part of daily practice. In moving towards an electronic health record, a hospital-wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit. Analysis of its implementation was carried out presenting early outcomes using general surgery as an example. Theatre-bookings (44 953) were made with compliance approaching 90% for all services. Of 7179 general surgical operations over 24 months, 5785 (80%) had an operation note created using the new system. Cumulative summation of uptake of synoptic operative reporting (SOR) for laparoscopic cholecystectomy (LC) was 81% with documentation being superior in terms of antibiotic use and steps to safe cholecystectomy (P < 0.001). A LC SOR took 4 min to complete (interquartile ranges 2-5 min, n = 425) and was immediately available on the day of surgery compared to narrative operative reports taking 2 days (interquartile ranges 1-5 days, n = 174) (P < 0.001). From July 2014 to November 2015, 557 (10%) complications were recorded for 5749 general surgical operations with 99% of complications being reviewed. The rapid and sustained uptake of both theatre-bookings and SOR likely reflect high end-user satisfaction with the system. Service metrics indicate a significant improvement in the time of delivery. The ability to seamlessly complete the audit cycle at an individual, department and hospital level has been achieved. © 2016 Royal Australasian College of Surgeons.

  4. Behavior of susceptible-vaccinated--infected--recovered epidemics with diversity in the infection rate of the individuals

    CERN Document Server

    Cai, Chao-Ran; Guan, Jian-Yue

    2013-01-01

    We study a susceptible-vaccinated--infected--recovered (SVIR) epidemic-spreading model with diversity of infection rate of the individuals. By means of analytical arguments as well as extensive computer simulations, we demonstrate that the heterogeneity in infection rate can either impede or accelerate the epidemic spreading, which depends on the amount of vaccinated individuals introduced in the population as well as the contact pattern among the individuals. Remarkably, as long as the individuals with different capability of acquiring the disease interact with unequal frequency, there always exist a cross point for the fraction of vaccinated, below which the diversity of infection rate hinders the epidemic spreading and above which expedites it. The overall results are robust to the SVIR dynamics defined on different population models; the possible applications of the results are discussed.

  5. Surgical Site Infection Rate and Risk Factors among Obstetric Cases ...

    African Journals Online (AJOL)

    Chorioamnionitis, presence of meconium, large intraoperative blood loss and Perioperative blood transfusion were associated with increased severity of SSIs with p < 0.001. Absence of antenatal care follow up was also associated with increased severity of Surgical Site Infections. CONCLUSION: it has been revealed that ...

  6. Incidence Rate for Hantavirus Infections without Pulmonary Syndrome, Panama

    Science.gov (United States)

    Armien, Blas; Pascale, Juan M.; Munoz, Carlos; Lee, Sang-Joon; Choi, Kook L.; Avila, Mario; Broce, Candida; Armien, Anibal G.; Gracia, Fernando; Hjelle, Brian

    2011-01-01

    During 2001–2007, to determine incidence of all hantavirus infections, including those without pulmonary syndrome, in western Panama, we conducted 11 communitywide surveys. Among 1,129 persons, antibody prevalence was 16.5%–60.4%. Repeat surveys of 476 found that patients who seroconverted outnumbered patients with hantavirus pulmonary syndrome by 14 to 1. PMID:22000376

  7. Correlating Phytophthora ramorum infection rate and lesion expansion in tanoak

    Science.gov (United States)

    Katherine Hayden; Heather Rickard; Matteo Garbelotto

    2008-01-01

    To date, resistance to Phytophthora ramorum in its most susceptible hosts has most commonly been quantified by lesion growth, after wounding or non-wounding inoculations via mycelia or high concentrations of zoospores. However, even highly susceptible hosts may not always become infected when they are exposed to a pathogen under ecologically...

  8. Rates of cardiovascular disease following smoking cessation in patients with HIV infection

    DEFF Research Database (Denmark)

    Petoumenos, K; Worm, S; Reiss, P

    2011-01-01

    The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection.......The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection....

  9. Rate of vertical transmission of human papillomavirus from mothers to infants: Relationship between infection rate and mode of delivery

    Directory of Open Access Journals (Sweden)

    Park Hyun

    2012-04-01

    Full Text Available Abstract Background In contrast to consistent epidemiologic evidence of the role of sexual transmission of human papillomavirus (HPV in adults, various routes may be related to HPV infection in infants. We have assessed the extent of HPV infection during the perinatal period, and the relationship between mode of delivery and vertical transmission. Results A total of 291 pregnant women over 36 weeks of gestation were enrolled with informed consent. Exfoliative cells were collected from maternal cervix and neonatal buccal mucosa. HPV infection and genotypes were determined with an HPV DNA chip, which can recognise 24 types. The HPV-positive neonates were re-evaluated 6 months after birth to identify the presence of persistent infection. HPV DNA was detected in 18.9 % (55/291 of pregnant women and 3.4 % (10/291 of neonates. Maternal infection was associated with abnormal cytology (p = 0.007 and primiparity (p = 0.015. The infected neonates were all born to HPV-positive mothers. The rate of vertical transmission was estimated at 18.2 % (10/55 which was positively correlated with maternal multiple HPV infection (p = 0.003 and vaginal delivery (p = 0.050, but not with labour duration and premature rupture of membranes. The rate of concordance of genotype was 100 % in mother-neonate pairs with vertical transmission. The neonatal HPV DNAs found at birth were all cleared at 6 months after delivery. Conclusions Vertical transmission of HPV DNA from HPV infected mother to the neonate increased when the infant was delivered through an infected cervix. However, the absence of persistent infection in infants at 6 months after delivery may suggest temporary inoculation rather than true vertical infection.

  10. Identification of Rhipicephalus microplus genes that modulate the infection rate of the rickettsia Anaplasma marginale.

    Directory of Open Access Journals (Sweden)

    Ricardo F Mercado-Curiel

    Full Text Available Arthropod vectors transmit a diversity of animal and human pathogens, ranging from RNA viruses to protozoal parasites. Chemotherapeutic control of pathogens has classically focused either on insecticides that kill the vector itself or antimicrobials for infected patients. The limitation of the former is that it targets both infected and uninfected vectors and selects for resistant populations while the latter requires prompt and accurate diagnosis. An alternative strategy is to target vector molecules that permit the pathogen to establish itself, replicate, and/or develop within the vector. Using the rickettsial pathogen Anaplasma marginale and its tropical tick vector, Rhipicephalus microplus, as a model, we tested whether silencing specific gene targets would affect tick infection rates (the % of fed ticks that are infected with the pathogen and pathogen levels within infected ticks. Silencing of three R. microplus genes, CK187220, CV437619 and TC18492, significantly decreased the A. marginale infection rate in salivary glands, whereas gene silencing of TC22382, TC17129 and TC16059 significantly increased the infection rate in salivary glands. However in all cases of significant difference in the infection rate, the pathogen levels in the ticks that did become infected, were not significantly different. These results are consistent with the targeted genes affecting the pathogen at early steps in infection of the vector rather than in replication efficiency. Identifying vector genes and subsequent determination of the encoded functions are initial steps in discovery of new targets for inhibiting pathogen development and subsequent transmission.

  11. Prevalence rates of infection in intensive care units of a tertiary teaching hospital

    Directory of Open Access Journals (Sweden)

    Toufen Junior Carlos

    2003-01-01

    Full Text Available OBJECTIVE: To determine the prevalence rates of infections among intensive care unit patients, the predominant infecting organisms, and their resistance patterns. To identify the related factors for intensive care unit-acquired infection and mortality rates. DESIGN: A 1-day point-prevalence study. SETTING:A total of 19 intensive care units at the Hospital das Clínicas - University of São Paulo, School of Medicine (HC-FMUSP, a teaching and tertiary hospital, were eligible to participate in the study. PATIENTS: All patients over 16 years old occupying an intensive care unit bed over a 24-hour period. The 19 intensive care unit s provided 126 patient case reports. MAIN OUTCOME MEASURES: Rates of infection, antimicrobial use, microbiological isolates resistance patterns, potential related factors for intensive care unit-acquired infection, and death rates. RESULTS: A total of 126 patients were studied. Eighty-seven patients (69% received antimicrobials on the day of study, 72 (57% for treatment, and 15 (12% for prophylaxis. Community-acquired infection occurred in 15 patients (20.8%, non- intensive care unit nosocomial infection in 24 (33.3%, and intensive care unit-acquired infection in 22 patients (30.6%. Eleven patients (15.3% had no defined type. The most frequently reported infections were respiratory (58.5%. The most frequently isolated bacteria were Enterobacteriaceae (33.8%, Pseudomonas aeruginosa (26.4%, and Staphylococcus aureus (16.9%; [100% resistant to methicillin]. Multivariate regression analysis revealed 3 risk factors for intensive care unit-acquired infection: age > 60 years (p = 0.007, use of a nasogastric tube (p = 0.017, and postoperative status (p = 0.017. At the end of 4 weeks, overall mortality was 28.8%. Patients with infection had a mortality rate of 34.7%. There was no difference between mortality rates for infected and noninfected patients (p=0.088. CONCLUSION: The rate of nosocomial infection is high in intensive care

  12. Rate of infection after carpal tunnel release surgery and effect of antibiotic prophylaxis.

    Science.gov (United States)

    Harness, Neil G; Inacio, Maria C; Pfeil, Faith F; Paxton, Liz W

    2010-02-01

    To determine the rate of postoperative wound infection and the association with prophylactic antibiotic use in uncomplicated carpal tunnel release surgery. We performed a multicenter, retrospective review of all the carpal tunnel release procedures performed between January 1, 2005, and August 30, 2007. Data reviewed included the use of prophylactic antibiotics, diabetic status, and the occurrence of postoperative wound infection. We determined the overall antibiotic usage rate and analyzed the correlation between antibiotic use and the development of postoperative wound infection. The rate of surgical site infections in the 3003 patients who underwent carpal tunnel release surgery (group A) was 11. Antibiotic usage data were available for 2336 patients (group B). Six patients without prophylactic antibiotics had infection, as did 5 patients with prophylactic antibiotics. This difference was not statistically significant. Of the 11 surgical site infections, 4 were deep (organ/space) and 7 superficial (incisional). The number of patients with diabetes in the overall study population was 546, 3 of whom had infections. This was not statistically different from the nondiabetic population infection rate (8 patients). The overall infection rate after carpal tunnel release surgery is low. In addition, the deep (organ/space) infection rate is much lower than previously reported. Antibiotic use did not decrease the risk of infection in this study population, including patients with diabetes. The routine use of antibiotic prophylaxis in carpal tunnel release surgery is not indicated. Surgeons should carefully consider the risks and benefits of routinely using prophylactic antibiotics in carpal tunnel release surgery. Therapeutic III. Copyright 2010. Published by Elsevier Inc.

  13. Infection Rates in Open Fractures of the Tibia: Is the 6-Hour Rule Fact or Fiction?

    Directory of Open Access Journals (Sweden)

    Ameya S. Kamat

    2011-01-01

    Full Text Available Aims. Emergency debridement has long been the standard of care for open fractures of the tibia as infection is an important complication. The timing of operative debridement can be debated. We review open fractures of the tibia and compare infection rates in those that were operated on within and after 6-hours. Method. 103 consecutive open fractures of the tibia were reviewed. The data was analysed retrospectively with regard to severity of fracture and incidence of infection. Infection rates over a three-month period were compared between the two groups. Results. 12 (11.6% patients developed an infection within the first 3 months of injury. 7 of which were taken to theatre within 6-hours, and 5 after 6-hours. No significant differences were found between these two groups. Conclusion. There is no significant difference in timing of surgery. Initial basic interventions may play more of a role in limiting the risk of infection.

  14. Estimation of the rate of egg contamination from Salmonella-infected chickens.

    Science.gov (United States)

    Arnold, M E; Martelli, F; McLaren, I; Davies, R H

    2014-02-01

    Salmonella enterica serovar Enteritidis (S. Enteritidis) is one of the most prevalent causes for human gastroenteritis and is by far the predominant Salmonella serovar among human cases, followed by Salmonella Typhimurium. Contaminated eggs produced by infected laying hens are thought to be the main source of human infection with S. Enteritidis throughout the world. Although previous studies have looked at the proportion of infected eggs from infected flocks, there is still uncertainty over the rate at which infected birds produce contaminated eggs. The aim of this study was to estimate the rate at which infected birds produce contaminated egg shells and egg contents. Data were collected from two studies, consisting of 15 and 20 flocks, respectively. Faecal and environmental sampling and testing of ovaries/caeca from laying hens were carried out in parallel with (i) for the first study, testing 300 individual eggs, contents and shells together and (ii) for the second study, testing 4000 eggs in pools of six, with shells and contents tested separately. Bayesian methods were used to estimate the within-flock prevalence of infection from the faecal and hen post-mortem data, and this was related to the proportion of positive eggs. Results indicated a linear relationship between the rate of contamination of egg contents and the prevalence of infected chickens, but a nonlinear (quadratic) relationship between infection prevalence and the rate of egg shell contamination, with egg shell contamination occurring at a much higher rate than that of egg contents. There was also a significant difference in the rate of egg contamination between serovars, with S. Enteritidis causing a higher rate of contamination of egg contents and a lower rate of contamination of egg shells compared to non-S. Enteritidis serovars. These results will be useful for risk assessments of human exposure to Salmonella-contaminated eggs. © 2013 Crown copyright. This article is published with the

  15. Adequacy of a hospital-wide standard dose of 7mg/kg bodyweight gentamicin sufficient to achieve an adequate prophylactic maximum serum concentration (Cmax) in burn patients undergoing surgical burn wound treatment.

    Science.gov (United States)

    Borra, Lennaert C P; Bosch, Tessa M; van Baar, Margriet E; Dokter, Jan; Oen, Irma M; Ruijgrok, Elisabeth J

    2016-12-01

    Pharmacokinetics of drugs can be significantly altered in burn patients. The aim of our study was to validate if the current hospital-wide standard dosage of 7mg/kg total bodyweight gentamicin is sufficient to achieve an adequate prophylactic Cmax (Cmax≥20mg/L). A prospective observational cohort pharmacokinetic study was conducted in burn patients undergoing surgical burn wound treatment. 36/40 (90%) burn patients undergoing surgical burn wound treatment at Rotterdam Burn Centre (Maasstad Hospital), the Netherlands, achieved adequate prophylactic serum concentrations (Cmax≥20mg/L) after a single prophylactic intravenous dose of 7mg/kg total bodyweight gentamicin. Total Body Surface Area (TBSA) burned and total bodyweight were statistically significantly correlated with the Cmax, with correlation coefficients of -0.316, 0.443 and p values of 0.047, 0.004, respectively. Other covariates (age, time after injury, serum creatinine, dose, gender, intensive care admittance) were not statistically significantly correlated. Occurrence of postoperative infection was limited (n=1), no statistically significant difference was observed between patients with a therapeutic and patients with a subtherapeutic serum concentration. The current hospital-wide standard dosage of 7mg/kg total bodyweight is sufficient to achieve an adequate prophylactic Cmax in burn patients undergoing surgical burn wound treatment. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  16. Central Line Associated Blood Stream Infection Rate after ...

    African Journals Online (AJOL)

    2012-12-31

    Hospital, Makkah Saudi Arabia from January 1 to December 31, 2012. Five key components of bundle were selected; hand hygiene, maximal barrier precautions upon insertion, skin antisepsis, optimum site selection and daily review of line necessity with prompt removal of unnecessary lines. Post‑intervention CLABSI rate ...

  17. Attempts to enhance the eradication rate of Helicobacter pylori infection.

    Science.gov (United States)

    Bang, Chang Seok; Baik, Gwang Ho

    2014-05-14

    Increasing rates of antimicrobial resistance to clarithromycin and metronidazole present challenges in maintaining optimal eradication rates. Knowledge of local antibiotic resistance and consumption pattern is important in selecting a reliable regimen. In addition, adverse effect profiles of therapeutic regimens are important and must be addressed to enhance compliance rates. Various methods of enhancing the eradication rates of Helicobacter pylori (H. pylori) have been investigated, including changing combinations or durations of established drugs, adding adjuvant drugs, or development of new molecules or agents. Bismuth-containing quadruple, sequential, concomitant, and levofloxacin-based triple therapies are replacing the long-standing standard of the triple regimen. Despite the encouraging results of these regimens, individualized approaches like treatment after antibiotics resistance test or CYP2C19 genotyping would be the mainstream of future therapy. Because scientific, economic, and technical problems make these advance therapies unfit for widespread use, future development for H. pylori therapy should be directed to overcome individualized antibiotic resistance. Although various novel regimens and additive agents have indicated favorable outcomes, more studies or validations are needed to become a mainstream H. pylori therapy.

  18. High rate of teenage pregnancy and sexually transmitted infections ...

    African Journals Online (AJOL)

    There is increased in teenage pregnancy despite the presence of dual protection practice and health care awareness programmes related to health and sexuality education in South Africa. The present study explores the underlying causes of high teenage pregnancy and sexually transmitted diseases rates, including HIV ...

  19. Helicobacter pylori Infection Rates in Patients Undergoing Endoscopy in the Interior of Borneo.

    Science.gov (United States)

    Chai, Feng Yih; Chong, Hock Chin; Tan, Yew Eng; Heng, Sophia Si Ling; Asilah, Siti Mohd Desa; Ridwan, Hashim

    2016-04-01

    Very limited data are available on the Helicobacter pylori infection among the population of interior Borneo. We aimed to investigate the H. pylori infection rate among an endoscoped interior Borneo population and to report the differences between the infected and noninfected patients. We retrospectively analyzed the data of the rapid urease test (RUT) records in Endoscopy Unit Hospital Keningau from January 2009 to May 2014. Student's t-test, chi-square test or Fisher's exact test were used accordingly. Multiple logistic regression analysis was used to identify independent risk factors for H. pylori infection. Birth cohort was analyzed against H. pylori infection rate with chi-square test. Overall, there were 215 of 774 (27.8%) positive RUTs. Patients with H. pylori infection were younger (47.66 ± 14.93 vs 50.50 ± 15.02 years, p = .019), more likely to be female (OR = 1.54, 95% CI 1.12-2.13, p = .008) and originated from the Pensiangan district (OR = 1.63, 95% CI 1.01-2.64, p = .047). Chinese patients were less likely infected with H. pylori (OR = 0.36, 95% CI 0.16-0.80, p = .013). Birth cohort was significantly associated with H. pylori infection rate (χ(2) (7) = 14.71, p = .040) with an increasing trend of H. pylori infection rate in patients born later (χ(2) (1) = 5.26, p = .022). The overall H. pylori infection rate in this population was unexpectedly low. Accordingly, it may be a recent arrival in this community. Gender, age, dietary practice, socioeconomic status, and ethnicity were among the factors associated with H. pylori infection. © 2015 John Wiley & Sons Ltd.

  20. Sporozoite Infection Rate and Identification of the Infective and Refractory Species of Anopheles gambiae (Giles) Complex

    OpenAIRE

    Music Temitope OBEMBE; Idowu J. AWOPETU

    2014-01-01

    The ability of Anopheles gambiae complex mosquitoes to transmit Plasmodium infection is known to be variable within sibling species of the complex with strains that cannot transmit the parasite. High sporozoite infection rate recorded showed that A. gambiae mosquitoes are potent malaria vectors in southwestern Nigeria. The aim of this study was to identify the infective and refractory strains of A. gambiae mosquitoes and to determine the sporozoite infection rate in this area. The infective s...

  1. A comparison of Internet search trends and sexually transmitted infection rates using Google trends.

    Science.gov (United States)

    Johnson, Amy K; Mehta, Supriya D

    2014-01-01

    Google Trends was used to determine the relationship between sexually transmitted infection (STI)-related search engine trends and STI rates. Trends seem to be similar to the relative rates of STIs and to regional differences in rates. Search engine trends are an innovative tool to integrate into STI surveillance.

  2. Hepatitis C virus infection rate in volunteer blood donors from the ...

    African Journals Online (AJOL)

    Introduction. Hepatitis G virus (HGV) antibody seroprevalence studies overestimate the true infection rate. No data exist on the incidence of HCV or its clinical features in blood donors of sub-Saharan Africa. Aims. To establish the true incidence of HCV infection in volunteer blood donors in the Western Gape, and compare.

  3. Modelling the Time Series Data of the Impact of the Infection Rate on ...

    African Journals Online (AJOL)

    Journal of the Nigerian Association of Mathematical Physics ... The critical HIV infection of decreasing viral load of the virions due to the variability of the infection rate constant is a challenging health problem that can now be tackled computationally on the implementation of a numerical simulation indexed by a shorter ...

  4. HIV infection connected to rising anal cancer rates in men in the U.S.

    Science.gov (United States)

    Human immunodeficiency virus (HIV) infection contributes substantially to the epidemic of anal cancer in men, but not women in the United States, according to new research from NCI. Chart shows overall incidence rates of anal cancers in general population

  5. Molecular detection, infection rate and vectors of Theileria lestoquardi in goats from West Azerbaijan province, Iran

    National Research Council Canada - National Science Library

    Seyyed Mostafa Mohammadi; Bijan Esmaeilnejad; Ghader Jalilzadeh-Amin

    2017-01-01

    Goat Iran Ixodid ticks Semi-nested PCR Theileria lestoquardi Abstract This study was aimed to determine the infection rate and vectors of Theileria lestoquardi in goats from West Azerbaijan province, Iran...

  6. Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC).

    Science.gov (United States)

    Singh, Sanjeev; Chakravarthy, Murali; Rosenthal, Victor Daniel; Myatra, Sheila N; Dwivedy, Arpita; Bagasrawala, Iqbal; Munshi, Nita; Shah, Sweta; Panigrahi, Bishnu; Sood, Sanjeev; Kumar-Nair, Pravin; Radhakrishnan, Kavitha; Gokul, B N; Sukanya, R; Pushparaj, L; Pramesh, C S; Shrikhande, S V; Gulia, A; Puri, A; Moiyadi, A; Divatia, J V; Kelkar, Rohini; Biswas, Sanjay; Raut, Sandhya; Sampat, Sulochana; Shetty, Suvin; Binu, Sheena; Pinto, Preethi; Arora, Sohini; Kamble, Asmita; Kumari, Neelakshi; Mendonca, Angelina; Singhal, Tanu; Naik, Reshma; Kothari, Vatsal; Sharma, Bindu; Verma, Neeru; Khanna, D K; Chacko, Felcy

    2015-09-01

    Surgical site infections are a threat to patient safety. However, in India, data on their rates stratified by surgical procedure are not available. From January 2005 to December 2011, the International Nosocomial Infection Control Consortium (INICC) conducted a cohort prospective surveillance study on surgical site infections in 10 hospitals in 6 Indian cities. CDC National Healthcare Safety Network (CDC-NHSN) methods were applied and surgical procedures were classified into 11 types, according to the ninth edition of the International Classification of Diseases. We documented 1189 surgical site infections, associated with 28 340 surgical procedures (4.2%; 95% CI: 4.0-4.4). Surgical site infections rates were compared with INICC and CDC-NHSN reports, respectively: 4.3% for coronary bypass with chest and donor incision (4.5% vs 2.9%); 8.3% for breast surgery (1.7% vs 2.3%); 6.5% for cardiac surgery (5.6% vs 1.3%); 6.0% for exploratory abdominal surgery (4.1% vs 2.0%), among others. In most types of surgical procedures, surgical site infections rates were higher than those reported by the CDC-NHSN, but similar to INICC. This study is an important advancement towards the knowledge of surgical site infections epidemiology in the participating Indian hospitals that will allow us to introduce targeted interventions. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Beyond the EPR: Complementary roles of the hospital-wide electronic health record and clinical departmental systems

    Science.gov (United States)

    2009-01-01

    Background Many hospital departments have implemented small clinical departmental systems (CDSs) to collect and use patient data for documentation as well as for other department-specific purposes. As hospitals are implementing institution-wide electronic patient records (EPRs), the EPR is thought to be integrated with, and gradually substitute the smaller systems. Many EPR systems however fail to support important clinical workflows. Also, successful integration of systems has proven hard to achieve. As a result, CDSs are still in widespread use. This study was conducted to see which tasks are supported by CDSs and to compare this to the support offered by the EPR. Methods Semi-structured interviews with users of 16 clinicians using 15 different clinical departmental systems (CDS) at a Medium-sized University hospital in Norway. Inductive analysis of transcriptions from the audio taped interviews. Results The roles of CDSs were complementary to those of the hospital-wide EPR system. The use of structured patient data was a characteristic feature. This facilitated quality development and supervision, tasks that were poorly supported by the EPR system. The structuring of the data also improved filtering of information to better support clinical decision-making. Because of the high value of the structured patient data, the users put much effort in maintaining their integrity and representativeness. Employees from the departments were also engaged in the funding, development, implementation and maintenance of the systems. Conclusion Clinical departmental systems are vital to the activities of a clinical hospital department. The development, implementation and clinical use of such systems can be seen as bottom-up, user-driven innovations. PMID:19523198

  8. Examination of Changes in Infection Rates in a Restructured Anaesthesia Intensive Care Unit: A Retrospective Study.

    Science.gov (United States)

    Deniz, Ahmet; Erhan, Ömer Lütfi; Bayar, Mustafa Kemal; Karatepe, Ümit; Demirel, İsmail

    2017-12-01

    This retrospective study aimed to evaluate the effect of a restructured anaesthesia intensive care unit (ICU) on changes in infection rates and infections. Organisational restructuring was done in the anaesthesia ICU of Firat University Hospital after it was relocated on 14 March 2012. This study was designed to investigate the effect of restructuring on infection rates through a comparison of periods encompassing one year before relocation and one year after relocation. Nosocomial infections were diagnosed according to modified Centers for Disease Control and Prevention (CDC) criteria. In total, 406 patients who were over 18 years old and admitted to the ICU were included; they were hospitalised for 48 h or longer and had non-infectious diseases according to physical examination, laboratory and culture results on admission. The data of 214 patients (Group A) and 192 patients (Group B) were examined. Parameters such as age, gender, primary diagnosis and mean GCS score at admission and mean duration of hospitalisation showed no effect on the rates of infection, but rates of total infection (41.1% vs. 25%), urinary (18.7% vs. 10.4%) and VIP (32.7% vs. 14.6%) were detected in Groups A and B. Statistically significant differences were found for the causative pathogens Pseudomonas (15.4% vs. 6.8%), Acinetobacter (18.2% vs. 12%) and Escherichia (8.9% vs. 2.1%); the mean duration of mechanical ventilation (15.01±16.681 vs. 12.22±17.595) and discharge with improvement (31.8% vs. 44.3%). We detected that restructuring (such as acclimatization, educated staff, hepa filter) caused a significant decline in infection rates. Because ICU staff may be a major cause of infection, we believe that providing education and conducting effective surveillance programs will be the most important factors for reducing infection rates.

  9. Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation

    DEFF Research Database (Denmark)

    Thrane, Jens F; Sunde, Niels A; Bergholt, Bo

    2014-01-01

    Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation......Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation...

  10. Hepatitis B Virus Infection and Immunizations among Asian American College Students: Infection, Exposure, and Immunity Rates

    Science.gov (United States)

    Lee, Haeok; Kiang, Peter; Watanabe, Paul; Halon, Patricia; Shi, Ling; Church, Daniel R.

    2013-01-01

    Objectives: To evaluate the prevalence of hepatitis B virus (HBV) infection, exposure, and immunity among Asian American college students as a basis for evaluating HBV screening and vaccination policy. Participants and Methods: Self-identified Asian American college students aged 18 years or older were examined. Serological tests of HBV surface…

  11. Device-associated infection rates in 398 intensive care units in Shanghai, China: International Nosocomial Infection Control Consortium (INICC) findings.

    Science.gov (United States)

    Tao, Lili; Hu, Bijie; Rosenthal, Victor D; Gao, Xiaodong; He, Lixian

    2011-11-01

    To determine device-associated healthcare-associated infection (DA-HAI) rates and the microorganism profile in 398 intensive care units (ICUs) of 70 hospitals in Shanghai, China. An open-label, prospective, cohort, active DA-HAI surveillance study was conducted on patients admitted to 398 tertiary-care ICUs in China from September 2004 to December 2009, implementing the methodology developed by the International Nosocomial Infection Control Consortium (INICC). The data were collected in the participating ICUs, and uploaded and analyzed at the INICC headquarters on proprietary software. DA-HAI rates were registered by applying the definitions of the US Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN). We analyzed the rates of DAI-HAI, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI), and their microorganism profiles. During the 5 years and 4 months of the study, 391 527 patients hospitalized in an ICU for an aggregate of 3,245,244 days, acquired 20,866 DA-HAIs, an overall rate of 5.3% (95% confidence interval (CI) 5.3-5.4) and 6.4 (95% CI 6.3-6.5) infections per 1000 ICU-days. VAP posed the greatest risk (20.8 per 1000 ventilator-days, 95% CI 20.4-21.1), followed by CAUTI (6.4 per 1000 catheter-days, 95% CI 6.3-6.6) and CLABSI (3.1 per 1000 catheter-days, 95% CI 3.0-3.2). The most common isolated microorganism was Acinetobacter baumannii (19.1%), followed by Pseudomonas aeruginosa (17.2%), Klebsiella pneumoniae (11.9%), and Staphylococcus aureus (11.9%). DA-HAIs in the ICUs of Shanghai pose a far greater threat to patient safety than in ICUs in the USA. This is particularly the case for the VAP rate, which is much higher than the rates found in developed countries. Active infection control programs that carry out infection surveillance and implement prevention guidelines can improve patient safety and must become a priority

  12. Baicalin prevents Candida albicans infections via increasing its apoptosis rate

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shulong; Fu, Yingyuan, E-mail: yingyuanfu@126.com; Wu, Xiuzhen; Zhou, Zhixing; Xu, Jing; Zeng, Xiaoping; Kuang, Nanzhen; Zeng, Yurong

    2014-08-15

    Highlights: • Baicalin increases the ratio of the G0/G1 stages and C. albicans apoptosis. • Baicalin decreases the proliferation index of C. albicans. • Baicalin inhibits the biosynthesis of DNA, RNA and protein in C. albicans. • Baicalin depresses Succinate Dehydrogenase and Ca{sup 2+}–Mg{sup 2+} ATPase in C. albicans. • Baicalin increases the endocytic free Ca{sup 2+} concentration in C. albicans. - Abstract: Background: These experiments were employed to explore the mechanisms underlying baicalin action on Candida albicans. Methodology and principal findings: We detected the baicalin inhibition effects on three isotope-labeled precursors of {sup 3}H-UdR, {sup 3}H-TdR and {sup 3}H-leucine incorporation into C. albicans using the isotope incorporation technology. The activities of Succinate Dehydrogenase (SDH), cytochrome oxidase (CCO) and Ca{sup 2+}–Mg{sup 2+} ATPase, cytosolic Ca{sup 2+} concentration, the cell cycle and apoptosis, as well as the ultrastructure of C.albicans were also tested. We found that baicalin inhibited {sup 3}H-UdR, {sup 3}H-TdR and {sup 3}H-leucine incorporation into C.albicans (P < 0.005). The activities of the SDH and Ca{sup 2+}–Mg{sup 2+} ATPase of C.albicans in baicalin groups were lower than those in control group (P < 0.05). Ca{sup 2+} concentrations of C. albicans in baicalin groups were much higher than those in control group (P < 0.05). The ratio of C.albicans at the G0/G1 stage increased in baicalin groups in dose dependent manner (P < 0.01). There were a significant differences in the apoptosis rate of C.albicans between baicalin and control groups (P < 0.01). After 12–48 h incubation with baicalin (1 mg/ml), C. albicans shown to be markedly damaged under transmission electron micrographs. Innovation and significance: Baicalin can increase the apoptosis rate of C. albicans. These effects of Baicalin may involved in its inhibiting the activities of the SDH and Ca{sup 2+}–Mg{sup 2+} ATPase, increasing

  13. Infection

    African Journals Online (AJOL)

    from the neonatal period to school age.' In Saudi Arabia, the rate of 5.3 per cent was reported' while in Nigeria,. Okafor et a1,7 found the prevalence rate .... the multiplication of the organisms in the urine, resulting in lalse diagnosis of urinary tract infection. This over-diagnosis ofl ITI may account for the high prevalence rate ...

  14. Zero rate of shunt infection in the first postoperative year in children--dream or reality?

    Science.gov (United States)

    Mottolese, C; Grando, J; Convert, J; Abdoulrahman, M; Lelievre, H; Vandenesch, F; Bret, P; Lapras, C

    2000-04-01

    The rate of infectious complications following shunt implantations at the Pierre Wertheimer Hospital was 6.4% in 1992-1994. In order to improve this infection rate, new recommendations for surgery were applied and a new type of valve was used. The effects of these measures after a 1-year follow-up were analyzed in 70 patients. The rate of infection was zero, 2.8, and 4.3% at 2, 6, and 12 months, respectively. A case-control study did not reveal any significant risk factor among the patient and surgical factors analyzed.

  15. Heart rate time series characteristics for early detection of infections in critically ill patients.

    Science.gov (United States)

    Tambuyzer, T; Guiza, F; Boonen, E; Meersseman, P; Vervenne, H; Hansen, T K; Bjerre, M; Van den Berghe, G; Berckmans, D; Aerts, J M; Meyfroidt, G

    2017-04-01

    It is difficult to make a distinction between inflammation and infection. Therefore, new strategies are required to allow accurate detection of infection. Here, we hypothesize that we can distinguish infected from non-infected ICU patients based on dynamic features of serum cytokine concentrations and heart rate time series. Serum cytokine profiles and heart rate time series of 39 patients were available for this study. The serum concentration of ten cytokines were measured using blood sampled every 10 min between 2100 and 0600 hours. Heart rate was recorded every minute. Ten metrics were used to extract features from these time series to obtain an accurate classification of infected patients. The predictive power of the metrics derived from the heart rate time series was investigated using decision tree analysis. Finally, logistic regression methods were used to examine whether classification performance improved with inclusion of features derived from the cytokine time series. The AUC of a decision tree based on two heart rate features was 0.88. The model had good calibration with 0.09 Hosmer-Lemeshow p value. There was no significant additional value of adding static cytokine levels or cytokine time series information to the generated decision tree model. The results suggest that heart rate is a better marker for infection than information captured by cytokine time series when the exact stage of infection is not known. The predictive value of (expensive) biomarkers should always be weighed against the routinely monitored data, and such biomarkers have to demonstrate added value.

  16. Trypanosoma Infection Rates in Glossina Species in Mtito Andei Division, Makueni County, Kenya

    Science.gov (United States)

    Nthiwa, Daniel Mutiso; Odongo, David O.; Ochanda, Horace; Khamadi, Samoel; Gichimu, Bernard M.

    2015-01-01

    African Animal Trypanosomiasis (AAT) transmitted cyclically by tsetse fly (Glossina spp.) is a major obstacle to livestock production in the tropical parts of Africa. The objective of this study was to determine the infection rates of trypanosomes in Glossina species in Mtito Andei Division, Makueni County, Kenya. Tsetse fly species, G. longipennis and G. pallidipes, were trapped and DNA was isolated from their dissected internal organs (proboscis, salivary glands, and midguts). The DNA was then subjected to a nested PCR assay using internal transcribed spacer primers and individual trypanosome species were identified following agarose gel electrophoresis. Out of the 117 flies trapped in the area 39 (33.3%) were teneral while 78 (67%) were nonteneral. G. pallidipes constituted the largest percentage of 58% while G. longipennis were 42%. The overall trypanosomes infection rate in all nonteneral Glossina spp. was 11.53% with G. longipennis recording the highest infection rate of 23.08% while G. pallidipes had an infection rate of 5.77%. T. vivax was the most infectious (10.26%) compared to T. congolense (1.28%). Mean apparent densities were strongly positively correlated with infection rates (r = 0.95) confirming the importance of this parameter as an indicator of AAT transmission risk. PMID:26617992

  17. Trypanosoma Infection Rates in Glossina Species in Mtito Andei Division, Makueni County, Kenya

    Directory of Open Access Journals (Sweden)

    Daniel Mutiso Nthiwa

    2015-01-01

    Full Text Available African Animal Trypanosomiasis (AAT transmitted cyclically by tsetse fly (Glossina spp. is a major obstacle to livestock production in the tropical parts of Africa. The objective of this study was to determine the infection rates of trypanosomes in Glossina species in Mtito Andei Division, Makueni County, Kenya. Tsetse fly species, G. longipennis and G. pallidipes, were trapped and DNA was isolated from their dissected internal organs (proboscis, salivary glands, and midguts. The DNA was then subjected to a nested PCR assay using internal transcribed spacer primers and individual trypanosome species were identified following agarose gel electrophoresis. Out of the 117 flies trapped in the area 39 (33.3% were teneral while 78 (67% were nonteneral. G. pallidipes constituted the largest percentage of 58% while G. longipennis were 42%. The overall trypanosomes infection rate in all nonteneral Glossina spp. was 11.53% with G. longipennis recording the highest infection rate of 23.08% while G. pallidipes had an infection rate of 5.77%. T. vivax was the most infectious (10.26% compared to T. congolense (1.28%. Mean apparent densities were strongly positively correlated with infection rates (r=0.95 confirming the importance of this parameter as an indicator of AAT transmission risk.

  18. Increased rate of survival in Streptococcus pneumoniae-infected rats treated with the new immunomodulator Pidotimod.

    Science.gov (United States)

    di Marco, R; Condorelli, F; Girardello, R; Uslenghi, C; Chisari, G; di Mauro, M; Speciale, A M; Meroni, P L; Nicoletti, F

    1992-01-01

    Wistar rats infected with Streptococcus pneumoniae (type III ATCC) rapidly develop an acute form of experimental lobar pneumonia (ELP) with death of 80-90% of the animals by 6 days after the infection. Prophylactic treatment of these animals with the novel immunomodulator Pidotimod, at the dose of 25 mg/kg bw, significantly increased their rate of survival as compared to the control group (50 vs. 90% respectively). Recovery from the infection appeared definitive since all the Pidotimod-treated survivors were alive and in good condition at the end of the observation period (45 days post infection). Prophylactic treatment with higher or lower doses of the drug was ineffective. Therapy with Pidotimod was not effective. This preliminary study suggests that Pidotimod may have contributed to activation of specific and non-specific immune effectors involved in the host response to S. pneumoniae infection.

  19. In situ growth rates and biofilm development of Pseudomonas aeruginosa populations in chronic lung infections

    DEFF Research Database (Denmark)

    Yang, L.; Haagensen, J.A.; Jelsbak, L.

    2008-01-01

    infections in cystic fibrosis (CF) patients for more than 20 years. We used fluorescence in situ hybridization (FISH) directly on sputum specimens to examine the spatial distribution of the infecting P. aeruginosa cells. Mucoid variants were present in sputum as cell clusters surrounded by an extracellular......The growth dynamics of bacterial pathogens within infected hosts are a fundamental but poorly understood feature of most infections. We have focused on the in situ distribution and growth characteristics of two prevailing and transmissible Pseudomonas aeruginosa clones that have caused chronic lung...... matrix, whereas nonmucoid variants were present mainly as dispersed cells. To obtain estimates of the growth rates of P. aeruginosa in CF lungs, we used quantitative FISH to indirectly measure growth rates of bacteria in sputum samples (reflecting the in vivo lung conditions). The concentration of r...

  20. In situ growth rates and biofilm development of Pseudomonas aeruginosa populations in chronic lung infections

    DEFF Research Database (Denmark)

    Yang, Lei; Haagensen, Janus Anders Juul; Jelsbak, Lars

    2008-01-01

    The growth dynamics of bacterial pathogens within infected hosts are a fundamental but poorly understood feature of most infections. We have focused on the in situ distribution and growth characteristics of two prevailing and transmissible Pseudomonas aeruginosa clones that have caused chronic lung...... infections in cystic fibrosis (CF) patients for more than 20 years. We used fluorescence in situ hybridization (FISH) directly on sputum specimens to examine the spatial distribution of the infecting P. aeruginosa cells. Mucoid variants were present in sputum as cell clusters surrounded by an extracellular...... matrix, whereas nonmucoid variants were present mainly as dispersed cells. To obtain estimates of the growth rates of P. aeruginosa in CF lungs, we used quantitative FISH to indirectly measure growth rates of bacteria in sputum samples (reflecting the in vivo lung conditions). The concentration of r...

  1. ICU ward design and nosocomial infection rates: a cross-sectional study in Germany.

    Science.gov (United States)

    Stiller, A; Schröder, C; Gropmann, A; Schwab, F; Behnke, M; Geffers, C; Sunder, W; Holzhausen, J; Gastmeier, P

    2017-01-01

    There is increasing interest in the effects of hospital and ward design on multi-faceted infection control. Definitive evidence is rare and the state of knowledge about current ward design is lacking. To collect data on the current status of ward design for intensive care units (ICUs) and to analyse associations between particular design factors and nosocomial infection rates. In 2015, operational infrastructure data were collected via an online questionnaire from ICUs participating voluntarily in the German nosocomial infection surveillance system (KISS). A multi-variate analysis was subsequently undertaken with nosocomial infection rates from the KISS database from 2014 to 2015. In total, 534 ICUs submitted data about their operational infrastructure. Of these, 27.1% of beds were hosted in single-bed rooms with a median size of 18m 2 (interquartile range 15-21m 2 ), and 73.5% of all ICU beds had a hand rub dispenser nearby. The authors were able to match 266 ICUs in the multi-variate analysis. ICUs with openable windows in patient rooms were associated with lower device-associated lower respiratory tract infections [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.58-0.90]. ICUs with >40% two-bed rooms were associated with lower primary bloodstream infection rates (OR 0.66, 95% CI 0.51-0.86). Only minor associations were found between design factors and ICU infection rates. Most were surrogates for other risk factors. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. Infection Rates of Electrical Leads Used for Percutaneous Neurostimulation of the Peripheral Nervous System.

    Science.gov (United States)

    Ilfeld, Brian M; Gabriel, Rodney A; Saulino, Michael F; Chae, John; Peckham, P Hunter; Grant, Stuart A; Gilmore, Christopher A; Donohue, Michael C; deBock, Matthew G; Wongsarnpigoon, Amorn; Boggs, Joseph W

    2017-07-01

    Percutaneous neurostimulation of the peripheral nervous system involves the insertion of a wire "lead" through an introducing needle to target a nerve/plexus or a motor point within a muscle. Electrical current may then be passed from an external generator through the skin via the lead for various therapeutic goals, including providing analgesia. With extended use of percutaneous leads sometimes greater than a month, infection is a concern. It was hypothesized that the infection rate of leads with a coiled design is lower than for leads with a noncoiled cylindrical design. The literature was retrospectively reviewed for clinical studies of percutaneous neurostimulation of the peripheral nervous system of greater than 2 days that included explicit information on adverse events. The primary endpoint was the number of infections per 1,000 indwelling days. Forty-three studies were identified that met inclusion criteria involving coiled (n = 21) and noncoiled (n = 25) leads (3 studies involved both). The risk of infection with noncoiled leads was estimated to be 25 times greater than with coiled leads (95% confidence interval [CI] 2 to 407, P = 0.006). The infection rates were estimated to be 0.03 (95% CI 0.01 to 0.13) infections per 1,000 indwelling days for coiled leads and 0.83 (95% CI 0.16 to 4.33) infections per 1,000 indwelling days for noncoiled leads (P = 0.006). Percutaneous leads used for neurostimulation of the peripheral nervous system have a much lower risk of infection with a coiled design compared with noncoiled leads: approximately 1 infection for every 30,000 vs. 1,200 indwelling days, respectively. © 2016 The Authors. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.

  3. Reduction in Surgical Wound Infection Rates Associated with Reporting Data to Surgeons

    Directory of Open Access Journals (Sweden)

    GD Taylor

    1994-01-01

    Full Text Available Several studies have shown that wound infection (surgical site infection [ ssi ] rates fall when surgeons are provided with data on their performance. Since 1987, the authors have been performing concurrent surveillance of surgical patients and confidentially reporting surgeon-specific ssi rates to individual surgeons and their clinical directors, and providing surgeons with the mean rates of their peers. The program has been gradually refined and expanded. Data are now collected on wound infection risk and report risk adjusted rates compared with the mean for hospitals in the United States National Nosocomial Infections Surveillance (nnis data bank. Since inception through to December 1993, ssi rates have fallen 68% in clean contaminated general surgery cases (relative risk [rr] 0.36, 95% ci 0.2 to 0.6, P=0.0001, 64% in clean plastic surgery cases (rr 0.35, 95% ci 0.06 to 1.8, 72% in caesarean section cases (rr 0.23, 95% ci 0.03 to 1.96 and 42% in clean cardiovascular surgery cases (rr 0.59, 95% ci 0.34 to 1.0. In clean orthopedic surgery the ssi rate remained stable from 1987 through 1992. In 1993 a marked increase was experienced. Reasons for this are being explored. Overall there was a 32% decrease in ssi rate between the index year and 1993 or, in percentage terms, 2.8% to 1.9% (rr 0.65, 95% ci 0.51 to 0.86, P=0.002. ssi surveillance should become standard in Canadian hospitals interested in improving the quality of surgical care and reducing the clinical impact and cost associated with nosocomial infection.

  4. Infection rate after minimally invasive noninstrumented spinal surgery based on 4350 procedures.

    Science.gov (United States)

    Shousha, Mootaz; Cirovic, Dusan; Boehm, Heinrich

    2015-02-01

    Retrospective review of a prospectively collected database. To assess the rate of postoperative infection associated with minimally invasive noninstrumented spinal surgery. Infection after spinal surgery results in significant morbidity, extended hospital stay, and significant costs. Minimally invasive spinal techniques require smaller incisions and less dissection, minimizing the risk of postoperative infection. Inclusion criteria were patients undergoing posterior spinal surgery using a tubular retractor system with the aid of operative microscope between June 1998 and November 2013. The analysis revealed a total number of 4350 procedures performed in 4037 patients (mean age=53.2 yr). Sixty percent of the patients were male. The majority of procedures were performed in the lumbar spine (98.4%), and the indication was mostly degenerative in nature (96.9%). The databases were then reviewed for any infectious complications. Postoperative infection was recorded in 4 patients (0.09%). All of them occurred in the lumbar region after discectomy. These patients presented with discitis and underwent revision in the form of open debridement and fusion. The time lapse between the index surgery and revision was 56 days. All 4 patients recovered, with a mean follow-up of 7.5 years. Infection rate after posterior transtubular microscopic assisted spinal surgery is very low (0.09%). Surgical debridement with fusion was the method of choice in treating such complications. This minimally invasive technique reduces markedly the risk of postoperative infection when compared with other large series published in the literature. 4.

  5. Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients.

    Science.gov (United States)

    Yogaraj, Jeya S; Elward, Alexis M; Fraser, Victoria J

    2002-09-01

    The objective of this study was to determine the rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit (PICU) patients. Prospective cohort study. This study was performed at St Louis Children's Hospital, a 235-bed academic tertiary care center with a combined 22-bed medical and surgical PICU. Subjects for this study were patients admitted to the PICU between September 1, 1999, and May 31, 2000. None. Patients were monitored for the development of nosocomial bloodstream infections from the day of PICU admission until 48 hours after PICU discharge. Of 911 patients, 526 (58%) were male and 674 (74%) were white. Congenital heart disease (29%), lung disease (25%), and genetic syndrome (18%) were common. There were 65 episodes of primary bloodstream infection in 57 patients; 5 were polymicrobial and 7 patients had multiple bloodstream infections. Coagulase-negative Staphylococcus was the leading cause of bloodstream infection (n = 28), followed by Enterobacter cloacae (n = 8). The rate of bloodstream infection was 13.8 per 1000 central venous catheter days. In multiple logistic regression analysis, patients with bloodstream infection were more likely to have multiple central venous catheters (adjusted odds ratio [aOR]: 5.7; 95% confidence interval [CI]: 2.9-10.9), arterial catheters (aOR: 5.5; 95% CI: 1.8-16.3), invasive procedures performed in the PICU (aOR: 4.0; 95%CI: 2.0-7.8), and be transported out of the PICU (aOR: 3.4; 95% CI: 1.8-6.7) to the radiology or operating room suites. Severity of illness as measured by admission Pediatric Risk of Mortality score, underlying illnesses, and medications were not associated with increased risk of nosocomial bloodstream infection. Conclusions This study identified a high rate of bloodstream infection among St Louis Children's Hospital PICU patients. Risk factors for bloodstream infection were related more to process of care than to severity of illness. Additional

  6. Splenectomy is associated with higher infection and pneumonia rates among trauma laparotomy patients.

    Science.gov (United States)

    Fair, Kelly A; Connelly, Christopher R; Hart, Kyle D; Schreiber, Martin A; Watters, Jennifer M

    2017-05-01

    Splenectomy increases lifetime risk of thromboembolism (VTE) and is associated with long-term infectious complications, primarily, overwhelming post-splenectomy infection (OPSI). Our objective was to evaluate risk of VTE and infection at index hospitalization post-splenectomy. Retrospective review of all patients who received a laparotomy in the NTDB. Propensity score matching for splenectomy was performed, based on ISS, abdominal abbreviated injury score >3, GCS, sex and mechanism. Major complications, VTE, and infection rates were compared. Multiple logistic regression models were utilized to evaluate splenectomy-associated complications. 93,221 laparotomies were performed and 17% underwent splenectomy. Multiple logistic regression models did not demonstrate an association between splenectomy and major complications (OR 0.96, 95% CI 0.91-1.03, p = 0.25) or VTE (OR 1.05, 95% CI 0.96-1.14, p = 0.33). Splenectomy was independently associated with infection (OR 1.07, 95% CI 1.00-1.14, p = 0.045). Subgroup analysis of patients with infection demonstrated that splenectomy was most strongly associated with pneumonia (OR 1.41, 95% CI 1.26-1.57, p Splenectomy is not associated with higher overall complication or VTE rates during index hospitalization. However, splenectomy is associated with a higher rate of pneumonia. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. The impact of statistical choices on neonatal intensive care unit quality ratings based on nosocomial infection rates.

    Science.gov (United States)

    Lee, Henry C; Chien, Alyna T; Bardach, Naomi S; Clay, Ted; Gould, Jeffrey B; Dudley, R Adams

    2011-05-01

    To examine the extent to which performance assessment methods affect the percentage of neonatal intensive care units (NICUs) and very low-birth-weight (VLBW) infants included in performance assessments, the distribution of NICU performance ratings, and the level of agreement in those ratings. Cross-sectional study based on risk-adjusted nosocomial infection rates. NICUs belonging to the California Perinatal Quality Care Collaborative 2007-2008. One hundred twenty-six California NICUs and 10 487 VLBW infants. Three performance assessment choices: (1) excluding "low-volume" NICUs (those caring for <30 VLBW infants per year) vs a criterion based on confidence intervals, (2) using Bayesian vs frequentist hierarchical models, and (3) pooling data across 1 vs 2 years. Proportion of NICUs and patients included in quality assessment, distribution of ratings for NICUs, and agreement between methods using the κ statistic. Depending on the methods applied, 51% to 85% of NICUs and 72% to 96% of VLBW infants were included in performance assessments, 76% to 87% of NICUs were considered "average," and the level of agreement between NICU ratings ranged from 0.23 to 0.89. The percentage of NICUs included in performance assessments and their ratings can shift dramatically depending on performance measurement method. Physicians, payers, and policymakers should continue to closely examine which existing performance assessment methods are most appropriate for evaluating pediatric care quality.

  8. "The 3/3 strategy": a successful multifaceted hospital wide hand hygiene intervention based on WHO and continuous quality improvement methodology.

    Directory of Open Access Journals (Sweden)

    Gabriel Mestre

    Full Text Available BACKGROUND: Only multifaceted hospital wide interventions have been successful in achieving sustained improvements in hand hygiene (HH compliance. METHODOLOGY/PRINCIPAL FINDINGS: Pre-post intervention study of HH performance at baseline (October 2007-December 2009 and during intervention, which included two phases. Phase 1 (2010 included multimodal WHO approach. Phase 2 (2011 added Continuous Quality Improvement (CQI tools and was based on: a Increase of alcohol hand rub (AHR solution placement (from 0.57 dispensers/bed to 1.56; b Increase in frequency of audits (three days every three weeks: "3/3 strategy"; c Implementation of a standardized register form of HH corrective actions; d Statistical Process Control (SPC as time series analysis methodology through appropriate control charts. During the intervention period we performed 819 scheduled direct observation audits which provided data from 11,714 HH opportunities. The most remarkable findings were: a significant improvements in HH compliance with respect to baseline (25% mean increase; b sustained high level (82% of HH compliance during intervention; c significant increase in AHRs consumption over time; c significant decrease in the rate of healthcare-acquired MRSA; d small but significant improvements in HH compliance when comparing phase 2 to phase 1 [79.5% (95% CI: 78.2-80.7 vs 84.6% (95% CI:83.8-85.4, p<0.05]; e successful use of control charts to identify significant negative and positive deviations (special causes related to the HH compliance process over time ("positive": 90.1% as highest HH compliance coinciding with the "World hygiene day"; and "negative":73.7% as lowest HH compliance coinciding with a statutory lay-off proceeding. CONCLUSIONS/SIGNIFICANCE: CQI tools may be a key addition to WHO strategy to maintain a good HH performance over time. In addition, SPC has shown to be a powerful methodology to detect special causes in HH performance (positive and negative and to help

  9. [Spatial regression analysis of relationship between schistosome infection rate of Oncomelania hupensis snails and climate factors].

    Science.gov (United States)

    Chen, Yan-yan; Iu, Jian-bing; Xiao, Ying; Zhou, Xiao-rong; Jiang, Yong; Dai, Ling-feng; Cai, Shun-xiang

    2015-04-01

    To explore the relationship between the schistosome infection rate of O. hupensis snails and the climate factors in endemic areas of schistosomiasis, so as to provide the evidence for improving the snail control. The snail and climate data of 18 counties in Hubei Province in 2009 were collected to obtain the infection rate of O. hupensis snails and to fit the spatial regression models. The multiple linear regression model showed that the residuals were autocorrelated (Moran's I = 0.182 8, P snails was positively correlated with the annual average temperature (P 0.05). The spatial regression models could be well applied in the analysis of the relationship between the O. hupensis snails and climate factors. The annual average temperature is the primary climate factor influencing the infection of O. hupensis snails.

  10. Improved Surgical Site Infection (SSI) rate through accurately assessed surgical wounds

    OpenAIRE

    John, Honeymol; Nimeri, Abdelrahman; Ellahham, Samer

    2015-01-01

    Sheikh Khalifa Medical City's (SKMC) Surgery Institute was identified as a high outlier in Surgical Site Infections (SSI) based on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) - Semi-Annual Report (SAR) in January 2012. The aim of this project was to improve SSI rates through accurate wound classification. We identified SSI rate reduction as a performance improvement and safety priority at SKMC, a tertiary referral center. We used the American Col...

  11. Rate of re-infection of tissue culture-derived Latin American and ...

    African Journals Online (AJOL)

    Jane

    2010-12-20

    Dec 20, 2010 ... Rate of re-infection of tissue culture-derived Latin. American and East and Southern African cassava genotypes by mosaic disease. E. B. Okorogri1, V. O. Adetimirin1, G. Ssemakula2*, B. Odu2 and A. G. O. Dixon2. 1Department of Agronomy, University of Ibadan, Oyo State, Nigeria. 2International Institute of ...

  12. The impact of HIV infection and disease stage on the rate of weight ...

    African Journals Online (AJOL)

    Background. Evidence of the effects of HIV infection and clinical stage on the duration of refeeding and treatment (DRT) and the rate of weight gain (RWG) in severely malnourished children remains inconclusive. Objectives. To determine whether the RWG and DRT differ by baseline clinical characteristics, and to assess the ...

  13. Examining the Role of the Reproductive Rate of the Infected Cell On ...

    African Journals Online (AJOL)

    Journal of the Nigerian Association of Mathematical Physics ... Abstract. The general variability of the reproductive rate of the infected cell on the viral load of the virions is a challenging medical science problem that requires the application of a mathematical reasoning using the technique of a numerical simulation.

  14. INFECTION RATE AND CHEMOTHERAPY OF VARIOUS HELMINTHS IN GOATS IN AND AROUND LAHORE

    Directory of Open Access Journals (Sweden)

    M. IJAZ, M. S. KHAN, M. AVAIS, K. ASHRAF1, M. M. ALI AND SAIMA2

    2008-12-01

    Full Text Available The current study was carried out to find out the infection rate of gastrointestinal tract (GIT helminths and its association with diarrhoea in goats in Lahore, Pakistan. For this purpose, 300 faecal samples from goats suffering from diarrhoea presented at the Outdoor Hospital, Department of Clinical Medicine and Surgery, UVAS Lahore and various private as well as government hospitals located in Lahore were examined coprologically for the presence of helminths. The result revealed that an overall infection rate of GIT helminths was 63.33% in goats. When compared the class wise infection rate, highest infection rate of nematodes (42.67% was observed, followed by trematodes (16.67% and cestodes (4%. The efficacy of Ricobendazole was observed to be 62, 96 and 98% at day 3, 7 and 14 of treatment, respectively. The efficacy of Ricobendazole was higher than Albendazole (46, 83 and 94% at day 3, 7 and 14, respectively. Lowest efficacy of garlic powder against helminth parasites was observed (13, 28 and 34% at day 3, 7 and 14, respectively. It was concluded that Ricobendazole is the most effective drugs against helminths in goats.

  15. Seasonal infection rates of Batrachochytrium dendrobatidis in populations of northern green frog Lithobates clamitans melanota tadpoles.

    Science.gov (United States)

    Julian, James T; Gould, Victoria A; Glenney, Gavin W; Brooks, Robert P

    2016-09-26

    Few studies have documented seasonal variation of Batrachochytrium dendrobatidis (Bd) infection rates in larval amphibians. We identified 4 natural populations of northern green frogs Lithobates clamitans melanota in Pennsylvania (USA) that contained Bd-infected tadpoles during post-wintering collections in May and June, after hibernating tadpoles had overwintered in wetlands. However, we failed to detect infected tadpoles at those wetlands when pre-wintering collections were made in late July through early September. We observed 2 cohorts of tadpoles that appeared to lack Bd-infected individuals in pre-wintering collections, yet contained Bd-infected individuals the following spring. We also observed 4 cohorts of pre-wintering tadpoles that were Bd-free, even though post-wintering tadpoles collected earlier in the year were infected with Bd. Our results suggest that tadpoles either reduce Bd infections during the summer months, and/or infections proliferate sometime prior to (or shortly after) tadpoles emerge from hibernation. It is unlikely that pre-wintering tadpoles were too small to detect Bd zoospores because (1) there was no correlation between Bd zoospore levels and tadpole size or stage, and (2) size was not a significant predictor of infection status. These results suggest that, while sampling larvae can be an effective means of collecting large sample sizes, investigators in our Mid-Atlantic region should conduct sampling by early summer to maximize the chances of detecting Bd. Further research is warranted to determine whether wetland topography and warm, shallow microhabitats within wetlands contribute to a population's ability to drastically reduce Bd prevalence prior to overwintering at ponds.

  16. Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bos, Aaron, E-mail: abos1210@gmail.com; Ahmed, Osman [University of Chicago Medical Center (United States); Jilani, Danial [Wright State University Boonshoft School of Medicine (United States); Giger, Maryellen; Funaki, Brian S.; Zangan, Steven M. [University of Chicago Medical Center (United States)

    2015-06-15

    PurposeThe aim of this study was to investigate dual-lumen chest port infection rates in patients with head and neck cancer (HNC) compared to those with other malignancies (non-HNC).Materials and MethodsAn IRB-approved retrospective study was performed on 1,094 consecutive chest ports placed over a 2-year period. Patients with poor follow-up (n = 53), no oncologic history (n = 13), or single-lumen ports (n = 183) were excluded yielding a study population of 845 patients. The electronic medical records were queried for demographic information, data regarding ports and infections, and imaging review.ResultsHNC patients experienced more infections (42 vs. 30), an increased infection rate per 1,000 catheter days (0.68 vs. 0.21), and more early infections within 30 days compared to non-HNC patients (10 vs. 6) (p < 0.001, p < 0.001, p = 0.02, respectively). An existing tracheostomy at the time of port placement was associated with infection in the HNC group (p = 0.02) but was not an independent risk factor for infection in the study population overall (p = 0.06). There was a significant difference in age, male gender, and right-sided ports between the HNC and non-HNC groups (p < 0.01, p < 0.001, and p = 0.01), although these were not found to be independent risk factors for infection (p = 0.32, p = 0.76, p = 0.16).ConclusionHNC patients are at increased risk for infection of dual-lumen chest ports placed via a jugular approach compared to patients with other malignancies. Tracheostomy is associated with infection in HNC patients but is not an independent risk factor for infection in the oncologic population as a whole.

  17. Thirty-day Readmission Rates in an HIV-infected Cohort From Rio de Janeiro, Brazil.

    Science.gov (United States)

    Coelho, Lara E; Ribeiro, Sayonara R; Japiassu, Andre M; Moreira, Ronaldo I; Lara, Priscila C; Veloso, Valdilea G; Grinsztejn, Beatriz; Luz, Paula M

    2017-08-01

    The 30-day readmission rate is an indicator of the quality of hospital care and transition to the outpatient setting. Recent studies suggest HIV infection might increase the risk of readmission although estimates of 30-day readmission rates are unavailable among HIV-infected individuals living in middle/low-income settings. Additionally, factors that may increase readmission risk in HIV-infected populations are poorly understood. Thirty-day readmission rates were estimated for HIV-infected adults from the Instituto Nacional de Infectologia Evandro Chagas/Fiocruz cohort in Rio de Janeiro, Brazil, from January 2007 to December 2013. Cox regression models were used to evaluate factors associated with the risk of 30-day readmission. Between January 2007 and December 2013, 3991 patients were followed and 1861 hospitalizations were observed. The estimated 30-day readmission rate was 14% (95% confidence interval: 12.3 to 15.9). Attending a medical visit within 30 days after discharge (adjusted hazard ratio [aHR] = 0.73, P = 0.048) and being hospitalized in more recent calendar years (aHR = 0.89, P = 0.002) reduced the risk of 30-day readmission. In contrast, low CD4 counts (51-200 cells/mm³: aHR = 1.70, P = 0.024 and ≤ 50 cells/mm³: aHR = 2.05, P = 0.003), time since HIV infection diagnosis ≥10 years (aHR = 1.58, P = 0.058), and leaving hospital against medical advice (aHR = 2.67, P = 0.004) increased the risk of 30-day readmission. Patients with advanced HIV/AIDS are most at risk of readmission and should be targeted with prevention strategies to reduce this risk. Efforts to reduce discharge against medical advice and to promote early postdischarge medical visit would likely reduce 30-day readmission rates in our population.

  18. Recurrence rate of clostridium difficile infection in hospitalized pediatric patients with inflammatory bowel disease.

    Science.gov (United States)

    Kelsen, Judith R; Kim, Jason; Latta, Dan; Smathers, Sarah; McGowan, Karin L; Zaoutis, Theodore; Mamula, Petar; Baldassano, Robert N

    2011-01-01

    The incidence and associated morbidity of Clostridium difficile (CD) infection has been increasing at an alarming rate in North America. Clostridium difficile-associated diarrhea (CDAD) is the leading cause of nosocomial diarrhea in the USA. Patients with CDAD have longer average hospital admissions and additional hospital costs. Evidence has demonstrated that patients with inflammatory bowel disease (IBD) have a higher incidence of CD in comparison to the general population. The aim of this study was to compare the rate of recurrence of CD in hospitalized pediatric patients with IBD compared to hospitalized controls. The secondary aim was to evaluate whether infection with CD resulted in a more severe disease course of IBD. This was a nested case control retrospective study of hospitalized pediatric patients. Diagnosis of CD was confirmed with stool Toxin A and B analysis. The following data were obtained from the medical records: demographic information, classification of IBD including location of disease, IBD therapy, and prior surgeries. In addition, prior hospital admissions within 1 year and antibiotic exposure were recorded. The same information was recorded following CD infection. Cases were patients with IBD and CD; two control populations were also studied: patients with CD but without IBD, and patients with IBD but without CD. For aim 1, a total of 111 eligible patients with IBD and CD infection and 77 eligible control patients with CD infection were included. The rate of recurrence of CD in the IBD population was 34% compared to 7.5% in the control population (P < 0.0001). In evaluating the effect of CD infection on IBD disease severity, we compared the 111 IBD patients with CD to a second control population of 127 IBD patients without CD. 57% of IBD-CD patients were readmitted with an exacerbation of disease within 6 months of infection with CD and 67% required escalation of therapy following CD infection, compared to 30% of IBD patients without CD (P

  19. Lovastatin delays infection and increases survival rates in AG129 mice infected with dengue virus serotype 2.

    Directory of Open Access Journals (Sweden)

    Marlen Martinez-Gutierrez

    Full Text Available BACKGROUND: It has been reported that treatment of DENV-infected cultures with Lovastatin (LOV, can affect viral assembly. The objective of this study was to evaluate the effect of LOV on the survival rate and viremia levels of DENV-2-infected AG129 mice. METHODOLOGY/PRINCIPAL FINDINGS: Mice were inoculated with 1 × 10(6 plaque-forming units (PFU/ml of DENV-2 and treated with LOV (200 mg/kg/day. Pre-treatment with one or three doses of LOV increased the survival rate compared to untreated mice (7.3 and 7.1 days, respectively, compared to 4.8 days. Viremia levels also decreased by 21.8% compared to untreated mice, but only in the group administered three doses prior to inoculation. When LOV was administered after viral inoculation, the survival rate increased (7.3 days in the group treated at 24 hpi, 6.8 days in the group treated at 48 hpi and 6.5 days in the group treated with two doses compared to the untreated group (4.8 days. Interestingly, the serum viral titer increased by 24.6% in mice treated at 48 hpi with a single dose of LOV and by 21.7% in mice treated with two doses (at 24 and 48 hpi of LOV compared to untreated mice. Finally histopathological changes in the liver and spleen in infected and untreated mice included massive extramedullary erythropoiesis foci and inflammatory filtration, and these characteristics were decreased or absent in LOV-treated mice. CONCLUSIONS/SIGNIFICANCE: Our results suggest that the effect of LOV on viremia depends on the timing of treatment and on the number of doses administered. We observed a significant increase in the survival rate in both schemes due to a delay in the progression of the disease. However, the results obtained in the post-treatment scheme must be handled carefully because this treatment scheme increases viremia and we do not know how this increase could affect disease progression in humans.

  20. Infected honeybee foragers incur a higher loss in efficiency than in the rate of energetic gain.

    Science.gov (United States)

    Naug, Dhruba

    2014-11-01

    Parasites, by altering the nutritional and energetic state of their hosts, can significantly alter their foraging behaviour. In honeybees, an infection with Nosema ceranae has been shown to lower the energetic state of individual bees, bringing about changes in behaviours associated with foraging. Comparing the foraging trip times, hive times in between trips, and the crop contents of uninfected and infected foragers as they depart on foraging trips and return from them, this study examined how any differences in these variables influence alternative foraging currencies. The results show that infected bees take longer foraging trips, spend shorter time in the hive between successive trips and bring back less sugar from each trip. These changes have a stronger adverse effect on their efficiency of energetic gain as compared with their rate of energetic gain, which has important implications for individual and colony life history. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  1. Laminar airflow ceiling size: no impact on infection rates following hip and knee prosthesis.

    Science.gov (United States)

    Breier, Ann-Christin; Brandt, Christian; Sohr, Dorit; Geffers, Christine; Gastmeier, Petra

    2011-11-01

    Laminar airflow (LAF) systems are widely used, at least in orthopedic surgery. However, there is still controversial discussion about the influence of LAF on surgical site infection (SSI) rates. The size of the LAF ceiling is also often a question of debate. Our objective is to determine the effect of this technique under conditions of actual rather than ideal use. Cohort study using multivariate analysis with generalized estimating equations method. Data for hip and knee prosthesis procedures from hospitals participating in the German national nosocomial infection surveillance system (KISS) from July 2004 to June 2009 were used for analysis. A total of 33,463 elective hip prosthesis procedures due to arthrosis (HIP-A) from 48 hospitals, 7,749 urgent hip prosthesis procedures due to fracture (HIP-F) from 41 hospitals, and 20,554 knee prosthesis (KPRO) procedures from 38 hospitals were included. The data were analyzed for hospitals with and without LAF in the operating rooms and by the size of the LAF ceiling. The endpoints were severe SSI rates. The overall severe SSI rate was 0.74 per 100 procedures for HIP-A, 2.39 for HIP-F, and 0.63 for KPRO. For all 3 prosthesis types, neither LAF nor the size of the LAF ceiling was associated with lower infection risk. The data demonstrate consistency and reproducibility with the results from earlier registry studies. Neither LAF nor ceiling size had an impact on severe SSI rates.

  2. The rate of immune escape vanishes when multiple immune responses control an HIV infection.

    Science.gov (United States)

    van Deutekom, Hanneke W M; Wijnker, Gilles; de Boer, Rob J

    2013-09-15

    During the first months of HIV infection, the virus typically evolves several immune escape mutations. These mutations are found in epitopes in viral proteins and reduce the impact of the CD8⁺ T cells specific for these epitopes. Recent data show that only a subset of the epitopes escapes, that most of these escapes evolve early, and that the rate of immune escape slows down considerably. To investigate why the evolution of immune escape slows down over the time of infection, we have extended a consensus mathematical model to allow several immune responses to control the virus together. In the extended model, most escapes also occur early, and the immune escape rate becomes small later, and typically only a minority of the epitopes escape. We show that escaping one of the many immune responses provides little advantage after viral setpoint has been approached because the total killing rate hardly depends on the breadth of the immune response. If the breadth of the immune response slowly wanes during disease progression, the model predicts an increase in the rate of immune escape at late stages of infection. Overall, the most striking prediction of the model is that HIV evolves a small number of immune escapes, in both relative and absolute terms, when the CTL immune response is broad.

  3. A population-based study examining hepatitis B virus infection and immunization rates in Northwest China.

    Science.gov (United States)

    Ji, Zhaohua; Wang, Tingcai; Shao, Zhongjun; Huang, Dahong; Wang, Anhui; Guo, Zhiwen; Long, Yong; Zhang, Lei; Su, Haixia; Zhang, Qi; Yan, Yongping; Fan, Daiming

    2014-01-01

    Current baseline data regarding the prevalence of hepatitis B virus (HBV) infections and the immune status in hyperendemic areas is necessary in evaluating the effectiveness of ongoing HBV prevention and control programs in northwest China. This study aims to determine the prevalence of chronic HBV infections, past exposure rates, and immune response profiles in Wuwei City, northwest China in 2010. Cross-sectional household survey representative of the Wuwei City population. 28,579 participants were interviewed in the seroepidemiological survey ≥1 year of age. House to house screening was conducted using a standard questionnaire. All serum samples were screened by enzyme-linked immunoassays for the presence of hepatitis B surface antigen, antibodies against HBV surface antigen, and antibodies to the hepatitis B core antigen. Among individuals ≥1 year of age, 7.2% (95%CI: 6.3-8.1%) had chronic HBV infections, 43.9% (CI: 40.4-47.4%) had been exposed to HBV, and 23.49% (CI: 21.6-25.3%) had vaccine-induced immunity. Multi-factor weighted logistic regression analysis showed that having household contact with HBV carriers (OR = 2.6, 95%CI: 2.3-3.0) and beauty treatments in public places (OR = 1.2, 95%CI: 1.1-1.3) were the risk factors of HBV infection in whole population. Having household contact with HBV carriers (OR = 3.8, 95% CI: 2.2-6.5) and lack of hepatitis vaccination (OR = 2.0, 95% CI: 1.4-3.3) were the risk factors for HBV infection in children aged 1-14 years. Hepatitis B infection remains a serious public health problem in northwest China. Having household contact with HBV carriers and beauty treatments in public places represented HBV infection risk factors. Hepatitis B vaccine immunization strategies need further improvement, particularly by targeting the immunization of rural migrant workers.

  4. Surgical wound infection rates in Spain: data summary, January 1997 through June 2012.

    Science.gov (United States)

    Díaz-Agero Pérez, Cristina; Robustillo Rodela, Ana; Pita López, María José; López Fresneña, Nieves; Monge Jodrá, Vicente

    2014-05-01

    The Indicadores Clínicos de Mejora Continua de la Calidad (INCLIMECC) program was established in Spain in 1997. INCLIMECC is a prospective system of health care-associated infection (HAI) surveillance that collects incidence data in surgical and intensive care unit patients. The protocol is based on the National Healthcare Safety Network (NHSN) surveillance system, formerly known as the National Nosocomial Infection Surveillance (NNIS) system, and uses standard infection definitions from the US Centers for Disease Control and Prevention. Each hospital takes part voluntarily and selects the units and surgical procedures to be surveyed. This report is a summary of the data collected between January 1997 and June 2012. A total of 370,015 patients were included, and the overall incidence of surgical wound infection (SWI) was 4.51%. SWI rates are provided by NHSN operating procedure category and NNIS risk index category. More than 27% of the patients received inadequate antibiotic prophylaxis, the main reason being unsuitable duration (57.05% of cases). Today, the INCLIMECC network includes 64 Spanish hospitals. We believe that an HAI surveillance system with trained personnel external to the surveyed unit is a key component not only in infection control and prevention, but also in a quality improvement system. Copyright © 2014. Published by Mosby, Inc.

  5. Effect of tunnel length on infection rate in patients with external ventricular drain.

    Science.gov (United States)

    Rafiq, Mirza Faisal Ahmed; Ahmed, Noor; Ali, Shafqut

    2011-01-01

    External ventricular drain involves catheter placement in ventricles of brain. It is used for various purposes. Basic theme is to drain cerebrospinal fluid so as to control intracranial pressure. This study was carried out to see the effect of tunnel length on rate of infection. This was a cross-sectional study carried out in Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad during 14 months from 1st December 2008 to 31 January 2010. External ventricular drain was placed in admitted patients after meticulous aseptic technique in operation theatre at right Kocher's point. It was carried out through a scalp tunnel and was connected to drainage bag through a drip set. Both long (> 5 Cm) and short (drain). All patients received prophylactic Ceftriaxone. Among 76 patients long tunnel was made in 44 (57.9%) and short in 32 (42.1%). Three patients (3.9%) with long tunnel while 6 (7.9%) patients with short tunnel had infection. The overall infection was in 9 (11.8%) patients. External ventricular drain tunnel length strongly influences the rate of infection.

  6. C-reactive protein, erythrocyte sedimentation rate and orthopedic implant infection.

    Directory of Open Access Journals (Sweden)

    Kerryl E Piper

    Full Text Available BACKGROUND: C-reactive protein (CRP and erythrocyte sedimentation rate (ESR have been shown to be useful for diagnosis of prosthetic hip and knee infection. Little information is available on CRP and ESR in patients undergoing revision or resection of shoulder arthroplasties or spine implants. METHODS/RESULTS: We analyzed preoperative CRP and ESR in 636 subjects who underwent knee (n=297, hip (n=221 or shoulder (n=64 arthroplasty, or spine implant (n=54 removal. A standardized definition of orthopedic implant-associated infection was applied. Receiver operating curve analysis was used to determine ideal cutoff values for differentiating infected from non-infected cases. ESR was significantly different in subjects with aseptic failure infection of knee (median 11 and 53.5 mm/h, respectively, p=<0.0001 and hip (median 11 and 30 mm/h, respectively, p=<0.0001 arthroplasties and spine implants (median 10 and 48.5 mm/h, respectively, p=0.0033, but not shoulder arthroplasties (median 10 and 9 mm/h, respectively, p=0.9883. Optimized ESR cutoffs for knee, hip and shoulder arthroplasties and spine implants were 19, 13, 26, and 45 mm/h, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 89 and 74% for knee, 82 and 60% for hip, and 32 and 93% for shoulder arthroplasties, and 57 and 90% for spine implants. CRP was significantly different in subjects with aseptic failure and infection of knee (median 4 and 51 mg/l, respectively, p<0.0001, hip (median 3 and 18 mg/l, respectively, p<0.0001, and shoulder (median 3 and 10 mg/l, respectively, p=0.01 arthroplasties, and spine implants (median 3 and 20 mg/l, respectively, p=0.0011. Optimized CRP cutoffs for knee, hip, and shoulder arthroplasties, and spine implants were 14.5, 10.3, 7, and 4.6 mg/l, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 79 and 88% for knee, 74 and 79% for hip, and 63 and 73% for shoulder arthroplasties, and 79 and

  7. Vector species composition and malaria infectivity rates in Mkuzi, Muheza District, north-eastern Tanzania

    DEFF Research Database (Denmark)

    Kweka, E J; Mahande, A M; Nkya, W M M

    2008-01-01

    Entomological surveys were conducted in Mkuzi village in Muheza District, north-east Tanzania from April to September 2003. The objectives were to determine the species composition and infectivity rates of mosquitoes in Mkuzi village. Mosquito collection was done using CDC light trap and pyrethrum...... spray catch (PSC) techniques. The light trap: spray catch ratio was 2.2:1. A total of 2157 mosquitoes were collected (light trap = 1483; PSC = 674). Anopheles gambiae s.s. accounted for 56.7% (N = 1224) of all mosquitoes collected. Other species were An. funestus complex (19.2%) and Culex...... quinquefasciatus (24.1%).The mosquito density per room was 74.15 and 33.7 for light trap and PSC techniques, respectively. A total of 1637 Anopheles mosquitoes were tested for circumsporozoite protein by Enzyme linked Immunosobent Assay (ELISA). The overall infectivity rate for circumsporozoite protein for P...

  8. Challenge infection as a means of determining the rate of disease resistant Trichomonas gallinae-free birds in a population.

    Science.gov (United States)

    Kocan, R M; Knisley, J O

    1970-01-01

    Trichomonas gallinae-free pigeons and mourning doves were infected with the Jones' Barn strain of T. gallinae to determine the rate of disease resistant T. gallinae-free birds in each population. Although all birds became infected 88% of the pigeons were resistant to trichomoniasis while 82% of the mourning doves were resistant. It was concluded that these birds had been previously infected and spontaneously lost their trichomonad fauna while retaining their resistance to fatal infection.

  9. Challenge infection as a means of determining the rate of disease resistant Trichomonas gallinae-free birds in a population

    Science.gov (United States)

    Kocan, R.M.; Knisley, J.O.

    1970-01-01

    Trichomonas gallinae-free pigeons and mourning doves were infected with the Jones' Barn strain of T. gallinae to determine the rate of disease resistant T. gallinae-free birds in each population. Although all birds became infected 88% of the pigeons were resistant to trichomoniasis while 82% of the mourning doves were resistant. It was concluded that these birds had been previously infected and spontaneously lost their trichomonad fauna while retaining their resistance to fatal infection.

  10. Nonsteroidal anti-inflammatory drugs' impact on nonunion and infection rates in long-bone fractures.

    Science.gov (United States)

    Jeffcoach, David R; Sams, Valerie G; Lawson, Christy M; Enderson, Blaine L; Smith, Scott T; Kline, Heather; Barlow, Patrick B; Wylie, Douglas R; Krumenacker, Laura A; McMillen, James C; Pyda, Jordan; Daley, Brian J

    2014-03-01

    There is a dearth of clinical data regarding the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on long-bone fracture (LBF) healing in the acute trauma setting. The orthopedic community believes that the use of NSAIDs in the postoperative period will result in poor healing and increased infectious complications. We hypothesized that, first, NSAID use would not increase nonunion/malunion and infection rates after LBF. Second, we hypothesized that tobacco use would cause higher rates of these complications. A retrospective study of all patients with femur, tibia, and/or humerus fractures between October 2009 and September 2011 at a Level 1 academic trauma center was performed . In addition to nonunion/malunion and infection rates, patient records were reviewed for demographic data, mechanism of fracture, type of fracture, tobacco use, Injury Severity Score (ISS), comorbidities, and medications given. During the 24-month period, 1,901 patients experienced LBF; 231 (12.1%) received NSAIDs; and 351 (18.4%) were smokers. The overall complication rate including nonunion/malunion and infection was 3.2% (60 patients). Logistic regression analysis with adjusted odds ratios were calculated on the risk of complications given NSAID use and/or smoking, and we found that a patient is significantly more likely to have a complication if he or she received an NSAID (odds ratio, 2.17; 95% confidence interval, 1.15-4.10; p < 0.016) in the inpatient postoperative setting. Likewise, smokers are significantly more likely to have complications (odds ratio, 3.19; 95% confidence interval, 1.84-5.53; p < 0.001). LBF patients who received NSAIDs in the postoperative period were twice as likely and smokers more than three times likely to suffer complications such as nonunion/malunion or infection. We recommend avoiding NSAID in traumatic LBF. Epidemiologic & therapeutic study; level II.

  11. Is zero central line-associated bloodstream infection rate sustainable? A 5-year perspective.

    Science.gov (United States)

    Erdei, Carmina; McAvoy, Linda L; Gupta, Munish; Pereira, Sunita; McGowan, Elisabeth C

    2015-06-01

    Adoption and implementation of evidence-based measures for catheter care leads to reductions in central line-associated bloodstream infection (CLABSI) rates in the NICU. The purpose of this study is to evaluate whether this rate reduction is sustainable for at least 1 year and to identify key determinants of this sustainability at the NICU of the Floating Hospital for Children at Tufts Medical Center. We reviewed the incidence of CLABSIs in the NICU temporally to the implementation of new practice policies and procedures, from July 2008 to December 2013. Adoption of standardized care practices, including bundles and checklists, was associated with a significant reduction of the CLABSI rate to zero for >370 consecutive days in our NICU in 2012. Overall, our CLABSI rates decreased from 4.1 per 1000 line days in 2009 (13 infections; 3163 line days) to 0.94 in 2013 (2 infections; 2115 line days), which represents a 77% reduction over a 5-year period. In the first quarter of 2013, there was a brief increase in CLABSI rate to 3.3 per 1000 line days; after a series of interventions, the CLABSI rate was maintained at zero for >600 days. Ongoing training, surveillance, and vigilance with catheter insertion and maintenance practices and improved documentation were identified as key drivers for success. High-quality training, strict compliance with evidence-based guidelines, and thorough documentation is associated with significant reductions in CLABSIs. Mindful organizing may lead to a better understanding of what goes into a unit's ability to handle peak demands and sustain extraordinary performance in the long-term. Copyright © 2015 by the American Academy of Pediatrics.

  12. Sporozoite Infection Rate and Identification of the Infective and Refractory Species of Anopheles gambiae (Giles Complex

    Directory of Open Access Journals (Sweden)

    Music Temitope OBEMBE

    2014-12-01

    Full Text Available The ability of Anopheles gambiae complex mosquitoes to transmit Plasmodium infection is known to be variable within sibling species of the complex with strains that cannot transmit the parasite. High sporozoite infection rate recorded showed that A. gambiae mosquitoes are potent malaria vectors in southwestern Nigeria. The aim of this study was to identify the infective and refractory strains of A. gambiae mosquitoes and to determine the sporozoite infection rate in this area. The infective strains were A. gambiae (sensu stricto and A. arabiensis, while the refractory strains were A. gambiae (sensu stricto. However, ovarian polytene chromosome banding patterns could not be used to distinguish between the infective and refractory strains of A. gambiae (sensu stricto. This study showed that the refractory strains of Anopheles gambiae complex are present, but in low frequencies, in southwestern Nigeria, and that the sibling species of Anopheles gambiae (A. gambiae s.s. and A. arabiensis are potent malaria vectors.

  13. Relationship between xerostomia and salivary flow rates in HIV-infected individuals.

    Science.gov (United States)

    Nittayananta, Wipawee; Chanowanna, Nilnara; Pruphetkaew, Nannapat; Nauntofte, Birgitte

    2013-08-01

    The aim of the present study was to determine the relationship between self-reported xerostomia and salivary flow rates among HIV-infected individuals. A cross-sectional study was performed on 173 individuals (81 HIV-infected individuals, mean age: 32 years, and 92 non-HIV controls, mean age: 30 years). Subjective complaints of dry mouth, based on a self-report of xerostomia questions, and dry mouth, based on a visual analogue scale (VAS), were recorded along with measurements of salivary flow rate of both unstimulated and wax-stimulated whole saliva. The relationship between subjective responses to the xerostomia questions, the VAS of dry mouth, and objective measurements of salivary flow rates were analyzed. Responses to the questions--Do you carry water or a saliva substitute? and Have you had taste disturbance?--were significantly different between HIV-infected and non-HIV individuals (P hyposalivation, especially at a resting stage. © 2013 Wiley Publishing Asia Pty Ltd.

  14. The Relationship of Nosocomial Infection Reduction to Changes in Neonatal Intensive Care Unit Rates of Bronchopulmonary Dysplasia.

    Science.gov (United States)

    Lapcharoensap, Wannasiri; Kan, Peiyi; Powers, Richard J; Shaw, Gary M; Stevenson, David K; Gould, Jeffrey B; Wirtschafter, David D; Lee, Henry C

    2017-01-01

    To examine whether recent reductions in rates of nosocomial infection have contributed to changes in rates of bronchopulmonary dysplasia (BPD) in a population-based cohort. This was a retrospective, population-based cohort study that used the California Perinatal Quality Care Collaborative database from 2006 to 2013. Eligible infants included those less than 30 weeks' gestational age and less than 1500 g who survived to 3 days of life. Primary variables of interest were rates of nosocomial infections and BPD. Adjusted rates of nosocomial infections and BPD from a baseline period (2006-2010) were compared with a later period (2011-2013). The correlation of changes in rates across periods for both variables was assessed by hospital of care. A total of 22 967 infants from 129 hospitals were included in the study. From the first to second time period, the incidence of nosocomial infections declined from 24.7% to 15% and BPD declined from 35% to 30%. Adjusted hospital rates of BPD and nosocomial infections were correlated positively with a calculated 8% reduction of BPD rates attributable to reductions in nosocomial infections. Successful interventions to reduce rates of nosocomial infections may have a positive impact on other comorbidities such as BPD. The prevention of nosocomial infections should be viewed as a significant component in avoiding long-term neonatal morbidities. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Isoniazid completion rates for latent tuberculosis infection among college students managed by a community pharmacist.

    Science.gov (United States)

    Hess, Karl; Goad, Jeffery; Wu, Joanne; Johnson, Kathleen

    2009-01-01

    The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacist-managed LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants were university students diagnosed with LTBI. The authors conducted a retrospective review of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken, characteristics of completers versus noncompleters, average time to treatment completion, and reported adverse drug events. The 9-month completion rate was 59%, and the 6-month completion rate was 67%. Among those not completing treatment, 15.2% experienced fatigue and 2.2% experienced a rash (p=.04 and p=.03, respectively). LTBI clinics are a unique niche for community pharmacies and can provide individualized patient care to ensure LTBI treatment adherence, monitoring for disease progression, and safety of INH.

  16. Effects of Cryptocaryon irritans infection on the survival, feeding, respiratory rate and ionic regulation of the marbled rockfish Sebastiscus marmoratus.

    Science.gov (United States)

    Yin, Fei; Gong, Qiyang; Li, Yanwei; Dan, Xueming; Sun, Peng; Gao, Quanxin; Shi, Zhaohong; Peng, Shiming; Li, Anxing

    2014-02-01

    To clarify the effects of a Cryptocaryon irritans infection on the physiological functions of the marbled rockfish Sebastiscus marmoratus, this study utilized C. irritans at concentrations of 2500; 5000; 7500; 10,000; 20,000; and 30,000 theronts/fish to infect marbled rockfish weighing 45 ± 3 g. The survival rate, food intake, respiratory rate, serum ion concentrations and gill Na+/K+-ATPase activity were determined. With the increase of the infection concentration and the passage of time, the survival rate of the rockfish gradually decreased. The groups infected with more than 5000 theronts/fish had stopped feeding within 4 days. The respiratory rates of the fish in the groups infected with 2500 and 5000 theronts/fish initially increased and then decreased. In contrast, the respiratory rate of the fish in the groups infected with more than 7500 theronts/fish was elevated to levels significantly higher than the control group after 12 h. The Na+/K+-ATPase activity and serum Na+ and Cl- concentrations increased with increasing infection concentration. In conclusion, the physiological functions of the fish infected with low concentrations of C. irritans can be effectively restored, whereas a high concentration infection induced severe stress. The declined food intake and accelerated respiratory rate could be useful for an early warning system as important indicators.

  17. Use of a Hospital-Wide Screening Program for Early Detection of Sepsis in General Surgery Patients.

    Science.gov (United States)

    MacQueen, Ian T; Dawes, Aaron J; Hadnott, Tracy; Strength, Kristen; Moran, Gregory J; Holschneider, Christine; Russell, Marcia M; Maggard-Gibbons, Melinda

    2015-10-01

    Sepsis remains a significant source of mortality among hospitalized patients. This study examines the usage of a vital sign-based screening protocol in identifying postoperative patients at risk for sepsis at an academic-affiliated medical center. We identified all general surgery inpatients undergoing abdominopelvic surgery from January to June 2014, and compared those with positive screening tests to a sample of screen-negative controls. Multivariate logistic regression was used to identify predictors of positive screening tests and progression to severe sepsis. In total, 478 patients underwent abdominopelvic operations, 59 had positive screening tests, 33 qualified for sepsis, and six progressed to severe sepsis. Predictors of a positive screening test were presence of cancer [odds ratio (OR) 30.7, 95% confidence interval (CI) 2.2-420], emergency operation (OR 6.5, 95% CI 1.7-24), longer operative time (OR 2.2/h, 95% CI 1.2-4.1), and presence of postoperative infection (OR 6.4, 95% CI 1.5-27). The screening protocol had sensitivity 100 per cent and specificity 88 per cent for severe sepsis. We identified no predictors of severe sepsis. In conclusion, vital sign-based screening provides value by drawing early attention to patients with potential to develop sepsis, but escalation of care for these patients should be based on clinical judgment.

  18. Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

    Directory of Open Access Journals (Sweden)

    Boris V Schmid

    Full Text Available BACKGROUND: A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future. METHODS AND FINDINGS: We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run. CONCLUSIONS: Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level

  19. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women.

    Science.gov (United States)

    Floridia, M; Tamburrini, E; Masuelli, G; Martinelli, P; Spinillo, A; Liuzzi, G; Vimercati, A; Alberico, S; Maccabruni, A; Pinnetti, C; Frisina, V; Dalzero, S; Ravizza, M

    2017-07-01

    The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple

  20. Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates.

    Science.gov (United States)

    Kovach, Christine R; Taneli, Yavuz; Neiman, Tammy; Dyer, Elaine M; Arzaga, Alvin Jason A; Kelber, Sheryl T

    2017-03-03

    The focus of nursing home infection control procedures has been on decreasing transmission between healthcare workers and residents. Less evidence is available regarding whether decontamination of high-touch environmental surfaces impacts infection rates or resident outcomes. The purpose of this study was to examine if ultraviolet disinfection is associated with changes in: 1) microbial counts and adenosine triphosphate counts on high-touch surfaces; and 2) facility wide nursing home acquired infection rates, and infection-related hospitalization. The study was conducted in one 160-bed long-term care facility. Following discharge of each resident, their room was cleaned and then disinfected using a newly acquired ultraviolet light disinfection device. Shared living spaces received weekly ultraviolet light disinfection. Thirty-six months of pretest infection and hospitalization data were compared with 12 months of posttest data. Pre and posttest cultures were taken from high-touch surfaces, and luminometer readings of adenosine triphosphate were done. Nursing home acquired infection rates were analyzed relative to hospital acquired infection rates using analysis of variance procedures. Wilcoxon signed rank tests, The Cochran's Q, and Chi Square were also used. There were statistically significant decreases in adenosine triphosphate readings on all high-touch surfaces after cleaning and disinfection. Culture results were positive for gram-positive cocci or rods on 33% (n = 30) of the 90 surfaces swabbed at baseline. After disinfectant cleaning, 6 of 90 samples (7.1%) tested positive for a gram-positive bacilli, and after ultraviolet disinfection 4 of the 90 samples (4.4%) were positive. There were significant decreases in nursing home acquired relative to hospital-acquired infection rates for the total infections (p = .004), urinary tract infection rates (p = .014), respiratory system infection rates (p = .017) and for rates of infection of the skin

  1. High prevalence of syphilis, HBV, and HCV co-infection, and low rate of effective vaccination against hepatitis B in HIV-infected patients in West China hospital.

    Science.gov (United States)

    Yang, Tingting; Chen, Qixia; Li, Dongdong; Wang, Tingting; Bin Wei, Yu Gou; Tao, Chuanmin

    2017-08-09

    To investigate the epidemiological features and risk factors of HBV, HCV, and syphilis infection among HIV-infected patients in West China Hospital. A retrospective study was conducted with HIV-infected patients from 2014 to 2016 in West China hospital, SCU. Serum makers for HBV, HCV, and syphilis were detected. Among 894 HIV-infected patients, the prevalence of HIV/HBV, HIV/HCV, HIV/syphilis co-infections was 14.4%, 5.7%, and 18.9% respectively. HIV/HBV/HCV, HIV/HCV/syphilis, and HIV/HBV/syphilis triple co-infection was 7 (0.7%), 12(1.3%), 29(3.2%) respectively. The rate of effective vaccination against HBV was only 7.7% in HIV-infected patients. Age (OR = 0.243 95% CI: 0.114 -0.518), ethnicity (OR = 3.654 95% CI: 1.849-7.218) and education level (OR = 0.140 95% CI: 0.033-0.606) are risk factors affecting HIV/HCV co-infection. A high prevalence of HIV/syphilis, HIV/HBV, and HIV/ HCV co-infection can be observed in west China. The rate for HIV-infected patients who were effectively vaccinated against HBV was fewer than 10%. © 2017 Wiley Periodicals, Inc.

  2. Prophylaxis with teicoplanin and cefuroxime reduces the rate of prosthetic joint infection after primary arthroplasty.

    Science.gov (United States)

    Tornero, Eduard; García-Ramiro, Sebastian; Martínez-Pastor, Juan C; Bori, Guillem; Bosch, Jordi; Morata, Laura; Sala, Marta; Basora, Misericordia; Mensa, Josep; Soriano, Alex

    2015-02-01

    The aim of this study was to compare the prosthetic joint infection (PJI) rate after total joint arthroplasty in two consecutive periods of treatment with different antibiotic prophylaxes: cefuroxime versus cefuroxime plus teicoplanin. We retrospectively reviewed 1,896 patients who underwent total hip arthroplasty or total knee arthroplasty between March 2010 and February 2013. From March 2010 to August 2011, patients received 1.5 g of cefuroxime during induction of anesthesia and another 1.5 g 2 h later (the C group). From September 2011, 800 mg of teicoplanin was added to cefuroxime (the CT group). Throughout the period studied, there were no variations in pre- or postoperative protocols. Univariate and multivariate analyses were performed to evaluate independent predictors of PJI. There were 995 (55.7%) patients in the C group and 791 (44.3%) in the CT group. Patients in the CT group had a significantly lower PJI rate than patients in the C group (1.26% versus 3.51%, P=0.002). There were no infections due to Staphylococcus aureus in the CT group (0% versus 1.6% in the C group, Pteicoplanin was associated with a lower risk of infection (HR, 0.35; 95% CI, 0.17 to 0.74). In conclusion, the addition of teicoplanin to cefuroxime during primary arthroplasty was associated with a significant reduction in the global PJI rate due to a reduction of infections caused by Gram-positive bacteria. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Molecular detection, infection rate and vectors of Theileria lestoquardi in goats from West Azerbaijan province, Iran.

    Science.gov (United States)

    Mohammadi, Seyyed Mostafa; Esmaeilnejad, Bijan; Jalilzadeh-Amin, Ghader

    2017-01-01

    This study was aimed to determine the infection rate and vectors of Theileria lestoquardi in goats from West Azerbaijan province, Iran. A total of 400 blood samples were collected from 40 randomly selected flocks in the study area from June to September, 2014. Out of 400 blood samples examined using microscopic examination, a number of 14 goats (3.50%) were positive for Theileria spp., whereas 25 goats (6.25%) yielded a specific T. lestoquardi SSU-rRNA fragment (235 bp). The prevalence of theileriosis in goats estimated by semi-nested PCR was significantly higher than the prevalence estimated by microscopic examination of the blood smears. The prevalence of Theileria infection in different age and sex groups of goats was not significantly different. The highest and lowest prevalence of Theileria infection was in July (12.00%) and September (2.00%), respectively. A number of 315 adult Ixodid ticks were also collected from naturally infested goats and they were characterized. Out of 315 examined ticks, a number of 37 ticks including Hyalomma marginatum (65.20%), Rhipicephalus turanicus (44.00%), and Dermacentor marginatus (68.70%) were infected by T. lestoquardi. Based on the obtained results, it was concluded that the semi-nested PCR assay based on SSU-rRNA gene is a valuable method for epidemiological investigation of caprine theileriosis. The results showed that H. marginatum, R. turanicus and D. marginatus can be considered as risk factor in the epidemiology of T. lestoquardi.

  4. The genotoxin colibactin exacerbates lymphopenia and decreases survival rate in mice infected with septicemic Escherichia coli.

    Science.gov (United States)

    Marcq, Ingrid; Martin, Patricia; Payros, Delphine; Cuevas-Ramos, Gabriel; Boury, Michèle; Watrin, Claude; Nougayrède, Jean-Philippe; Olier, Maïwenn; Oswald, Eric

    2014-07-15

    Sepsis is a life-threatening infection. Escherichia coli is the first known cause of bacteremia leading to sepsis. Lymphopenia was shown to predict bacteremia better than conventional markers of infection. The pks genomic island, which is harbored by extraintestinal pathogenic E. coli (ExPEC) and encodes the genotoxin colibactin, is epidemiologically associated with bacteremia. To investigate a possible relationship between colibactin and lymphopenia, we examined the effects of transient infection of lymphocytes with bacteria that were and those that were not producing the genotoxin. A mouse model of sepsis was used to compare the virulence of a clinical ExPEC isolate with its isogenic mutant impaired for the production of colibactin. We observed that colibactin induced double-strand breaks in the DNA of infected lymphocytes, leading to cell cycle arrest and to cell death by apoptosis. E. coli producing colibactin induced a more profound lymphopenia in septicemic mice, compared with the isogenic mutant unable to produce colibactin. In a sepsis model in which the mice were treated by rehydration and antibiotics, the production of colibactin by the bacteria was associated with a significantly lower survival rate. In conclusion, we demonstrate that production of colibactin by E. coli exacerbates lymphopenia associated with septicemia and could impair the chances to survive sepsis. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. Condom deserts: geographical disparities in condom availability and their relationship with rates of sexually transmitted infections.

    Science.gov (United States)

    Shacham, Enbal; Nelson, Erik J; Schulte, Lauren; Bloomfield, Mark; Murphy, Ryan

    2016-05-01

    Identifying predictors that contribute to geographical disparities in sexually transmitted infections (STIs) is necessary. This study assesses the spatial relationship between condom availability to locations of STIs in order to better understand these geographical disparities. We conducted a condom availability audit among potential condom-selling establishments. New gonorrhoea and chlamydia cases in 2011 (n=6034) and HIV infection cases from 2006 to 2011 (n=565) were collected by census tract in St Louis, Missouri. 829 potential condom-selling establishments participated in the condom availability audit in St Louis City; 242 of which sold condoms. A negative linear relationship exists between condom vendors and cases of gonorrhoea and chlamydia, after adjusting for concentrated disadvantage and free condom locations. Higher concentrated disadvantage, higher proportions of convenience vendors and free locations were associated with higher rates of HIV. This study was conducted to provide evidence that lack of condom availability is associated with STI rates, and likely is an integral component to influencing the subjective norms surrounding condom use and STI rates. Condom distribution interventions may be addressing availability needs and social norms, yet are more likely to be effective when placed in locations with the highest STI rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. The effect of pharmacy restriction of clindamycin on Clostridium difficile infection rates in an orthopedics ward.

    Science.gov (United States)

    Cruz-Rodríguez, Nora Cecilia; Hernández-García, Raúl; Salinas-Caballero, Ana Gabriela; Pérez-Rodríguez, Edelmiro; Garza-González, Elvira; Camacho-Ortiz, Adrián

    2014-06-01

    A high consumption of clindamycin was noted in an orthopedics ward with high rates of Clostridium difficile infection (CDI). We restricted clindamycin for the entire ward. A reduction of 88% in CDI (1.07 to 0.12 × 1,000 patients-days, P = .056) and 84% for all-cause diarrhea (2.40 to 0.38 × 1,000 patients-days, P = .021) was achieved. Clindamycin was reduced 92.61% without an increase in other antibiotics. We identified high consumption of clindamycin as a risk factor for CDI. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Postoperative Infection Rates in Patients with a Negative Baseline Urine Culture Undergoing Ureteroscopic Stone Removal

    DEFF Research Database (Denmark)

    Martov, Alexey; Gravas, Stavros; Etemadian, Masoud

    2015-01-01

    placement. Patient characteristics, operative data, and postoperative outcomes, including the development of urinary tract infection (UTI) and fever, in the two groups were compared. Results: Antibiotic prophylaxis use differed widely across participating countries (13%-100%). Differences were found between......Abstract Purpose: To examine the effects of antibiotic prophylaxis on postoperative infection rate in patients with negative urine cultures undergoing ureteroscopy (URS). Patients and Methods: Using the Clinical Research Office of the Endourological Society (CROES) URS Global Study database...... patients who did or did not receive antibiotic prophylaxis regarding the frequency of anticoagulation medication, previous treatment with URS, stone burden, previous presence of kidney stones, duration of current URS, and complications post-URS. The prevalence of fever and UTI was low (≤2.2%) and similar...

  8. The Impact of Health Education Counseling on Rate of Recurrent Sexually Transmitted Infections in Adolescents.

    Science.gov (United States)

    In-Iw, Supinya; Braverman, Paula K; Bates, Justin R; Biro, Frank M

    2015-12-01

    To evaluate the effectiveness of a sexually transmitted infection (STI) intervention by a health educator that included partner notification, condom use, and retesting within 3 months. Retrospective chart review was conducted, and data were collected from 274 sexually active adolescent girls, aged 15 to 19 years, who were diagnosed with gonorrhea (GC), Chlamydia (CT), and Trichomonas (TV) infection, during a 9-month span in an urban hospital-based adolescent medicine clinic. Data regarding recurrent STIs (GC, CT, and TV) were collected for 12 months following the incident infection. There were 161 in the intervention group (health educator counseling), and 113 controls who received usual care. Differences between groups were analyzed using χ(2) and survival analyses. There were no significant differences in age, gender, or race between the intervention and control groups at baseline. The majority in both groups were diagnosed initially with CT infection (57% CT, 16% GC, and 5% TV in the intervention group; 46% CT, 21% GC, and 12% TV in the control group). There was a significantly lower rate of STI in the intervention group for those retested within 12 months of the initial diagnosis (P = .002). The median (SD) time to recurrence in the intervention group was greater: 134 (14.7) days versus 116 (12.1) days (P = .034). Health education counseling, initial diagnosis with TV, and duration of time from initial diagnosis to retest (interval to retest) were significant protective factors for recurrent STI. Health education counseling in an urban adolescent clinic is effective in reducing recurrent infection at 12-month follow-up and can serve as an important component in reducing STI recidivism. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  9. [Healthcare-associated infection rates: measuring and comparing. Experiences from the German National Nosocomial Infection Surveillance System (KISS) and from other surveillance systems].

    Science.gov (United States)

    Gastmeier, P; Behnke, M; Breier, A-C; Piening, B; Schwab, F; Dettenkofer, M; Geffers, C

    2012-11-01

    Surveillance of nosocomial infections is meanwhile a cornerstone of infection prevention activities in hospitals. The objective of this article is to compare healthcare-associated infection rates in intensive care patients, neonatal intensive care patients and operated patients (ICU-KISS, OP-KISS, NEO-KISS) of the German nosocomial infection surveillance system (KISS) with the corresponding data of the US American National Healthcare Safety Network (NHSN) and the European Centre for Disease Prevention and Control (ECDC). In general, the methodological differences among the three surveillance systems are minor but there are some exceptions. Therefore, differences between countries have to be interpreted very carefully as they may be due to differences in diagnostics, patient mix, types of interventions, length of stay, selection of participating hospitals, post-discharge surveillance activities and interpretation of case definitions. Organizational aspects, such as mandatory participation with public disclosure on infection rates may also have an impact.

  10. Rising HIV infection rates in Ho Chi Minh City herald emerging AIDS epidemic in Vietnam.

    Science.gov (United States)

    Lindan, C P; Lieu, T X; Giang, L T; Lap, V D; Thuc, N V; Thinh, T; Lurie, P; Mandel, J S

    1997-09-01

    To describe the epidemiology of HIV in Ho Chi Minh City in the context of current surveillance data from Vietnam. Since the late 1980s, HIV surveillance data have been collected in Ho Chi Minh City from centers for the treatment of venereal disease and tuberculosis, centers for the rehabilitation of injecting drug users and sex workers, prenatal clinics, blood banks and other sites. The first case of HIV infection in Vietnam was identified in 1990 in Ho Chi Minh City. The cumulative number of reported HIV infections in this city at the end of 1996 was 2774, about half of the number of cases in the country; 86% of infections were among men, 86% among injecting drug users, 2.5% among patients with sexually transmitted diseases and 2.5% among sex workers. The first HIV infection among antenatal women was detected in 1994. The prevalence of HIV among injecting drug users rose dramatically from 1% in 1992 to 39% in 1996, compared with 1.2% among sex workers, 0.3% among blood donors and 1.3% among tuberculosis patients in 1996. The populations of injecting drug users and sex workers in Ho Chi Minh City are estimated to be 30000 and 80000, respectively, and rates of sexually transmitted diseases are 2-3 per 1000 persons per year. By the end of December 1996, 42 out of 53 provinces had reported HIV infections, and border areas near China and Cambodia began identifying large numbers of HIV-seropositive people. Ho Chi Minh City is at the forefront of a new HIV epidemic in Vietnam. This epidemic shows similarities to that in Thailand nearly a decade ago, with rapidly rising HIV rates among injecting drug users and infection already established among sex workers. Prevention efforts should include the targeting of injecting drug users and sex workers outside rehabilitation centers, the availability of sterile needles and condoms, the establishment of anonymous testing sites, the control of sexually transmitted diseases and the coordination of programs within southeast Asia.

  11. A population-based study examining hepatitis B virus infection and immunization rates in Northwest China.

    Directory of Open Access Journals (Sweden)

    Zhaohua Ji

    Full Text Available BACKGROUND AND AIM: Current baseline data regarding the prevalence of hepatitis B virus (HBV infections and the immune status in hyperendemic areas is necessary in evaluating the effectiveness of ongoing HBV prevention and control programs in northwest China. This study aims to determine the prevalence of chronic HBV infections, past exposure rates, and immune response profiles in Wuwei City, northwest China in 2010. METHODS: Cross-sectional household survey representative of the Wuwei City population. 28,579 participants were interviewed in the seroepidemiological survey ≥1 year of age. House to house screening was conducted using a standard questionnaire. All serum samples were screened by enzyme-linked immunoassays for the presence of hepatitis B surface antigen, antibodies against HBV surface antigen, and antibodies to the hepatitis B core antigen. RESULTS: Among individuals ≥1 year of age, 7.2% (95%CI: 6.3-8.1% had chronic HBV infections, 43.9% (CI: 40.4-47.4% had been exposed to HBV, and 23.49% (CI: 21.6-25.3% had vaccine-induced immunity. Multi-factor weighted logistic regression analysis showed that having household contact with HBV carriers (OR = 2.6, 95%CI: 2.3-3.0 and beauty treatments in public places (OR = 1.2, 95%CI: 1.1-1.3 were the risk factors of HBV infection in whole population. Having household contact with HBV carriers (OR = 3.8, 95% CI: 2.2-6.5 and lack of hepatitis vaccination (OR = 2.0, 95% CI: 1.4-3.3 were the risk factors for HBV infection in children aged 1-14 years. CONCLUSIONS: Hepatitis B infection remains a serious public health problem in northwest China. Having household contact with HBV carriers and beauty treatments in public places represented HBV infection risk factors. Hepatitis B vaccine immunization strategies need further improvement, particularly by targeting the immunization of rural migrant workers.

  12. Reduction in Rate of Nosocomial Respiratory Virus Infections in a Children's Hospital Associated With Enhanced Isolation Precautions.

    Science.gov (United States)

    Rubin, Lorry G; Kohn, Nina; Nullet, Susan; Hill, Margaret

    2018-02-01

    OBJECTIVE To determine whether the use of enhanced isolation precautions (droplet and contact precautions) for inpatients with respiratory tract viral infections is associated with a reduction in rate of nosocomial viral respiratory infections. DESIGN Quasi-experimental study with the rate of nosocomial respiratory virus infection as the primary dependent variable and rate of nosocomial Clostridium difficile infection as a nonequivalent dependent variable comparator. SETTING Cohen Children's Medical Center of NY, a tertiary-care children's hospital attached to a large general hospital. INTERVENTION During years 1 and 2 (July 2012 through June 2014), the Centers for Disease Control and Prevention/Healthcare Infection Control Practices Advisory Committee's recommended isolation precautions for inpatients with selected respiratory virus infections were in effect. Enhanced isolation precautions were in effect during years 3 and 4 (July, 2014 through June, 2016), except for influenza, for which enhanced precautions were in effect during year 4 only. RESULTS During the period of enhanced isolation precautions, the rate of nosocomial respiratory virus infections with any of 4 virus categories decreased 39% from 0.827 per 1,000 hospital days prior to enhanced precautions to 0.508 per 1,000 hospital days (Pinfections, the rates decreased 58% from 0.317 per 1,000 hospital days to 0.134 per 1,000 hospital days during enhanced precautions (Pnosocomial C. difficile infection. CONCLUSIONS Enhanced isolation precautions for inpatients with respiratory virus infections were associated with a reduction in the rate of nosocomial respiratory virus infections. Infect Control Hosp Epidemiol 2018;39:152-156.

  13. [Post-appendectomy surgical site infection: overall rate and type according to open/laparoscopic approach].

    Science.gov (United States)

    Aranda-Narváez, José Manuel; Prieto-Puga Arjona, Tatiana; García-Albiach, Beatriz; Montiel-Casado, María Custodia; González-Sánchez, Antonio Jesús; Sánchez-Pérez, Belinda; Titos-García, Alberto; Santoyo-Santoyo, Julio

    2014-02-01

    To compare the incidence and profile of surgical site infection (SSI) after laparoscopic (LA) or open (OA) appendicectomy. Observational and analytical study was conducted on patients older than 14years-old with suspected acute appendicitis operated on within a 4-year period (2007-2010) at a third level hospital (n=868). They were divided in two groups according to the type of appendicectomy (LA, study group, 135; OA, control group, 733). The primary endpoint was a surgical site infection (SSI), and to determine the overall rate and types (incisional/organ-space). The risk of SSI was stratified by: i)National Nosocomial Infection Surveillance (NNIS) index (low risk: 0E, 0 and 1; high risk: 2 and 3); ii)status on presentation (low risk: normal or phlegmonous; high risk: gangrenous or perforated). The statistical analysis was performed using the software SPSS. The main result and stratified analysis was determined with χ(2), and the risk parameters using OR and Mantel-Haenszel OR with 95%CI, accepting statistical significance with P<.05. Age, gender, ASA index and incidence of advanced cases were similar in both groups. The overall SSI rate was 13.4% (more than a half of them detected during follow-up after discharge). Type of SSI: OA, 13% (superficial 9%, deep 2%, organ-space 2%); AL, 14% (superficial 5%, deep 1%, organ-space 8%) (overall: not significant; distribution: P<.000). Stratified analysis showed that there is an association between incisional SSI/OA and organ-space SSI/LA, and is particularly stronger in those patients with high risk of postoperative SSI (high risk NNIS or gangrenous-perforated presentation). OA and LA are associated with a higher rate of incisional and organ-space SSI respectively. This is particularly evident in patients with high risk of SSI. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  14. Molecular detection, infection rate and vectors of Theileria lestoquardi in goats from West Azerbaijan province, Iran

    OpenAIRE

    Mohammadi, Seyyed Mostafa; ESMAEILNEJAD, Bijan; Jalilzadeh-Amin, Ghader

    2017-01-01

    This study was aimed to determine the infection rate and vectors of Theileria lestoquardi in goats from West Azerbaijan province, Iran. A total of 400 blood samples were collected from 40 randomly selected flocks in the study area from June to September, 2014. Out of 400 blood samples examined using microscopic examination, a number of 14 goats (3.50%) were positive for Theileria spp., whereas 25 goats (6.25%) yielded a specific T. lestoquardi SSU-rRNA fragment (235 bp). The prevalence of the...

  15. Malaria signs and infection rate among asymptomatic schoolchildren in Hajr Valley, Yemen.

    Science.gov (United States)

    Bin Mohanna, M A; Bin Ghouth, A S; Rajaa, Y A

    2007-01-01

    This study recorded malaria signs and the rate of parasitaemia among asymptomatic schoolchildren in Hajr valley, Hadhramout governorate, Yemen. Tests were made for malaria parasites and anaemia in 469 randomly selected primary-school children aged 6-11 years, together with clinical examination to determine spleen size, and interviews to study sociodemographic factors. Of the children, 12.8% had positive malaria blood films and 11.3% had spleen enlargement. There were significant associations between malaria infection, anaemia and splenomegaly and fever. Children with malaria parasitaemia were more often absent from school.

  16. The Mortality Rate of Nosocomial Infection in Neonatal Intensive Care Unit (NICU) of Taleghani Educational and Treatment Center, Tabriz, 2013

    OpenAIRE

    Parvin Abbasian; Mariye Mahmoodi Yegane; Mina karimi; Faezeh Ahmadi; khadijeh Pazani; Zohreh Tahmasbi

    2015-01-01

    Background and Objectives : Information about nosocomial infections (NIs) is necessary for both appropriate management and establishment of preventative measures in hospitals. Neonates admitted to the Neonatal Intensive Care Unit (NICU) are at high-risk of developing nosocomial infection. The aim of this study was to determine the mortality rate of nosocomial infections and the distribution of pathogens among newborns who were admitted to the neonatal intensive care unit in Taleghani educatio...

  17. Sensitivity of Erythrocyte Sedimentation Rate and C-reactive Protein in Childhood Bone and Joint Infections

    Science.gov (United States)

    Kallio, Markku J. T.; Kallio, Pentti E.; Peltola, Heikki

    2009-01-01

    In addition to the examination of clinical signs, several laboratory markers have been measured for diagnostics and monitoring of pediatric septic bone and joint infections. Traditionally erythrocyte sedimentation rate (ESR) and leukocyte cell count have been used, whereas C-reactive protein (CRP) has gained in popularity. We monitored 265 children at ages 3 months to 15 years with culture-positive osteoarticular infections with a predetermined series of ESR, CRP, and leukocyte count measurements. On admission, ESR exceeded 20 mm/hour in 94% and CRP exceeded 20 mg/L in 95% of the cases, the mean (± standard error of the mean) being 51 ± 2 mm/hour and 87 ± 4 mg/L, respectively. ESR normalized in 24 days and CRP in 10 days. Elevated CRP gave a slightly better sensitivity in diagnostics than ESR, but best sensitivity was gained with the combined use of ESR and CRP (98%). Elevated ESR or CRP was seen in all cases during the first 3 days. Measuring ESR and CRP on admission can help the clinician rule out an acute osteoarticular infection. CRP normalizes faster than ESR, providing a clear advantage in monitoring recovery. Level of Evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:19533263

  18. Influenza infection rates, measurement errors and the interpretation of paired serology.

    Directory of Open Access Journals (Sweden)

    Simon Cauchemez

    Full Text Available Serological studies are the gold standard method to estimate influenza infection attack rates (ARs in human populations. In a common protocol, blood samples are collected before and after the epidemic in a cohort of individuals; and a rise in haemagglutination-inhibition (HI antibody titers during the epidemic is considered as a marker of infection. Because of inherent measurement errors, a 2-fold rise is usually considered as insufficient evidence for infection and seroconversion is therefore typically defined as a 4-fold rise or more. Here, we revisit this widely accepted 70-year old criterion. We develop a Markov chain Monte Carlo data augmentation model to quantify measurement errors and reconstruct the distribution of latent true serological status in a Vietnamese 3-year serological cohort, in which replicate measurements were available. We estimate that the 1-sided probability of a 2-fold error is 9.3% (95% Credible Interval, CI: 3.3%, 17.6% when antibody titer is below 10 but is 20.2% (95% CI: 15.9%, 24.0% otherwise. After correction for measurement errors, we find that the proportion of individuals with 2-fold rises in antibody titers was too large to be explained by measurement errors alone. Estimates of ARs vary greatly depending on whether those individuals are included in the definition of the infected population. A simulation study shows that our method is unbiased. The 4-fold rise case definition is relevant when aiming at a specific diagnostic for individual cases, but the justification is less obvious when the objective is to estimate ARs. In particular, it may lead to large underestimates of ARs. Determining which biological phenomenon contributes most to 2-fold rises in antibody titers is essential to assess bias with the traditional case definition and offer improved estimates of influenza ARs.

  19. Diseases and causes of death in European bats: dynamics in disease susceptibility and infection rates.

    Directory of Open Access Journals (Sweden)

    Kristin Mühldorfer

    Full Text Available BACKGROUND: Bats receive increasing attention in infectious disease studies, because of their well recognized status as reservoir species for various infectious agents. This is even more important, as bats with their capability of long distance dispersal and complex social structures are unique in the way microbes could be spread by these mammalian species. Nevertheless, infection studies in bats are predominantly limited to the identification of specific pathogens presenting a potential health threat to humans. But the impact of infectious agents on the individual host and their importance on bat mortality is largely unknown and has been neglected in most studies published to date. METHODOLOGY/PRINCIPAL FINDINGS: Between 2002 and 2009, 486 deceased bats of 19 European species (family Vespertilionidae were collected in different geographic regions in Germany. Most animals represented individual cases that have been incidentally found close to roosting sites or near human habitation in urban and urban-like environments. The bat carcasses were subjected to a post-mortem examination and investigated histo-pathologically, bacteriologically and virologically. Trauma and disease represented the most important causes of death in these bats. Comparative analysis of pathological findings and microbiological results show that microbial agents indeed have an impact on bats succumbing to infectious diseases, with fatal bacterial, viral and parasitic infections found in at least 12% of the bats investigated. CONCLUSIONS/SIGNIFICANCE: Our data demonstrate the importance of diseases and infectious agents as cause of death in European bat species. The clear seasonal and individual variations in disease prevalence and infection rates indicate that maternity colonies are more susceptible to infectious agents, underlining the possible important role of host physiology, immunity and roosting behavior as risk factors for infection of bats.

  20. The impact of lifestyle risk factors on the rate of infection after surgery for a fracture of the ankle

    DEFF Research Database (Denmark)

    Olsen, L L; Møller, A M; Brorson, S

    2017-01-01

    .PATIENTS AND METHODS: We retrospectively reviewed all patients who underwent internal fixation of a fracture of the ankle between 2008 and 2013. The primary outcome was the rate of deep infection and the secondary outcome was any surgical site infection (SSI). Associations with the risk factors and possible...

  1. Middle-aged to elderly women have a higher asymptomatic infection rate with Mycobacterium avium complex, regardless of body habitus.

    Science.gov (United States)

    Nishimura, Tomoyasu; Fujita-Suzuki, Yukiko; Mori, Masaaki; Carpenter, Stephen M; Fujiwara, Hiroshi; Uwamino, Yoshifumi; Tamizu, Eiko; Yano, Ikuya; Kawabe, Hiroshi; Hasegawa, Naoki

    2016-04-01

    Mycobacterium avium complex (MAC) pulmonary disease is prevalent in middle-aged to elderly women with a thin body habitus. By comparing the rate of serologically diagnosed asymptomatic MAC infection and body mass index among 1033 healthy subjects, we find that middle-aged to elderly women became infected with MAC, regardless of their body habitus. © 2015 Asian Pacific Society of Respirology.

  2. Trends in the incidence rate of device-associated infections in intensive care units after the establishment of the Korean Nosocomial Infections Surveillance System.

    Science.gov (United States)

    Choi, J Y; Kwak, Y G; Yoo, H; Lee, S-O; Kim, H B; Han, S H; Choi, H J; Kim, Y K; Kim, S R; Kim, T H; Lee, H; Chun, H K; Kim, J-S; Eun, B W; Kim, D W; Koo, H-S; Bae, G-R; Lee, K

    2015-09-01

    The effectiveness of continuous nationwide surveillance on healthcare-associated infections should be investigated in each country. To assess the rate of device-associated infections (DAIs) in intensive care units (ICUs) since the establishment of the Korean Nosocomial Infections Surveillance System (KONIS). Nationwide data were obtained on the incidence rate of DAI in ICUs reported to KONIS by all participating hospitals. The three major DAIs were studied: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CABSI), and catheter-associated urinary tract infection (CAUTI). The pooled and year-wise incidence rates (cases per 1000 device-days) of these DAIs were determined for the period 2006 and 2012. In addition, data from institutions that had participated in KONIS for at least three consecutive years were analysed separately. The number of ICUs participating in KONIS gradually increased from 76 in 2006 to 162 in 2012. Between 2006 and 2012, the incidence rate per 1000 device-days for VAP decreased significantly from 3.48 to 1.64 (F = 11, P Infection Society. Published by Elsevier Ltd. All rights reserved.

  3. Postoperative prophylactic antibiotics and surgical site infection rates in breast surgery patients.

    Science.gov (United States)

    Throckmorton, Alyssa D; Boughey, Judy C; Boostrom, Sarah Y; Holifield, Andrea C; Stobbs, Melissa M; Hoskin, Tanya; Baddour, Larry M; Degnim, Amy C

    2009-09-01

    A single preoperative prophylactic dose of an intravenous antibiotic with antistaphylococcal activity is standard of care for breast and axillary surgical procedures. Some surgeons also prescribe postoperative prophylaxis for all patients with drains to prevent infection despite its lack of proven efficacy. A retrospective chart review of patients with breast and/or axillary surgical procedures between July 2004 and June 2006 were included. Data were collected on patient demographics, procedure types, and use of prophylactic antibiotics. Surgical site infection (SSI) was defined by means of Centers for Disease Control and Prevention criteria, including patients meeting the physician diagnosis criterion if an antibiotic was prescribed for a clinical diagnosis of cellulitis. chi(2) and Fisher's exact tests were used to compare SSI rates. Three hundred fifty-three patients with 436 surgical sites who received either preoperative or both pre- and postoperative antibiotic were analyzed. Overall, the SSI rate was 7.8% (34 of 436 surgical sites). Eighty-five patients (24%) with 127 surgical sites were provided both preoperative and postoperative prophylactic antibiotics. The SSI rates did not differ statistically (P = .67) for the groups that did (95% confidence interval, 4.8-15.0; 11 of 127 surgical sites, 8.7%) and did not receive postoperative antibiotic prophylaxis (95% confidence interval, 5.0-11.0; 23 of 309, 7.4%). Although the overall number of patients who developed SSI was relatively small, there was no reduction in the SSI rate among those who received postoperative antibiotic prophylaxis. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

  4. Increasing rates in Clostridium difficile infection (CDI) among hospitalised patients, Spain 1999-2007.

    Science.gov (United States)

    Asensio, A; Vaque-Rafart, J; Calbo-Torrecillas, F; Gestal-Otero, J J; López-Fernández, F; Trilla-Garcia, A; Canton, R

    2008-07-31

    Limited information is available on the burden and epidemiology of Clostridium difficile infection (CDI) in Spain. The present report communicates the secular trends in prevalence of CDI among hospitalised patients in Spain from 1999 through 2007. Data were obtained through the EPINE study (Estudio de prevalencia de las infecciones nosocomiales en los hospitales españoles), a point prevalence study series of nosocomial infections among patients admitted to hospital in Spain. A total of 378 cases with CDI were identified. Median age was 74 years. Prevalence rates of CDI increased from 3.9 to 12.2 cases per 10,000 hospitalised patients and showed a significantly increasing secular trend from 1999 through 2007 (prevalence rate ratio per each year increment 1.09; 95% CI 1.05 - 1.14). Percentage of hospitalised patients receiving antimicrobials increased linearly from 36.0% in 1999 to 40.7% in 2007 (p <0.001) and was strongly correlated to CDI prevalence (R square = 0.73; regression coefficient =1.194, 95% CI= 1.192 - 1.196).

  5. Low infection rate after tumor hip arthroplasty for metastatic bone disease in a cohort treated with extended antibiotic prophylaxis

    DEFF Research Database (Denmark)

    Hettwer, Werner H; Horstmann, Peter Frederik; Hovgaard, Thea Bechmann

    2015-01-01

    Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI), with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic...

  6. Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004-2013: Findings of the International Nosocomial Infection Control Consortium.

    Science.gov (United States)

    Mehta, Yatin; Jaggi, Namita; Rosenthal, Victor Daniel; Kavathekar, Maithili; Sakle, Asmita; Munshi, Nita; Chakravarthy, Murali; Todi, Subhash Kumar; Saini, Narinder; Rodrigues, Camilla; Varma, Karthikeya; Dubey, Rekha; Kazi, Mohammad Mukhit; Udwadia, F E; Myatra, Sheila Nainan; Shah, Sweta; Dwivedy, Arpita; Karlekar, Anil; Singh, Sanjeev; Sen, Nagamani; Limaye-Joshi, Kashmira; Ramachandran, Bala; Sahu, Suneeta; Pandya, Nirav; Mathur, Purva; Sahu, Samir; Singh, Suman P; Bilolikar, Anil Kumar; Kumar, Siva; Mehta, Preeti; Padbidri, Vikram; Gita, N; Patnaik, Saroj K; Francis, Thara; Warrier, Anup R; Muralidharan, S; Nair, Pravin Kumar; Subhedar, Vaibhavi R; Gopinath, Ramachadran; Azim, Afzal; Sood, Sanjeev

    2016-02-01

    To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004-2013. Surveillance using US National Healthcare Safety Network's criteria and definitions, and International Nosocomial Infection Control Consortium methodology. We collected data from 236,700 ICU patients for 970,713 bed-days Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line-associated bloodstream infections (CLABSIs)/1,000 central line-days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator-days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter-days In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line-days and 1.9 VAPs/1,000 mechanical ventilator-days Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs. Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.

  7. Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium’s findings

    Science.gov (United States)

    Salgado Yepez, Estuardo; Bovera, Maria M; Rosenthal, Victor D; González Flores, Hugo A; Pazmiño, Leonardo; Valencia, Francisco; Alquinga, Nelly; Ramirez, Vanessa; Jara, Edgar; Lascano, Miguel; Delgado, Veronica; Cevallos, Cristian; Santacruz, Gasdali; Pelaéz, Cristian; Zaruma, Celso; Barahona Pinto, Diego

    2017-01-01

    AIM To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador. METHODS A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection (CLABSI) rate was 6.5 per 1000 central line (CL)-days, the ventilator-associated pneumonia (VAP) rate was 44.3 per 1000 mechanical ventilator (MV)-days, and the catheter-associated urinary tract infection (CAUTI) rate was 5.7 per 1000 urinary catheter (UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9 (CLABSI) and 5.3 (CAUTI)] and higher than NHSN rates [0.8 (CLABSI) and 1.3 (CAUTI)] - although device use ratios for CL and UC were higher than INICC and CDC/NSHN’s ratios. By contrast, despite the VAP rate was higher than INICC (16.5) and NHSN’s rates (1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates. PMID:28289522

  8. Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection

    Directory of Open Access Journals (Sweden)

    Hajishafiha M

    2011-10-01

    Full Text Available Masomeh Hajishafiha1, Mohammad Ghasemi-rad1, Aishe Memari1, Siamak Naji1, Nikol Mladkova2, Vida Saeedi1 1Urmia University of Medical Sciences, Urmia, Iran; 2Institute of Cell and Molecular Science, London, UK Background: There is a need to elucidate what affects the implantation and early pregnancy course in pregnancies conceived with assisted reproductive technology (ART so that pregnancy rates and outcomes can be improved. Our aim was to determine the role of maternal Helicobacter pylori infection. Material and methods: We did a prospective study of 187 infertile couples undergoing intracytoplasmic sperm injection (ICSI and segregated those according to underlying infertility etiology. We assessed the status of H. pylori IgG antibodies and anti-CagA IgG antibodies by ELISA assay. All pregnancies were followed for early pregnancy loss (EPL, first 12 weeks. Results: The likelihood of H. pylori infection increased with age (1.01, 95% confidence interval [CI]: 1.0–1.13; P = 0.040 but there was no association with EPL. Women infected with CagA-positive strains were more likely to have EPL (19.39, 95% CI: 1.8–208.4; P = 0.014. Women with tubal factor or ovulatory disorder infertility were more likely to abort early (12.95, 95% CI: 1.28–131.11; P = 0.030, 10.84, 95% CI: 1.47–80.03; P = 0.020, respectively. There was no association between EPL and age, number of embryos formed or transferred, or number of oocytes retrieved. Conclusion: Our findings suggest that infection with CagA-positive H. pylori strains is linked to an increase in women's potential to abort early (possibly through increased release of inflammatory cytokines. In addition, tubal factor and ovulatory disorder infertility are linked to EPL after ICSI due to unknown mechanisms. Proposals to eradicate H. pylori infection prior to ICSI could lead to a decrease in EPL after ART.Keywords: Helicobacter pylori, early pregnancy loss, early abortion, infertility, intracytoplasmic sperm

  9. Treatment of occult reflux lowers the incidence rate of pediatric febrile urinary tract infection.

    Science.gov (United States)

    Hagerty, Jennifer; Maizels, Max; Kirsch, Andrew; Liu, Dennis; Afshar, Kourosh; Bukowski, Timothy; Caione, Paolo; Homsy, Yves; Meyer, Theresa; Kaplan, William

    2008-07-01

    To examine whether vesicourethral reflux diagnosed by positioned instillation of contrast (PIC-VUR) shows clinical importance by comparing the incidence rates of febrile urinary tract infection (FUTI) before and after treatment of PIC-VUR. Beginning in 2001 we used a multi-institutional registry to prospectively enroll consecutive pediatric patients with a history of FUTI without VUR according to voiding cystourethrogram (VCUG) and yet who show PIC-VUR. Treatment of PIC-VUR was with prophylactic antimicrobials or antireflux surgery. The post-treatment occurrence of FUTI was tracked. A total of 14 centers enrolled 118 patients (mean age, 7.2 years; range, 0.5 to 20 years). Parents self-selected the treatment of PIC-VUR as endoscopic injection (104), ureteral reimplantation (3), or antimicrobial prophylaxis (11). Study intervals surveying for FUTI before PIC (mean, 12 months; range, 1 to 17 years) and after PIC treatment (mean, 11 months; range, 0 to 3 years) were not significantly different. Overall the incidence rate for FUTI decreased significantly from 0.16 per patient per month before PIC-VUR treatment to 0.008 per patient per month after treatment (rate ratio 20; 95% confidence interval 11 to 36). The post-treatment rate of FUTI in patients treated with antibiotics versus surgery was not significantly different (rate ratio 2.5; 95% confidence interval 0.33 to 27). The diagnosis of PIC-VUR is clinically important because children treated for PIC-VUR with either antimicrobial prophylaxis or surgery show a significant reduction in the incidence rate of FUTI. This is the basis for a current prospective study randomizing patients with PIC-VUR to treatment or observation.

  10. Higher rate of major depression among blood donor candidates infected with human t-cell lymphotropic virus type 1.

    Science.gov (United States)

    Stumpf, Barbara P; Carneiro-Proietti, Anna Bárbara; Proietti, Fernando A; Rocha, Fábio L

    2008-01-01

    Viral infections have been previously associated with psychiatric disorders. This work aimed to study the relationship between the human T-cell lymphotropic virus type 1 (HTLV-1) and depression. A case-control study with prevalent cases was conducted from April 2004 to June 2005. Participants were from a public transfusion center in Belo Horizonte, Brazil. The base population was composed of blood donor candidates infected with HTLV-1 (asymptomatic carriers), followed-up in a cohort study. As a control group, HTLV-1 seronegative blood donors were selected in a random fashion. Study participants underwent psychiatric evaluation using a structured diagnostic instrument, the Mini International Neuropsychiatry Interview (MINI), to estimate the rate of depression. The interviewer was unaware of participants' HTLV-1 serostatus. The co-variables studied were gender, age, formal education, personal income, and the presence of other psychiatric diagnoses. Logistic regression was used to examine the relation between HTLV-1 infection and depression. The final sample was composed of 74 individuals infected with HTLV-1 and 24 uninfected controls. The rate of depression was significantly higher in HTLV-1 carriers when compared with controls (39% vs. 8%; p-value = 0.005). HTLV-1 infection was independently associated with depression (OR = 6.17; CI 95% = 1.32-28.82). The results showed a higher rate of depression in HTLV-1 infected individuals. It was not possible to determine whether depression was related to knowledge of chronic retroviral infection or related to a biological effect of the retroviral infection.

  11. Infection rates of rifampin/gentamicin-coated Titan Coloplast penile implants. Comparison with Inhibizone-impregnated AMS penile implants.

    Science.gov (United States)

    Dhabuwala, Chirpriya; Sheth, Sheila; Zamzow, Brent

    2011-01-01

    It is a common practice to soak Titan(®) Coloplast penile implants in antibiotic solution prior to implantation. Experience with Inhibizone impregnation suggests that rifampin coating significantly reduces infection rates of penile implant surgery. In this article we describe the results of coating Titan Coloplast penile implants with rifampin/gentamicin solution. To compare infection rates of Titan(®) Coloplast penile implants coated with vancomycin/gentamycin, rifampin/gentamicin, and Inhibizone-impregnated American Medical Systems (AMS) penile implants. Chart review was done for all Mentor/Coloplast and AMS implant surgeries performed at our center between the dates January 1, 2002 and February 8, 2010. Infection rates for Titan(®) Coloplast penile implants coated with vancomycin/gentamycin, rifampin/gentamicin, and Inhibizone-impregnated (AMS) penile implants were compared. Infection rates for penile implants coated with different antibiotics. Infection rates for Titan(®) Coloplast penile implants coated with vancomycin/gentamycin and Inhibizone-impregnated (AMS) penile implants was 4.4% and 1.3%, respectively (P = 0.05). None of the rifampin/gentamicin-coated Titan(®) Coloplast penile implants have developed infection. Rifampin is the common antibiotic both in rifampin/gentamicin-coated Coloplast implants and Inhibizone(®) . The infection rate in this combined rifampin/gentamicin-coated Titan Coloplast implants and Inhibizone-coated AMS implants group was 0.63% (P = 0.03). Both rifampin/gentamicin-coated Titan(®) Coloplast penile implants and Inhibizone-impregnated (AMS) penile implants appear to have lower infection rates compared with vancomycin/gentamycin-coated Titan(®) Coloplast penile implants The present study does not suggest superiority of rifampin/gentamicin-coated Titan(®) Coloplast penile implants or Inhibizone-impregnated (AMS) penile implants but we strongly suggest that all Titan(®) Coloplast penile implants should be coated with

  12. Effects of pond salinization on survival rate of amphibian hosts infected with the chytrid fungus.

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    Stockwell, Michelle Pirrie; Storrie, Lachlan James; Pollard, Carla Jean; Clulow, John; Mahony, Michael Joseph

    2015-04-01

    The chytrid fungus Batrachochytrium dendrobatidis has been implicated in the decline and extinction of amphibian populations worldwide, but management options are limited. Recent studies show that sodium chloride (NaCl) has fungicidal properties that reduce the mortality rates of infected hosts in captivity. We investigated whether similar results can be obtained by adding salt to water bodies in the field. We increased the salinity of 8 water bodies to 2 or 4 ppt and left an additional 4 water bodies with close to 0 ppt and monitored salinity for 18 months. Captively bred tadpoles of green and golden bell frog (Litoria aurea) were released into each water body and their development, levels of B. dendrobatidis infection, and survival were monitored at 1, 4, and 12 months. The effect of salt on the abundance of nontarget organisms was also investigated in before and after style analyses. Salinities remained constant over time with little intervention. Hosts in water bodies with 4 ppt salt had a significantly lower prevalence of chytrid infection and higher survival, following metamorphosis, than hosts in 0 ppt salt. Tadpoles in the 4 ppt group were smaller in length after 1 month in the release site than those in the 0 and 2 ppt groups, but after metamorphosis body size in all water bodies was similar . In water bodies with 4 ppt salt, the abundance of dwarf tree frogs (Litoria fallax), dragonfly larvae, and damselfly larvae was lower than in water bodies with 0 and 2 ppt salt, which could have knock-on effects for community structure. Based on our results, salt may be an effective field-based B. dendrobatidis mitigation tool for lentic amphibians that could contribute to the conservation of numerous susceptible species. However, as in all conservation efforts, these benefits need to be weighed against negative effects on both target and nontarget organisms. © 2014 Society for Conservation Biology.

  13. The effect of a hospital-wide urine culture screening intervention on the incidence of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella species.

    Science.gov (United States)

    Han, Jennifer H; Bilker, Warren B; Nachamkin, Irving; Zaoutis, Theoklis E; Coffin, Susan E; Linkin, Darren R; Hu, Baofeng; Tolomeo, Pam; Fishman, Neil O; Lautenbach, Ebbing

    2013-11-01

    Optimal strategies for limiting the transmission of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella spp (ESBL-EK) in the hospital setting remain unclear. The objective of this study was to evaluate the impact of a urine culture screening strategy on the incidence of ESBL-EK. Prospective quasi-experimental study. Two intervention hospitals and one control hospital within a university health system from 2005 to 2009. All clinical urine cultures with E. coli or Klebsiella spp were screened for ESBL-EK. Patients determined to be colonized or infected with ESBL-EK were placed in a private room with contact precautions. The primary outcome of interest was nosocomial ESBL-EK incidence in nonurinary clinical cultures (cases occurring more than 48 hours after admission). Changes in monthly ESBL-EK incidence rates were evaluated with mixed-effects Poisson regression models, with adjustment for institution-level characteristics (eg, total admissions). The overall incidence of ESBL-EK increased from 1.42/10,000 patient-days to 2.16/10,000 patient-days during the study period. The incidence of community-acquired ESBL-EK increased nearly 3-fold, from 0.33/10,000 patient-days to 0.92/10,000 patient-days (P < .001). On multivariable analysis, the intervention was not significantly associated with a reduction in nosocomial ESBL-EK incidence (incidence rate ratio, 1.38 [95% confidence interval, 0.83-2.31]; P - .21). Universal screening of clinical urine cultures for ESBL-EK did not result in a reduction in nosocomial ESBL-EK incidence rates, most likely because of increases in importation of ESBL-EK cases from the community. Further studies are needed on elucidating optimal infection control interventions to limit spread of ESBL-producing organisms in the hospital setting.

  14. Hospitalization Rates and Reasons Among HIV Elite Controllers and Persons With Medically Controlled HIV Infection.

    Science.gov (United States)

    Crowell, Trevor A; Gebo, Kelly A; Blankson, Joel N; Korthuis, P Todd; Yehia, Baligh R; Rutstein, Richard M; Moore, Richard D; Sharp, Victoria; Nijhawan, Ank E; Mathews, W Christopher; Hanau, Lawrence H; Corales, Roberto B; Beil, Robert; Somboonwit, Charurut; Edelstein, Howard; Allen, Sara L; Berry, Stephen A

    2015-06-01

    Elite controllers spontaneously suppress human immunodeficiency virus (HIV) viremia but also demonstrate chronic inflammation that may increase risk of comorbid conditions. We compared hospitalization rates and causes among elite controllers to those of immunologically intact persons with medically controlled HIV. For adults in care at 11 sites from 2005 to 2011, person-years with CD4 T-cell counts ≥350 cells/mm(2) were categorized as medical control, elite control, low viremia, or high viremia. All-cause and diagnostic category-specific hospitalization rates were compared between groups using negative binomial regression. We identified 149 elite controllers (0.4%) among 34 354 persons in care. Unadjusted hospitalization rates among the medical control, elite control, low-viremia, and high-viremia groups were 10.5, 23.3, 12.6, and 16.9 per 100 person-years, respectively. After adjustment for demographic and clinical factors, elite control was associated with higher rates of all-cause (adjusted incidence rate ratio, 1.77 [95% confidence interval, 1.21-2.60]), cardiovascular (3.19 [1.50-6.79]) and psychiatric (3.98 [1.54-10.28]) hospitalization than was medical control. Non-AIDS-defining infections were the most common reason for admission overall (24.1% of hospitalizations) but were rare among elite controllers (2.7%), in whom cardiovascular hospitalizations were most common (31.1%). Elite controllers are hospitalized more frequently than persons with medically controlled HIV and cardiovascular hospitalizations are an important contributor. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Medicaid status is associated with higher surgical site infection rates after spine surgery.

    Science.gov (United States)

    Manoso, Mark W; Cizik, Amy M; Bransford, Richard J; Bellabarba, Carlo; Chapman, Jens; Lee, Michael J

    2014-09-15

    The Spine End Results Registry (2003-2004) is a registry of prospectively collected data of all patients undergoing spinal surgery at the University of Washington Medical Center and Harborview Medical Center. Insurance data were prospectively collected and used in multivariate analysis to determine risk of perioperative complications. Given the negative financial impact of surgical site infections (SSIs) and the higher overall complication rates of patients with a Medicaid payer status, we hypothesized that a Medicaid payer status would have a significantly higher SSI rate. The medical literature demonstrates lesser outcomes and increased complication rates in patients who have public insurance than those who have private insurance. No one has shown that patients with a Medicaid payer status compared with Medicare and privately insured patients have a significantly increased SSI rate for spine surgery. The prospectively collected Spine End Results Registry provided data for analysis. SSI was defined as treatment requiring operative debridement. Demographic, social, medical, and the surgical severity index risk factors were assessed against the exposure of payer status for the surgical procedure. The population included Medicare (N = 354), Medicaid (N = 334), the Veterans' Administration (N = 39), private insurers (N = 603), and self-pay (N = 42). Those patients whose insurer was Medicaid had a 2.06 odds (95% confidence interval: 1.19-3.58, P = 0.01) of having a SSI compared with the privately insured. The study highlights the increased cost of spine surgical procedures for patients with a Medicaid payer status with the passage of the Patient Protection and Affordable Care Act of 2010. The Patient Protection and Affordable Care Act of 2010 provisions could cause a reduction in reimbursement to the hospital for taking care of patients with Medicaid insurance due to their higher complication rates and higher costs. This very issue could inadvertently lead to access

  16. Developing algorithms for healthcare insurers to systematically monitor surgical site infection rates

    Directory of Open Access Journals (Sweden)

    Livingston James M

    2007-06-01

    Full Text Available Abstract Background Claims data provide rapid indicators of SSIs for coronary artery bypass surgery and have been shown to successfully rank hospitals by SSI rates. We now operationalize this method for use by payers without transfer of protected health information, or any insurer data, to external analytic centers. Results We performed a descriptive study testing the operationalization of software for payers to routinely assess surgical infection rates among hospitals where enrollees receive cardiac procedures. We developed five SAS programs and a user manual for direct use by health plans and payers. The manual and programs were refined following provision to two national insurers who applied the programs to claims databases, following instructions on data preparation, data validation, analysis, and verification and interpretation of program output. A final set of programs and user manual successfully guided health plan programmer analysts to apply SSI algorithms to claims databases. Validation steps identified common problems such as incomplete preparation of data, missing data, insufficient sample size, and other issues that might result in program failure. Several user prompts enabled health plans to select time windows, strata such as insurance type, and the threshold number of procedures performed by a hospital before inclusion in regression models assessing relative SSI rates among hospitals. No health plan data was transferred to outside entities. Programs, on default settings, provided descriptive tables of SSI indicators stratified by hospital, insurer type, SSI indicator (inpatient, outpatient, antibiotic, and six-month period. Regression models provided rankings of hospital SSI indicator rates by quartiles, adjusted for comorbidities. Programs are publicly available without charge. Conclusion We describe a free, user-friendly software package that enables payers to routinely assess and identify hospitals with potentially high SSI

  17. Disease associated with equine coronavirus infection and high case fatality rate.

    Science.gov (United States)

    Fielding, C L; Higgins, J K; Higgins, J C; McIntosh, S; Scott, E; Giannitti, F; Mete, A; Pusterla, N

    2015-01-01

    Equine coronavirus (ECoV) is associated with clinical disease in adult horses. Outbreaks are associated with a low case fatality rate and a small number of animals with signs of encephalopathic disease are described. The aim of this study is to describe the epidemiological and clinical features of two outbreaks of ECoV infection that were associated with an high case fatality rate. 14 miniature horses and 1 miniature donkey testing fecal positive for ECoV from two related disease outbreaks. Retrospective study describing the epidemiological findings, clinicopathological findings, and fecal viral load from affected horses. In EcoV positive horses, 27% (4/15) of the animals died or were euthanized. Severe hyperammonemia (677 μmol/L, reference range ≤ 60 μmol/L) was identified in one animal with signs of encephalopathic disease that subsequently died. Fecal viral load (ECoV genome equivalents per gram of feces) was significantly higher in the nonsurvivors compared to animals that survived (P = .02). Equine coronavirus had a higher case fatality rate in this group of miniature horses than previously reported in other outbreaks of varying breeds. Hyperammonemia could contribute to signs of encephalopathic disease, and the fecal viral load might be of prognostic value in affected horses. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  18. HIV infection among foreign transsexual sex workers in Rome: prevalence, behavior patterns, and seroconversion rates.

    Science.gov (United States)

    Spizzichino, L; Zaccarelli, M; Rezza, G; Ippolito, G; Antinori, A; Gattari, P

    2001-07-01

    The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people. To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center. A cross-sectional, follow-up study was conducted. Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion. The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.

  19. Albumin excretion rate is not affected by asymptomatic urinary tract infection: a prospective study.

    Science.gov (United States)

    Hernández, Cristina; Simó, Rafael

    2004-07-01

    The aim of the study was to evaluate whether asymptomatic urinary tract infection (UTI) significantly influences the level of albumin excretion rate (AER) in diabetic patients. We screened prospectively for UTI and AER in 765 type 2 diabetic subjects. AER was determined before and after antimicrobial therapy in those patients in whom an asymptomatic UTI was diagnosed (n = 59). To interpret the clinical significance of AER changes, the coefficient of biological variation (CVb) of the AER (CVb-AER) was assessed in a control group of type 2 diabetic patients without UTI (n = 56). AER did not change after antimicrobial treatment either in the whole group of patients with UTI (pre: 13.8 microg/min [0.1-195] vs. post: 8.5 microg/min [0.1-185]; P = 0.1) or in those patients in whom the infection was eradicated (pre: 11.7 microg/min [0.1-195] vs. post: 7.1 microg/min [0.1-185]; NS). The CVb-AER was 64% in the control group and was inversely correlated with AER (r = -0.44; P = 0.001). The decrease of AER after antimicrobial therapy (55%) did not exceed the biological variation of AER (64%). Finally, UTI did not significantly influence the classification of diabetic patients as normo- or microalbuminuric. Asymptomatic UTI does not increase AER in type 2 diabetic patients. Therefore, our results suggest that testing for UTI is not necessary when AER is measured in diabetic patients.

  20. Dynamics of a Delayed HIV-1 Infection Model with Saturation Incidence Rate and CTL Immune Response

    Science.gov (United States)

    Guo, Ting; Liu, Haihong; Xu, Chenglin; Yan, Fang

    2016-12-01

    In this paper, we investigate the dynamics of a five-dimensional virus model incorporating saturation incidence rate, CTL immune response and three time delays which represent the latent period, virus production period and immune response delay, respectively. We begin this model by proving the positivity and boundedness of the solutions. Our model admits three possible equilibrium solutions, namely the infection-free equilibrium E0, the infectious equilibrium without immune response E1 and the infectious equilibrium with immune response E2. Moreover, by analyzing corresponding characteristic equations, the local stability of each of the feasible equilibria and the existence of Hopf bifurcation at the equilibrium point E2 are established, respectively. Further, by using fluctuation lemma and suitable Lyapunov functionals, it is shown that E0 is globally asymptotically stable when the basic reproductive numbers for viral infection R0 is less than unity. When the basic reproductive numbers for immune response R1 is less than unity and R0 is greater than unity, the equilibrium point E1 is globally asymptotically stable. Finally, some numerical simulations are carried out for illustrating the theoretical results.

  1. High rates of undiagnosed leprosy and subclinical infection amongst school children in the Amazon Region

    Directory of Open Access Journals (Sweden)

    Josafá Gonçalves Barreto

    2012-12-01

    Full Text Available Leprosy in children is correlated with community-level factors, including the recent presence of disease and active foci of transmission in the community. We performed clinical and serological examinations of 1,592 randomly selected school children (SC in a cross-sectional study of eight hyperendemic municipalities in the Brazilian Amazon Region. Sixty-three (4% SC, with a mean age of 13.3 years (standard deviation = 2.6, were diagnosed with leprosy and 777 (48.8% were seropositive for anti-phenolic glycolipid-I (PGL-I. Additionally, we evaluated 256 house-hold contacts (HHCs of the students diagnosed with leprosy; 24 (9.4% HHC were also diagnosed with leprosy and 107 (41.8% were seropositive. The seroprevalence of anti-PGL-I was significantly higher amongst girls, students from urban areas and students from public schools (p < 0.0001. Forty-five (71.4% new cases detected amongst SC were classified as paucibacillary and 59 (93.6% patients did not demonstrate any degree of physical disability at diagnosis. The results of this study suggest that there is a high rate of undiagnosed leprosy and subclinical infection amongst children in the Amazon Region. The advantages of school surveys in hyperendemic areas include identifying leprosy patients at an early stage when they show no physical disabilities, preventing the spread of the infection in the community and breaking the chain of transmission.

  2. Association of Hepatitis C Virus Infection with Proteinuria and Glomerular Filtration Rate.

    Science.gov (United States)

    Kurbanova, Nargiza; Qayyum, Rehan

    2015-10-01

    Despite several studies, the extent to which hepatitis C virus (HCV) infection is associated with chronic kidney disease (CKD) remains controversial. Thus, we examined the relationship between HCV and CKD using the continuous National Health and Nutrition Examination Survey (1999-2012). Specimens positive for anti-HCV antibodies were retested and confirmed with recombinant immunoblot assay (RIBA). Proteinuria was defined as urine albumin creatinine ratio > 30 mg/g. CKD was defined as estimated glomerular filtration rate (GFR) proteinuria (OR = 1.40, p = 0.01 and OR = 1.50, p = 0.02, respectively). In both unadjusted and adjusted analyses, individuals with HCV had significantly higher GFR than individuals without (1.4 mL/min, p = 0.04 and 2.7 mL/min, p proteinuria and high GFR but not with CKD. The biological mechanism of the observed association needs further study. © 2015 Wiley Periodicals, Inc.

  3. Penicillin-susceptible Staphylococcus aureus: susceptibility testing, resistance rates and outcome of infection.

    Science.gov (United States)

    Hagstrand Aldman, Malin; Skovby, Annette; I Påhlman, Lisa

    2017-06-01

    Staphylococcus aureus (SA) is an important human pathogen that causes both superficial and invasive infections. Penicillin is now rarely used in the treatment of SA infections due to widespread resistance and a concern about the accuracy of existing methods for penicillin susceptibility testing. The aims of the present study were to determine the frequency of penicillin-susceptible SA isolates from blood and wound cultures in Lund, Sweden, and to evaluate methods for penicillin testing in SA. We also wanted to investigate if penicillin-susceptible isolates are associated with higher mortality. Hundred blood culture isolates collected 2008/2009, 140 blood culture isolates from 2014/2015, and 141 superficial wound culture strains from 2015 were examined. Penicillin susceptibility was tested with disk diffusion according to EUCAST guidelines, and results were confirmed with a cloverleaf assay and PCR amplification of the BlaZ gene. Patient data for all bacteraemia cases were extracted from medical records. The disk diffusion method with assessment of both zone size and zone edge appearance had high accuracy in our study. About 57% of bacteraemia isolates from 2008/2009 were sensitive to penicillin compared to 29% in 2014/2015 (p penicillin susceptible. There was no difference in co-morbidity or mortality rates between patients with penicillin resistant and penicillin sensitive SA bacteraemia. Disk-diffusion is a simple and reliable method to detect penicillin resistance in SA, and susceptibility rates are significant. Penicillin has many theoretical advantages and should be considered in the treatment of SA bacteraemia when susceptible.

  4. Turnover rates of B cells, T cells, and NK cells in simian immunodeficiency virus-infected and uninfected rhesus macaques

    NARCIS (Netherlands)

    Boer, R.J. de; Mohri, H.; Ho, D.D.; Perelson, A.S.

    2003-01-01

    We determined average cellular turnover rates by fitting mathematical models to 5-bromo-2'-deoxyuridine measurements in SIV-infected and uninfected rhesus macaques. The daily turnover rates of CD4(+) T cells, CD4(-) T cells, CD20(+) B cells, and CD16(+) NK cells in normal uninfected rhesus macaques

  5. Case-mix adjustment approach to benchmarking prevalence rates of nosocomial infection in hospitals in Cyprus and Greece.

    Science.gov (United States)

    Kritsotakis, Evangelos I; Dimitriadis, Ioannis; Roumbelaki, Maria; Vounou, Emelia; Kontou, Maria; Papakyriakou, Panikos; Koliou-Mazeri, Maria; Varthalitis, Ioannis; Vrouchos, George; Troulakis, George; Gikas, Achilleas

    2008-08-01

    To examine the effect of heterogeneous case mix for a benchmarking analysis and interhospital comparison of the prevalence rates of nosocomial infection. Cross-sectional survey. Eleven hospitals located in Cyprus and in the region of Crete in Greece. The survey included all inpatients in the medical, surgical, pediatric, and gynecology-obstetrics wards, as well as those in intensive care units. Centers for Disease Control and Prevention criteria were used to define nosocomial infection. The information collected for all patients included demographic characteristics, primary admission diagnosis, Karnofsky functional status index, Charlson comorbidity index, McCabe-Jackson severity of illness classification, use of antibiotics, and prior exposures to medical and surgical risk factors. Outcome data were also recorded for all patients. Case mix-adjusted rates were calculated by using a multivariate logistic regression model for nosocomial infection risk and an indirect standardization method.Results. The overall prevalence rate of nosocomial infection was 7.0% (95% confidence interval, 5.9%-8.3%) among 1,832 screened patients. Significant variation in nosocomial infection rates was observed across hospitals (range, 2.2%-9.6%). Logistic regression analysis indicated that the mean predicted risk of nosocomial infection across hospitals ranged from 3.7% to 10.3%, suggesting considerable variation in patient risk. Case mix-adjusted rates ranged from 2.6% to 12.4%, and the relative ranking of hospitals was affected by case-mix adjustment in 8 cases (72.8%). Nosocomial infection was significantly and independently associated with mortality (adjusted odds ratio, 3.6 [95% confidence interval, 2.1-6.1]). The first attempt to rank the risk of nosocomial infection in these regions demonstrated the importance of accounting for heterogeneous case mix before attempting interhospital comparisons.

  6. Neuropathy and poorly controlled diabetes increase the rate of surgical site infection after foot and ankle surgery.

    Science.gov (United States)

    Wukich, Dane K; Crim, Brandon E; Frykberg, Robert G; Rosario, Bedda L

    2014-05-21

    This prospective study was designed to evaluate the frequency of surgical site infection in patients treated with foot and ankle surgery. Our hypothesis was that patients with complications of diabetes are at increased risk for surgical site infection compared with patients without diabetes and patients with diabetes who do not have diabetic complications. Another goal was to compare the association of neuropathy with surgical site infection in both nondiabetic and diabetic patients. Two thousand and sixty consecutive surgical cases were evaluated. Group 1 included nondiabetic patients without neuropathy, Group 2 included nondiabetic patients with neuropathy, Group 3 included patients with diabetes but no diabetic complications, and Group 4 included patients with diabetes who had at least one complication of diabetes. The surgical site infection rate in this study was 3.1%. Patients with complicated diabetes had a 7.25-fold increased risk of surgical site infection compared with nondiabetic patients without neuropathy and a 3.72-fold increased risk compared with patients with uncomplicated diabetes. Patients with complicated diabetes had a nonsignificant 1.54-fold higher rate of surgical site infection compared with nondiabetic patients with neuropathy. Nondiabetic patients with neuropathy had a significant 4.72-fold increased risk of surgical site infection compared with nondiabetic patients without neuropathy. Despite this, nondiabetic patients with neuropathy did not have a significantly higher rate of surgical site infection than patients with uncomplicated diabetes, and the frequency of surgical site infection in the group with uncomplicated diabetes was not significantly different from that in the nondiabetic patients without neuropathy. Multivariable logistic regression analysis demonstrated that peripheral neuropathy and a hemoglobin A1c of ≥8% were independently associated with surgical site infection. Complicated diabetes increases the risk of surgical

  7. Dynamics of tsetse natural infection rates in the Mouhoun river, Burkina Faso, in relation with environmental factors

    Directory of Open Access Journals (Sweden)

    Jérémy eBouyer

    2013-08-01

    Full Text Available In Burkina Faso, the cyclical vectors of African animal trypanosomoses (AAT are riverine tsetse species, namely Glossina palpalis gambiensis Vanderplank (G.p.g. and Glossina tachinoides Westwood (G. t. (Diptera: Glossinidae. Experimental work demonstrated that environmental stress can increase the sensitivity of tsetse to trypanosome infection.Seasonal variations of the tsetse infection rates were monitored monthly over 17 months (May 2006-Sept 2007 in two sites (Douroula and Kadomba. In total, 1,423 flies were dissected and the infection of the proboscis, middle intestine and salivary glands was noted. All the positive organs were analyzed using monospecific polymerase chain reaction (PCR primers. To investigate the role of different environmental factors, fly infection rates were analyzed using generalized linear mixed binomial models using the species, sex, and monthly averages of the maximal, minimal and mean daily temperatures, rainfalls, Land Surface Temperature day (LSTd and night (LSTn as fixed effects and the trap position as a random effect.The overall infection rate was 10% from which the predominant species was T. congolense (7.6% of the flies, followed by T. vivax (2.2% of the flies. The best model (lowest AICc for the global infection rates was the one with the maximal daily temperature only as fixed effect (p<0.001. For T. congolense, the best model was the one with the tsetse species, sex, maximal daily temperature and rainfalls as fixed effect, where the maximal daily temperature was the main effect (p<0.001. The number of T. vivax infections was too low to allow the models to converge. The maturation rate of T. congolense was very high (94%, and G. t. harbored a higher maturation rate (p=0.03.The results are discussed in view of former laboratory studies showing that temperature stress can increase the susceptibility of tsetse to trypanosomes, as well as the possibility to improve AAT risk mapping using satellite images.

  8. Multicenter prospective study on device-associated infection rates and bacterial resistance in intensive care units of Venezuela: International Nosocomial Infection Control Consortium (INICC) findings.

    Science.gov (United States)

    Empaire, Gabriel D; Guzman Siritt, Maria E; Rosenthal, Victor D; Pérez, Fernando; Ruiz, Yvis; Díaz, Claudia; Di Silvestre, Gabriela; Salinas, Evelyn; Orozco, Nelva

    2017-01-01

    Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety in the intensive care unit (ICU). A DA-HAI surveillance study was conducted by the International Nosocomial Infection Control Consortium (INICC) in two adult medical/surgical ICUs at two hospitals in Caracas, Venezuela, in different periods from March 2008 to April 2015, using the US Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria, and INICC methods. We followed 1041 ICU patients for 4632 bed days. Central line-associated bloodstream infection (CLABSI) rate was 5.1 per 1000 central line days, ventilator-associated pneumonia (VAP) rate was 7.2 per 1000 mechanical ventilator days, and catheter-associated urinary tract infection (CAUTI) rate was 3.9 per 1000 urinary catheter days, all similar to or lower than INICC rates (4.9 [CLABSI]; 16.5 [VAP]; 5.3 [CAUTI]), and higher than CDC/NHSN rates (0.8 [CLABSI]; 1.1 [VAP]; and 1.3 [CAUTI]). Device utilization ratios were higher than INICC and CDC/NHSN rates, except for urinary catheter, which was similar to INICC. Extra length of stay was 8 days for patients with CLABSI, 9.6 for VAP and 5.7 days for CAUTI. Additional crude mortality was 3.0% for CLABSI, 4.4% for VAP, and 16.9% for CAUTI. DA-HAI rates in our ICUs are higher than CDC/NSHN's and similar to or lower than INICC international rates. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.

  9. Trends in postoperative infection rates and their relationship to glycosylated hemoglobin levels in diabetic patients undergoing foot and ankle surgery.

    Science.gov (United States)

    Jupiter, Daniel C; Humphers, Jon M; Shibuya, Naohiro

    2014-01-01

    The association of hyperglycemia with postoperative infectious complications after foot and ankle surgery has been well studied. However, many surgeons in their current practice use the somewhat arbitrary cutoff of 7% glycosylated hemoglobin (HbA1c) as the level above which surgery is considered unsafe and conducive to complications. Our goal in the present study was to assess the relationship between the HbA1c levels and the rate of postoperative infection to begin to determine whether 7% is a suitable cutoff or whether this level needs to be reevaluated. Furthermore, we were interested in the general trends relating to the infection rates and preoperative HbA1c levels. Our preliminary, subjective, analysis has indicated that infection rates increase steadily as the HbA1c increases toward 7.3%, increase rapidly at an HbA1c of 7.3% to 9.8%, and then level off. Additional study is warranted to better understand the role played by other covariates in determining the infection rate and to investigate whether patient selection has influenced the appearance of decreased infection rates at high HbA1c levels. Additional study could also assess similar relationships for other types of complication, such as nonunion, and perhaps examine different foot and ankle procedures in isolation. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Co-infection rate of HIV, HBV and Syphilis among HCV seropositive identified blood donors in Kathmandu, Nepal

    Directory of Open Access Journals (Sweden)

    Ashish Chandra Shrestha

    2012-02-01

    Full Text Available Background: HIV, HBV, Syphilis and HCV share common modes of transmission. Objective: The study was aimed to determine the co-infection rate of HIV, HBV and Syphilis among HCV seropositive identified blood donors. Methods: The study was conducted on blood samples screened as HCV seropositive at Nepal Red Cross Society, Central Blood Transfusion Service, Kathmandu, Nepal. HCV seropositive samples were further tested for HIV, HBV and Syphilis. Results: Eight co-infections were observed in 139 HCV seropositives with total co-infection rate of 5.75% (95% CI = 2.52-11.03. Conclusion: Co-infection of HIV, HBV and Syphilis with HCV is prevalent in the healthy looking blood donors of Kathmandu, Nepal.

  11. Variability in testing policies and impact on reported Clostridium difficile infection rates: results from the pilot Longitudinal European Clostridium difficile Infection Diagnosis surveillance study (LuCID).

    Science.gov (United States)

    Davies, K; Davis, G; Barbut, F; Eckert, C; Petrosillo, N; Wilcox, M H

    2016-12-01

    Lack of standardised Clostridium difficile testing is a potential confounder when comparing infection rates. We used an observational, systematic, prospective large-scale sampling approach to investigate variability in C. difficile sampling to understand C. difficile infection (CDI) incidence rates. In-patient and institutional data were gathered from 60 European hospitals (across three countries). Testing methodology, testing/CDI rates and case profiles were compared between countries and institution types. The mean annual CDI rate per hospital was lowest in the UK and highest in Italy (1.5 vs. 4.7 cases/10,000 patient bed days [pbds], p testing rate was highest in the UK compared with Italy and France (50.7/10,000 pbds vs. 31.5 and 30.3, respectively, p tested for CDI across all countries. Overall, only 64 % of hospitals used recommended testing algorithms for laboratory testing. Small hospitals were significantly more likely to use standalone toxin tests (SATTs). There was an inverse correlation between hospital size and CDI testing rate. Hospitals using SATT or assays not detecting toxin reported significantly higher CDI rates than those using recommended methods, despite testing similar testing frequencies. These data are consistent with higher false-positive rates in such (non-recommended) testing scenarios. Cases in Italy and those diagnosed by SATT or methods NOT detecting toxin were significantly older. Testing occurred significantly earlier in the UK. Assessment of testing practice is paramount to the accurate interpretation and comparison of CDI rates.

  12. Experimental bovine infection with Taenia saginata eggs: recovery rates and cysticerci location

    Directory of Open Access Journals (Sweden)

    João Carlos Minozzo

    2002-12-01

    Full Text Available Studies were carried out on the recovery rate and cysticerci location in bovines experimentally infected with Taenia saginata eggs. Three calves of 6.5 months and one with 19 months of age were infected orally with 2 x 10(4 eggs of Taenia saginata. A fifth calf served as control. After 90 days of infection, the animals were slaughtered and organs and skeletal muscles were inspected using a slicing technique every 5 mm. From the four infected calves, 702 cysticerci were recovered, of which 570 (81.2% were alive and 132 (18.8% were degenerated. The recovery rate ranged from 0.01 to 1.43% with an average of 0.88%. The cysticerci presented the following anatomical distribution: hioideos muscles 02 (0.28%, kidneys 03 (0.43%, tongue 07 (1.00%, liver 12 (1.71%, lungs 15 (2.14%, diaphragm 18 (2.56%, mastication muscles 25 (3.56%, heart 49 (6.98%, anterior muscle 323 (46.00% and posterior muscle 248 (35.33%.Foi avaliada a taxa de recuperação e localização de cisticercos em bovinos experimentalmente infectados com ovos de Taenia saginata. Três bezerros de 6,5 meses e um adulto com 19 meses de idade foram infectados, por via oral, com 2 x 10(4 ovos de Taenia saginata. Um quinto bezerro serviu como testemunha. Após 90 dias da infecção, os animais foram abatidos. Fez-se inspeção, de todos os animais, por fatiamento de órgãos e musculatura esquelética, com intervalo entre os cortes de, no máximo, cinco milímetros. Dos quatros bezerros desafiados foram recuperados 702 cisticercos sendo 570 (81,20% vivos e 132 (18,80% degenerados. A taxa de recuperação foi de 0,01% a 1,43% com média de 0,88%. Os 702 cistos encontrados apresentaram a seguinte distribuição anatômica: músculos hióideos 02 (0,28%, rins 03 (0,43%, língua 07 (1,00%, fígado 12 (1,71%, pulmões 15 (2,14%, diafragma 18 (2,56%, músculos da mastigação 25 (3,56%, coração 49 (6,98%, musculatura dianteira 323 (46,00% e musculatura traseira 248 (35,33%. Na infecção experimental

  13. Physiological Status Drives Metabolic Rate in Mediterranean Geckos Infected with Pentastomes.

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    Isabel C Caballero

    Full Text Available Negative effects of parasites on their hosts are well documented, but the proximate mechanisms by which parasites reduce their host's fitness are poorly understood. For example, it has been suggested that parasites might be energetically demanding. However, a recent meta-analysis suggests that they have statistically insignificant effects on host resting metabolic rate (RMR. It is possible, though, that energetic costs associated with parasites are only manifested during and/or following periods of activity. Here, we measured CO2 production (a surrogate for metabolism in Mediterranean geckos (Hemidactylus turcicus infected with a lung parasite, the pentastome Raillietiella indica, under two physiological conditions: rested and recently active. In rested geckos, there was a negative, but non-significant association between the number of pentastomes (i.e., infection intensity and CO2 production. In recently active geckos (chased for 3 minutes, we recorded CO2 production from its maximum value until it declined to a stationary phase. We analyzed this decline as a 3 phase function (initial decline, secondary decline, stationary. Geckos that were recently active showed, in the secondary phase, a significant decrease in CO2 production as pentastome intensity increased. Moreover, duration of the secondary phase showed a significant positive association with the number of pentastomes. These results suggest that the intensity of pentastome load exerts a weak effect on the metabolism of resting geckos, but a strong physiological effect on geckos that have recently been active; we speculate this occurs via mechanical constraints on breathing. Our results provide a potential mechanism by which pentastomes can reduce gecko fitness.

  14. The Mortality Rate of Nosocomial Infection in Neonatal Intensive Care Unit (NICU of Taleghani Educational and Treatment Center, Tabriz, 2013

    Directory of Open Access Journals (Sweden)

    Parvin Abbasian

    2015-09-01

    Full Text Available Background and Objectives : Information about nosocomial infections (NIs is necessary for both appropriate management and establishment of preventative measures in hospitals. Neonates admitted to the Neonatal Intensive Care Unit (NICU are at high-risk of developing nosocomial infection. The aim of this study was to determine the mortality rate of nosocomial infections and the distribution of pathogens among newborns who were admitted to the neonatal intensive care unit in Taleghani educational and treatment center, Tabriz. Material and Methods : This was a cross-sectional study. The sampling method was census. The inclusion criteria were dead infants who developed signs of infection after 48 hours of hospitalization and those who had symptoms at the admission were excluded. Data were collected through hospital records and were analyzed using Excel software. Results: From 904 infants admitted to NICU, 39 (4.3% acquired hospital infection. Mortality from nosocomial infections in NICU was 20.5% that was 12% of the total deaths. Coagulase-negative staphylococcal Cook (37.5% and Escherichia coli (25% were the most commonly identified agents among dead neonates. Conclusion: For more reduction in nosocomial infection and its mortality rate, mercury hygiene principles and also optimizing bed spaces are recommended. ​

  15. Excess mortality rate associated with hepatitis C virus infection: A community-based cohort study in rural Egypt.

    Science.gov (United States)

    Mostafa, Aya; Shimakawa, Yusuke; Medhat, Ahmed; Mikhail, Nabiel N; Chesnais, Cédric B; Arafa, Naglaa; Bakr, Iman; El Hoseiny, Mostafa; El-Daly, Mai; Esmat, Gamal; Abdel-Hamid, Mohamed; Mohamed, Mostafa K; Fontanet, Arnaud

    2016-06-01

    >80% of people chronically infected with hepatitis C virus (HCV) live in resource-limited countries, yet the excess mortality associated with HCV infection in these settings is poorly documented. Individuals were recruited from three villages in rural Egypt in 1997-2003 and their vital status was determined in 2008-2009. Mortality rates across the cohorts were compared according to HCV status: chronic HCV infection (anti-HCV antibody positive and HCV RNA positive), cleared HCV infection (anti-HCV antibody positive and HCV RNA negative) and never infected (anti-HCV antibody negative). Data related to cause of death was collected from a death registry in one village. Among 18,111 survey participants enrolled in 1997-2003, 9.1% had chronic HCV infection, 5.5% had cleared HCV infection, and 85.4% had never been infected. After a mean time to follow-up of 8.6years, vital status was obtained for 16,282 (89.9%) participants. When compared to those who had never been infected with HCV in the same age groups, mortality rate ratios (MRR) of males with chronic HCV infection aged <35, 35-44, and 45-54years were 2.35 (95% CI 1.00-5.49), 2.87 (1.46-5.63), and 2.22 (1.29-3.81), respectively. No difference in mortality rate was seen in older males or in females. The all-cause mortality rate attributable to chronic HCV infection was 5.7% (95% CI: 1.0-10.1%), while liver-related mortality was 45.5% (11.3-66.4%). Use of a highly potent new antiviral agent to treat all villagers with positive HCV RNA may reduce all-cause mortality rate by up to 5% and hepatic mortality by up to 40% in rural Egypt. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  16. Low Infection Rate after Tumor Hip Arthroplasty for Metastatic Bone Disease in a Cohort Treated with Extended Antibiotic Prophylaxis

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    Werner H. Hettwer

    2015-01-01

    Full Text Available Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI, with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic prophylaxis for this patient population remains unknown. Material and Methods. To establish the infection rate associated with prolonged antibiotic prophylaxis in our department, we performed a retrospective review of all adult patients who underwent endoprosthetic reconstruction of the proximal femur after tumor resection for metastatic bone disease during a 4-year period from 2010 to 2013 (n=105 patients. Results. Intravenous antibiotic prophylaxis was administrated for an extended duration of a mean of 7.4 days. The overall infection rate was 3.6% (4/111 implants, infection free survival was 96% at 2 years, and the risk of amputation associated with infection was 25% (1/4 patients. Discussion. Preemptive eradication of bacterial contamination may be of value in certain clinical situations, where the risk level and consequences of implant-associated infection are unacceptable. Our findings suggest that extended postoperative antibiotic prophylaxis may reduce the risk of PJI in patients undergoing tumor resection and endoprosthetic replacement for metastatic bone disease associated impending or de facto pathologic fractures of the proximal femur.

  17. A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital

    LENUS (Irish Health Repository)

    O’ Hanlon, M

    2016-09-01

    Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.

  18. Violent crime rates as a proxy for the social determinants of sexually transmissible infection rates: the consistent state-level correlation between violent crime and reported sexually transmissible infections in the United States, 1981-2010.

    Science.gov (United States)

    Chesson, Harrell W; Owusu-Edusei, Kwame; Leichliter, Jami S; Aral, Sevgi O

    2013-11-01

    Numerous social determinants of health are associated with violent crime rates and sexually transmissible infection (STI) rates. This report aims to illustrate the potential usefulness of violent crime rates as a proxy for the social determinants of STI rates. For each year from 1981 to 2010, we assessed the strength of the association between the violent crime rate and the gonorrhoea (Neisseria gonorrhoeae) rate (number of total reported cases per 100?000) at the state level. Specifically, for each year, we calculated Pearson correlation coefficients (and P-values) between two variables (the violent crime rate and the natural log of the gonorrhoea rate) for all 50 states and Washington, DC. For comparison, we also examined the correlation between gonorrhoea rates, and rates of poverty and unemployment. We repeated the analysis using overall syphilis rates instead of overall gonorrhoea rates. The correlation between gonorrhoea and violent crime was significant at the Pcrime rates. In contrast, the P-value for the correlation coefficient exceeded 0.05 in 9 of the 30 years for the association between gonorrhoea and poverty, and in 17 of the 30 years for that between gonorrhoea and unemployment. Because violent crime is associated with many social determinants of STIs and because it is consistently associated with STI rates, violent crime rates can be a useful proxy for the social determinants of health in statistical analyses of STI rates.

  19. The step from a voluntary to a mandatory national nosocomial infection surveillance system: the influence on infection rates and surveillance effect

    Science.gov (United States)

    2012-01-01

    Abstract Background The German national nosocomial infection surveillance system, KISS, has a component for very low birth weight (VLBW) infants (called NEO-KISS) which changed from a system with voluntary participation and confidential data feedback to a system with mandatory participation and confidential feedback. Methods In order to compare voluntary and mandatory surveillance data, two groups were defined by the surveillance start date. Neonatal intensive care unit (NICU) parameters and infection rates of the NICUs in both groups were compared. In order to analyze the surveillance effect on primary bloodstream infection rates (BSI), all VLBW infants within the first three years of participation in both groups were considered. The adjusted effect measures for the year of participation were calculated. Results An increase from 49 NICUs participating in 2005 to 152 in 2006 was observed after the introduction of mandatory participation. A total of 4280 VLBW infants was included in this analysis. Healthcare-associated incidence densities rates were similar in both groups. Using multivariate analysis with the endpoint primary BSI rate and comparing the first and third year of participation lead to an adjusted incidence rate ratio (IRR) of 0.78 (CI95 0.66-0.93) for old (voluntary) and 0.81 (CI95 0.68-0.97) for new (mandatory) participants. Conclusions The step from a voluntary to a mandatory HCAI surveillance system alone may lead to substantial improvements on a countrywide scale. PMID:22958509

  20. Dynamics of tsetse natural infection rates in the Mouhoun river, Burkina Faso, in relation with environmental factors.

    Science.gov (United States)

    Bouyer, Jérémy; Koné, Naférima; Bengaly, Zakaria

    2013-01-01

    In Burkina Faso, the cyclical vectors of African animal trypanosomoses (AAT) are riverine tsetse species, namely Glossina palpalis gambiensis Vanderplank (G.p.g.) and Glossina tachinoides Westwood (G.t.) (Diptera: Glossinidae). Experimental work demonstrated that environmental stress can increase the sensitivity of tsetse to trypanosome infection. Seasonal variations of the tsetse infection rates were monitored monthly over 17 months (May 2006-September 2007) in two sites (Douroula and Kadomba). In total, 1423 flies were dissected and the infection of the proboscis, middle intestine and salivary glands was noted. All the positive organs were analyzed using monospecific polymerase chain reaction (PCR) primers. To investigate the role of different environmental factors, fly infection rates were analyzed using generalized linear mixed binomial models using the species, sex, and monthly averages of the maximum, minimum and mean daily temperatures, rainfalls, Land Surface Temperature day (LSTd) and night (LSTn) as fixed effects and the trap position as a random effect. The overall infection rate was 10% from which the predominant species was T. congolense (7.6% of the flies), followed by T. vivax (2.2% of the flies). The best model (lowest AICc) for the global infection rates was the one with the maximum daily temperature only as fixed effect (p temperature and rainfalls as fixed effect, where the maximum daily temperature was the main effect (p rate of T. congolense was very high (94%), and G. t. harbored a higher maturation rate (p = 0.03). The results are discussed in view of former laboratory studies showing that temperature stress can increase the susceptibility of tsetse to trypanosomes, as well as the possibility to improve AAT risk mapping using satellite images.

  1. The effect of comprehensive infection control measures on the rate of late-onset bloodstream infections in very low-birth-weight infants.

    Science.gov (United States)

    Wicker, Linda; Saslow, Judy; Shah, Sahil; Bhat, Vishwanath; Sannoh, Sulaiman; Brandon, Emma; Kemble, Nicole; Pyon, Kee; Stahl, Gary; Aghai, Zubair H

    2011-03-01

    Late-onset bloodstream infection (LOBI) is a significant problem in very low-birth-weight (VLBW) infants and can lead to increased mortality and morbidity. The incidence of LOBI in VLBW infants in our unit was >35% before 2004, much higher than 20% reported in other studies. A comprehensive infection control measure was introduced in our unit in 2005. Here we report the effects of comprehensive infection control measures on the rate of LOBI in VLBW infants. Infants in the preintervention group (born 2001 to 2004) were compared with the intervention group (born 2005 to 2008) for baseline demographics, risk factors for infection, and the rate of LOBI. LOBI was defined as a positive blood and/or cerebrospinal fluid culture after 3 days of life. Three hundred thirty-four VLBW infants were admitted to our unit during the preintervention period and 303 during the intervention period. There was no significant difference in baseline demographics and risk factors for LOBI between the two groups. The incidence of LOBI was significantly reduced from 38% before intervention to 23% after intervention ( P control measures significantly reduced the rate of LOBI in VLBW infants. © Thieme Medical Publishers.

  2. Infection rates of MRSA in complicated pediatric rhinosinusitis: An up to date review.

    Science.gov (United States)

    Hamill, Chelsea S; Sykes, Kevin J; Harrison, Christopher J; Weatherly, Robert A

    2018-01-01

    Published studies have reported a rise in MRSA isolates in head and neck infections, but the microbiology of complicated pediatric rhinosinusitis is unclear. One study of such patients showed that MRSA isolates were seen only in the last three years of data collection, suggesting a possible recent increased prevalence. Given the public health concerns of increasing rates of antimicrobial resistance, the goal of this study was to investigate the microbiologic patterns and outcomes of complicated pediatric rhinosinusitis. Retrospective cohort of pediatric patients admitted to our children's hospital with complicated acute rhinosinusitis from 2004 to 2014. The mean age of 250 hospitalized children with complicated rhinosinusitis was 7.6 ± 4.9 years; 109 of these (43%) underwent surgical procedures. Although MRSA prevalence was highest in 2014, no significant trend in overall MRSA prevalence occurred when considering the entire study period. No significant relationship was identified between MRSA and intra-orbital versus intra-cranial complications. Interestingly, 22.7% of patients with anaerobes detected by culture had persistent abnormal physical examination (PE) findings versus 6.1% of patients without anaerobes (p = 0.025). Furthermore, multivariate analysis also revealed that detection of anaerobes or MRSA was associated with persistent PE findings being 21.8 and 14.8 times more likely, respectively, when compared to other detected pathogens. Our data indicate modest variability in the annual rates of MRSA associated pediatric rhinosinusitis, however there was no statistically significant pattern of change in MRSA prevalence during 2004-2014. Although detection of MRSA was not significantly associated with either intraorbital or intracranial complications of sinusitis, a significant association with a poorer outcome was observed by multivariate analysis for patients from whom MRSA or anaerobes were detected. These data raise the question as to whether

  3. High Rate of Simian Immunodeficiency Virus (SIV Infections in Wild Chimpanzees in Northeastern Gabon

    Directory of Open Access Journals (Sweden)

    Vanina Boué

    2015-09-01

    Full Text Available The emergence of HIV-1 groups M, N, O, and P is the result of four independent cross-species transmissions between chimpanzees (cpz and gorillas (gor from central/south Cameroon and humans respectively. Although the first two SIVcpz were identified in wild-born captive chimpanzees in Gabon in 1989, no study has been conducted so far in wild chimpanzees in Gabon. To document the SIVcpz infection rate, genetic diversity, and routes of virus transmission, we analyzed 1458 faecal samples collected in 16 different locations across the country, and we conducted follow-up missions in two of them. We found 380 SIV antibody positive samples in 6 different locations in the north and northeast. We determined the number of individuals collected by microsatellite analysis and obtained an adjusted SIV prevalence of 39.45%. We performed parental analysis to investigate viral spread between and within communities and found that SIVs were epidemiologically linked and were transmitted by both horizontal and vertical routes. We amplified pol and gp41 fragments and obtained 57 new SIVcpzPtt strains from three sites. All strains, but one, clustered together within a specific phylogeographic clade. Given that these SIV positive samples have been collected nearby villages and that humans continue to encroach in ape’s territories, the emergence of a new HIV in this area needs to be considered.

  4. International Nosocomial Infection Control Consortium Findings of Device-Associated Infections Rate in an Intensive Care Unit of a Lebanese University Hospital

    Science.gov (United States)

    Kanj, SS; Kanafani, ZA; Sidani, N; Alamuddin, L; Zahreddine, N; Rosenthal, VD

    2012-01-01

    Objectives: To determine the rates of device-associated healthcare-associated infections (DA-HAI), microbiological profile, bacterial resistance, length of stay (LOS), excess mortality and hand hygiene compliance in one intensive care unit (ICU) of a hospital member of the International Infection Control Consortium (INICC) in Beirut, Lebanon. Materials and Methods: An open label, prospective cohort, active DA-HAI surveillance study was conducted on adults admitted to a tertiary-care ICU in Lebanon from November 2007 to March 2010. The protocol and methodology implemented were developed by INICC. Data collection was performed in the participating ICUs. Data uploading and analyses were conducted at INICC headquarters on proprietary software. DA-HAI rates were recorded by applying the definitions of the National Healthcare Safety Network (NHSN) at the US Centers for Disease Control and Prevention (CDC). We analyzed the DA-HAI, mechanical ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI), and catheter-associated urinary tract infection (CAUTI) rates, microorganism profile, excess LOS, excess mortality, and hand hygiene compliance. Results: A total of 666 patients hospitalized for 5,506 days acquired 65 DA-HAIs, an overall rate of 9.8% [(95% confidence interval (CI) 7.6–12.3], and 11.8 (95% CI 9.1–15.0) DA-HAIs per 1000 ICU-days. The CLA-BSI rate was 5.2 (95% CI 2.8–8.7) per 1000 catheter-days; the VAP rate was 8.1 (95% CI 5.5–11.7) per 1000 ventilator-days; and the CAUTI rate was 4.1 (95% CI 2.6–6.2) per 1000 catheter-days. LOS of patients was 7.3 days for those without DA-HAI, 13.8 days for those with CLA-BSI, 18.8 days for those with VAP. Excess mortality was 40.9% [relative risk (RR) 3.14; P 0.004] for CLA-BSI. Mortality of VAP and CAUTI was not significantly different from patients without DA-HAI. Escherichia coli was the most common isolated microorganism. Overall hand hygiene compliance was 84.9% (95% CI 82

  5. Locking plate and screw fixation after tibial plateau leveling osteotomy reduces postoperative infection rate in dogs over 50 kg.

    Science.gov (United States)

    Solano, Miguel A; Danielski, Alan; Kovach, Karla; Fitzpatrick, Noel; Farrell, Michael

    2015-01-01

    To assess the influence of locking plate and screw implants on postoperative infection rate in dogs >50 kg undergoing tibial plateau leveling osteotomy (TPLO). Retrospective case series. Dogs >50 kg (n = 208) that had TPLO. Medical records (January 2003-September 2011) were reviewed for dogs that had TPLO. Type of implant used (locking plate and screw fixation [LP] and dynamic compression plate and screw fixation [NLP]), use of postoperative antibiotics and presence of postoperative infection were recorded. Multivariate analysis was performed. Forty dogs (21.3%) had clinical signs compatible with postoperative infection. A positive microbiology swab was available in 16/40 cases (40%). Administration of postoperative antibiotics was associated with a lower incidence of infection (P = .006) and the use of NLP was associated with a higher incidence of infection (P = .01). Use of LP construct and postoperative antibiotic therapy significantly decreased infection rate in dogs >50 kg that have TPLO. © Copyright 2014 by The American College of Veterinary Surgeons.

  6. [Seasonality of rotavirus infection in Venezuela: relationship between monthly rotavirus incidence and rainfall rates].

    Science.gov (United States)

    González Chávez, Rosabel

    2015-09-01

    In general, it has been reported that rotavirus infection was detected year round in tropical countries. However, studies in Venezuela and Brazil suggest a seasonal behavior of the infection. On the other hand, some studies link infection with climatic variables such as rainfall. This study analyzes the pattern of behavior of the rotavirus infection in Carabobo-Venezuela (2001-2005), associates the seasonality of the infection with rainfall, and according to the seasonal pattern, estimates the age of greatest risk for infection. The analysis of the rotavirus temporal series and accumulated precipitation was performed with the software SPSS. The infection showed two periods: high incidence (November-April) and low incidence (May-October). Accumulated precipitation presents an opposite behavior. The highest frequency of events (73.8% 573/779) for those born in the period with a low incidence of the virus was recorded at an earlier age (mean age 6.5 +/- 2.0 months) when compared with those born in the station of high incidence (63.5% 568/870, mean age 11.7 +/- 2.2 months). Seasonality of the infection and the inverse relationship between virus incidence and rainfall was demonstrated. In addition, it was found that the period of birth determines the age and risk of infection. This information generated during the preaccine period will be helpful to measure the impact of the vaccine against the rotavirus.

  7. The rate of following infection control principles in educational hospitals of Khorramabad

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    tahereh Toulabi

    2006-11-01

    Results: The degree of following infection control principles in most of the personnel’s was medium (53.7% and in hand washing was low (90%. Wards status about physical environment (47.83%, resources and equipment (78.3% were medium level. Conclusion: Continuous education of personnel in different job categories, using instruments and methods to reduce infection, improvement of resources and equipment and physical environment, establishment of National Nosocomial Infection surveillance system (NNISS, yearly epidemiological investigations and performing regular microbiological cultures are the most important strategies for infection control, that must be performed in educational hospitals.

  8. Impact of polymerase chain reaction testing on Clostridium difficile infection rates in an acute health care facility.

    Science.gov (United States)

    Murad, Yanal M; Perez, Justo; Nokhbeh, Reza; Ybazeta, Gustavo; Dewar, Brenda; Lefebvre, Sebastien; Diaz-Mitoma, Francisco

    2015-04-01

    Two rapid methods of Clostridium difficile infection (CDI) diagnosis were compared between June 2012 and March 2013: a GeneXpert (Cepheid, Sunnyvale, Calif) polymerase chain reaction (PCR) test and an enzyme immunoassay (EIA). The influence of these methods on the detection of hospital-acquired CDI and identification of CDI outbreaks was evaluated. We tested 1,592 stool samples for C difficile. The GeneXpert PCR test identified 211 positive samples (68 determined to be hospital-acquired infection), whereas EIA identified 105 positive samples (36 determined to be hospital-acquired infection). The GeneXpert PCR method in contrast to the EIA method increased the detection rates of nosocomial CDI cases and contributed to the declaration of CDI outbreaks. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Health-care associated infections rates, length of stay, and bacterial resistance in an intensive care unit of Morocco: findings of the International Nosocomial Infection Control Consortium (INICC).

    Science.gov (United States)

    Madani, Naoufel; Rosenthal, Victor D; Dendane, Tarek; Abidi, Khalid; Zeggwagh, Amine Ali; Abouqal, Redouane

    2009-10-07

    Most studies related to healthcare-associated infection (HAI) were conducted in the developed countries. We sought to determine healthcare-associated infection rates, microbiological profile, bacterial resistance, length of stay (LOS), and extra mortality in one ICU of a hospital member of the International Infection Control Consortium (INICC) in Morocco. We conducted prospective surveillance from 11/2004 to 4/2008 of HAI and determined monthly rates of central vascular catheter-associated bloodstream infection (CVC-BSI), catheter-associated urinary tract infection (CAUTI) and ventilator-associated pneumonia (VAP). CDC-NNIS definitions were applied. device-utilization rates were calculated by dividing the total number of device-days by the total number of patient-days. Rates of VAP, CVC-BSI, and CAUTI per 1000 Device-days were calculated by dividing the total number of HAI by the total number of specific Device-days and multiplying the result by 1000. 1,731 patients hospitalized for 11,297 days acquired 251 HAIs, an overall rate of 14.5%, and 22.22 HAIs per 1,000 ICU-days. The central venous catheter-related bloodstream infections (CVC-BSI) rate found was 15.7 per 1000 catheter-days; the ventilator-associated pneumonia (VAP) rate found was 43.2 per 1,000 ventilator-days; and the catheter-associated urinary tract infections (CAUTI) rate found was 11.7 per 1,000 catheter-days.Overall 25.5% of all Staphylococcus aureus HAIs were caused by methicillin-resistant strains, 78.3% of Coagulase-negative-staphylococci were methicillin resistant as well. 75.0% of Klebsiella were resistant to ceftriaxone and 69.5% to ceftazidime. 31.9% of E. Coli were resistant to ceftriaxone and 21.7% to ceftazidime. 68.4% of Enterobacter sp were resistant to ceftriaxone, 55.6% to ceftazidime, and 10% to imipenem; 35.6% of Pseudomonas sp were resistant to ceftazidime and 13.5% to imipenem.LOS of patients was 5.1 days for those without HAI, 9.0 days for those with CVC-BSI, 10.6 days for those

  10. The re-infection rate of high-risk HPV and the recurrence rate of vulvar intraepithelial neoplasia (VIN) usual type after surgical treatment.

    Science.gov (United States)

    Frega, Antonio; Sopracordevole, Francesco; Scirpa, Paolo; Biamonti, Alberto; Lorenzon, Laura; Scarani, Simona; De Sanctis, Luana; Pacchiarotti, Arianna; Moscarini, Massimo; French, Deborah

    2011-09-01

    VIN usual type appears to be related to the HPV's oncogenic types. The aim of this prospective multicenter study was to evaluate the re-infection rate of high-risk HPV and the recurrence rate of VIN usual type after surgical treatment. The study enrolled 103 women affected by VIN usual type. They underwent wide local excision by CO2 laser. The patients were investigated by clinical evaluation and HPV DNA test 6 months after surgical treatment, and then were followed-up at 12, 18, 24, and 36 months. The recurrences were treated with re-excision. The rate of HPV infection after surgical treatment was 34% at 6 months, 36.9% at 12 months, 40% at 18 months, 41.7% at 24 months and 44.7% at 36 months. The mean time from HPV infection to the development of VIN was 18.8 months. HPV testing in the follow-up of VIN usual type patients might be useful for identifying those patients with a higher risk of recurrence after surgical treatment, although more studies are needed. These preliminary data suggest that the test, in addition to clinical examination, can improve the efficacy of the follow-up.

  11. Adequacy of a hospital-wide standard dose of 7mg/kg bodyweight gentamicin sufficient to achieve an adequate prophylactic maximum serum concentration (Cmax) in burn patients undergoing surgical burn wound treatment

    NARCIS (Netherlands)

    Borra, L.C.P.; Bosch, T.M.; Baar, M.E. van; Dokter, J.; Oen, I.M.; Ruijgrok, E.J.

    2016-01-01

    INTRODUCTION: Pharmacokinetics of drugs can be significantly altered in burn patients. The aim of our study was to validate if the current hospital-wide standard dosage of 7mg/kg total bodyweight gentamicin is sufficient to achieve an adequate prophylactic Cmax (Cmax>/=20mg/L). MATERIALS AND

  12. Quantifying factors determining the rate of CTL escape and reversion during acute and chronic phases of HIV infection

    Energy Technology Data Exchange (ETDEWEB)

    Ganusov, Vitaly V [Los Alamos National Laboratory; Korber, Bette M [Los Alamos National Laboratory; Perelson, Alan S [Los Alamos National Laboratory

    2009-01-01

    Human immunodeficiency virus (HIV) often evades cytotoxic T cell (CTL) responses by generating variants that are not recognized by CTLs. However, the importance and quantitative details of CTL escape in humans are poorly understood. In part, this is because most studies looking at escape of HIV from CTL responses are cross-sectional and are limited to early or chronic phases of the infection. We use a novel technique of single genome amplification (SGA) to identify longitudinal changes in the transmitted/founder virus from the establishment of infection to the viral set point at 1 year after the infection. We find that HIV escapes from virus-specific CTL responses as early as 30-50 days since the infection, and the rates of viral escapes during acute phase of the infection are much higher than was estimated in previous studies. However, even though with time virus acquires additional escape mutations, these late mutations accumulate at a slower rate. A poor correlation between the rate of CTL escape in a particular epitope and the magnitude of the epitope-specific CTL response suggests that the lower rate of late escapes is unlikely due to a low efficacy of the HIV-specific CTL responses in the chronic phase of the infection. Instead, our results suggest that late and slow escapes are likely to arise because of high fitness cost to the viral replication associated with such CTL escapes. Targeting epitopes in which virus escapes slowly or does not escape at all by CTL responses may, therefore, be a promising direction for the development of T cell based HIV vaccines.

  13. PSYCHOSOCIAL GROUP INTERVENTION AND THE RATE OF DECLINE OF IMMUNOLOGICAL PARAMETERS IN ASYMPTOMATIC HIV-INFECTED HOMOSEXUAL MEN

    NARCIS (Netherlands)

    MULDER, CL; ANTONI, MH; EMMELKAMP, PMG; VEUGELERS, PJ; SANDFORT, TGM; VANDEVIJVER, FAJR; DEVRIES, MJ

    1995-01-01

    The aim of the study was to determine changes in the rate of decline of immunological parameters after psychosocial group intervention. Subjects were 26 asymptomatic HIV-infected homosexual men who participated in a cognitive-behavioral group therapy (CBT; n = 14), or an experiential group therapy

  14. Silver-Impregnated Occlusive Dressing Reduces Rates of Acute Periprosthetic Joint Infection After Total Joint Arthroplasty.

    Science.gov (United States)

    Grosso, Matthew J; Berg, Ari; LaRussa, Samuel; Murtaugh, Taylor; Trofa, David P; Geller, Jeffrey A

    2017-03-01

    Commercial silver-impregnated occlusive dressings (such as Aquacel Ag Surgical wound dressing) have been touted as antimicrobial dressings to be used following total joint arthroplasty. Given the increased cost of an Aquacel dressing over a standard dressing for total joint arthroplasty, the objective of this study was to determine whether Aquacel surgical dressing is effective in reducing the rates of acute periprosthetic joint infection (PJI) compared to standard sterile dressing. We retrospectively reviewed the charts of 1173 consecutive patients who underwent a total knee or total hip arthroplasty between 2007 and 2015 by 1 surgeon. The surgeon switched from using a standard xeroform/gauze dressing to an Aquacel dressing in June 2011, with no other major changes in antimicrobial management. Charts were reviewed for evidence of acute PJI (within 3 months of surgery). There were a total of 11 cases of acute PJI in this patient cohort (0.94%). The incidence of acute PJI for patients managed with a sterile xeroform dressing was 1.58% (9 of 568 patients), compared to 0.33% (2 of 605 patients) with the use of Aquacel dressing. Univariate analysis showed this to be statistically significant (P = .03), and a multiple logistic regression model supported Aquacel surgical dressing as a protective factor with an odds ratio of 0.092 (95% confidence interval, 0.017-0.490; P = .005). This 4-fold decrease in acute PJI with the use of Aquacel dressing supports the use of silver-impregnated occlusive dressings for the reduction of acute PJI. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Serious tonsil infections versus tonsillectomy rates in Wales: A 15-year analysis.

    Science.gov (United States)

    Yap, D; Harris, A S; Clarke, J

    2017-01-01

    INTRODUCTION Sore throat and tonsillitis place a significant burden on the National Health Service. National guideline criteria for gauging the severity of sore throat and tonsillitis have reduced the number of tonsillectomies performed, which is thought to have increased the rate of tonsil-related infections. METHODS Data was extracted from the prospective Patient Episode Database of Wales and analysed to determine the annual number of tonsillectomies for recurrent tonsillitis, adjusted for population changes. Admissions to acute hospitals for tonsillitis, peritonsillar abscess and deep neck space abscesses were also examined. RESULTS Between 1999 and 2014, hospital admissions for tonsillitis rose three-fold (r=0.968), while admissions for peritonsillar abscess rose by 48% (r=0.857) and retro or parapharyngeal abscess admissions also increased (r=0.709). In contrast, the number of tonsillectomies per 100,000 population gradually decreased (r=-0.16). There was a positive correlation between the incidence of tonsillitis and admissions for peritonsillar abscess (adjusted r(2) 0.631; p=0.015) and retropharyngeal abscess (adjusted r(2) 0.442; p=0.00254). There was a statistically significant negative correlation between the incidence of tonsillitis and the number of tonsillectomies performed (adjusted r(2)=-0.07; p=0.0235). CONCLUSIONS The significant rise in tonsillitis in Wales raises the question as to whether we should revisit the criteria for tonsillectomy. The perceived cost saving from limiting certain procedures should not prevent healthcare policymakers from considering all other evidence. The rise in peritonsillar, retropharyngeal and parapharyngeal abscess is alarming, as they are associated with significant morbidity and mortality.

  16. Long-term recurrence rate after treatment of Helicobacter pylori infection in children and adolescents in Estonia.

    Science.gov (United States)

    Oona, M; Rägo, T; Maaroos, H I

    2004-12-01

    Helicobacter pylori infection is common in Estonia: 87% of adults and 56% of children aged 9-15 years have been found to be H. pylori seropositive. The aim of this study was to evaluate the long-term recurrence rate after treatment in children and adolescents in a setting of high H. pylori prevalence. All children (n = 27) who underwent gastroscopy at the Children's Clinic of Tartu University Clinics during 1993--95 and in whom H. pylori infection was verified by histological examination and rapid urease test and who had completed a treatment course against H. pylori infection were invited for a post-treatment follow-up endoscopy 4-6 weeks after completion of therapy (1st follow-up visit) and to the follow-up control by [13C]-urea breath test in 1997 (2nd follow-up visit) and 2002 (3rd follow-up visit). Recurrence of H. pylori infection occurred in I patient out of 16 at the 2nd follow-up visit (mean 17.8+/-7.1 months after treatment), and in 5 patients out of 15 at the 3rd follow-up visit (mean 6.6+/-0.9 years after treatment). The recurrence rate calculated for the period between the 1st and the 2nd follow-up visits was 4.2% per patient-year, and between the 2nd and the 3rd follow-up visits the rate was 7.6% (95% CI 2.5%-17.6%) per patient-year. The recurrence rate calculated for the whole follow-up period was 6.7% (95% CI 2.5%-14.5%) per patient-year. The post-treatment recurrence rate of H. pylori infection in children and adolescents is higher in Estonia than in low prevalence settings.

  17. Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis

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    Andrea Stiller

    2016-11-01

    Full Text Available Abstract Background The influence of the hospital’s infrastructure on healthcare-associated colonization and infection rates has thus far infrequently been examined. In this review we examine whether healthcare facility design is a contributing factor to multifaceted infection control strategies. Methods We searched PubMed/MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL from 1990 to December 31st, 2015, with language restriction to English, Spanish, German and French. Results We identified three studies investigating accessibility of the location of the antiseptic hand rub dispenser. Each of them showed a significant improvement of hand hygiene compliance or agent consumption with the implementation of accessible dispensers near the patient bed. Nine eligible studies evaluated the impact of single-patient rooms on the acquisition of healthcare-associated colonization and infections in comparison to multi-bedrooms or an open ward design. Six of these studies showed a significant benefit of single-patient bedrooms in reducing the healthcare-associated colonization and infection rate, whereas three studies found that single-patient rooms are neither a protective nor risk factor. In meta-analyses, the overall risk ratio for acquisition of healthcare-associated colonization and infection was 0.55 (95% CI: 0.41 to 0.74, for healthcare-associated colonization 0.52 (95% CI: 0.32 to 0.85 and for bacteremia 0.64 (95% CI: 0.53 to 0.76, all in favor of patient care in single-patient bedrooms. Conclusion Implementation of single-patient rooms and easily accessible hand rub dispensers located near the patient’s bed are beneficial for infection control and are useful parts of a multifaceted strategy for reducing healthcare-associated colonization and infections.

  18. Patterns of tsetse abundance and trypanosome infection rates among habitats of surveyed villages in Maasai steppe of northern Tanzania.

    Science.gov (United States)

    Ngonyoka, Anibariki; Gwakisa, Paul S; Estes, Anna B; Salekwa, Linda P; Nnko, Happiness J; Hudson, Peter J; Cattadori, Isabella M

    2017-09-04

    Changes of land cover modify the characteristics of habitat, host-vector interaction and consequently infection rates of disease causing agents. In this paper, we report variations in tsetse distribution patterns, abundance and infection rates in relation to habitat types and age in the Maasai Steppe of northern Tanzania. In Africa, Tsetse-transmitted trypanosomiasis negatively impacted human life where about 40 million people are at risk of contracting the disease with dramatic socio-economical consequences, for instance, loss of livestock, animal productivity, and manpower. We trapped tsetse flies in dry and wet seasons between October 2014 and May 2015 in selected habitats across four villages: Emboreet, Loiborsireet, Kimotorok and Oltukai adjacent to protected areas. Data collected include number and species of tsetse flies caught in baited traps, PCR identification of trypanosome species and extraction of monitored Normalized Difference Vegetation Index (NDVI) data from Moderate Resolution Imaging Spectrometer (MODIS). Our findings demonstrate the variation of tsetse fly species abundance and infection rates among habitats in surveyed villages in relation to NDVI and host abundance. Results have shown higher tsetse fly abundance in Acacia-swampy ecotone and riverine habitats for Emboreet and other villages, respectively. Tsetse abundance was inconsistent among habitats in different villages. Emboreet was highly infested with Glossina swynnertoni (68%) in ecotone and swampy habitats followed by G. morsitans (28%) and G. pallidipes (4%) in riverine habitat. In the remaining villages, the dominant tsetse fly species by 95% was G. pallidipes in all habitats. Trypanosoma vivax was the most prevalent species in all infected flies (95%) with few observations of co-infections (with T. congolense or T. brucei). The findings of this study provide a framework to mapping hotspots of tsetse infestation and trypanosomiasis infection and enhance the communities to plan for

  19. Compliance with American Urological Association Guidelines for Post-Percutaneous Nephrolithotomy Antibiotics Does Not Appear to Increase Rates of Infection.

    Science.gov (United States)

    Deshmukh, Sameer; Sternberg, Kevan; Hernandez, Natalia; Eisner, Brian H

    2015-10-01

    We compared infection rates after percutaneous nephrolithotomy in a group of patients without a history of infection or struvite calculi who received 24 hours or less of antibiotics postoperatively (ie compliance with AUA guidelines) vs a group that received 5 to 7 days of antibiotics postoperatively. We retrospectively reviewed the records of consecutive percutaneous nephrolithotomy procedures in patients without a history of urinary tract infection. Group 1 received 24 hours or less of antibiotics postoperatively and group 2 received a mean of 6 days of antibiotics postoperatively. A total of 52 patients in group 1 (24 hours or less of antibiotics) and 30 in group 2 (mean 6 days of antibiotics) met study inclusion criteria. In 5 group 1 patients (9.6%) fever developed within 72 hours of percutaneous nephrolithotomy but none demonstrated bacteriuria or bacteremia on cultures. No patient in group 1 was treated for urinary tract infection on postoperative days 3 to 14. In 4 group 2 patients (13.3%) fever developed within 72 hours of percutaneous nephrolithotomy. A single patient showed bacteriuria (less than 10,000 cfu mixed gram-positive bacteria) on culture while no patient demonstrated bacteremia. No patient in group 2 was treated for urinary tract infection on postoperative days 3 to 14. There was no difference in stone-free rates or the need for additional procedures between the 2 groups. In this pilot series compliance with AUA guidelines for antibiotic prophylaxis did not result in higher rates of infection than in a comparable group of 30 patients who received approximately 6 days of antibiotics postoperatively. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Infection rate in mandibular angle fractures treated with a 2.0-mm 8-hole curved strut plate.

    Science.gov (United States)

    Bui, Peter; Demian, Nagi; Beetar, Patrick

    2009-04-01

    The aim of this study was to determine the rate of postoperative infection and the efficacy of removing teeth in the line of mandibular angle fractures treated with 2.0-mm 8-hole titanium curved strut plates. Our understanding is that this method of repair is currently being used only in a few centers in the United States. A retrospective review of mandibular angle fractures treated with a 2.0-mm 8-hole strut plate during a 4-year period. Postoperative antibiotics were given for 1 week. Follow-up appointments were 4 weeks or longer. A nonchewing diet was instructed for 6 weeks. Data for all selected patients include the information such as age, gender, etiology of injuries, medical history, concurrent injuries, nerve deficits, pre- and postoperative antibiotic administration, postop infection, a presence or absence of teeth in the line of fractures, and whether these teeth were removed. Four patients (4 of 49 or 8.2%) developed infections. Two of those patients had a tooth in the line of a fracture that was retained (2 of 14 or 14%). The third had a tooth in the line of a fracture that was extracted (1 of 18 or 5.6%). The fourth patient was 1 of the 17 patients who did not have teeth in the line of fracture and developed infection (1 of 17 or 5.9%). None of the patients developed failed hardware, malunion, nonunion, malocclusion, or iatrogenic nerve injury. The use of a 2.0-mm 8-hole strut plate is associated with a low infection rate (8.2%). The infection rate for those mandibular angle fractures with teeth in the line of fracture retained was 14% compared with 5.6% for those fractures with the teeth in the line of fracture extracted.

  1. Japanese Encephalitis Virus Infection Rate and Detection of Genotype I From Culex tritaeniorhynchus Collected From Jiangsu, China.

    Science.gov (United States)

    Chu, Hongliang; Wu, Zhiming; Chen, Hongna; Li, Chunxiao; Guo, Xiaoxia; Liu, Ran; Wang, Gang; Zhou, Minghao; Zhao, Tongyan

    2017-07-01

    Information regarding the infection rate and genotype shifts for Japanese encephalitis virus (JEV) are important for JE vaccine application. In Jiangsu province, China, which is one of the provinces with a high prevalence of JE, JEV infection in swine and mosquitoes in certain cities has only been investigated in 2008-2009. Lianyungang City has one of the highest numbers of JE cases in Jiangsu province, and it has a high risk of JEV invasion via migrant birds. JEV infection in vectors in Lianyungang City, which has urban and rural parts, has not been investigated. In 2015-2016, we collected mosquitoes in cowsheds with ultraviolet light traps and detected JEV by reverse transcription-polymerase chain reaction (RT-PCR) method in Culex tritaeniorhynchus in Xintan village, Xuzhuang village, and Xiaogaozhuang village in Lianyungang City, China. The proportion of positive pools, which is calculated by the number of infected pools to the total number of pools tested in these villages, were 16.67%, 20.00%, and 4.17%, respectively, and the minimum infection rates, which is calculated as the ratio of the number of positive pools to the total number of mosquitoes tested, were 3.33‰, 4.00‰, and 0.83‰, respectively. Four JEV strains from positive samples were coded as LYG-1, LYG-2, LYG-3, and LYG-4, and the complete E genes were sequenced. Furthermore, the complete genome of LYG-3 was sequenced. The phylogenetic analysis indicated that all the four JEV strains belonged to genotype I-b. This is the first report of genotype I JEV strain in Jiangsu province. The high JEV infection rate in Culex tritaeniorhynchus indicated a high risk of JE reemergence in Lianyungang. The detected JEV strains may have similar antigenicity to that of SA14-14-2 according to molecular characters. These findings suggest that the vaccine can still be effective in Lianyungang.

  2. Extracting the time-dependent transmission rate from infection data via solution of an inverse ODE problem.

    Science.gov (United States)

    Pollicott, Mark; Wang, Hao; Weiss, Howard Howie

    2012-01-01

    The transmission rate of many acute infectious diseases varies significantly in time, but the underlying mechanisms are usually uncertain. They may include seasonal changes in the environment, contact rate, immune system response, etc. The transmission rate has been thought difficult to measure directly. We present a new algorithm to compute the time-dependent transmission rate directly from prevalence data, which makes no assumptions about the number of susceptible or vital rates. The algorithm follows our complete and explicit solution of a mathematical inverse problem for SIR-type transmission models. We prove that almost any infection profile can be perfectly fitted by an SIR model with variable transmission rate. This clearly shows a serious danger of overfitting such transmission models. We illustrate the algorithm with historic UK measles data and our observations support the common belief that measles transmission was predominantly driven by school contacts.

  3. High rate of A(H1N1pdm09 infections among rural Thai villagers, 2009-2010.

    Directory of Open Access Journals (Sweden)

    Benjawan Khuntirat

    Full Text Available Pandemic influenza A(H1N1pdm09 emerged in Thailand in 2009. A prospective longitudinal adult cohort and household transmission study of influenza-like illness (ILI was ongoing in rural Thailand at the time of emergence. Symptomatic and subclinical A(H1N1pdm09 infection rates in the cohort and among household members were evaluated.A cohort of 800 Thai adults underwent active community-based surveillance for ILI from 2008-2010. Acute respiratory samples from ILI episodes were tested for A(H1N1pdm09 by qRT-PCR; acute and 60-day convalescent blood samples were tested by A(H1N1pdm09 hemagglutination inhibition assay (HI. Enrollment, 12-month and 24-month follow-up blood samples were tested for A(H1N1pdm09 seroconversion by HI. Household members of influenza A-infected cohort subjects with ILI were enrolled in household transmission investigations in which day 0 and 60 blood samples and acute respiratory samples were tested by either qRT-PCR or HI for A(H1N1pdm09. Seroconversion between annual blood samples without A(H1N1pdm09-positive ILI was considered as subclinical infection.The 2-yr cumulative incidence of A(H1N1pdm09 infection in the cohort in 2009/2010 was 10.8% (84/781 with an annual incidence of 1.2% in 2009 and 9.7% in 2010; 83.3% of infections were subclinical (50% in 2009 and 85.9% in 2010. The 2-yr cumulative incidence was lowest (5% in adults born ≤ 1957. The A(H1N1pdm09 secondary attack rate among household contacts was 47.2% (17/36; 47.1% of these infections were subclinical. The highest A(H1N1pdm09 secondary attack rate among household contacts (70.6%, 12/17 occurred among children born between 1990 and 2003.Subclinical A(H1N1pdm09 infections in Thai adults occurred frequently and accounted for a greater proportion of all A(H1N1pdm09 infections than previously estimated. The role of subclinical infections in A(H1N1pdm09 transmission has important implications in formulating strategies to predict and prevent the spread of A(H1N1pdm

  4. Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era.

    Science.gov (United States)

    Brady, Michael T; Oleske, James M; Williams, Paige L; Elgie, Carol; Mofenson, Lynne M; Dankner, Wayne M; Van Dyke, Russell B

    2010-01-01

    Introduction of highly active antiretroviral therapy has significantly decreased mortality in HIV-1-infected adults and children. Although an increase in non-HIV-related mortality has been noted in adults, data in children are limited. To evaluate changes in causes and risk factors for death among HIV-1-infected children in Pediatric AIDS Clinical Trials Group 219/219C. Multicenter, prospective cohort study designed to evaluate long-term outcomes in HIV-1-exposed and infected US children. There were 3553 HIV-1-infected children enrolled and followed up between April 1993 and December 2006, with primary cause of mortality identified in the 298 observed deaths. Mortality rates per 100 child-years overall and by demographic factors; survival estimates by birth cohort; and hazard ratios for mortality by various demographic, health, and antiretroviral treatment factors were determined. Among 3553 HIV-1-infected children followed up for a median of 5.3 years, 298 deaths occurred. Death rates significantly decreased between 1994 and 2000, from 7.2 to 0.8 per 100 person-years, and remained relatively stable through 2006. After adjustment for other covariates, increased risk of death was identified for those with low CD4 and AIDS-defining illness at entry. Decreased risks of mortality were identified for later birth cohorts, and for time-dependent initiation of highly active antiretroviral therapy (hazard ratio 0.54, P causes of death were "End-stage AIDS" (N = 48, 16%) and pneumonia (N = 41, 14%). The proportion of deaths due to opportunistic infections (OIs) declined from 37% in 1994-1996 to 24% after 2000. All OI mortality declined during the study period. However, a greater decline was noted for deaths due to Mycobacterium avium complex and cryptosporidium. Deaths from "End-stage AIDS," sepsis and renal failure increased. Overall death rates declined from 1993 to 2000 but have since stabilized at rates about 30 times higher than for the general US pediatric population

  5. High Infection Rates for Adult Macaques after Intravaginal or Intrarectal Inoculation with Zika Virus

    Science.gov (United States)

    Nalca, Aysegul; Rossi, Franco D.; Miller, Lynn J.; Wiley, Michael R.; Perez-Sautu, Unai; Washington, Samuel C.; Norris, Sarah L.; Wollen-Roberts, Suzanne E.; Shamblin, Joshua D.; Kimmel, Adrienne E.; Bloomfield, Holly A.; Valdez, Stephanie M.; Sprague, Thomas R.; Principe, Lucia M.; Bellanca, Stephanie A.; Cinkovich, Stephanie S.; Lugo-Roman, Luis; Cazares, Lisa H.; Pratt, William D.; Palacios, Gustavo F.; Bavari, Sina; Pitt, M. Louise; Nasar, Farooq

    2017-01-01

    Unprotected sexual intercourse between persons residing in or traveling from regions with Zika virus transmission is a risk factor for infection. To model risk for infection after sexual intercourse, we inoculated rhesus and cynomolgus macaques with Zika virus by intravaginal or intrarectal routes. In macaques inoculated intravaginally, we detected viremia and virus RNA in 50% of macaques, followed by seroconversion. In macaques inoculated intrarectally, we detected viremia, virus RNA, or both, in 100% of both species, followed by seroconversion. The magnitude and duration of infectious virus in the blood of macaques suggest humans infected with Zika virus through sexual transmission will likely generate viremias sufficient to infect competent mosquito vectors. Our results indicate that transmission of Zika virus by sexual intercourse might serve as a virus maintenance mechanism in the absence of mosquito-to-human transmission and could increase the probability of establishment and spread of Zika virus in regions where this virus is not present. PMID:28548637

  6. High rate of transplacental infection and transmission of Neospora caninum following experimental challenge of cattle at day 210 of gestation

    Directory of Open Access Journals (Sweden)

    Benavides Julio

    2012-12-01

    Full Text Available Abstract In order to investigate the pathogenesis of neosporosis following a primary infection in late pregnancy, cattle were subcutaneously challenged with 5 × 108Neospora caninum (NC1 isolate tachyzoites at day 210 of gestation and serial necropsies were then carried out at 14, 28, 42 and 56 days post-infection (dpi. No abortions occurred and all the foetuses were viable at the time of euthanasia. There was a high rate of vertical transmission, as parasites were detected by immunohistochemical labelling and PCR in all the foetuses from 28 dpi. Focal necrotic lesions were observed in the placentomes of the placenta from 28 dpi and showed resolution during later time points, denoted by infiltration of inflammatory cells at 42 dpi and fibrosis at 56 dpi. Foetuses at 28 and 42 dpi showed scarce and isolated lesions which are unlikely to represent a threat to foetal viability. No lesions were observed in the foetuses at 14 or 56 dpi suggesting control of the infection and resolution of the lesions by maternal and foetal immune responses. Once infection was established, it could not be cleared from the host and vertical transmission of the parasite occurred in all infected hosts. Parasite was detected in the placenta at 28 dpi, while in previous experimental infections of cattle at day 70 and 140 of gestation using the same challenge model, it was already present at day 14 post infection. This suggests that a change in the maternal immune response plays a crucial role in limiting the initial infection during the last term of pregnancy.

  7. A new non-invasive approach based on polyhexamethylene biguanide increases the regression rate of HPV infection

    Directory of Open Access Journals (Sweden)

    Gentile Antonio

    2012-09-01

    Full Text Available Abstract Background HPV infection is a worldwide problem strictly linked to the development of cervical cancer. Persistence of the infection is one of the main factors responsible for the invasive progression and women diagnosed with intraepithelial squamous lesions are referred for further assessment and surgical treatments which are prone to complications. Despite this, there are several reports on the spontaneous regression of the infection. This study was carried out to evaluate the effectiveness of a long term polyhexamethylene biguanide (PHMB-based local treatment in improving the viral clearance, reducing the time exposure to the infection and avoiding the complications associated with the invasive treatments currently available. Method 100 women diagnosed with HPV infection were randomly assigned to receive six months of treatment with a PHMB-based gynecological solution (Monogin®, Lo.Li. Pharma, Rome - Italy or to remain untreated for the same period of time. Results A greater number of patients, who received the treatment were cleared of the infection at the two time points of the study (three and six months compared to that of the control group. A significant difference in the regression rate (90% Monogin group vs 70% control group was observed at the end of the study highlighting the time-dependent ability of PHMB to interact with the infection progression. Conclusions The topic treatment with PHMB is a preliminary safe and promising approach for patients with detected HPV infection increasing the chance of clearance and avoiding the use of invasive treatments when not strictly necessary. Trial registration ClinicalTrials.gov Identifier NCT01571141

  8. Dynamics of a Fractional Order HIV Infection Model with Specific Functional Response and Cure Rate

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    Adnane Boukhouima

    2017-01-01

    Full Text Available We propose a fractional order model in this paper to describe the dynamics of human immunodeficiency virus (HIV infection. In the model, the infection transmission process is modeled by a specific functional response. First, we show that the model is mathematically and biologically well posed. Second, the local and global stabilities of the equilibria are investigated. Finally, some numerical simulations are presented in order to illustrate our theoretical results.

  9. Asymptomatic endemic Chlamydia pecorum infections reduce growth rates in calves by up to 48 percent.

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    Anil Poudel

    Full Text Available Intracellular Chlamydia (C. bacteria cause in cattle some acute but rare diseases such as abortion, sporadic bovine encephalomyelitis, kerato-conjunctivitis, pneumonia, enteritis and polyarthritis. More frequent, essentially ubiquitous worldwide, are low-level, asymptomatic chlamydial infections in cattle. We investigated the impact of these naturally acquired infections in a cohort of 51 female Holstein and Jersey calves from birth to 15 weeks of age. In biweekly sampling, we measured blood/plasma markers of health and infection and analyzed their association with clinical appearance and growth in dependence of chlamydial infection intensity as determined by mucosal chlamydial burden or contemporaneous anti-chlamydial plasma IgM. Chlamydia 23S rRNA gene PCR and ompA genotyping identified only C. pecorum (strains 1710S, Maeda, and novel strain Smith3v8 in conjunctival and vaginal swabs. All calves acquired the infection but remained clinically asymptomatic. High chlamydial infection associated with reduction of body weight gains by up to 48% and increased conjunctival reddening (P<10(-4. Simultaneously decreased plasma albumin and increased globulin (P<10(-4 suggested liver injury by inflammatory mediators as mechanisms for the growth inhibition. This was confirmed by the reduction of plasma insulin like growth factor-1 at high chlamydial infection intensity (P<10(-4. High anti-C. pecorum IgM associated eight weeks later with 66% increased growth (P = 0.027, indicating a potential for immune protection from C. pecorum-mediated growth depression. The worldwide prevalence of chlamydiae in livestock and their high susceptibility to common feed-additive antibiotics suggests the possibility that suppression of chlamydial infections may be a major contributor to the growth promoting effect of feed-additive antibiotics.

  10. High Infection Rates in Adult Macaques Following Intravaginal or Intrarectal Zika Virus Inoculation

    Science.gov (United States)

    2017-04-07

    of sexual transmission from men to women . International Journal of Infectious 325 Diseases . 2016;51:128-32. 326 20. Arsuaga M, Bujalance SG, Diaz...susceptibility to ZIKV infection in 244 human and/or sylvatic NHP populations. Furthermore, sexually transmitted infections (STIs) are 245 known risk...Menendez M, Vazquez A, Arribas JR. Probable sexual 327 transmission of Zika virus from a vasectomised man. The Lancet Infectious Diseases . 2016 328

  11. [Age-related dynamics of roach infection rate with Ligula intestinalis (Cestoda: Ligulidae) plerocercoids and probability of its usage for the calculation of host death rate].

    Science.gov (United States)

    Pronin, N M; Pronina, S V

    2014-01-01

    Results of special parasitological dissections of roach samples from catches with the same fishing gear and at the same station (Monakhovo Cove, Chivyrkui Bay of the Lake Baikal) and at the same time in different years (1998-2002) are given. Stability of age-related dynamics of roach infection rate with Ligula intestinalisis in different years with the maximum of prevalence and mean abundance in fish of 3+ age, and the following sharp decrease in these rates in elder age groups, was revealed. Basing on prevalence decreasing of a single roach generation, the rate of fish mortality during its growth from age group 3+ to 4+ was estimated as 15.9-20.7%.

  12. Effects of 70% ethanol locks on rates of central line infection, thrombosis, breakage, and replacement in pediatric intestinal failure.

    Science.gov (United States)

    Abu-El-Haija, Maisam; Schultz, Jonathan; Rahhal, Riad M

    2014-06-01

    Parenteral nutrition is essential for the growth and nutrition of patients with intestinal failure (IF). Catheter-related bloodstream infections (CRBSI) are a major complication of parenteral nutrition use. Few retrospective studies have shown that 70% ethanol lock (ETL) therapy for central lines can reduce the infection rate. Studies assessing line breakage, thrombosis, and replacement with the use of ETL are lacking in the pediatric literature. The present study is a retrospective chart review, with a primary outcome of CRBSI rate per 1000 catheter days, and secondary outcomes of line thrombosis, line breakage requiring repair, and line replacement rates with use of ETL compared with heparin locks. Rates were compared using the Wilcoxon signed-rank test for paired nonparametric data. Seven patients satisfied the inclusion criteria that included having a single-lumen silicone central line exposed to both heparin and ETL therapy during the study period. There was a statistically significant decrease in overall and Gram-negative CRBSI rates per 1000 catheter days with a use of ETL therapy (10.3-1.4 per 1000 catheter days for overall CRBSIs, P = 0.02; 6.7-0 per 1000 catheter days for Gram-negative CRBSI, P = 0.03). There was an increasing trend in line thrombosis and repair rates with ETL therapy. Logistic regression analysis evaluating the impact of line luminal size on line repair rate showed a reduced risk of line repair when using larger-diameter central lines. ETL therapy is an effective method for decreasing CRBSI in patients with IF; however, it may have a negative impact on line integrity. Patients should be carefully selected when deciding on ETL therapy use for central line care. Studies are needed on the effect of different ethanol concentrations on infection rate and line integrity to optimize the outcome in this high-risk population.

  13. Estimating the Number of Heterosexual Persons in the United States to Calculate National Rates of HIV Infection.

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    Amy Lansky

    Full Text Available This study estimated the proportions and numbers of heterosexuals in the United States (U.S. to calculate rates of heterosexually acquired human immunodeficiency virus (HIV infection. Quantifying the burden of disease can inform effective prevention planning and resource allocation.Heterosexuals were defined as males and females who ever had sex with an opposite-sex partner and excluded those with other HIV risks: persons who ever injected drugs and males who ever had sex with another man. We conducted meta-analysis using data from 3 national probability surveys that measured lifetime (ever sexual activity and injection drug use among persons aged 15 years and older to estimate the proportion of heterosexuals in the United States population. We then applied the proportion of heterosexual persons to census data to produce population size estimates. National HIV infection rates among heterosexuals were calculated using surveillance data (cases attributable to heterosexual contact in the numerators and the heterosexual population size estimates in the denominators.Adult and adolescent heterosexuals comprised an estimated 86.7% (95% confidence interval: 84.1%-89.3% of the U.S. population. The estimate for males was 84.1% (CI: 81.2%-86.9% and for females was 89.4% (95% CI: 86.9%-91.8%. The HIV diagnosis rate for 2013 was 5.2 per 100,000 heterosexuals and the rate of persons living with diagnosed HIV infection in 2012 was 104 per 100,000 heterosexuals aged 13 years or older. Rates of HIV infection were >20 times as high among black heterosexuals compared to white heterosexuals, indicating considerable disparity. Rates among heterosexual men demonstrated higher disparities than overall population rates for men.The best available data must be used to guide decision-making for HIV prevention. HIV rates among heterosexuals in the U.S. are important additions to cost effectiveness and other data used to make critical decisions about resources for

  14. Infection

    Science.gov (United States)

    2010-09-01

    whether BMPs maintain their osteoinductive capability in infected human wounds. The authors are aware of only one series describing the use of BMP in an...et al. Osteogenic protein-1 induces bone formation in the presence of bacterial infection in a rat intramuscular osteoinduction model. J Orthop Trauma

  15. Single-stage orthoplastic reconstruction of Gustilo-Anderson Grade III open tibial fractures greatly reduces infection rates.

    Science.gov (United States)

    Mathews, J A; Ward, J; Chapman, T W; Khan, U M; Kelly, M B

    2015-11-01

    Grade III open fractures of the tibia represent a serious injury. It is recognised that combined management of these cases by experienced orthopaedic and plastic surgeons improves outcomes. Previous studies have not considered the timing of definitive soft tissue cover in relation to the definitive orthopaedic management. This paper reviews the outcomes in patients treated in an orthoplastic unit where the emphasis was on undertaking the definitive orthopaedic and plastic surgical procedures in a single stage, following initial debridement and temporary stabilisation as necessary. We reviewed medical notes of 73 consecutive patients with 74 Grade III open tibia fractures (minimum 1 year follow up), to compare deep infection rates in patients who had (a) a single-stage definitive fixation and soft tissue coverage vs. those who had separate operations, and (b) those who had definitive treatment completed in 72h. (a) Combined Single-stage Orthoplastic Fixation and Coverage: 48 fractures were managed with definitive orthopaedic fixation and plastic surgical coverage performed at the same time, whilst 26 had these performed at separate stages. Of those subjects that had definitive fixation and coverage in one procedure 2 (4.2%) developed deep infections, compared with 9 (34.6%) deep infections (p<0.001) in those who underwent definitive fixation and coverage at separate operations. (b) Timing of surgery: Of the fractures that had definitive fixation and coverage completed within 72h of injury, 5 (20%) developed deep infections, compared with 6 (12.2%) deep infections (p=0.492) in those whose definitive fixation/coverage was completed at later than 72h. Joint orthoplastic operating lists facilitate simultaneous definitive fixation and cover that greatly reduces infection rates. Based on our experience presented in this paper, we believe that emphasis should be placed on timely transfer to a specialist centre, aiming for a single-stage combined orthoplastic procedure to

  16. Increasing rates of obesity among HIV-infected persons during the HIV epidemic.

    Directory of Open Access Journals (Sweden)

    Nancy Crum-Cianflone

    2010-04-01

    Full Text Available The prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV-infected persons are unknown.We evaluated prospective data from a U.S. Military HIV Natural History Study (1985-2004 consisting of early diagnosed patients. Statistics included multivariate linear regression and longitudinal linear mixed effects models.Of 1682 patients, 2% were underweight, 37% were overweight, and 9% were obese at HIV diagnosis. Multivariate predictors of a higher body mass index (BMI at diagnosis included more recent year of HIV diagnosis, older age, African American race, and earlier HIV stage (all p<0.05. The majority of patients (62% gained weight during HIV infection. Multivariate factors associated with a greater increase in BMI during HIV infection included more recent year of diagnosis, lower BMI at diagnosis, higher CD4 count, lower HIV RNA level, lack of AIDS diagnosis, and longer HIV duration (all p<0.05. Nucleoside agents were associated with less weight gain; other drug classes had no significant impact on weight change in the HAART era.HIV-infected patients are increasingly overweight/obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general population. Weight management programs may be important components of HIV care.

  17. Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

    Science.gov (United States)

    2013-01-01

    Background Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB

  18. Nosocomial catheter-related bloodstream infections in a pediatric intensive care unit: risk and rates associated with various intravascular technologies.

    Science.gov (United States)

    Odetola, Folafoluwa O; Moler, Frank W; Dechert, Ronald E; VanDerElzen, Kristen; Chenoweth, Carol

    2003-10-01

    Nosocomial bloodstream infections are associated with increased patient morbidity, mortality, and hospital costs. More than 90% of these infections are related to the use of intravascular catheter devices. This study was done to assess the risk and rates of catheter related-bloodstream infections (CR-BSI) associated with different intravascular technologies in a pediatric intensive care unit population. Retrospective cohort study. A 16-bed pediatric intensive care unit in a tertiary children's hospital. All admissions between July 1997 and December 1999 requiring placement of an intravascular access device for care were examined. Patients with CR-BSI were identified through ongoing surveillance using Centers for Disease Control/National Nosocomial Infections Surveillance System definitions for bloodstream infection. None. Of the 2,728 admissions during the review period, 1,043 (38.3%) required placement of an intravascular access device. Bivariate analysis revealed that patients who required intravascular cannulae for extracorporeal life support had a 10-fold increased risk of developing a CR-BSI, and patients requiring vascular access for renal replacement therapy demonstrated a 4-fold increase in the risk of developing CR-BSI compared with the referent group. There was a significant increase in the CR-BSI rate associated with the use of more intravascular access devices per patient admission. Multivariate logistic regression identified the use of extracorporeal life support therapy and the total duration of use of intravascular access devices as significant independent predictors of CR-BSI when controlling for other predictors. The use of extracorporeal life support therapy, the presence of multiple intravascular access devices, and the total duration of intravascular access device use were associated with an increase in the rate and risk of developing CR-BSI in our pediatric intensive care unit population. Larger, prospective studies may help elucidate

  19. Topically Applied Vancomycin Powder Reduces the Rate of Surgical Site Infection in Diabetic Patients Undergoing Foot and Ankle Surgery.

    Science.gov (United States)

    Wukich, Dane K; Dikis, Jeffrey W; Monaco, Spencer J; Strannigan, Kristin; Suder, Natalie C; Rosario, Bedda L

    2015-09-01

    The purpose of this study was to evaluate the efficacy of topically applied vancomycin powder in reducing the rate of surgical site infections (SSIs) in patients with diabetes mellitus (DM) undergoing foot and ankle surgery. Eighty-one patients with DM who underwent reconstructive surgery of a foot and/or ankle deformity and/or trauma and who received topically applied vancomycin were matched to 81 patients with DM who did not receive topically applied vancomycin. The mean age was 60.6 years in the vancomycin group and 59.4 years in the control group (P infection was not significantly different between the 2 groups (OR, 0.400; 95% CI, 0.078-2.062; P = .2734); however, deep infections were 80% less likely in patients who received vancomycin powder (OR, 0.200; 95% CI, 0.044-0.913; P = .0377). High-risk diabetic patients undergoing foot and ankle surgery were notably less likely to develop an SSI with the use of topically applied vancomycin powder in the surgical wound, particularly with regard to deep infections. Topically applied vancomycin was associated with a very low rate of complications and was inexpensive ($5 per 1000 mg). Based on this study, foot and ankle surgeons may consider applying 500 to 1000 mg of vancomycin powder prior to skin closure in diabetic patients who are not allergic to vancomycin. Level III, retrospective case control series. © The Author(s) 2015.

  20. Improved patient safety through reduced airway infection rates in a paediatric cystic fibrosis programme after a quality improvement effort to enhance infection prevention and control measures.

    Science.gov (United States)

    Savant, Adrienne P; O'Malley, Catherine; Bichl, Stacy; McColley, Susanna A

    2014-04-01

    To reduce the risk of pathogen transmission between patients with cystic fibrosis (CF) and decrease the rate of acquisition of new CF pathogens in our patients. Using the Model for Improvement, we developed a new process for infection prevention and control in our outpatient CF clinics. Paediatric CF programme at Ann & Robert H. Lurie Children's Hospital of Chicago; approximately 180 paediatric patients aged birth to 21 years. All paediatric patients enrolled in the Cystic Fibrosis Foundation Patient Data Registry at this institution. Implemented contact precautions with all patients, regardless of respiratory tract culture results. Respiratory tract culture rates of specific pathogens by quarter were compared prior to and after implementation. Our percentage of patients with a positive respiratory tract culture for Pseudomonas aeruginosa dropped from 30% to 21% (p<0.0001) and for methicillin-resistant Staphylococcus aureus (MRSA) dropped from 10.8% to 8.7% (p=0.008). Use of contact precautions by all care providers, for all patients, regardless of respiratory tract culture results resulted in decreased P aeruginosa and MRSA infection rates.

  1. Simultaneous vaccination with MMR and DTaP-IPV-Hib and rate of hospital admissions with any infections

    DEFF Research Database (Denmark)

    Sørup, Signe; Benn, Christine S; Poulsen, Anja

    2016-01-01

    and inactivated vaccines may increase child mortality compared with the live vaccine alone. We examined the hypothesis that simultaneous administration of MMR and the inactivated DTaP-IPV-Hib vaccine compared with MMR alone is associated with higher incidence of infectious disease admissions. METHODS: Nationwide......BACKGROUND: In Denmark, live measles, mumps, and rubella vaccine (MMR) is associated with a reduced risk of infectious disease admissions, particularly for lower respiratory tract infections. In low-income countries, simultaneous vaccination (i.e. vaccination at the same visit) with live......, 4965 children had simultaneous MMR and DTaP-IPV-Hib as their most recent vaccination. Compared with MMR alone, simultaneous administration was associated with a higher rate of lower respiratory tract infections (adjusted incidence rate ratio (IRR), 1.27; 95% confidence interval (CI), 1...

  2. Effects of dietary Gracilaria sp. and Alaria sp. supplementation on growth performance, metabolic rates and health in meagre (Argyrosomus regius) subjected to pathogen infection

    DEFF Research Database (Denmark)

    Peixoto, Maria João; Salas-Leitón, Emílio; Brito, Francisca

    2017-01-01

    . Standard and routine metabolic rates, and aerobic metabolic scope did not vary significantly among dietary treatments. Conversely, maximum metabolic rate was significantly higher in fish fed Alaria sp. diet when compared to control group. Non-infected fish had higher hematocrit levels than the infected...... enzymes activities when compared to non-infected. An interaction between infection and diet was found for glutathione peroxidase and reduced glutathione activities. The current study suggests that dietary seaweed supplementation modulates metabolic rates and biomarker responses in meagre, which may confer...

  3. Increased Incidence of Campylobacter spp. Infection and High Rates among Children, Israel

    Science.gov (United States)

    Lerner, Larisa; Valinsky, Lea; Moran-Gilad, Jacob; Nissan, Israel; Agmon, Vered; Peretz, Chava

    2013-01-01

    During 1999–2010, the annual incidence of Campylobacter spp. infection in Israel increased from 31.04 to 90.99 cases/100,000 population, a yearly increase of 10.24%. Children 26-fold higher than for the 30–<50 age group. PMID:24188185

  4. The rate of immune escape vanishes when multiple immune responses control an HIV infection

    NARCIS (Netherlands)

    van Deutekom, Hanneke W. M.; Wijnker, Gilles; de Boer, Rob J.

    2013-01-01

    During the first months of HIV infection, the virus typically evolves several immune escape mutations. These mutations are found in epitopes in viral proteins and reduce the impact of the CD8⁺ T cells specific for these epitopes. Recent data show that only a subset of the epitopes escapes, that most

  5. Phlebotomine fauna, natural infection rate and feeding habits of Lutzomyia cruzi in Jaciara, state of Mato Grosso, Brazil

    Directory of Open Access Journals (Sweden)

    Veruska Nogueira de Brito

    2014-11-01

    Full Text Available Visceral leishmaniasis (VL in Brazil is transmitted by the phlebotomine Lutzomyia longipalpis and in some midwestern regions by Lutzomyia cruzi. Studies of the phlebotomine fauna, feeding habits and natural infection rate by Leishmania contribute to increased understanding of the epidemiological chain of leishmaniases and their vectorial capacity. Collections were performed in Jaciara, state of Mato Grosso from 2010-2013, during which time 2,011 phlebotomines (23 species were captured (68.70% Lu. cruzi and 20.52% Lutzomyia whitmani. Lu. cruzi females were identified by observing the shapes of the cibarium (a portion of the mouthpart and spermatheca, from which samples were obtained for polymerase chain reaction to determine the rates of natural infection. Engorged phlebotomines were assessed to identify the blood-meal host by ELISA. A moderate correlation was discovered between the number of Lu. cruzi and the temperature and the minimum rate of infection was 6.10%. Twenty-two females were reactive to the antisera of bird (28%, dog (3.30% and skunk (1.60%. We conclude that Lu. cruzi and Lu. whitmani have adapted to the urban environment in this region and that Lu. cruzi is the most likely vector of VL in Jaciara. Moreover, maintenance of Leishmania in the environment is likely aided by the presence of birds and domestic and synanthropic animals.

  6. A TWO-WAY ROAD: RATES OF HIV INFECTION AND BEHAVIORAL RISK FACTORS AMONG DEPORTED MEXICAN LABOR MIGRANTS

    Science.gov (United States)

    Rangel, M. Gudelia; Martinez-Donate, Ana P.; Hovell, Melbourne; Sipan, Carol L.; Zellner, Jennifer A.; Gonzalez-Fagoaga, Eduardo; Kelley, Norma J.; Asadi-Gonzalez, Ahmed; Amuedo-Dorantes, Catalina; Magis-Rodriguez, Carlos

    2012-01-01

    A large number of Mexican migrants are deported to Mexico and released in the North Mexican border region every year. Despite their volume and high vulnerability, little is known about the level of HIV infection and related risk behaviors among this hard-to-reach population. We conducted a cross-sectional, probability survey with deported Mexican migrants in Tijuana, Mexico (N=693) and estimated levels of HIV infection and behavioral risk factors among this migrant flow. The sample and population estimated rates of HIV for deported males were 1.23% and 0.80%, respectively. No positive cases were found among the female sample. We found high lifetime rates of reported sexually transmitted infections (22.3%) and last 12-months rates of unprotected sex (63.0%), sex with multiple sexual partners (18.1%), casual partners (25.7%), and sex workers (8.6%), compared to U.S. and Mexico adults. HIV prevention, testing, and treatment programs for this large, vulnerable, and transnational population need to be implemented in both the U.S. and Mexico. PMID:22562390

  7. Substantial molecular evolution and mutation rates in prolonged latent Mycobacterium tuberculosis infection in humans

    DEFF Research Database (Denmark)

    Lillebaek, Troels; Norman, Anders; Rasmussen, Erik Michael

    2016-01-01

    The genome of Mycobacterium tuberculosis (Mtb) of latently infected individuals may hold the key to understanding the processes that lead to reactivation and progression to clinical disease. We report here analysis of pairs of Mtb isolates from putative prolonged latent TB cases. We identified two...... confirmed cases, and used whole genome sequencing to investigate the mutational processes that occur over decades in latent Mtb. We found an estimated mutation rate between 0.2 and 0.3 over 33 years, suggesting that latent Mtb accumulates mutations at rates similar to observations from cases of active...

  8. PCR reveals significantly higher rates of Trypanosoma cruzi infection than microscopy in the Chagas vector, Triatoma infestans: High rates found in Chuquisaca, Bolivia

    Directory of Open Access Journals (Sweden)

    Lucero David E

    2007-06-01

    Full Text Available Abstract Background The Andean valleys of Bolivia are the only reported location of sylvatic Triatoma infestans, the main vector of Chagas disease in this country, and the high human prevalence of Trypanosoma cruzi infection in this region is hypothesized to result from the ability of vectors to persist in domestic, peri-domestic, and sylvatic environments. Determination of the rate of Trypanosoma infection in its triatomine vectors is an important element in programs directed at reducing human infections. Traditionally, T. cruzi has been detected in insect vectors by direct microscopic examination of extruded feces, or dissection and analysis of the entire bug. Although this technique has proven to be useful, several drawbacks related to its sensitivity especially in the case of small instars and applicability to large numbers of insects and dead specimens have motivated researchers to look for a molecular assay based on the polymerase chain reaction (PCR as an alternative for parasitic detection of T. cruzi infection in vectors. In the work presented here, we have compared a PCR assay and direct microscopic observation for diagnosis of T. cruzi infection in T. infestans collected in the field from five localities and four habitats in Chuquisaca, Bolivia. The efficacy of the methods was compared across nymphal stages, localities and habitats. Methods We examined 152 nymph and adult T. infestans collected from rural areas in the department of Chuquisaca, Bolivia. For microscopic observation, a few drops of rectal content obtained by abdominal extrusion were diluted with saline solution and compressed between a slide and a cover slip. The presence of motile parasites in 50 microscopic fields was registered using 400× magnification. For the molecular analysis, dissection of the posterior part of the abdomen of each insect followed by DNA extraction and PCR amplification was performed using the TCZ1 (5' – CGA GCT CTT GCC CAC ACG GGT GCT – 3

  9. Infection rate of Babesia spp. sporokinetes in engorged Boophilus microplus from an area of enzootic stability in the State of Minas Gerais, Brazil

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    Quintão-Silva Maria G

    2003-01-01

    Full Text Available The infection rates of Babesia sporokinetes in engorged Boophilus microplus were evaluated during a 2-year period in a dairy farm located in an area of enzootic stability. Every 14 days engorged females were collected from calves and from adult animals. Ticks were incubated at 27 ± 0.5ºC and 80-90% relative humidity and Babesia infection rates were determined by microscopic examination of Giemsa-stained hemolymph smears. After 52 collections, 2105 ticks were obtained, from which 982 were collected from calves and 1123 from cows. The total Babesia infection rate was 10%, however the incidence was higher (p < 0.05 in ticks collected from calves (17.5% than in those collected from cows (3.6%. Females collected from cows showed the highest infection rates in January, March, and August, and absence of infection in April and May. Ticks feeding on calves were infected throughout the experimental period. The infection rates of engorged females collected from naturally infected calves that were artificially infested with Babesia-free-larvae of B. microplus gradually decreased until the calves were four months old. No differences were observed among infection rates of ticks collected from calves maintained under natural conditions.

  10. Infection rate and genetic diversity of Giardia duodenalis in pet and stray dogs in Henan Province, China.

    Science.gov (United States)

    Qi, Meng; Dong, Haiju; Wang, Rongjun; Li, Junqiang; Zhao, Jinfeng; Zhang, Longxian; Luo, Jianxun

    2016-04-01

    Giardia duodenalis is an important protozoan parasite that is known to be zoonotic. To assess the potential zoonotic transmission of giardiasis from dogs and to identify genetic diversity of G. duodenalis in dog populations, we examined the infection rate and genotypes of G. duodenalis in both pet dogs (from pet dog farms, pet shops, pet hospitals, pet markets) and stray dogs of different ages in Henan Province, China. A total of 940 fresh fecal specimens were collected from 2007 to 2013 in Henan Province. The overall infection rate of G. duodenalis was 14.3% (134/940) as determined by microscopy, with the highest infection rate (17.3%) observed in dogs from shelters. Young dogs were more likely to be infected with G. duodenalis than adult dogs, and G. duodenalis cysts were found more frequently in diarrheic dogs. All G. duodenalis-positive isolates were characterized at the triose phosphate isomerase (tpi), glutamate dehydrogenase (gdh), and β-giardin (bg) loci, and 37, 51, and 48 sequences were obtained, respectively. The dog-specific assemblages C and D were identified using multi-locus sequence analysis. Six novel sequences of the tpi locus, one novel sequence of the gdh locus and two novel sequences of the bg locus were detected among the G. duodenalis assemblage C isolates, while two novel sequences of the gdh locus were found among the G. duodenalis assemblage D isolates. Our data indicate that G. duodenalis is a common parasite and cause of diarrheal disease in dogs in Henan Province. However, there was no evidence for zoonotic G. duodenalis assemblages in the study population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Microcephaly Case Fatality Rate Associated with Zika Virus Infection in Brazil: Current Estimates.

    Science.gov (United States)

    Cunha, Antonio José Ledo Alves da; de Magalhães-Barbosa, Maria Clara; Lima-Setta, Fernanda; Medronho, Roberto de Andrade; Prata-Barbosa, Arnaldo

    2017-05-01

    Considering the currently confirmed cases of microcephaly and related deaths associated with Zika virus in Brazil, the estimated case fatality rate is 8.3% (95% confidence interval: 7.2-9.6). However, a third of the reported cases remain under investigation. If the confirmation rates of cases and deaths are the same in the future, the estimated case fatality rate will be as high as 10.5% (95% confidence interval: 9.5-11.7).

  12. Cefazolin-containing poly(ε-caprolactone sponge pad to reduce pin tract infection rate in rabbits

    Directory of Open Access Journals (Sweden)

    Hirotaka Mutsuzaki

    2014-04-01

    Full Text Available In our previous study, a fibroblast growth factor-2 (FGF-2–apatite composite layer coated on titanium screws effectively prevented pin tract infection in rabbits because of enhanced wound healing; however, the FGF-2–apatite composite layers did not completely prevent pin tract infection. Thus, we recently developed a poly(ε-caprolactone (PCL sponge pad embedded with cefazolin sodium (+CEZ, which has a fast-acting bactericidal effect. The pad is placed on the skin around the screws. The purpose of this study was to determine the anti-infective efficacy of the +CEZ pad on the pin–skin interface of the FGF-2–apatite-coated titanium screws. The +CEZ pads were prepared by mixing PCL and CEZ in 1,4-dioxane, followed by freeze-drying and compaction. They were analyzed regarding their surface structure, in vitro CEZ release profile, and bactericidal activity. The FGF-2–apatite-coated screws were implanted percutaneously in bilateral rabbit proximal tibial metaphyses—with and without the +CEZ pad—for 4 weeks (n = 20. The + CEZ pads consisted of a porous matrix of PCL in which CEZ was embedded. The CEZ-release profile showed an initial burst on Day 1 and a sustained release lasting for 30 days. The +CEZ pad retained its bactericidal activity against Staphylococcus aureus after preincubation on an agar plate for 7 days. Based on visual inspection, the pin tract infection rate was successfully reduced from 72.2% to 15.0% with the +CEZ pad (p < 0.05, which reduced the bacterial count, especially S. aureus (p < 0.05. The histological inflammation rate of the soft tissues was also significantly lower with the +CEZ pad than without it (p < 0.05. The pin tract infection rate was reduced to one-fifth with the +CEZ pad. Using it as described improves infection resistance during percutaneous implantation.

  13. Correlation between infection rate of triatominies and Chagas Disease in Southwest of Bahia, Brazil: a warning sign?

    Science.gov (United States)

    Silveira, Eliezer A DA; Ribeiro, Israel S; Amorim, Miguel S; Rocha, Dalva V; Coutinho, Helder S; Freitas, Leandro M DE; Tomazi, Laize; Silva, Robson A A DA

    2016-01-01

    Chagas disease, caused by the Trypanosoma cruzi, has a wide distribution in South America, and its main method of control is the elimination of triatomines. It is presented here the geographic distribution and the rate of natural infection by T. cruzi of triatomines collected and evaluated from 2008 to 2013 in southwest of Bahia. Triatomines were captured in the intradomiciliary and peridomiciliary areas of five cities located in the southwest of Bahia state, identified, and analyzed for the presence of trypanosomatids in their feces. During the study period the number of patients suspected for acute Chagas disease was recovered from the Notifiable Diseases Information System (SINAN). 8966 triatomines were captured and identified as belonging to eight species. Twenty-six presented themselves infected, being Triatoma sordida the most abundant and with the highest percentage of infection by T. cruzi. Tremedal was the city with the highest number of cases of acute Chagas' disease reported to SINAN. All cities showed triatomines infected with T. cruzi, so there is considerable risk of vectorial transmission of Chagas disease in the southwestern Bahia state, evidencing the need for vector transmission control programs and preventive surveillance measures.

  14. HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

    Science.gov (United States)

    Ubesie, A C; Iloh, K K; Emodi, I J; Ibeziako, N S; Obumneme-Anyim, I N; Iloh, O N; Ayuk, A C; Anikene, C J; Enemuo, J E

    2016-12-01

    To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

  15. [Infection rates of mollusks and fishes with the larval stages of Trematoda of the family Opisthorchidae in the Yaroslavl Region].

    Science.gov (United States)

    Molodozhnikova, N M

    2006-01-01

    The paper presents the results of a study of the infection rates of mollusks of the family Bythiniidae (Bithynia tentaculata, Opisthorchophorus troscheli) and fishes with the larval stages of Opisthorchidae in different districts of the Yaroslavl Region. A total of 3,708 mollusks from the water reservoirs of different types (small rivers, lakes, ponds, and canals) were examined in the Nekouzsky, Yaroslavsky, and Pereslavsky Districts of the Yaroslavl Region in 1989 to 1999. Opisthorchis cercarias were found in 7 of the 10 studied water reservoirs. The total rate of infection of mollusks with all types with Trematoda partenitas and cercarias in different water reservoirs averaged 18.5 +/- 3.5% for Bithynia tentaculata and 19.1 +/- 4.1% for Opisthorchophorus troscheli. Trematoda metacercarias of the family Opisthorchidae were revealed in roaches, ides, verkhovkas, silver breams, and chubs in four different water reservoirs (small rivers and a lake) of the region. Pseudamphistomum truncates, Opisthorchis felineus, and Metorchis xanthosomus were present among the metacercarias found. It is concluded that there may be sporadic cases of Opisthorchis infection in wild and domestic animals and humans in the Yaroslavl Region.

  16. The role of native vegetation on infection rates of Calacarus heveae (Acari: Eriophyidae) by Hirsutella thompsonii (Ascomycota: Ophiocordycipitaceae).

    Science.gov (United States)

    Nuvoloni, Felipe Micali; de Castro, Elizeu Barbosa; Feres, Reinaldo José Fazzio

    2014-06-01

    Hirsutella thompsonii (Fischer) (Ascomycota: Ophiocordycipitaceae), a fungal pathogen, often causes high mortality in populations of Calacarus heveae Feres (Acari: Eriophyidae), an important pest mite in rubber tree plantations (Hevea brasiliensis Muell. Arg., Euphorbiaceae). However, the ecological and climatic factors regulating this host-pathogen system are poorly known. We compared fungal infections in agroforestry and traditional rubber plantations to evaluate the role of native vegetation and climatic factors on infection rates of C. heveae by H. thompsonii. While the prevalence of H. thompsonii was higher in managed rubber tree plantations, the abundance of C. heveae was about three times higher in traditional plantations. Abundance of C. heveae, agroecosystem management type and microclimatic variables were responsible for driving the infection rates of H. thompsonii. Native vegetation was a source for H. thompsonii and also modified the crop's microclimate, which contributed to its maintenance in the crop fields. Therefore, appropriate management practices may enhance the effects of entomopathogens on conservative biological control of pest mites in agroforestry systems.

  17. Declining rate of infection with maternal human immunodeficiency virus at delivery units in north-central Nigeria.

    Science.gov (United States)

    Imade, Godwin E; Sagay, Atiene S; Musa, Jonah; Ocheke, Amaka N; Adeniyi, David S; Idighri, Monica; Powl, Rosemary; Sendeht, Ayuba; Ogwuche, Jerry P; Elujoba, Michael; Egbodo, Chris O; Oyebode, Tinuade; Daru, Patrick H; Agbaji, Oche; Pam, Ishaya C; Meloni, Seema T; Okonkwo, Prosper; Kanki, Phyllis J

    2013-12-01

    HIV testing during labour and delivery provides a critical opportunity for administering appropriate interventions to prevent mother-to-child-transmission (PMTCT). We studied current HIV rates and infection trend among women tested during delivery following scale-up of PMTCT and antiretroviral therapy (ART) programs in Jos, north central Nigeria. Between March 2010 and January 2012, provider-initiated HIV testing and counselling was offered in early labour. Women were recruited from a government tertiary health centre, a faith-based hospital, and a private health centre. Those who previously tested HIV negative during antenatal care (ANC) and those who presented at the labour ward with unknown HIV status were tested. A total of 944 subjects (727 re-tested for HIV infection and 217 with unknown HIV status) were enrolled and tested during labour. The HIV incidence and sero-conversion rates during pregnancy among women who repeated HIV testing at delivery was 1.7 per 100 person-years of observation (pyo) and 0.6% (4/727), respectively, while the rate among those who tested for the first time in labour was 1.8% (4/217). Women who accessed ANC were older and had achieved a higher educational status than those who did not access ANC. A 3- to 5-fold decline in HIV incidence and prevalence rates was detected among women tested at delivery when compared to data from a report in 2004. It is not certain whether the decline in maternal HIV infection is due to the major state-wide scale-up of PMTCT and HIV treatment programs. A broader and purposefully designed evaluation study would be required to verify observed occurrence.

  18. Effect of infection with Metacercariae of Himasthla elongata (Trematoda: Echinostomatidae) on cardiac activity and growth rate in blue mussels (Mytilus edulis) in situ

    Science.gov (United States)

    Bakhmet, Igor; Nikolaev, Kirill; Levakin, Ivan

    2017-05-01

    Trematode parasites can affect their molluscan hosts, which serve as the first intermediate hosts in their life cycles, in manifold ways, but little is known about trematode-induced effects on their second intermediate hosts. Experimental infection of blue mussels Mytilus edulis serving as second intermediate hosts for larval stages (metacercariae) of the trematodes Himasthla elongata was studied in field experiments during one year. The heart rates and growth rates of noninfected mussels were significantly higher than those of infected mussels. During the summer, the heart rates of noninfected mussels showed rhythmic oscillations, whereas the parasitized animals displayed no any rhythmicity. There was a significant difference between the infected and uninfected mussels in relation to heart rates and temperature. The results indicate that mussels infected with H. elongata metacercariae may be at an energetic disadvantage relative to noninfected mussels. Furthermore, trematode infection may disrupt neuronal control of cardiac function.

  19. Rates of infection after spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee.

    Science.gov (United States)

    Smith, Justin S; Shaffrey, Christopher I; Sansur, Charles A; Berven, Sigurd H; Fu, Kai-Ming G; Broadstone, Paul A; Choma, Theodore J; Goytan, Michael J; Noordeen, Hilali H; Knapp, Dennis R; Hart, Robert A; Donaldson, William F; Polly, David W; Perra, Joseph H; Boachie-Adjei, Oheneba

    2011-04-01

    Retrospective review of a prospectively collected database. Our objective was to assess the rates of postoperative wound infection associated with spine surgery. Although wound infection after spine surgery remains a common source of morbidity, estimates of its rates of occurrence remain relatively limited. The Scoliosis Research Society prospectively collects morbidity and mortality data from its members, including the occurrence of wound infection. The Scoliosis Research Society morbidity and mortality database was queried for all reported spine surgery cases from 2004 to 2007. Cases were stratified based on factors including diagnosis, adult (≥ 21 years) versus pediatric (scoliosis, and type of kyphosis for both adult and pediatric patients. Factors associated with increased rate of infection included revision surgery (P spine surgeons, is an inherent potential complication. These data provide general benchmarks of infection rates as a basis for ongoing efforts to improve safety of care.

  20. Cost Analysis and Surgical Site Infection Rates in Total Knee Arthroplasty Comparing Traditional vs. Single-Use Instrumentation.

    Science.gov (United States)

    Siegel, Geoffrey W; Patel, Neil N; Milshteyn, Michael A; Buzas, David; Lombardo, Daniel J; Morawa, Lawrence G

    2015-12-01

    Surgical site infections (SSIs) are a significant complications in total knee arthroplasty (TKA). The purpose of this study was to evaluate if traditional vs. single-use instrumentation had an effect on SSI's. We compared SSI rates and costs of TKAs performed with single-use (449) and traditional (169) TKA instrumentation trays. Total OR Time was, on average, 30 min less when single-use instrumentation was used. SSIs decreased in the single-use group (n=1) compared to the traditional group (n=5) (P=0.006). Single-use instrumentation added $490 in initial costs; however it saved between $480 and $600. Single-use instrumentation may provide a benefit to the patient by potentially decreasing the risk of infection and reducing the overall hospital costs. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Aminoglycoside resistance rates, phenotypes, and mechanisms of Gram-negative bacteria from infected patients in upper Egypt.

    Directory of Open Access Journals (Sweden)

    Gamal F Gad

    Full Text Available With the re-emergence of older antibiotics as valuable choices for treatment of serious infections, we studied the aminoglycoside resistance of Gram-negative bacteria isolated from patients with ear, urinary tract, skin, and gastrointestinal tract infections at Minia university hospital in Egypt. Escherichia coli (mainly from urinary tract and gastrointestinal tract infections was the most prevalent isolate (28.57%, followed by Pseudomonas aeruginosa (25.7% (mainly from ear discharge and skin infections. Isolates exhibited maximal resistance against streptomycin (83.4%, and minimal resistance against amikacin (17.7% and intermediate degrees of resistance against neomycin, kanamycin, gentamicin, and tobramycin. Resistance to older aminoglycosides was higher than newer aminoglycosides. The most common aminoglycoside resistance phenotype was that of streptomycin resistance, present as a single phenotype or in combination, followed by kanamycin-neomycin as determined by interpretative reading. The resistant Pseudomonas aeruginosa strains were capable of producing aminoglycoside-modifying enzymes and using efflux as mechanisms of resistance. Using checkerboard titration method, the most frequently-observed outcome in combinations of aminoglycosides with β-lactams or quinolones was synergism. The most effective combination was amikacin with ciprofloxacin (100% Synergism, whereas the least effective combination was gentamicin with amoxicillin (53.3% Synergistic, 26.7% additive, and 20% indifferent FIC indices. Whereas the studied combinations were additive and indifferent against few of the tested strains, antagonism was never observed. The high resistance rates to aminoglycosides exhibited by Gram-negative bacteria in this study could be attributed to the selective pressure of aminoglycoside usage which could be controlled by successful implementation of infection control measures.

  2. High rates of anal dysplasia in HIV-infected men who have sex with men, women, and heterosexual men.

    Science.gov (United States)

    Gaisa, Michael; Sigel, Keith; Hand, Jonathan; Goldstone, Stephen

    2014-01-14

    To determine rates of anal dysplasia in a cohort of HIV-infected men who have sex with men (MSM), women, and heterosexual men with abnormal anal cytology. We evaluated histologic findings in 728 HIV-infected MSM, women, and heterosexual men referred for high-resolution anoscopy (HRA) after abnormal anal cytology in a single-center cohort study. Using multivariable logistic regression, we evaluated predictors of high-grade squamous intraepithelial lesion (HSIL) histology or invasive carcinoma including age, sexual behavior, receptive anal intercourse (RAI), anogenital warts, smoking status, antiretroviral therapy, CD4 T-cell count, and HIV-1 plasma viral load. A total of 2075 HIV-positive patients were screened with anal cytology and 62% of MSM, 42% of women, and 29% of heterosexual men had abnormal findings (P anal cytology who underwent HRA, 71% were MSM, 23% women, and 6% heterosexual men. HSIL/cancer was found in 32% of MSM, 26% of women, and 23% of heterosexual men (P = 0.3). There were five cases of anal squamous cell carcinoma (0.7%), four in MSM and one in a heterosexual man. In a multivariable adjusted analysis, biopsy-proven HSIL/cancer was associated with RAI [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.3-3.7]. CD4 T-cell counts more than 500/μl conferred a lower risk of HSIL/cancer (OR 0.5; 95% CI 0.3-0.9). Rates of anal HSIL histology are high in HIV-infected patients of all sexual risk groups with abnormal anal cytology. Consequently, all HIV-infected patients may warrant anal cancer screening.

  3. The effects of equine rhinovirus, influenza virus and herpesvirus infection on tracheal clearance rate in horses.

    OpenAIRE

    Willoughby, R; Ecker, G.; McKee, S; Riddolls, L; Vernaillen, C; Dubovi, E; Lein, D; Mahony, J B; Chernesky, M; Nagy, E.

    1992-01-01

    The response of horses exposed to three common respiratory viruses was studied by measuring tracheal mucociliary clearance rates in the trachea. Tracheal clearance rates (TCR) were determined before, during illness and following recovery in horses exposed to equine rhinovirus (ERhV-2), equine influenza virus (EIV) and equine herpesvirus (EHV-4) by means of lateral scintigraphs made following an injection of technetium-99m sulphide colloid into the tracheal lumen. In six horses exposed to ERhV...

  4. Infection rate of Giardia duodenalis, Cryptosporidium spp. and Enterocytozoon bieneusi in cashmere, dairy and meat goats in China.

    Science.gov (United States)

    Peng, Xian-Qi; Tian, Ge-Ru; Ren, Guan-Jing; Yu, Zheng-Qing; Lok, James Barron; Zhang, Long-Xian; Wang, Xue-Ting; Song, Jun-Ke; Zhao, Guang-Hui

    2016-07-01

    Cryptosporidiosis, microsporidiosis, and giardiasis contribute significantly to the high burden of zoonotic diarrhea worldwide. Goats constitute an important species in animal agriculture by providing cashmere wool, meat, and dairy products for human consumption. However, zoonotic pathogens with the potential to cause morbidity and to degrade production have been reported frequently in goats recently. The present study examined 629 fecal specimens from goats, including 315 cashmere goats, 170 dairy goats and 144 meat goats, in multiple cities of Shaanxi and Henan provinces, northwestern and central China, to investigate the infection rate and species/assemblages/genotypes of Giardia duodenalis, Cryptosporidium spp. and Enterocytozoon bieneusi. Of these samples, 274 (43.6%) were positive for three zoonotic pathogens, including 80 (12.7%), 104 (16.5%) and 179 (28.5%) for G. duodenalis, Cryptosporidium spp. and E. bieneusi, respectively. Infections with G. duodenalis, Cryptosporidium spp. and E. bieneusi existed in meat, dairy and cashmere goats, with the highest infection rate of each pathogen being observed in meat goats. DNA sequencing of the SSU rRNA gene from 104 Cryptosporidium-positive specimens revealed existence of Cryptosporidium xiaoi, and the zoonotic parasites Cryptosporidium parvum and Cryptosporidium ubiquitum. Genotyping of G. duodenalis based on the triosephosphate isomerase (TPI) gene identified parasites from zoonotic assemblage A in four cashmere goats and the animal-adapted assemblage E in a group of 76 goats that included cashmere, dairy and meat animals. Polymorphisms in the ribosomal internal transcribed spacer characterized E. bieneusi genotype CHG1 and a novel genotype named as SX1 in both dairy and cashmere goats, genotypes CHS7 and COSI in meat goats, the genotype CHG2 in dairy goats, and the human-pathogenic genotype BEB6 in dairy and meat goats. This is the first detailed study to compare infection rate of the zoonotic protozoan pathogens

  5. Minimising central line-associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units.

    Science.gov (United States)

    Hina, Hedaya Rateb; McDowell, Joan R S

    2017-12-01

    To investigate the procedural aspects in inserting central venous catheters that minimise central line-associated bloodstream infection rates in adult intensive care units through a structured literature review. In adult intensive care units, central line-associated bloodstream infections are a major cause of high mortality rates and increased in costs due to the consequences of complications. Eligible articles were identified by combining indexed keywords using Boolean operator of "AND" under databases of Ovid and CINAHL. Titles and abstract of retrieved papers were screened and duplicates removed. Inclusion and exclusion criteria were applied to derive the final papers, which contained seminal studies. The quality of papers was assessed using a special data extraction form. The number of papers retrieved from all databases was 337, reduced to 302 after removing duplicates. Papers were scanned for titles and abstract to locate those relevant to the review question. After this, 250 papers were excluded for different reasons and a total of 52 papers were fully accessed to assess for eligibility. The final number of papers included was 10 articles. Many interventions can be implemented in the adult intensive care unit during the insertion of a central venous catheter to minimise central line-associated bloodstream infections rates. These include choosing the subclavian site to insert the catheters as the least infectious and decolonising patients' skin with alcoholic chlorhexidine gluconate preparation due to its broad antimicrobial effect and durability. Choosing optimal sites for central venous catheter insertion is a complex process that relies on many factors. Furthermore, the introduction of chlorhexidine gluconate preparations should be accompanied with multifaceted interventions including quality improvement initiatives to improve healthcare workers' compliance. As a quality marker in adult intensive care units, healthcare sectors should work on establishing

  6. An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: Direct observation of catheter insertion procedure.

    Science.gov (United States)

    Galiczewski, Janet M; Shurpin, Kathleen M

    2017-06-01

    Healthcare associated infections from indwelling urinary catheters lead to increased patient morbidity and mortality. The purpose of this study was to determine if direct observation of the urinary catheter insertion procedure, as compared to the standard process, decreased catheter utilization and urinary tract infection rates. This case control study was conducted in a medical intensive care unit. During phase I, a retrospective data review was conducted on utilsiation and urinary catheter infection rates when practitioners followed the institution's standard insertion algorithm. During phase II, an intervention of direct observation was added to the standard insertion procedure. The results demonstrated no change in utilization rates, however, CAUTI rates decreased from 2.24 to 0 per 1000 catheter days. The findings from this study may promote changes in clinical practice guidelines leading to a reduction in urinary catheter utilization and infection rates and improved patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Apparently-Different Clearance Rates from Cohort Studies of Mycoplasma genitalium Are Consistent after Accounting for Incidence of Infection, Recurrent Infection, and Study Design.

    Directory of Open Access Journals (Sweden)

    Timo Smieszek

    Full Text Available Mycoplasma genitalium is a potentially major cause of urethritis, cervicitis, pelvic inflammatory disease, infertility, and increased HIV risk. A better understanding of its natural history is crucial to informing control policy. Two extensive cohort studies (students in London, UK; Ugandan sex workers suggest very different clearance rates; we aimed to understand the reasons and obtain improved estimates by making maximal use of the data from the studies. As M. genitalium is a sexually-transmitted infectious disease, we developed a model for time-to-event analysis that incorporates the processes of (reinfection and clearance, and fitted to data from the two cohort studies to estimate incidence and clearance rates under different scenarios of sexual partnership dynamics and study design (including sample handling and associated test sensitivity. In the London students, the estimated clearance rate is 0.80 p.a. (mean duration 15 months, with incidence 1.31%-3.93% p.a. Without adjusting for study design, corresponding estimates from the Ugandan data are 3.44 p.a. (mean duration 3.5 months and 58% p.a. Apparent differences in clearance rates are probably mostly due to lower testing sensitivity in the Uganda study due to differences in sample handling, with 'true' clearance rates being similar, and adjusted incidence in Uganda being 28% p.a. Some differences are perhaps due to the sex workers having more-frequent antibiotic treatment, whilst reinfection within ongoing sexual partnerships might have caused some of the apparently-persistent infection in the London students. More information on partnership dynamics would inform more accurate estimates of natural-history parameters. Detailed studies in men are also required.

  8. Effect of Mass Stool Examination and Mass Treatment For Decreasing Intestinal Helminth and Protozoan Infection Rates in Bolivian Children: A Cross-Sectional Study.

    Science.gov (United States)

    Asai, Takao; Còrdova Vidal, Claudia; Strauss, Wilma; Ikoma, Toshikazu; Endoh, Kazuo; Yamamoto, Masaharu

    2016-12-01

    Bolivia is one of the countries with a high intestinal helminth and protozoan infection rate. Despite the high prevalence of the parasitic infection, nationwide preventive measures for Bolivian children have not yet been implemented. We evaluated the effect of mass stool examination and treatment as a strategy for decreasing the infection rate. This study was conducted between 2013 and 2015 in children aged 2-18 years. A total of 2,033 stool samples (575 in 2013, 815 in 2014 and 642 in 2015) were collected and examined using the formalin-ether medical sedimentation method. As an anthelminthic medicine, nitazoxanide was given to all infected children within 2 months post-examination, each year. The effect of mass stool examination and treatment was evaluated based on the changes in the overall or individual parasitic infection rates during the study period. The overall parasitic infection rate decreased significantly from 65.2% in 2013 to 43.0% in 2015; a 22.2 percentage point decrease (PHymenolepis nana, decreased significantly from 9.0% in 2013 to 6.4% in 2014 to 3.4% in 2015 (P<0.001). Prevalence of the most common pathogenic protozoan infection, Entamoeba histolytica, decreased significantly from 19.0% in 2013 to 3.0% in 2015 (P<0.001). Conversely, the rate of Giardia intestinalis increased significantly from 16.5% in 2013 to 21.2% in 2015 (P<0.01). Mass stool examination and treatment for intestinal helminth and protozoan infections was effective for decreasing the overall parasitic infection rate in the study population, excluding Giardia intestinalis. Further studies on the long-term effect of mass stool examination and treatment for decreasing all intestinal parasitic infection rates in Bolivian children are needed.

  9. Water birth: microbiological colonisation of the newborn, neonatal and maternal infection rate in comparison to conventional bed deliveries.

    Science.gov (United States)

    Fehervary, Patricia; Lauinger-Lörsch, Eva; Hof, Herbert; Melchert, Frank; Bauer, Lelia; Zieger, Wolfgang

    2004-07-01

    The risk of infectious complications after water birth which might be due to water contaminated by faecal bacteria or environmental microbes from the water supply system is still in discussion. We performed a microbiological study comparing neonatal bacterial colonisation after water birth to conventional bed deliveries with or without relaxation bath. In all three groups (96 deliveries) we isolated most frequently from ear and palate of the newborns Staphylococcus epidermidis, E. coli and enterococci, which belong to the normal vaginal flora. Neonatal outcome, infantś and maternal infection rate did not differ between the three groups.

  10. Infection,

    Science.gov (United States)

    1980-10-16

    lost by diuresis in early convalescence (1). Severe retention of body water, especially during central nervous system infection, has now been widely...adrenocortical production of glucocorticoid and ketosteroid hormones often declines into a subnormal range. The labile pool of body nitrogen is...may not become apparent until early convalescence when postfebrile diuresis causes excessive fluid to be excreted. (3) Protein requirements ’- Despite

  11. Impact of Hospital Population Case-Mix, Including Poverty, on Hospital All-Cause and Infection-Related 30-Day Readmission Rates.

    Science.gov (United States)

    Gohil, Shruti K; Datta, Rupak; Cao, Chenghua; Phelan, Michael J; Nguyen, Vinh; Rowther, Armaan A; Huang, Susan S

    2015-10-15

    Reducing hospital readmissions, including preventable healthcare-associated infections, is a national priority. The proportion of readmissions due to infections is not well-understood. Better understanding of hospital risk factors for readmissions and infection-related readmissions may help optimize interventions to prevent readmissions. Retrospective cohort study of California acute care hospitals and their patient populations discharged between 2009 and 2011. Demographics, comorbidities, and socioeconomic status were entered into a hierarchical generalized linear mixed model predicting all-cause and infection-related readmissions. Crude verses adjusted hospital rankings were compared using Cohen's kappa. We assessed 30-day readmission rates from 323 hospitals, accounting for 213 879 194 post-discharge person-days of follow-up. Infection-related readmissions represented 28% of all readmissions and were associated with discharging a high proportion of patients to skilled nursing facilities. Hospitals serving populations with high proportions of males, comorbidities, prolonged length of stay, and populations living in a federal poverty area, had higher all-cause and infection-related readmission rates. Academic hospitals had higher all-cause and infection-related readmission rates (odds ratio 1.24 and 1.15, respectively). When comparing adjusted vs crude hospital rankings for infection-related readmission rates, adjustment revealed 31% of hospitals changed performance category for infection-related readmissions. Infection-related readmissions accounted for nearly 30% of all-cause readmissions. High hospital infection-related readmissions were associated with serving a high proportion of patients with comorbidities, long lengths of stay, discharge to skilled nursing facility, and those living in federal poverty areas. Preventability of these infections needs to be assessed. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases

  12. High rate of hepatitis C virus (HCV) recurrence in HIV-infected individuals with spontaneous HCV RNA clearance

    DEFF Research Database (Denmark)

    Peters, L; Mocroft, A; Soriano, V

    2014-01-01

    OBJECTIVES: Following resolution of hepatitis C virus (HCV) infection, recurrence has been shown to occur in some persons with repeated exposure to HCV. We aimed to investigate the rate and factors associated with HCV RNA recurrence among HIV-1-infected patients with prior spontaneous HCV RNA...... clearance in the EuroSIDA cohort. METHODS: All HIV-infected patients with documented prior spontaneous HCV clearance, and at least one subsequently collected plasma sample, were examined. The last sample was tested for HCV RNA and those with HCV RNA ≥ 615 IU/mL were defined as having HCV recurrence...... (IDUs). The median time between the first and last samples was 3.6 years (interquartile range 2.0-5.8 years). After adjustment, those on combination antiretroviral therapy [odds ratio (OR) 0.44; 95% CI 0.20-0.99; P = 0.046] and older persons (OR 0.51 per 10 years older; 95% CI 0.28-0.95; P = 0.033) were...

  13. Antibiotic Prophylaxis With Trimethoprim/Sulfamethoxazole Instead of Cloxacillin Fails to Improve Inguinal Surgical Site Infection Rate After Vascular Surgery.

    Science.gov (United States)

    Hasselmann, Julien; Kühme, Tobias; Acosta, Stefan

    2015-01-01

    Surgical site infections (SSIs) and their prevention continue to be a major point of focus in all surgical specialties today. Antibiotic prophylaxis is one of the mainstays in their prevention. Due to the consistently high proportion of infections caused by intestinal flora from the start of our wound surveillance registry in 2005, we conducted a change in prophylactic antibiotic therapy from cloxacillin in 2012 to trimethoprim/sulfamethoxazole (TMP-SMX) in 2013. The study included all patients undergoing vascular surgery with groin incisions between March 1 and June 30 in 2012 and 2013, respectively, whereby the antibiotic regime was changed in between the 2 sampling periods. The diagnosis of SSI was based on clinical examination and microbiological results. Two hundred nineteen patients with inguinal incisions were included in the analysis: 105 in the cloxacillin group of which 19% had SSI and 114 in the TMP-SMX group with an SSI rate of 18% (P = .77), without differences between the 2 groups regarding age, gender, proportion of emergency surgery, type of surgery, or frequency of concomitant foot ulcers. The high proportion of infections caused by intestinal flora between time periods was unchanged (67% vs 81%, P = .34). There was no difference between the 2 groups, suggesting that the choice of antibiotic prophylaxis had a limited role in preventing SSI at our center. Despite this, the lower cost and ease of the administration of TMP-SMX can be seen as convincing advantages. © The Author(s) 2015.

  14. [Rate of human papillomavirus infection in rural areas diagnosed by direct visualization with acetic acid and lugol].

    Science.gov (United States)

    José Daniel, Flores-Alatriste; Karla Georgina, Saldivar-Gutiérrez; Josué Sarmiento-Ángeles; Jaime Claudio, Granados-Marin; Marco Antonio, Olaya-Rivera; Stark, Carlotta; Hugo, Flores-Navarro; Jaroslav, Stern-Colin

    2015-07-01

    Infection by HPV is a major global health problem and the main risk factor for cervical cancer with high morbidity and mortality. Simple diagnostic methods, such as visual inspection with the naked eye of the cervix with acetic acid application 5% (VAT) or solution of iodine (tincture of iodine) are simple to detect early lesions, sensitivity varies from 87 to 99% and specificity varies from 23 to 87%. To find the proportion of infection by human papillomavirus in a population of extreme poverty. Linear, observational and descriptive pilot study was done in patients of marginalized communities in extreme poverty in Chiapas (Mexico), from 1 to 30 November 2013. The existence of acetowhite lesions suggestive of virus was verified human papillomavirus, and medical history of all patients was formed for the incidence of risk factors. 214 women with age limits of 19 and 78 years, median age of 37 years were studied. Of the total, 66 (31%) had acetowhite lesions consistent with human papillomavirus at the time of the study. Marginalized populations have a higher risk of infection with human papillomavirus, consequently high rate of progression to cervical cancer due to sociodemographic characteristics, risk factors and lack of resources in health. Diagnostic tests like the simple display with acetic acid are ideal for people such as this.

  15. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates

    NARCIS (Netherlands)

    Thanh, D. H.; Sy, D. N.; Linh, N. D.; Hoan, T. M.; Dien, H. T.; Thuy, T. B.; Hoa, N. P.; Tung, L. B.; Cobelens, F.

    2010-01-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of

  16. Rate of re-infection of tissue culture-derived Latin American and ...

    African Journals Online (AJOL)

    The rate of reinfection by cassava mosaic disease (CMD) in initially virus-free cassava plants of two Latin American and twelve East and Southern African cassava genotypes grown was studied under high disease pressure conditions. An improved clone, TMS 4(2)1425, from the International Institute of Tropical Agriculture ...

  17. Relation of Total and Cardiovascular Death Rates to Climate System, Temperature, Barometric Pressure, and Respiratory Infection.

    Science.gov (United States)

    Schwartz, Bryan G; Qualls, Clifford; Kloner, Robert A; Laskey, Warren K

    2015-10-15

    A distinct seasonal pattern in total and cardiovascular death rates has been reported. The factors contributing to this pattern have not been fully explored. Seven locations (average total population 71,354,000) were selected where data were available including relatively warm, cold, and moderate temperatures. Over the period 2004 to 2009, there were 2,526,123 all-cause deaths, 838,264 circulatory deaths, 255,273 coronary heart disease deaths, and 135,801 ST-elevation myocardial infarction (STEMI) deaths. We used time series and multivariate regression modeling to explore the association between death rates and climatic factors (temperature, dew point, precipitation, barometric pressure), influenza levels, air pollution levels, hours of daylight, and day of week. Average seasonal patterns for all-cause and cardiovascular deaths were very similar across the 7 locations despite differences in climate. After adjusting for multiple covariates and potential confounders, there was a 0.49% increase in all-cause death rate for every 1°C decrease. In general, all-cause, circulatory, coronary heart disease and STEMI death rates increased linearly with decreasing temperatures. The temperature effect varied by location, including temperature's linear slope, cubic fit, positional shift on the temperature axis, and the presence of circulatory death increases in locally hot temperatures. The variable effect of temperature by location suggests that people acclimatize to local temperature cycles. All-cause and circulatory death rates also demonstrated sizable associations with influenza levels, dew point temperature, and barometric pressure. A greater understanding of how climate, temperature, and barometric pressure influence cardiovascular responses would enhance our understanding of circulatory and STEMI deaths. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The use of genetically marked infection cohorts to study changes in establishment rates during the time course of a repeated Ascaridia galli infection in chickens

    DEFF Research Database (Denmark)

    Ferdushy, Tania; Luna Olivares, Luz Adilia; Nejsum, Peter

    2015-01-01

    This study investigated the changes in establishment rates during the time course of a 6week trickle infection of chickens with Ascaridia galli at two different dose levels, using a molecular marker. To differentiate early and late infection, two different egg cohorts (haplotype a and haplotype b...

  19. Do stocking rate and a simple run management practice influence the infection of laying hens with gastrointestinal helminths?

    Science.gov (United States)

    Heckendorn, F; Häring, D A; Amsler, Z; Maurer, V

    2009-01-22

    The aim of this experiment conducted at four sites in Switzerland was to investigate the transmission and infectivity of the two main helminth parasite species of poultry (Ascaridia galli and Heterakis gallinarum) in outdoor runs with two different stocking rates. Additionally, the influence of a simple management practice (mowing of run) on helminth transmission was studied. Three run types were created on each site: runs C served as control (stocking rate 10 m(2)/hen, no management), runs B corresponded to runs C but were managed (10 m(2)/hen, management). In runs A stocking rates were doubled compared to control runs (5m(2)/hen, no management). During two subsequent layer flocks, a set of parasitological parameters (faecal egg counts (FECs), prevalence, worm burdens in hens and in tracer animals, helminth eggs in soil) as well as parameters describing the run vegetation were determined. The increased stocking rate (runs A) led to a larger proportion of bare soil and to a reduction of the average vegetation height. In runs with a lower stocking rate (B and C), the proportion of bare soil did not increase during the experimental period. Irrespective of the run type, numbers of helminth eggs in the soil decreased significantly with an increasing distance to the hen houses, while the percentage of ground coverage as well as vegetation height increased. However, across runs the correlation between the percentage of ground cover and the values of eggs per gram soil between runs was very low (r(2)=0.0007, P=0.95) indicating a non-causal relationship. Significant differences in FEC were found in flock 2 (Phens in managed runs B were 24% lower (Phens from managed runs as well. Hens from runs with a high stocking rate (A) had significantly higher FEC than hens from control runs (C). In flock 2 management (n.s.) and higher stocking rates (-62%, Phens in the outdoor run seemed not to influence the transmission patterns of A. galli and H. gallinarum and repeated mowing of

  20. Reduction in driveline infection rates: Results from the HeartMate II Multicenter Driveline Silicone Skin Interface (SSI) Registry.

    Science.gov (United States)

    Dean, David; Kallel, Faouzi; Ewald, Gregory A; Tatooles, Antony; Sheridan, Brett C; Brewer, Robert J; Caldeira, Christian; Farrar, David J; Akhter, Shahab A

    2015-06-01

    During left ventricular assist device implantation, a surgical tunneling technique to keep the entire driveline (DL) velour portion in the subcutaneous tunnel, resulting in a silicone-skin interface (SSI) at the exit site, has been adopted by many centers. To assess long-term freedom from DL infection associated with this technique, a multicenter SSI registry was initiated. It was hypothesized that the modified tunneling technique is associated with at least 50% reduction in DL infection at 1 year post-implant compared with the velour-to-skin method used in the HeartMate II (HMII) Destination Therapy (DT) trial. SSI is a retrospective and prospective registry of patients who have received the HMII device. Results are reported from the retrospective cohort, which consists of 200 patients who were implanted during the period 2009-2012 with the SSI tunneling method and on HMII support for at least 10 months at the time of enrollment. The prevalence and incidence of DL infection after left ventricular assist device implantation in the SSI retrospective cohort were determined and compared with a control group of 201 patients also on HMII support for at least 10 months from the HMII DT clinical trial who were implanted during the period 2007-2009 using the traditional method in which a small section of the velour portion of the DL was externalized. The 1-year and 2-year prevalence rates of DL infection were 9% and 19% in the SSI patient group compared with 23% and 35% in the control group (hazard ratio 0.49, 95% confidence interval 0.33-0.73, p < 0.001). The event-per-patient year was 0.11 and 0.22 for the SSI and control groups, respectively (p < 0.001). Based on a multivariate analysis, age and DL exit side were the only independent variables associated with DL infection. Effects of management changes over the eras were not studied and could have contributed to the findings. These results suggest that leaving the entire DL velour portion below the skin is associated

  1. Sodium chloride inhibits the growth and infective capacity of the amphibian chytrid fungus and increases host survival rates.

    Directory of Open Access Journals (Sweden)

    Michelle Pirrie Stockwell

    Full Text Available The amphibian chytrid fungus Batrachochytrium dendrobatidis is a recently emerged pathogen that causes the infectious disease chytridiomycosis and has been implicated as a contributing factor in the global amphibian decline. Since its discovery, research has been focused on developing various methods of mitigating the impact of chytridiomycosis on amphibian hosts but little attention has been given to the role of antifungal agents that could be added to the host's environment. Sodium chloride is a known antifungal agent used routinely in the aquaculture industry and this study investigates its potential for use as a disease management tool in amphibian conservation. The effect of 0-5 ppt NaCl on the growth, motility and survival of the chytrid fungus when grown in culture media and its effect on the growth, infection load and survivorship of infected Peron's tree frogs (Litoria peronii in captivity, was investigated. The results reveal that these concentrations do not negatively affect the survival of the host or the pathogen. However, concentrations greater than 3 ppt significantly reduced the growth and motility of the chytrid fungus compared to 0 ppt. Concentrations of 1-4 ppt NaCl were also associated with significantly lower host infection loads while infected hosts exposed to 3 and 4 ppt NaCl were found to have significantly higher survival rates. These results support the potential for NaCl to be used as an environmentally distributed antifungal agent for the prevention of chytridiomycosis in susceptible amphibian hosts. However, further research is required to identify any negative effects of salt exposure on both target and non-target organisms prior to implementation.

  2. Postoperative intracranial neurosurgery infection rates in North America versus Europe: a systematic analysis.

    Science.gov (United States)

    McClelland, Shearwood

    2008-10-01

    Postoperative wound infection (PWI) after intracranial neurosurgery remains a significant worldwide problem, resulting in substantial morbidity/mortality if not combatted quickly and energetically. Although the danger of PWI is universally recognized, the reported incidence of PWI after intracranial neurosurgery remains variable, ranging from 1% to 8% in published series. The impact of geography on this reported variability has not been previously investigated. To address this issue, published comprehensive intracranial neurosurgery series were reviewed, segregating findings geographically between North American and European series. A comprehensive literature search was conducted using the Entrez gateway of the PubMed database. Studies conducted in North America and Europe reporting the incidence of PWI after intracranial neurosurgery were subjected to a thorough review. Data from studies meeting inclusion criteria (minimum of 500 cases with no systematic exclusion of procedures) were categorized by origin (North American/European) and design (retrospective/prospective). Recorded incidences were then compared using chi(2) analysis, and estimates of the relative risk of PWI were calculated. Seven studies (4 North American, 3 European) met all of the inclusion criteria, with a 2.6-fold greater PWI incidence reported in the European studies (P PWI for Europeans versus North Americans per operative case was 2.60. PWI after intracranial neurosurgery was nearly 3 times more likely in European versus North American studies. These findings should be considered by clinicians when estimating the risks of intracranial neurosurgery, and highlight the need for future prospective studies to provide evidence-based explanations for these differences.

  3. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales.

    Science.gov (United States)

    Myer, Landon; Smit, Joalida; Roux, Liezel Le; Parker, Siraaj; Stein, Dan J; Seedat, Soraya

    2008-02-01

    Despite the high prevalence of both mental disorders and HIV infection in much of sub-Saharan Africa, little is known about the occurrence of mental health disorders among HIV-infected individuals. We conducted a cross-sectional study among individuals enrolled into HIV care and treatment services near Cape Town, South Africa. Psychiatric diagnoses were measured using the Mini-International Neuropsychiatric Interview (MINI) administered by trained research nurses. In addition, all participants were administered brief rating scales for depression (the Center for Epidemiological Studies Depression Scale [CES-D]), posttraumatic stress disorder (PTSD), the Harvard Trauma Questionnaire (HTQ), and alcohol dependence/abuse (the Alcohol Use Disorders Identification Test [AUDIT]). The median age among the 465 participants was 33 years and 75% were female; 48% were receiving antiretroviral therapy. Overall, the prevalence of depression, PTSD and alcohol dependence/abuse was 14% (n = 62), 5% (n = 24), and 7% (n = 35), respectively. In multivariate analysis, the prevalence of all disorders was significantly higher among individuals who spoke Afrikaans compared to Xhosa. While the AUDIT showed excellent sensitivity and specificity in detecting MINI-defined dependence/abuse (area under the receiver-operating characteristic curve, 0.96), the HTQ and CES-D had lower performance characteristics in detecting PTSD (0.74) and depression (0.76), respectively. These data demonstrate high levels of depression, PTSD and alcohol dependence/abuse among HIV-infected individuals in this setting. Additional research is required to refine these rating scales for maximum applicability in cross-cultural populations. More generally, HIV care and treatment services represent an important venue to identify and manage individuals with common mental disorders in resource-limited settings.

  4. High Influenza A Virus Infection Rates in Mallards Bred for Hunting in the Camargue, South of France

    Science.gov (United States)

    Champagnon, Jocelyn; Guillemain, Matthieu; Crescenzo-Chaigne, Bernadette; Renaud, François; Thomas, Frédéric; Gauthier-Clerc, Michel; van der Werf, Sylvie

    2012-01-01

    During the last decade, the role of wildlife in emerging pathogen transmission to domestic animals has often been pointed out. Conversely, far less attention has been paid to pathogen transmission from domestic animals to wildlife. Here, we focus on the case of game restocking, which implies the release of millions of animals worldwide each year. We conducted a 2-year study in the Camargue (Southern France) to investigate the influence of hand-reared Mallard releases on avian influenza virus dynamics in surrounding wildlife. We sampled Mallards (cloacal swabs) from several game duck facilities in 2009 and 2010 before their release. A very high (99%) infection rate caused by an H10N7 strain was detected in the game bird facility we sampled in 2009. We did not detect this strain in shot ducks we sampled, neither during the 2008/2009 nor the 2009/2010 hunting seasons. In 2010 infection rates ranged from 0 to 24% in hand-reared ducks. The 2009 H10N7 strain was fully sequenced. It results from multiple reassortment events between Eurasian low pathogenic strains. Interestingly, H10N7 strains had previously caused human infections in Egypt and Australia. The H10 and N7 segments we sequenced were clearly distinct from the Australian ones but they belonged to the same large cluster as the Egyptian ones. We did not observe any mutation linked to increased virulence, transmission to mammals, or antiviral resistance in the H10N7 strain we identified. Our results indicate that the potential role of hand-reared Mallards in influenza virus epizootics must be taken into account given the likely risk of viral exchange between game bird facilities and wild habitats, owing to duck rearing conditions. Measures implemented to limit transmission from wildlife to domestic animals as well as measures to control transmission from domestic animals to wild ones need to be equally reinforced. PMID:22952832

  5. TRIMETHOPRIM-SULFAMETHOXAZOLE RESISTANCE AND FOSFOMYCIN SUSCEPTIBILITY RATES IN UNCOMPLICATED URINARY TRACT INFECTIONS: TIME TO CHANGE THE ANTIMICROBIAL PREFERENCES.

    Science.gov (United States)

    Guneysel, Ozlem; Suman, Enes; Ozturk, Tuba Cimilli

    2016-03-01

    Urinary tract infections (UTIs) are among the most common bacterial infections in adult population. They are prevalent in all age groups both in women and men. Also, UTIs are the most frequent indication for empirical antibiotic treatment in emergency department. The aim of this study was to determine the antibiotic resistance rates in the treatment of uncomplicated UTIs. Adult patients admitted to emergency department with uncomplicated UTIs were included in this cross-sectional study. Mid-stream urine samples were obtained under sterile conditions and cultured quantitatively. After 24 hours, the samples showing 10(5) colony forming unit per milliliter (CFU/mL) were tested for antibiotic susceptibility. Resistance to fosfomycin-trometamol (FT), amoxicillin-clavulanic acid (AC), ciprofloxacin (CIP), trimethoprim-sulfamethoxazole (TMP-SMX) and cefpodoxime (CEF) was tested by Kirby-Bauer disc diffusion system. Escherichia (E.) coli accounted for the vast majority (93.4%) of the organisms isolated in the study. Among the E. coli positive patients, resistance to TMP-SMX was the most common antibiotic resistance. The E. coli species detected in our study group were least resistant to FT (2.4%). The resistance rates, especially to CEF, AC and CIP, were significantly higher in patients over 50 years of age. In conclusion, in the treatment of uncomplicated UTIs, TMP-SMX should be excluded from empirical treatment, while fosfomycin could be a viable option in all age groups.

  6. Radiotherapy Reduced Salivary Flow Rate and Might Induced C. albicans Infection

    Directory of Open Access Journals (Sweden)

    Nadia Surjadi

    2013-07-01

    Full Text Available Radiotherapy has impact in oral health especially on the secretion capacity of the salivary glands. Another impact is the increase of Candida albicans colony. Objectives: To evaluate salivary flow in relation with Candida albicans colony in head and neck cancer patients during and after radiotherapy. Methods: Twenty-four head and neck cancer patients in Dharmais Cancer Hospital, Jakarta who were undergoing radiotherapy or had undergone radiotherapy and 24 match healthy volunteers were included in the study. Clinical observation carried out by collecting unstimulated salivary flow rate and followed by culture of Candida in Saboraud agar medium. Data were analyzed statistically by Chi-square. Results: Nasopharynx cancer was the most frequent type of head and neck cancers (87.5% followed by tongue cancer (12.5% and and found in 41-50 years old patients and 51-60 years old patients respectively, with male predilection compare to female (17:7. Approxiamtely 87.5% of subjects showed decreased salivary flow rate (1.01-1.50mL/10min during and after radiotherapy. However, 91.7% of cancer patients had increased C.albicans colony during and after radiotherapy compared to control (p=0.00. Conclusion: This study showed that radiotherapy induced hyposalivation and might increase the C.albicans colony.  

  7. The effects of equine rhinovirus, influenza virus and herpesvirus infection on tracheal clearance rate in horses.

    Science.gov (United States)

    Willoughby, R; Ecker, G; McKee, S; Riddolls, L; Vernaillen, C; Dubovi, E; Lein, D; Mahony, J B; Chernesky, M; Nagy, E

    1992-04-01

    The response of horses exposed to three common respiratory viruses was studied by measuring tracheal mucociliary clearance rates in the trachea. Tracheal clearance rates (TCR) were determined before, during illness and following recovery in horses exposed to equine rhinovirus (ERhV-2), equine influenza virus (EIV) and equine herpesvirus (EHV-4) by means of lateral scintigraphs made following an injection of technetium-99m sulphide colloid into the tracheal lumen. In six horses exposed to ERhV-2, TCR remained within normal limits. Exposure to EIV resulted in reduced TCR in six of seven horses, with TCR remaining below the 95% confidence limits of normal values for each horse for up to 32 days despite the resolution of clinical signs. Moderate changes were observed in six horses exposed to EHV-4, but significant reductions in TCR were evident in three animals. Measurement of TCR was a useful, minimally-invasive technique which demonstrated that respiratory viruses may cause persistent changes in TCR, even though clinical signs are not evident.

  8. Impact of definition and procedures used for absent blood culture data on the rate of intravascular catheter infection during parenteral nutrition.

    Science.gov (United States)

    Austin, P D; Hand, K S; Elia, M

    2016-06-01

    Diagnosis of intravascular catheter infection may be affected by the definition and procedures applied in the absence of blood culture data. To examine the extent to which different definitions of catheter infection and procedures for handling absent blood culture data can affect reported catheter infection rates. Catheter infection rates were established in a cohort of hospitalized patients administered parenteral nutrition according to three clinical and four published definitions. Paired and unpaired comparisons were made using available case analyses, sensitivity analyses and intention-to-categorize analyses. Complete data were available for each clinical definition (N = 193), and there were missing data (4.1-26.9%) for the published definitions. In an available case analysis, the catheter infection rate was 13.0-36.8% for the clinical definitions and 2.1-12.4% for the published definitions. For the published definitions, the rate was 1.6-32.1% in a sensitivity analysis and 11.4-16.9% in an intention-to-categorize analysis, with suggestion of bias towards a higher catheter infection rate in those with missing data, in keeping with the analyses of the clinical definitions. For paired comparisons, the strength of agreement between definitions varied from 'poor' (Cohen's kappa definitions of catheter infection and procedures applied in the absence of blood culture data produced widely different catheter infection rates, which could compromise measurements or comparisons of service quality or study outcome. As such, there is a need to establish and use a valid, consistent and practical definition. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  9. Ureteroneocystostomy in primary vesicoureteral reflux: critical retrospective analysis of factors affecting the postoperative urinary tract infection rates

    Directory of Open Access Journals (Sweden)

    Hasan Serkan Dogan

    2014-08-01

    Full Text Available Introduction To determine the parameters affecting the outcome of ureteroneocystostomy (UNC procedure for vesicoureteral reflux (VUR. Materials and Methods Data of 398 patients who underwent UNC procedure from 2001 to 2012 were analyzed retrospectively. Different UNC techniques were used according to laterality of reflux and ureteral orifice configuration. Effects of several parameters on outcome were examined. Disappearance of reflux on control VCUG or absence of any kind of UTI/symptoms in patients without control VCUG was considered as clinical improvement. Results Mean age at operation was 59.2 ± 39.8 months and follow-up was 25.6 ± 23.3 months. Grade of VUR was 1-2, 3 and 4-5 in 17, 79, 302 patients, respectively. Male to female ratio was 163/235. UNC was performed bilaterally in 235 patients and intravesical approach was used in 373 patients. The frequency of voiding dysfunction, scar on preoperative DMSA, breakthrough infection and previous surgery was 28.4%, 70.7%, 49.3% and 22.4%, respectively. Twelve patients (8.9% with postoperative contralateral reflux were excluded from the analysis. Overall clinical improvement rate for UNC was 92%. Gender, age at diagnosis and operation, laterality and grade of reflux, mode of presentation, breakthrough infections (BTI under antibiotic prophylaxis, presence of voiding dysfunction and renal scar, and operation technique did not affect the surgical outcome. However, the clinical improvement rate was lower in patients with a history of previous endoscopic intervention (83.9% vs. 94%. Postoperative UTI rate was 27.2% and factors affecting the occurrence of postoperative UTI were previous failed endoscopic injection on univariate analysis and gender, preoperative BTI, postoperative VUR state, voiding dysfunction on multivariate analysis. Surgery related complication rate was 2% (8/398. These were all low grade complications (blood transfusion in 1, hematoma under incision in 3 and prolonged

  10. PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Roger J. Chin, MA, MPA

    2015-04-01

    Full Text Available Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President’s Emergency Plan for AIDS Relief (PEPFAR with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country’s HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

  11. Kidney Transplantation and Waitlist Mortality Rates among Candidates Registered as Willing to Accept a Hepatitis C Infected Kidney.

    Science.gov (United States)

    Shelton, Brittany A; Sawinski, Deirdre; Mehta, Shikha; Reed, Rhiannon D; MacLennan, Paul A; Locke, Jayme E

    2017-12-26

    HCV-infected (HCV+) ESRD patients derive significant survival benefit from kidney transplantation (KT) over remaining on dialysis. Given high mortality rates on dialysis and the unique ability to accept HCV+ and HCV- donor kidneys, understanding their access to KT is essential. 3,963 adult kidney-only candidates reported as willing to accept an HCV+ kidney from 2008-2014 were identified and assumed to be HCV+. Time-at-risk began at date of listing. Cumulative incidence of transplant and waitlist mortality were assessed using competing risks, and separate mixed effects Cox proportional hazards models were used to examine waitlist mortality and transplantation rates. All models were adjusted for candidate demographic and clinical characteristics with a random effect for listing OPO with nested listing center. HCV+ candidates were commonly older (>50 years: 82.6%), African-American (52.8%), and male (73.6%). Five years after listing 35.5% of candidates were transplanted with an HCV+ donor kidney, 9.7% transplanted with an HCV- donor kidney, and 23.6% died on the waitlist. Overall transplant rates exceeded waitlist mortality rates (22.69 vs. 11.45 per 100 person-years [PY]), largely driven by transplantation with HCV+ donor kidneys. Utilization of HCV+ donor kidneys was associated with increased transplantation rate (17.72 per 100 PY) while rate of transplant with HCV- donor kidneys was much lower (4.97 per 100 PY) than waitlist mortality (11.45 per 100 PY). In light of effective HCV therapies, it may be prudent to institute strategies to decrease waiting time and waitlist mortality for HCV+ candidates by increasing utilization of HCV+ donor kidneys. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Effect of Filmless Imaging on Utilization of Radiologic Services with a Two-stage, Hospital-Wide Implementation of a Picture Archiving and Communication System: Initial Experience of a Fee-for-Service Model

    Directory of Open Access Journals (Sweden)

    Yu-Ting Kuo

    2003-02-01

    Full Text Available A medium-sized general hospital using a fee-for-service model implemented a hospital-wide picture archiving and communication system (PACS in two stages. This study evaluated the reporting time with filmless operation and the effect of filmless imaging on referring physicians' use of the radiologic service before and after completion of the second stage of PACS implementation. The relationship between the total number of hospital patients and the number of radiologic department patients was also evaluated. All sample images were retrieved from the PACS. All corresponding reports except for one for a computerized tomography study were available. The median reporting time for different studies performed during working hours was less than 2 hours. There was a significantly positive and linear relationship (p < 0.01 between the total number of hospital patients and the number of radiologic department patients after hospital-wide implementation of PACS. We conclude that the fee-for-service model had no negative impact on referring physicians' use of radiologic services in a filmless hospital.

  13. Diabetes Mellitus is Associated with Increased Death Rates Among HIV-Infected Patients in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Moreira, Rodrigo C; Pacheco, Antonio G; Paula, Adelzon; Cardoso, Sandra W; Moreira, Ronaldo I; Ribeiro, Sayonara R; Nunes, Estevão P; Guimarães, Maria R; Mello, Fernanda C; Veloso, Valdilea G; Grinsztejn, Beatriz

    2016-12-01

    Diabetes mellitus (DM) is a major cause of morbidity worldwide and a known factor leading to increased risk of death, especially in conjunction with other risk factors. In this study, we evaluated the prevalence of DM among HIV-infected patients and its association with overall mortality. All HIV-infected patients 18 years or older who were followed in the Instituto Nacional de Infectologia Evandro Chagas (INI) cohort from January 1991 to December 2011 were included. Time-updated covariables included DM status, calendar year, combination antiretroviral therapy (cART), and CD4 cell counts. Fixed demographic covariables included gender and age at entry. Poisson models were used to calculate mortality rate ratios (RR) with robust variances. Among the 4,871 patients included, 1,192 (24.4%) died (mortality rate = 4.72/100 person-years [PY]; 95% confidence interval [CI] = 4.46-5.00). Death rates were significantly higher among those presenting with DM compared with those who did not (6.16/100 vs. 4.61/100 PY, respectively. p = 0.001). In the final model, DM was significantly associated with mortality (RR = 1.74; 95% CI = 1.57-1.94; p < 0.001). When the analysis was restricted to those on cART or the period post-1996, the association between DM and mortality was even stronger (RR = 2.17; 95% CI = 1.91-2.46; p < 0.001 and RR = 1.95; 95% CI = 1.75-2.18; p < 0.001, respectively). Among the major groups of cause of deaths (CODs), the proportion of AIDS-related conditions in patients with DM was lower (74.27% vs. 58.93%, respectively; p < 0.001); whereas in non-AIDS-related conditions, nonimmunodeficiency-related causes (22.44% vs. 34.82%, respectively; p = 0.004) were more common in patients with DM. In conclusion, DM was associated with increased mortality rates even after controlling for HIV-related variables associated to this outcome. Differences in the underlying CODs were identified, reinforcing the necessity to

  14. Effects of stocking rates on gastrointestinal nematode infection levels in a goat/cattle rotational stocking system.

    Science.gov (United States)

    Mahieu, Maurice

    2013-11-15

    Gastrointestinal nematodes (GIN) are increasingly resistant to anthelmintic drugs worldwide, so integrated control methods are more and more needed for the sustainability of small ruminant farming. Such methods rely on knowledge in epidemiology, physiology, and genetics. Ecological studies have highlighted the effect of host density on parasite populations, and in the humid tropics, rotational grazing systems were designed according to the survival of GIN free-living stages. This study aimed to assess the effects of mixed stocking and host stocking rate on host GIN infection level. Four groups of 15-17 Creole male kids were raised on irrigated pasture from weaning (about 3 months) until the age of 7 months, at four partial stocking rates (pSR): 100% (control), 75% (G75), 50% (G50), and 25% (G25) of the total stocking rate of the pasture. The last three groups were associated with weaned Creole heifers to obtain the same overall stocking rate as the control. Animals grazed in a 'leader' goat and 'follower' cattle design: the G25, G50, and G75 paddocks were split into six plots; each plot was grazed by goats for 1 week and by heifers the following week. The pasture then rested for 4 weeks before the animals were returned for a new grazing sequence. Five control plots were grazed rotationally for 1 week, and rested for 4 weeks. This design was repeated three times a year for a total of 10 repetitions. Average faecal egg counts (FEC) decreased according to a power function of the pSR: FEC=1829pSR(3.7). The observed death rate decreased significantly with the pSR (27.6%, 16.4%, 11.9%, and 12.2%). The kids grew faster in G25 (51 g d(-1)) than in G50 (43 g d(-1)) and G75 or control (32 g d(-1), p<0.05). Heifers were not significantly infected with GIN and grew normally (about 0.48 kg d(-1)). Reducing the pSR by associating a non-host species in a rotational stocking system may be a very promising component of integrated GIN control, at least for the humid tropics

  15. Relationship between Chlamydia trachomatis and Mycoplasma genitalium infection and pregnancy rate and outcome in Iranian infertile couples.

    Science.gov (United States)

    Dehghan Marvast, L; Aflatoonian, A; Talebi, A R; Eley, A; Pacey, A A

    2017-11-01

    The study was performed to investigate the prevalence of Chlamydia trachomatis and Mycoplasma genitalium in a population of infertile couples from Iran and how this relates to tubal factor infertility, pregnancy rate and outcome of pregnancy. Blood, semen and first-void urine samples were obtained from 250 infertile couples and 250 fertile women as a control. Infertile couples were followed up after 24 months to determine diagnosis, referral for assisted conception, any pregnancy and pregnancy outcome. Data were analysed with regard to the results of (i) serological analysis for specific antibodies to C. trachomatis in serum; (ii) the presence of C. trachomatis and M. genitaliumDNA in first-void urine; and (iii) in a semen sample of the male partner. Prevalence of C. trachomatis in our study population was comparable to other studies using similar methods and test specimens. No evidence of M. genitalium infection was found. Detection of C. trachomatis in one partner rarely correlated with infection in the other. The risk of tubal factor infertility and the probability of pregnancy and pregnancy outcome were unrelated to the results of serological tests for C. trachomatis antibodies or the presence of C. trachomatisDNA in first-void urine of both partners and in a semen sample provided by the male. © 2016 Blackwell Verlag GmbH.

  16. Comparison of Infection and Urosepsis Rates of Ciprofloxacin and Ceftriaxone Prophylaxis before Percutaneous Nephrolithotomy: A Prospective and Randomised Study

    Directory of Open Access Journals (Sweden)

    Abdullah Demirtas

    2012-01-01

    Full Text Available This study aimed at determining the choice and administration duration of ideal antibiotic prophylaxis before percutaneous nephrolithotomy (PNL operation, a treatment modality for nephrolithiasis. The study included 90 patients who had no internal problem, yet had a negative urine culture and underwent a PNL operation. We compared infection rates between ciprofloxacin and ceftriaxone groups and their subgroups. The results showed no statistical difference between ciprofloxacin and ceftriaxone groups in terms of systemic inflammatory response syndrome (SIRS (CIPP=0.306, CTX P=0.334. As a result of this study no statistical difference was observed between ciprofloxacin and ceftriaxone in terms of SIRS. It seems, however, reasonable to choose ceftriaxone, considering antibiotic sensitivity of microorganisms and detection of three cases accepted as urosepsis in the ciprofloxacin group. As there is no difference between short, and long-term prophylactic use of these antibiotics, preference of short-term prophylaxis for patients with no risk of infection will be important to avoid inappropriate antibiotic usage.

  17. Survey on th incidence of homeless pulmonary tuberculosis infection rate through chest x-ray examination

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Shin, Sung Rae [Dept. of Nursing, Sahmyook University, Seoul (Korea, Republic of); Ryu, Young Hwan [Dept. of Radiology, Seoul Medical Center, Seoul (Korea, Republic of); Lim, Hwan Yeal [Dept. of Medical Business Administration, U1 University, Yeongdong (Korea, Republic of)

    2017-02-15

    This study, Seoul City shelter, you are trying to seek medical cooperation and cure rate increase proposal Yu fndings’s current situation and tuberculosis of homeless tuberculosis. Inspector, and has a total 591 people is targeted to implement an interview after acquiring utilization agreement in studies conducted chest X-ray photography. Of the interview questions, three or more protons, it is determined that the TB symptomatic conducted sputum examination, chest X-ray examination confrms the physician radiology, when sputum examination primarily chromatic fndings the double implemented and conducted by requesting the ship inspection also said inspection sputum acid-fast bacteria if it is true one, respectively. confrmed case result of checking whether there is a difference due to risk factors (Jb) at the chi square black, it was found that there is no statistically significant difference at 95% confidence level. (χ{sup 2}=0.276, p>0.05), suspected case (Ac, Ae) results of examining whether there is a difference due to risk factors in chi square black, that there is a statistically significant difference at 99% confidence level is I found (χ{sup 2}=9.414, p<0.01). The nature of the homeless tuberculosis screening and directed to the distance homeless specifc location are likely to evaluate the actual incidence low and aggressive or management needs, the rationale is allowed insufficient reality is. Through this research, future, for tuberculosis high risk tuberculosis patient, such as homeless to expand the tuberculosis screening of infectious tuberculosis patients in private medical institutions, and one-stop service that chest X-ray examination and sputum examination is carried out at the same time introduced immediately to prevent the inspection and examination, cure, and should establish a foundation that can be up to post administration.

  18. Effect of a Hospital-wide High-Flow Nasal Cannula Protocol on Clinical Outcomes and Resource Utilization of Bronchiolitis Patients Admitted to the PICU.

    Science.gov (United States)

    Riese, Jeffrey; Fierce, Jamie; Riese, Alison; Alverson, Brian K

    2015-12-01

    To assess the association of the introduction of a high-flow nasal cannula (HFNC) protocol with clinical outcomes and hospital charges of infants with bronchiolitis initially admitted to the PICU. We conducted a retrospective, nonrandomized, preintervention-postintervention study of infants with bronchiolitis initially admitted to the PICU for HFNC. We compared patients admitted in the 24 months before and after protocol initiation for HFNC use on the general wards. The primary outcome assessed was length of hospital stay (LOS), and the secondary outcomes included total hospital charges, intubation, and 30-day readmission. We conducted bivariate analysis using χ² test for categorical variables and Student's t test or Wilcoxon rank sum test for continuous variables. Two hundred and ninety patients were admitted to the PICU on HFNC; 120 patients were admitted before and 170 admitted after the introduction of HFNC use on the general wards. Comparing the 2 groups, the median LOS was significantly reduced (4 days vs 3 days; P < .001), as was the median total hospital charges ($12 257 vs $9337; P < .001). After starting HFNC use on the wards, 30% of patients initially admitted to the PICU were ultimately transferred to the wards while still on HFNC. There was no difference in intubation rate or 30-day readmission between the 2 groups. For bronchiolitis patients initially admitted to the PICU, initiating a guideline for HFNC use on the general pediatric wards is associated with reduced total hospital LOS and total hospital charges, with no difference in intubation rates or 30-day readmission. Copyright © 2015 by the American Academy of Pediatrics.

  19. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2006-04-01

    Full Text Available Abstract Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.

  20. Impacts of 12-dose regimen for latent tuberculosis infection: Treatment completion rate and cost-effectiveness in Taiwan.

    Science.gov (United States)

    Huang, Yi-Wen; Yang, Shun-Fa; Yeh, Yen-Po; Tsao, Thomas Chang-Yao; Tsao, Shih-Ming

    2016-08-01

    Treatment of latent tuberculosis infection (LTBI) is essential for eradicating tuberculosis (TB). Moreover, the patient adherence is crucial in determining the effectiveness of TB control. Isoniazid given by DOTS daily for 9 months (9H) is the standard treatment for LTBI in Taiwan. However, the completion rate is low due to the long treatment period and its side effects. The combined regimen using a high dose of rifapentine/isoniazid once weekly for 12 weeks (3HP) has been used as an alternative treatment option for LTBI in the United States. This may result in a higher completion rate. In this pilot study, patient adherence and cost of these 2 treatment regimens were investigated. Thus, we aimed to assess the treatment completion rate and costs of 3HP and compare to those with 9H.Data from 691 cases of LTBI treatments including 590 cases using the conventional regimen and 101 cases with rifapentine/Isoniazid were collected. The cost was the sum of the cost of treatment with Isoniazid for 9 months or with rifapentin/Isoniazid for 3 months of all contacts. The effectiveness was the cost of cases of tuberculosis avoided.In this study, the treatment completion rate for patients prescribed with the 3 months rifapentine/isoniazid regimen (97.03%) was higher than those given the conventional 9-month isoniazid regimen (87.29%) (P rifapentine/isoniazid regimen due to undesirable side effects.This was the first study to compare the 2 treatment regimens in Taiwan, and it showed that a short-term high-dosage rifapentine/isoniazid treatment regimen reduced costs and resulted in higher treatment completion than the standard LTBI isoniazid treatment.

  1. Rate of candidiasis among HIV-infected children in Spain in the era of highly active antiretroviral therapy (1997-2008).

    Science.gov (United States)

    Álvaro-Meca, Alejandro; Jensen, Julia; Micheloud, Dariela; Díaz, Asunción; Gurbindo, Dolores; Resino, Salvador

    2013-03-04

    Candidiasis is the most common opportunistic infection seen in human immunodeficiency virus (HIV)-infected individuals. The aim of our study was to estimate the candidiasis rate and evaluate its trend in HIV-infected children in Spain during the era of highly active antiretroviral therapy (HAART) compared to HIV-uninfected children. We carried out a retrospective study. Data were obtained from the records of the Minimum Basic Data Set from hospitals in Spain. All HIV-infected children were under 17 years of age, and a group of HIV-uninfected children with hospital admissions matching the study group by gender and age were randomly selected. The follow-up period (1997-2008) was divided into three calendar periods: a) From 1997 to 1999 for early-period HAART; b) from 2000 to 2002 for mid-period HAART; and c) from 2003 to 2008 for late-period HAART. Among children with hospital admissions, HIV-infected children had much higher values than HIV-uninfected children during each of the three calendar periods for overall candidiasis rates (150.0 versus 6.1 events per 1,000 child hospital admissions/year (p candidiasis rate (events per 1,000 HIV-infected children/year) decreased from 1997-1999 to 2000-2002 (18.8 to 10.6; p candidiasis, both non-ICM and ICM rates experienced significant decreases from 1997-1999 to 2003-2008 (15.9 to 5.7 (p candidiasis rate still remains higher than in the general population (from 1997 to 2008), candidiasis diagnoses have decreased among HIV-infected children throughout the HAART era, and it has ceased to be a major health problem among children with HIV infection.

  2. Rate of candidiasis among HIV-infected children in Spain in the era of highly active antiretroviral therapy (1997–2008)

    Science.gov (United States)

    2013-01-01

    Background Candidiasis is the most common opportunistic infection seen in human immunodeficiency virus (HIV)-infected individuals. The aim of our study was to estimate the candidiasis rate and evaluate its trend in HIV-infected children in Spain during the era of highly active antiretroviral therapy (HAART) compared to HIV-uninfected children. Methods We carried out a retrospective study. Data were obtained from the records of the Minimum Basic Data Set from hospitals in Spain. All HIV-infected children were under 17 years of age, and a group of HIV-uninfected children with hospital admissions matching the study group by gender and age were randomly selected. The follow-up period (1997–2008) was divided into three calendar periods: a) From 1997 to 1999 for early-period HAART; b) from 2000 to 2002 for mid-period HAART; and c) from 2003 to 2008 for late-period HAART. Results Among children with hospital admissions, HIV-infected children had much higher values than HIV-uninfected children during each of the three calendar periods for overall candidiasis rates (150.0 versus 6.1 events per 1,000 child hospital admissions/year (p candidiasis rate (events per 1,000 HIV-infected children/year) decreased from 1997–1999 to 2000–2002 (18.8 to 10.6; p candidiasis, both non-ICM and ICM rates experienced significant decreases from 1997–1999 to 2003–2008 (15.9 to 5.7 (p candidiasis rate still remains higher than in the general population (from 1997 to 2008), candidiasis diagnoses have decreased among HIV-infected children throughout the HAART era, and it has ceased to be a major health problem among children with HIV infection. PMID:23510319

  3. Multicentre evaluation of prescribing concurrence with anti-infective guidelines : epidemiological assessment of indicators

    NARCIS (Netherlands)

    Fijn, R; Chow, MC; Schuur, PMH; De Jong-Van den Berg, LTW; Brouwers, JRBJ

    2002-01-01

    Purpose To assess indicators for anti-infective prescribing not concurrent with regional pharmacotherapeutic treatment guidelines (PTGs) on infectious diseases. Methods A retrospective explorative cohort study based on hospital-wide anti-infective prescription data of a 2-month cross-sectional

  4. Post-appendectomy surgical site infection rate after using an antimicrobial film incise drape: a prospective study.

    Science.gov (United States)

    Al-Qahtani, Saleh M; Al-Amoudi, Hani M; Al-Jehani, Suhad; Ashour, Abdullah S; Abd-Hammad, Mohammed R; Tawfik, Omar R; Baslaim, Muna M; Farrokhyar, Forough

    2015-04-01

    An appendectomy is a contaminated or potentially dirty surgical procedure that can be associated with surgical site infection (SSI). A single-center unblinded prospective cohort study examined the role of antimicrobial incise film drapes in lowering the rate of SSI after appendectomy. Any patient aged 12 years or older who was scheduled for open appendectomy for acute appendicitis was included. Patients were assigned to two groups. Group 1 (n=52) had the standard five-minute skin preparation with 10% povidone-iodine soap followed by the application of an antimicrobial film incise drape, and group 2 (n=39) had the standard skin preparation alone. Six (11.5%) of the 52 patients who had the antimicrobial film incise drape and two (5.1%) of the 39 patients who did not have the drape developed SSI (p=NS). Of the six patients in the antimicrobial film group with post-operative SSI, three had a perforated appendix, two had a gangrenous appendix, and one had an inflamed appendix. In group 2, one patient had an inflamed appendix and the other had a perforated appendix. The median length of stay in the hospital was two days (range 1-11 days) for both groups. Our study did not support the view that antimicrobial film incise drapes can lower the rate of post-appendectomy SSI. Moreover, the length of stay was not minimized by the use of these drapes.

  5. The effect of diluent pH on bloodstream infection rates in patients receiving IV treprostinil for pulmonary arterial hypertension.

    Science.gov (United States)

    Rich, Jonathan D; Glassner, Cherylanne; Wade, Michael; Coslet, Sandra; Arneson, Carl; Doran, Aimee; Gomberg-Maitland, Mardi

    2012-01-01

    Recent studies have reported an increase in catheter-related bloodstream infections (BSIs) and gram-negative BSIs among patients with pulmonary arterial hypertension treated with IV treprostinil. One possible explanation is the neutral pH of the treprostinil diluent compared with the basic pH of epoprostenol. We hypothesized that administering IV treprostinil with epoprostenol diluent will lower the rate of gram-negative BSI. We prospectively enrolled patients treated with IV treprostinil and changed the diluent from native diluent to epoprostenol diluent. We compared the incidence of BSI and gram-negative BSI between those receiving IV treprostinil with epoprostenol diluent (n = 25) and those actively receiving IV epoprostenol (n = 61), as well as with a cohort of patients who received IV treprostinil in native diluent (n = 34). Incidence rates of BSI were expressed as a fraction of 1,000 medicine treatment days. There were similar rates of BSI in those treated with treprostinil with epoprostenol diluent and those treated with epoprostenol (0.32 of 1,000 vs 0.40 of 1,000; P = .79). Also, there were similar rates of gram-negative BSI in these two cohorts (0.08 of 1,000 vs 0.20 of 1,000; P = .46). BSI rates were not statistically different between those treated with treprostinil with epoprostenol diluent and those treated with treprostinil (0.32 of 1,000 vs 0.90 of 1,000; P = .06). However, gram-negative BSIs were significantly lower in patients treated with treprostinil with epoprostenol diluent than in those treated with treprostinil (0.08 of 1,000 vs 0.71 of 1,000, respectively; P = .01). Patients treated with treprostinil with epoprostenol diluent have a lower incidence of gram-negative BSI than do those treated with treprostinil and a similar rate to those treated with epoprostenol. Changing the diluent of treprostinil to epoprostenol diluent, in combination with the use of water-tight seals throughout the delivery system, appears to be an effective safety

  6. Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe

    DEFF Research Database (Denmark)

    Judd, A; Lodwick, R; Noguera-Julian, A

    2017-01-01

    OBJECTIVES: The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. METHODS:...

  7. Local irrigation of the surgical field with antibiotics in the end of procedure reduces the infection rate in herniated lumbar disc surgery.

    Science.gov (United States)

    Kërveshi, Armend; Halili, Nehat; Kastrati, Bujar; Qosja, Faik; Kabashi, Serbeze; Muçaj, Sefedin

    2014-12-01

    Reported rate of infections after lumbar discectomy is 1%-15 %. This complication may result in disability or even the death. The aim of the study is to assess the rate of infection associated with lumbar discectomies when combined systemic and local antibiotic prophylaxis was employed. In this retrospective study we analyzed all patients operated for herniated lumbar disc from 2009 -2012 in our institute. Beside of receiving systemic prophylaxis with 2g of Cefazoline, all patients had their operative field irrigated at the end of operation with Amikacin sulfate injection. Wound was considered infected when local and systemic signs of infection were revealed and were associated with elevated ESR, leukocytosis and elevated CRP. Assessment of infection is done by neurosurgeon during the hospitalization and later at outpatient's clinic along postoperative course of three months. A total of 604 patients were operated, of those 285 patients (47.2 %) females and 319 males (52.8 %), 12 patients were operated on two levels (1.98 %). Average patient age was 32.5 years (range 20-65 years) Localization of herniated disc was: in L/2-L/3 20 patients or 3.3 %, the L/3-L/4 level 42 patients or 7 % , the L/4 -L /5 262 patients or 43.3 % at the level L/V- S/1 280 patients or 46.3 %. Three patients (0.49%) developed wound infection, two of them superficial infection only with local signs: local pain, redness and leakage. They were treated with oral antibiotics. One with deep wound infection. He presented with local and systemic signs and treated with i.v antibiotics. All the cultures from wound swab revealed staphylococcus aureus. Prophylaxis with systemic antibiotic (Cefazoline 2.0) intravenous administration 30 minutes before the incision and irrigation of operative field with local antibiotic Amikacine sulfate at the end of procedure reduces the infection rate in patients operated for herniated lumbar disc when compared with systemic antibiotic prophylaxis only.

  8. Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence.

    Science.gov (United States)

    Alsbeih, Ghazi A; Al-Harbi, Najla M; Bin Judia, Sara S; Khoja, Hatim A; Shoukri, Mohamed M; Tulbah, Asma M

    2017-07-01

    Cervical cancer is a predominantly human papillomavirus (HPV)-driven disease worldwide. However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C single nucleotide polymorphism (SNP) presumed to affect cancer incidence. Patients treated between 1990 and 2012 were reviewed, and a series of 232 invasive cervical cancer cases were studied and compared with 313 matched controls without cancer. SNP was genotyped by way of direct sequencing. HPV linear array analysis was used to detect and genotype HPV in tumor samples. The incidence of cervical cancer revealed bimodal peaks at 42.5 years, with a slighter rebound at 60.8 years. Among all cases, 77% were HPV-positive and 16 HPV genotypes were detected-mostly genotypes 16 (75%) and 18 (9%)-with no difference by age, histology, or geographical region. Although the TP53 G72C genotype was not associated with overall cervical cancer risk, it was significantly associated with HPV positivity (odds ratio, 0.57; 95% confidence interval, 0.36-0.90; P = .016). Furthermore, the variant C allele was significantly overtransmitted in the population (P Cervical cancer incidence displays bimodal curve peaking at a young age with secondary rebound at older age. The combination of relative low HPV infection and variant TP53 72C allele overtransmission provide a plausible explanation for the low incidence of cervical cancer in our population. Therefore, HPV screening and host SNP genotyping may provide more relevant biomarkers to gauge the risk of developing cervical cancer. Cancer 2017;123:2459-66. © 2017 American Cancer Society. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  9. Alterations of peripheral leukocyte count, erythrocyte sedimentation rate, and C-reactive protein in febrile urinary tract infection.

    Science.gov (United States)

    Naseri, Mitra

    2008-07-01

    The aim of this study was to assess the usefulness of peripheral leukocyte count, differential leukocyte count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level in febrile urinary tract infection (UTI) for defining the UTI level. A total of 61 children aged between 1 and 10 years with documented febrile UTI (axillary temperature > or = 38 degrees C) were studied. They had a urine culture positive for infection. Laboratory investigations including peripheral total and differential leukocyte counts, ESR, and CRP were assessed in relation to the inflammatory responses. Leukocyte count results were available in all of the patients, ESR in 41, and CRP in 36. Leukocyte count was normal in 6 patients (9.8%). Lymphocytic leukocytosis was seen in 1 patients (1.6%), neutrophilic leukocytosis in 25 (41.0%), and relative neutrophilia in 29 (47.5%). Thirty patients (73.2%) had a high ESR and 23 (63.9%) had a positive CRP. In children with a high ESR, 12 (29.3%) had neutrophilic leukocytosis and 14 (34.1%) had relative neutrophilia. Relative neutrophilia and neutrophilic leukocytosis with positive CRP both were found in 11 patients (30.6%). Negative CRP with absence of neutrophilic leukocytosis was found in a significantly higher proportion of patients. There were no direct correlations between the severity of systemic inflammatory responses and urinary tract inflammatory response. Findings of this study showed that ESR and differential leukocyte count are two valuable tests in febrile UTI and may be useful for localization of UTI level, but the total leukocyte count and CRP level as in qualitative methods are not useful, and many patients with febrile UTI do not have leukocytosis.

  10. Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles.

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    Martha Tibebu Lemma

    Full Text Available MRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care.This study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia.Culture swabs were collected from the anterior nares, the skin and the perineum of 400 participants. In vitro antimicrobial susceptibility testing was done on Muller Hinton Agar by the Kirby-Bauer disk diffusion method, using 30 μg cefoxitin (OXOID, ENGLAND according to the recommendations of the Clinical and Laboratory Standards Institute. Methicillin sensitivity/resistance was tested using cefoxitin. Data was analyzed by descriptive statistics and logistic regression model using Epi Info 7.S. aureus was detected in 206 participants (51.5%. The prevalence of MRSA colonization in this study was 16.8%. Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812-0.9036; p-value = 0.0155, history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707-4.9948; p-value = 0.0329 and having CD4 T-cell counts of more than 350 x 10(6 cells / L (OR = 0.5739; 95% CI = 0.3343-0.9851; p-value = 0.0440. Colonization by MRSA was not associated with any one of the variables. Concomitant resistance of the MRSA to clindamycin, chloramphenicol, co-trimoxazole, ceftriaxone, erythromycin and tetracycline was 7.6%, 6%, 5.25%, 20.9%, 23.9% and 72.1%, respectively.High rates of colonization by pathogenic MRSA strains is observed among HIV positive pediatric patients in the Amhara National Regional state.

  11. In nondiabetic, human immunodeficiency virus-infected patients with lipodystrophy, hepatic insulin extraction and posthepatic insulin clearance rate are decreased in proportion to insulin resistance

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Hansen, Birgitte R

    2005-01-01

    In healthy, nondiabetic individuals with insulin resistance, fasting insulin is inversely correlated to the posthepatic insulin clearance rate (MCRi) and the hepatic insulin extraction (HEXi). We investigated whether similar early mechanisms to facilitate glucose homeostasis exist in nondiabetic......, human immunodeficiency virus (HIV)-infected patients with and without lipodystrophy. We studied 18 HIV-infected patients with lipodystrophy (LIPO) on antiretroviral therapy and 25 HIV-infected patients without lipodystrophy (controls) of whom 18 were on antiretroviral therapy and 7 were not. Posthepatic...... insulin (130%, P .8). In LIPO, HEXi and MCRi correlated inversely with fasting insulin (r = -0.56, P

  12. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients

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    Xiu-Bin Tao

    2014-10-01

    Full Text Available A single-day hospital-acquired infections (HAIs point prevalence study was conducted in a tertiary care hospital in China. The overall prevalence rate of HAIs was 3.53% (95% confidence interval 2.80–4.26% among 2434 inpatients surveyed. Respiratory system infection was the most common type of HAI (49.43%, followed by surgical site infection (22.99%. The pathogen detection results for 50 patients showed Pseudomonas aeruginosa to account for 24.00% of isolates, followed by Klebsiella pneumoniae (14.00% and Escherichia coli (14.00%.

  13. Synanthropic triatomines (Hemiptera, Reduviidae in the state of Pernambuco, Brazil: geographical distribution and natural Trypanosoma infection rates between 2006 and 2007

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    Maria Beatriz Araújo Silva

    2012-02-01

    Full Text Available INTRODUCTION: The present study shows a descriptive analysis of triatomine occurrence and its natural Trypanosoma infection rates in the state of Pernambuco, Brazil, between 2006 and 2007. METHODS: Entomological data for the species, such as specimens captured in both intra and peridomiciles and natural infection index, were obtained via domiciliary capture in 147 municipalities from 11 Regional Managements of Health. The database was obtained from a sample of insects (100% infected and 20% non-infected sent to the Central Laboratory of Pernambuco. RESULTS: A total of 18,029 triatomines were analyzed from 138 municipalities of the state. Triatoma pseudomaculata (35%, Triatoma brasiliensis (34%, and Panstrongylus lutzi (25% were the most captured species. These species also showed a widespread geographical distribution in the state. Panstrongylus megistus, Triatoma petrocchiae, Triatoma melanocephala, Triatoma sordida, Rhodnius nasutus, Rhodnius neglectus, and Triatoma infestans showed more limited geographical distribution and lower relative abundance. The parasitological research showed that 8.8% of the triatomines were naturally infected with flagellates morphologically similar to Trypanosoma cruzi and 91.3% of them were captured inside houses in 113 municipalities. P. lutzi showed the highest rates of natural infection. CONCLUSIONS: After the control of T. infestans, synanthropic species, such as T. brasiliensis, T. pseudomaculata, and P. lutzi, maintain the risk of T. cruzi transmission to humans in the state of Pernambuco. These species are widely distributed, and infected specimens have been found inside houses. Thus, an enhanced surveillance and vector control of Chagas disease is recommended in Pernambuco.

  14. The association between social networks and self-rated risk of HIV infection among secondary school students in Moshi Municipality, Tanzania

    DEFF Research Database (Denmark)

    Lyimo, Elizabeth; Todd, Jim; Richey, Lisa Ann

    2013-01-01

    participants rated themselves at low risk of HIV infection despite practicing unsafe sex. Efforts to raise adolescents' self-awareness of risk of HIV infection through life skills education and HIV/acquired immunodeficiency syndrome risk reduction strategies may be beneficial to students in this at-risk group.......This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15–24 years in 5 secondary schools...... participation in bonding and bridging social networks and self-rated HIV risk behavior. More participants participated in bonding networks (72%) than in bridging networks (29%). Participation in bridging networks was greater among females (25%) than males (12%, p 

  15. International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003–2012

    OpenAIRE

    Leblebicioglu, Hakan; Erben, Nurettin; Rosenthal, Victor Daniel; Atasay, Begüm; Erbay, Ayse; Unal, Serhat; Senol, Gunes; Willke, Ayse; Özgültekin, Asu; Altin, Nilgün; Bakir, Mehmet; Oncul, Oral; Ersöz, Gülden; Ozdemir, Davut; Yalcin, Ata Nevzat

    2014-01-01

    Background Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results We...

  16. Infection rate of Babesia spp. sporokinetes in engorged Boophilus microplus from an area of enzootic stability in the State of Minas Gerais, Brazil

    OpenAIRE

    Maria G Quintão-Silva; Múcio FB Ribeiro

    2003-01-01

    The infection rates of Babesia sporokinetes in engorged Boophilus microplus were evaluated during a 2-year period in a dairy farm located in an area of enzootic stability. Every 14 days engorged females were collected from calves and from adult animals. Ticks were incubated at 27 ± 0.5ºC and 80-90% relative humidity and Babesia infection rates were determined by microscopic examination of Giemsa-stained hemolymph smears. After 52 collections, 2105 ticks were obtained, from which 982 were coll...

  17. Comparison of Urinary Tract Infection Rates Associated with Transurethral Catheterization, Suprapubic Tube and Clean Intermittent Catheterization in the Postoperative Setting: A Network Meta-Analysis.

    Science.gov (United States)

    Han, Christopher S; Kim, Sinae; Radadia, Kushan D; Zhao, Philip T; Elsamra, Sammy E; Olweny, Ephrem O; Weiss, Robert E

    2017-12-01

    We performed a network meta-analysis of available randomized, controlled trials to elucidate the risks of urinary tract infection associated with transurethral catheterization, suprapubic tubes and intermittent catheterization in the postoperative setting. PubMed®, EMBASE® and Google Scholar™ searches were performed for eligible randomized, controlled trials from January 1980 to July 2015 that included patients who underwent transurethral catheterization, suprapubic tube placement or intermittent catheterization at the time of surgery and catheterization lasting up to postoperative day 30. The primary outcome of comparison was the urinary tract infection rate via a network meta-analysis with random effects model using the netmeta package in R 3.2 (www.r-project.org/). Included in analysis were 14 randomized, controlled trials in a total of 1,391 patients. Intermittent catheterization and suprapubic tubes showed no evidence of decreased urinary tract infection rates compared to transurethral catheterization. Suprapubic tubes and intermittent catheterization had comparable urinary tract infection rates (OR 0.903, 95% CI 0.479-2.555). On subgroup analysis of 10 randomized, controlled trials with available mean catheterization duration data in a total of 928 patients intermittent catheterization and suprapubic tube were associated with significantly decreased risk of urinary tract infection compared to transurethral catheterization when catheterization duration was greater than 5 days (OR 0.173, 95% CI 0.073-0.412 and OR 0.142, 95% CI 0.073-0.276, respectively). Transurethral catheterization is not associated with an increased urinary tract infection risk compared to suprapubic tubes and intermittent catheterization if catheterization duration is 5 days or less. However, a suprapubic tube or intermittent catheterization is associated with a lower rate of urinary tract infection if longer term catheterization is expected in the postoperative period. Copyright

  18. Impact of an Educational Intervention Implanted in a Neurological Intensive Care Unit on Rates of Infection Related to External Ventricular Drains

    Science.gov (United States)

    Camacho, Eduardo Fernandes; Boszczowski, Ícaro; Freire, Maristela Pinheiro; Pinto, Fernando Campos Gomes; Guimaraes, Thais; Teixeira, Manuel Jacobsen; Costa, Silvia Figueiredo

    2013-01-01

    Background Studies on the implantation of care routines showed reduction on EVD catheter-related infections rates; however zero tolerance is difficult to be achieved. The objective of this study was to assess the impact of an educational intervention on the maximal reduction on rates of EVD-related infections. Methodology/Principal Findings The quasi-experimental (before-after intervention) study occurred in two phases: pre-intervention, from April 2007 to July 2008, and intervention, from August 2008 to July 2010. Patients were followed for 30 days after the removal of the EVD, and EVD-related infections were considered as only those with laboratorial confirmation in the CSF. Observations were made of the care of the EVD and compliance with Hygiene of the Hands (HH), a routine of care was drawn up, training was given, and intervention was made to reduce the time the EVD catheter remained in place. Results during the study, 178 patients were submitted to 194 procedures, corresponding to 1217 EVD catheters-day. Gram-negative agents were identified in 71.4% of the infections during the pre-intervention period and in 60% during the intervention period. During the study, EVD-related infection rates were reduced from 9.5% to 4.8% per patient, from 8.8% to 4.4% per procedure, and the incidence density dropped from 14.0 to 6.9 infections per 1000 catheters-day (p = 0.027). The mortality reduced 12% (from 42% to 30%). Conclusions/Significance During one year after the fourth intervention, no microbiologically identified infection was documented. In light of these results, educational intervention proved to be a useful tool in reducing these rates and showed also impact on mortality. PMID:23390486

  19. Spatio-temporal variations of Anopheles coluzzii and An. gambiae and their Plasmodium infectivity rates in Lobito, Angola.

    Science.gov (United States)

    Carnevale, Pierre; Toto, Jean-Claude; Besnard, Patrick; Santos, Maria Adelaide Dos; Fortes, Filomeno; Allan, Richard; Manguin, Sylvie

    2015-06-01

    From 2003 to 2007, entomological surveys were conducted in Lobito town (Benguela Province, Angola) to determine which Anopheles species were present and to identify the vectors responsible for malaria transmission in areas where workers of the Sonamet Company live. Two types of surveys were conducted: (1) time and space surveys in the low and upper parts of Lobito during the rainy and dry periods; (2) a two-year longitudinal study in Sonamet workers' houses provided with long-lasting insecticide-treated nets (LLIN), "PermaNet," along with the neighboring community. Both species, An. coluzzii (M molecular form) and An. gambiae (S molecular form), were collected. Anopheles coluzzii was predominant during the dry season in the low part of Lobito where larvae develop in natural ponds and temporary pools. However, during the rainy season, An. gambiae was found in higher proportions in the upper part of the town where larvae were collected in domestic water tanks built near houses. Anopheles melas and An. listeri were captured in higher numbers during the dry season and in the low part of Lobito where larvae develop in stagnant brackish water pools. The infectivity rates of An. gambiae s.l. varied from 0.90% to 3.41%. © 2015 The Society for Vector Ecology.

  20. Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe.

    Science.gov (United States)

    Judd, A; Lodwick, R; Noguera-Julian, A; Gibb, D M; Butler, K; Costagliola, D; Sabin, C; van Sighem, A; Ledergerber, B; Torti, C; Mocroft, A; Podzamczer, D; Dorrucci, M; De Wit, S; Obel, N; Dabis, F; Cozzi-Lepri, A; García, F; Brockmeyer, N H; Warszawski, J; Gonzalez-Tome, M I; Mussini, C; Touloumi, G; Zangerle, R; Ghosn, J; Castagna, A; Fätkenheuer, G; Stephan, C; Meyer, L; Campbell, M A; Chene, G; Phillips, A

    2017-03-01

    The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged start of ART for those with perinatal infection and 15-29 years for those with heterosexual infection, with ART containing at least two nucleoside reverse transcriptase inhibitors (NRTIs) and a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (bPI), were followed from ART initiation until the most recent viral load (VL) measurement. Virological failure of a drug was defined as VL > 500 HIV-1 RNA copies/mL despite ≥ 4 months of use. TCVF was defined as cumulative failure of two NRTIs, an NNRTI and a bPI. The median number of weeks between diagnosis and the start of ART was higher in participants with perinatal HIV infection compared with participants with heterosexually acquired HIV infection overall [17 (interquartile range (IQR) 4-111) vs. 8 (IQR 2-38) weeks, respectively], and highest in perinatally infected participants aged 10-14 years [49 (IQR 9-267) weeks]. The cumulative proportion with TCVF 5 years after starting ART was 9.6% [95% confidence interval (CI) 7.0-12.3%] in participants with perinatally acquired infection and 4.7% (95% CI 3.9-5.5%) in participants with heterosexually acquired infection, and highest in perinatally infected participants aged 10-14 years when starting ART (27.7%; 95% CI 13.2-42.1%). Across all participants, significant predictors of TCVF were those with perinatal HIV aged 10-14 years, African origin, pre-ART AIDS, NNRTI-based initial regimens, higher pre-ART viral load and lower pre-ART CD4. The results

  1. Estimating the number of persons who inject drugs in the united states by meta-analysis to calculate national rates of HIV and hepatitis C virus infections.

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    Amy Lansky

    Full Text Available BACKGROUND: Injection drug use provides an efficient mechanism for transmitting bloodborne viruses, including human immunodeficiency virus (HIV and hepatitis C virus (HCV. Effective targeting of resources for prevention of HIV and HCV infection among persons who inject drugs (PWID is based on knowledge of the population size and disparity in disease burden among PWID. This study estimated the number of PWID in the United States to calculate rates of HIV and HCV infection. METHODS: We conducted meta-analysis using data from 4 national probability surveys that measured lifetime (3 surveys or past-year (3 surveys injection drug use to estimate the proportion of the United States population that has injected drugs. We then applied these proportions to census data to produce population size estimates. To estimate the disease burden among PWID by calculating rates of disease we used lifetime population size estimates of PWID as denominators and estimates of HIV and HCV infection from national HIV surveillance and survey data, respectively, as numerators. We calculated rates of HIV among PWID by gender-, age-, and race/ethnicity. RESULTS: Lifetime PWID comprised 2.6% (95% confidence interval: 1.8%-3.3% of the U.S. population aged 13 years or older, representing approximately 6,612,488 PWID (range: 4,583,188-8,641,788 in 2011. The population estimate of past-year PWID was 0.30% (95% confidence interval: 0.19 %-0.41% or 774,434 PWID (range: 494,605-1,054,263. Among lifetime PWID, the 2011 HIV diagnosis rate was 55 per 100,000 PWID; the rate of persons living with a diagnosis of HIV infection in 2010 was 2,147 per 100,000 PWID; and the 2011 HCV infection rate was 43,126 per 100,000 PWID. CONCLUSION: Estimates of the number of PWID and disease rates among PWID are important for program planning and addressing health inequities.

  2. The association between social networks and self-rated risk of HIV infection among secondary school students in Moshi Municipality, Tanzania.

    Science.gov (United States)

    Lyimo, Elizabeth J; Todd, Jim; Richey, Lisa Ann; Njau, Bernard

    2013-01-01

    This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15-24 years in 5 secondary schools in Moshi, Tanzania. Bonding networks were defined as social groupings of students participating in activities within the school, while bridging networks were groups that included students participating in social groupings from outside of the school environs. A structured questionnaire was used to ask about participation in bonding and bridging social networks and self-rated HIV risk behavior. More participants participated in bonding networks (72%) than in bridging networks (29%). Participation in bridging networks was greater among females (25%) than males (12%, psexually experienced, and of these 62 (70%) considered themselves to be at low risk of HIV infection. Factors associated with self-rated risk of HIV included: type of school (psexually experienced (psex in the past three months (psexual partner (psexual intercourse (passociation between bonding and bridging social networks on self-rated risk of HIV among study participants. However, sexually experienced participants rated themselves at low risk of HIV infection despite practicing unsafe sex. Efforts to raise adolescents' self-awareness of risk of HIV infection through life skills education and HIV/acquired immunodeficiency syndrome risk reduction strategies may be beneficial to students in this at-risk group.

  3. Usefulness of nucleic acid testing to reduce risk of hepatitis B virus transfusion-transmitted infection in Argentina: high rate of recent infections.

    Science.gov (United States)

    Blanco, Sebastián; Balangero, Marcos César; Valle, Mildre Cledy; Montini, Oscar Luis; Carrizo, Luis Horacio; Gallego, Sandra Verónica

    2017-03-01

    Results from 10-year experience using nucleic acid test (NAT) screening in a blood bank of Córdoba are presented, showing the first data on prevalence of recent hepatitis B virus (HBV) infections and occult HBV infections (OBIs) in Argentina. Molecular screening was performed by COBAS AmpliScreen human immunodeficiency virus Type 1 (HIV-1) test Version 1.5 and COBAS AmpliScreen hepatitis C virus (HCV) test Version 2.0 and COBAS TaqScreen MPX and MPX Version 2.0 test (Roche Molecular Systems). To characterize OBI, additional molecular and serologic assays were performed. As results of NAT, 0.075% of the donors (155/205,388) tested positive for HIV, 0.05% (106/205,388) for HCV, and 0.045% (76/168,215) for HBV. Donors who tested positive for HIV or HCV by NAT were also positive by serology. There was one of 33,643 donors recently infected with HBV. At time of donation, six of 76 (7.9%) donors with confirmed HBV infection presented virologic and serologic profiles consistent with OBI. By additional studies three were OBI, two were window period infections, and one remained unclassified. NAT contributed significantly to the reduction of the potential risk of HBV transmission with a frequency of one in 56,072, detecting three in 168,215 donors without serologic evidence of infection. NAT also detected three in 168,215 OBIs. The finding of high frequency of recent infections (1/33,643), unexpected for this country, highlights the need of promoting unified effective regulations that enforce the use of NAT in all blood banks in Argentina and points out the importance of assessing the risk of HBV transmission in blood banks of other countries considered to be low-endemic. © 2016 AABB.

  4. Anti-Toxoplasma antibody prevalence, primary infection rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan.

    Science.gov (United States)

    Sakikawa, Makiko; Noda, Shunichi; Hanaoka, Masachi; Nakayama, Hirotoshi; Hojo, Satoshi; Kakinoki, Shigeko; Nakata, Maki; Yasuda, Takashi; Ikenoue, Tsuyomu; Kojima, Toshiyuki

    2012-03-01

    Toxoplasmosis is a zoonosis caused by infection with Toxoplasma gondii and is prevalent worldwide under various climatic conditions. It is usually asymptomatic, but infection in pregnant women can pose serious health problems for the fetus. However, epidemiological information regarding toxoplasmosis in Japanese pregnant women is limited. This study aimed to determine the prevalence of anti-Toxoplasma antibodies, the primary infection rate, and the risk factors for toxoplasmosis in Japanese pregnant women. We measured anti-Toxoplasma antibody titers in 4,466 pregnant women over a period of 7.5 years and simultaneously conducted interviews to identify the risk factors for toxoplasmosis. The overall prevalence of anti-Toxoplasma antibodies was 10.3%, and it was significantly higher in women aged above 35 years. The rate of primary Toxoplasma infection during pregnancy was estimated to be 0.25%. A possibility of infection in the later stages of pregnancy was identified for those women who were not infected in the early stages. A history of raw meat intake was identified to be a risk factor related to toxoplasmosis. Therefore, to lower the risk of toxoplasmosis, pregnant women should refrain from eating raw and undercooked meat and maintain personal hygiene.

  5. Influence of host gender on infection rate, density and distribution of the parasitic fungus, Hesperomyces virescens, on the multicolored Asian lady beetle, Harmonia axyridis.

    Science.gov (United States)

    Riddick, E W

    2006-01-01

    Hesperomyces virescens Thaxter (Laboulbeniales: Laboulbeniaceae) is a parasitic fungus that infects lady beetles (Coleoptera: Coccinellidae) via horizontal transmission between adults at overwintering and feeding sites. The differential behavior of male and female hosts could have profound effects on intensity of infection and positioning of fungus on the host's integument. The influence of host gender on infection rate, density and distribution of this parasite on the multicolored Asian lady beetle, Harmonia axyridis (Pallas) (Coleoptera: Coccinellidae), was determined at a feeding site. Adult H. axyridis were sampled from pecan, Carya illinoinensis (Wangenh.) K. Koch, trees in northern Mississippi, USA, during summer and early fall 2003-2004. Results indicated that the behavior of male or female beetles on pecan trees had only a limited effect on the intensity of infection. When averaged over the entire season, the percentage of H. axyridis infected with H. virescens was not influenced by host gender. In 2003, a seasonal average of 54 and 39% of males and females, respectively, were infected; whereas in 2004, 36 and 41% of male and female beetles, respectively, were infected. The percentage of males infected with H. virescens was correlated with the number of males captured at the site in 2003; infection rate decreased as male abundance increased. Infection rate did not correlate with female abundance in 2003 or male or female abundance in 2004. Host gender had a considerable effect on the density and distribution of the fungus. Hesperomyces virescens mature thalli were denser on male rather than female beetles. Also, thallus density was often greatest on the elytra, meso- and metathorax, and abdomen of males and elytra of females, than on other body parts, in 2003. In 2003 and 2004, approximately 59 and 97% and 67 and 96% of males and females, respectively, had mature thalli distributed on the elytra. Prevalence of H. virescens thalli on the dorsum of H

  6. Polymerase chain reaction is superior to serology for the diagnosis of acute Mycoplasma pneumoniae infection and reveals a high rate of persistent infection

    Directory of Open Access Journals (Sweden)

    Persson Kenneth

    2008-06-01

    Full Text Available Abstract Background Diagnosis of Mycoplasma pneumoniae (MP infection is traditionally based on serology, which may require more than two weeks for diagnostic antibodies to develop. PCR-based methods offer earlier diagnosis. During a community outbreak of MP infection, we compared semi-nested and real-time PCR of oropharyngeal swabs with serology for diagnosis of MP infection at different time points after disease onset. PCR-positive individuals were followed longitudinally to assess the persistence of MP DNA in throat secretions. We also studied carriage of MP among household contacts and school children. Results MP infection was diagnosed in 48 of 164 patients with respiratory tract infection. Forty-five (29% had detectable MP DNA in oropharynx. A significant increase in MP IgG IgG titre or MP IgM antibodies was detected in 44/154 (27% subjects. Two MP PCR-positive patients lacked antibody responses. Sera were missing from another two patients. The agreement between serology and PCR was good, κ = 0.90. During the first three weeks after disease onset the performance of PCR was excellent and all patients but one were detected. In contrast, only 21% of the patients with confirmed MP infection were positive by serum 1 during the first symptomatic week (56% during the second and 100% during the third week. Only 1/237 (0.4% school children was positive by PCR. This child had respiratory symptoms. Eighteen of 22 (75% symptomatic household contacts were MP PCR positive. Persistence of MP DNA in the throat was common. Median time for carriage of MP DNA was 7 weeks after disease onset (range 2 days – 7 months. Adequate antibiotic treatment did not shorten the period of persistence. Bacterial load, measured by quantitative real-time PCR declined gradually, and all followed patients eventually became PCR-negative. Conclusion PCR is superior to serology for diagnosis of MP infection during the early phases of infection. Persistent, sometimes long

  7. Infection rate in adult patients with open fractures treated at the emergency hospital and at the ULBRA university hospital in Canoas, Rio Grande do Sul, Brazil.

    Science.gov (United States)

    Guerra, Marcelo Teodoro Ezequiel; Gregio, Fernando Machado; Bernardi, Adriane; Castro, Cyntia Cordeiro de

    2017-01-01

    To identify the infection rate in adult patients with open fractures treated at two tertiary hospitals in the city of Canoas, Rio Grande do Sul, Brazil. This quantitative descriptive study was conducted at Hospital de Pronto Socorro de Canoas. Eligible participants were adults aged 18-60 years with open fractures who were admitted to the orthopedic trauma service from January to May 2014 and followed-up for one year. A total of 133 patients with open fractures were included; most were men (92.48%), with a mean age of 36 years. There was a predominance of Gustilo-Anderson type III fractures. The infection rate was 18.80%, being more frequent in Gustilo-Anderson type III fractures (72.00%). The most commonly observed bacteria were Staphylococcus aureus and Enterobacter aerogenes . The infection rate in open fractures of patients initially treated at the emergency department of HPSC was 18.8%. The infections occurred predominantly in Gustilo-Anderson type III fractures. The bacteria with the highest incidence in infections were Staphylococcus aureus and Enterobacter aerogenes .

  8. A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients.

    Science.gov (United States)

    Moody, Karen M; Baker, Rebecca A; Santizo, Ruth O; Olmez, Inan; Spies, Jeanie M; Buthmann, Amanda; Granowetter, Linda; Dulman, Robin Y; Ayyanar, Kanyalakshmi; Gill, Jonathan B; Carroll, Aaron E

    2018-01-01

    The neutropenic diet (ND) is prescribed to avoid introduction of bacteria into a host's gastrointestinal tract and reduce infection. Due to a lack of evidence to support the ND, there continues to be debate among pediatric oncologists regarding its usefulness. This prospective randomized controlled trial evaluated the difference in neutropenic infection rates in pediatric oncology patients randomized to Food and Drug Administration approved food safety guidelines (FSGs) versus the ND plus FSGs during one cycle of chemotherapy. Pediatric patients receiving cancer treatment with myelosuppressive chemotherapy were eligible. Neutropenic infection was the primary outcome and defined as (i) fever with neutropenia or (ii) hospital admission and treatment for clinical infection and neutropenia. The rate of neutropenic infection was compared with Student's t-test for independent samples. Documented infections were identified by comprehensive chart review and compared between groups using a χ 2 test. One hundred fifty patients were randomly assigned to FSGs (n = 73) or ND + FSGs (n = 77). The most common diagnoses were acute lymphoblastic leukemia (32%) and sarcoma (32%). There was no significant difference between the groups in the percentage of patients who developed neutropenic infection: FSGs 33% versus ND + FSGs 35% (P = 0.78). Patients randomized to ND + FSGs reported that following the diet required more effort than those on FSGs alone. The ND offers no benefit over FSGs in the prevention of infection in pediatric oncology patients undergoing myelosuppressive chemotherapy and adherence requires more effort for patients and families. Institutions caring for children with cancer should consider replacing ND guidelines with FSGs. © 2017 Wiley Periodicals, Inc.

  9. Independent association between rate of clearance of infection and clinical outcome of HIV-associated cryptococcal meningitis: analysis of a combined cohort of 262 patients.

    NARCIS (Netherlands)

    Bicanic, T.; Muzoora, C.; Brouwer, A.E.; Meintjes, G.; Longley, N.; Taseera, K.; Rebe, K.; Loyse, A.; Jarvis, J.; Bekker, L.G.; Wood, R.; Limmathurotsakul, D.; Chierakul, W.; Stepniewska, K.; White, N.J.; Jaffar, S.; Harrison, T.S.

    2009-01-01

    BACKGROUND: Progress in therapy for cryptococcal meningitis has been slow because of the lack of a suitable marker of treatment response. Previously, we demonstrated the statistical power of a novel endpoint, the rate of clearance of infection, based on serial quantitative cultures of cerebrospinal

  10. Transmissibility and Pathogenicity of Ebola Virus: A Systematic Review and Meta-analysis of Household Secondary Attack Rate and Asymptomatic Infection

    OpenAIRE

    Dean, Natalie E; Halloran, M. Elizabeth; Yang, Yang; Longini, Ira M.

    2016-01-01

    Household spread of Ebola virus is driven by direct physical contact, especially through nursing care. There is no evidence of an increase in the household secondary attack rate since 1976. We estimate that one-quarter of Ebola infections are asymptomatic.

  11. Low Infection-Related Re-Admission Rates in a Retrospective of 4725 Children with Appendicitis Using a Clinical Pathway in a Tertiary Care Pediatric Center.

    Science.gov (United States)

    Marino, Nikolas E; Davenport, Kate; Hilfiker, Mary; Langness, Simone; Fairbanks, Timothy; Stucky Fisher, Erin; Newbury, Robert; Andrews, Allyson; Wells, Alan; Chaparro, Juan D; Bradley, John S

    2017-10-24

    Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway. Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens. From children originally admitted for appendicitis, those who were re-admitted with infection were compared with those who were not re-admitted for infection. The populations were controlled by severity of infection using a pathology-defined appendicitis severity scale: Grade 0, no appendicitis; grade 1, simple acute appendicitis with gross and microscopic evidence of inflammation, but no perforation; grade 2, gangrenous/necrotizing/micro-perforated appendicitis with subserosal or serosal exudate, but no frank or visually appreciated perforation; and grade 3, frank perforation. Of 4725 children (total population, TP) admitted with a diagnosis of appendicitis, only 199 (4.2%) were re-admitted, with 125 of these admissions for infection (2.65% of the TP). Age, race/ethnicity, language preference, and body mass index were not found to correlate with re-admission for infection. Length of stay significantly differed between the no infection-related re-admission population and infection-related re-admission population (3.02 vs. 4.03 d, p admission rates as the pathology grade increased (odds ratio grade 1 vs. grade 3 = 2.28, 95% confidence interval 1.03, 5.03). Infection-related re-admission rates for children on the clinical pathway in our institution were infrequent. The greater association of all-cause and infection-related re-admission rates with pathology

  12. Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011.

    Science.gov (United States)

    Adih, William K; Selik, Richard M; Hall, H Irene; Babu, Aruna Surendera; Song, Ruiguang

    2016-01-01

    Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased.

  13. Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection

    Science.gov (United States)

    Al-Abdely, Hail M; Alshehri, Areej Dhafer; Rosenthal, Victor Daniel; Mohammed, Yassir Khidir; Banjar, Weam; Orellano, Pablo Wenceslao; Assiri, Abdullah Mufareh; Kader, Nahla Moustafa Abedel; Enizy, Hessa Abdullah Al; Mohammed, Diaa Abdullah; Al-Awadi, Duaa Khalil; Cabato, Analen Fabros; Wasbourne, Maria; Saliya, Randa; Aromin, Rosita Gasmin; Ubalde, Evangelina Balon; Diab, Hanan Hanafy; Alkamaly, Modhi Abdullah; Alanazi, Nawal Mohammed; Hassan Assiry, Ibtesam Yahia; Molano, Apsia Musa; Flores Baldonado, Celia; Al-Azhary, Mohamed; Al Atawi, Sharifa; Molano, Apsia Musa; Al Adwani, Fatima Mohammad; Casuyon Pahilanga, Arlu Marie; Nakhla, Raslan; Al Adwani, Fatma Mohammad; Nair, Deepa Sasithran; Sindayen, Grace; Malificio, Annalyn Amor; Helali, Najla Jameel; Al Dossari, Haya Barjas; Kelany, Ashraf; Algethami, Abdulmajid Ghowaizi; Yanne, Leigh; Tan, Avigail; Babu, Sheema; Abduljabbar, Shatha Mohammad; Bukhari, Syed Zahid; Basri, Roaa Hasan; Mushtaq, Jeyashri Jaji; Rushdi, Hala; Turkistani, Abdullah Abdulaziz; Gonzales Celiz, Jerlie Mae; Al Raey, Mohammed Abdullah; Al-Zaydani Asiri, Ibrahim AM; Aldarani, Saeed Ali; Laungayan Cortez, Elizabeth; Demaisip, Nadia Lynette; Aziz, Misbah Rehman; Omer Abdul Aziz, Ali; Al Manea, Batool; Samy, Eslam; Al-Dalaton, Mervat; Alaliany, Mohammed Jkedeb

    2016-01-01

    Objective: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. Design: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (1) a bundle of infection prevention practice interventions; (2) education; (3) outcome surveillance; (4) process surveillance; (5) feedback on CLABSI rates and consequences; and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed. Results: During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28–0.72; P = 0.001). Conclusions: Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia. PMID:28989500

  14. Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions

    Directory of Open Access Journals (Sweden)

    Michele Tornatore

    2012-03-01

    Full Text Available Human immunodeficiency virus type 1 (HIV-positive pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs. The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV and hepatitis C virus (HCV. Human papillomavirus (HPV diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8% for HCV, 2.3% for chronic HBV, 3.1% for syphilis and 40.8% for HPV. Of those co-infected with HPV, 52.9% presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.

  15. [Nosocomial urinary tract and surgical site infection rates in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo].

    Science.gov (United States)

    Lukuke, Hendrick Mbutshu; Kasamba, Eric; Mahuridi, Abdulu; Nlandu, Roger Ngatu; Narufumi, Suganuma; Mukengeshayi, Abel Ntambue; Malou, Vicky; Makoutode, Michel; Kaj, Françoise Malonga

    2017-01-01

    In Intertropical Africa hospitalized patients are exposed to a risk of nosocomial infections. The dearth of published data on this subject limits the descriptive analysis of the situation. This study aimed to determine the incidence, the germs responsible for these infections and the risk factors of nosocomial infections in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo. We conducted a descriptive, longitudinal study from 1 October 2014 to 1 January 2015. Our study population consisted of 207 women who had been hospitalized in the Maternity Ward at the General Referral Hospital in Katuba. We carried out a comprehensive data collection. Nosocomial infection rate accounted for 15.5%. Parturient women who had been hospitalized for more than three days were three times more likely to develop a nosocomial infection (p=0.003), while those who had had a complicated delivery were four times more likely to be at risk of developing nosocomial infection (p = 0.000). Escherichia coli was the most isolated causative agent (38.1%), followed by Citrobacter freundi (23.8%), Acinobacter baumani (.18, 2%), Staphylococcus aureus (18.2%), Enterococcus aureus (14.3%) and Pseudomonas aeroginosa (9.1%). Ampicillin was the most prescribed antibiotic, to which isolated microbes were resistant. It is necessary to improve hospital hygiene and to conduct further study to examine the similarity between germs strains in the environment and those in biological fluids.

  16. Rate of hepatitis C viral clearance by human livers in human patients: Liver transplantation modeling primary infection and implications for studying entry inhibition.

    Directory of Open Access Journals (Sweden)

    Michael G Hughes

    Full Text Available To better understand the dynamics of early hepatitis C virus (HCV infection, we determined how rapidly non-cirrhotic HCV-uninfected liver allografts clear HCV from the circulation of cirrhotic HCV-infected patients at the time of transplantation but before administration of immunosuppression. Specifically, we characterized serum HCV kinetics during the first 90 min of reperfusion for 19 chronically HCV-infected patients transplanted with an HCV-uninfected liver by measuring serum viral load immediately prior to reperfusion (t = 0 and then every 15 min for a total of 90 min (t = 90. Immunosuppression was withheld until all samples were taken to better model primary infection. During this period, rates of viral clearance varied more than 20-fold with a median rate constant of 0.0357 1/min, range 0.0089-0.2169; half-life (minutes median 19.4, range 3.2-77.8. The majority of viral clearance occurred within the first 60 min. The amount of blood transfused during this 90-min period (a potential confounding variable of this human liver transplant model of primary infection accounted for 53% and 59% of k (r = 0.53, p = 0.05 and half-life (r = 0.59, p = 0.03 variability, respectively. No other clinical variables tested (age, allograft weight, and degree of reperfusion injury as assessed by peak postoperative ALT or AST accounted for the remaining variability (p>0.05.In a human liver transplant model of primary infection, HCV rapidly clears the bloodstream. With approximately 90% of clearance occurring in the first 90 minutes of reperfusion, studies of HCV entry inhibition could utilize rate of clearance during this early period as an outcome measure.

  17. Investigation of the high rates of extrapulmonary tuberculosis in Ethiopia reveals no single driving factor and minimal evidence for zoonotic transmission of Mycobacterium bovis infection.

    Science.gov (United States)

    Berg, Stefan; Schelling, Esther; Hailu, Elena; Firdessa, Rebuma; Gumi, Balako; Erenso, Girume; Gadisa, Endalamaw; Mengistu, Araya; Habtamu, Meseret; Hussein, Jemal; Kiros, Teklu; Bekele, Shiferaw; Mekonnen, Wondale; Derese, Yohannes; Zinsstag, Jakob; Ameni, Gobena; Gagneux, Sebastien; Robertson, Brian D; Tschopp, Rea; Hewinson, Glyn; Yamuah, Lawrence; Gordon, Stephen V; Aseffa, Abraham

    2015-03-03

    Ethiopia, a high tuberculosis (TB) burden country, reports one of the highest incidence rates of extra-pulmonary TB dominated by cervical lymphadenitis (TBLN). Infection with Mycobacterium bovis has previously been excluded as the main reason for the high rate of extrapulmonary TB in Ethiopia. Here we examined demographic and clinical characteristics of 953 pulmonary (PTB) and 1198 TBLN patients visiting 11 health facilities in distinct geographic areas of Ethiopia. Clinical characteristics were also correlated with genotypes of the causative agent, Mycobacterium tuberculosis. No major patient or bacterial strain factor could be identified as being responsible for the high rate of TBLN, and there was no association with HIV infection. However, analysis of the demographic data of involved patients showed that having regular and direct contact with live animals was more associated with TBLN than with PTB, although no M. bovis was isolated from patients with TBLN. Among PTB patients, those infected with Lineage 4 reported "contact with other TB patient" more often than patients infected with Lineage 3 did (OR = 1.6, CI 95% 1.0-2.7; p = 0.064). High fever, in contrast to low and moderate fever, was significantly associated with Lineage 4 (OR = 2.3; p = 0.024). On the other hand, TBLN cases infected with Lineage 4 tended to get milder symptoms overall for the constitutional symptoms than those infected with Lineage 3. The study suggests a complex role for multiple interacting factors in the epidemiology of extrapulmonary TB in Ethiopia, including factors that can only be derived from population-based studies, which may prove to be significant for TB control in Ethiopia.

  18. Plasmodium falciparum infection rates for some Anopheles spp. from Guinea-Bissau, West Africa [v1; ref status: indexed, http://f1000r.es/4in

    Directory of Open Access Journals (Sweden)

    Michelle R. Sanford

    2014-10-01

    Full Text Available Presence of Plasmodium falciparum circumsporozoite protein (CSP was detected by enzyme linked immunosorbent assay (ELISA in a sample of Anopheles gambiae s.s., A. melas and A. pharoensis collected in Guinea-Bissau during October and November 2009. The percentage of P. falciparum infected samples (10.2% overall was comparable to earlier studies from other sites in Guinea-Bissau (9.6-12.4%. The majority of the specimens collected were identified as A. gambiae which had an individual infection rate of 12.6 % across collection sites. A small number of specimens of A. coluzzii, A. coluzzii x A. gambiae hybrids, A. melas and A. pharoensis were collected and had infection rates of 4.3%, 4.1%, 11.1% and 33.3% respectively. Despite being present in low numbers in indoor collections, the exophilic feeding behaviors of A. melas (N=18 and A. pharoensis (N=6 and high infection rates observed in this survey suggest falciparum-malaria transmission potential outside of the protection of bed nets.

  19. Aggregata (Protozoa: Apicomplexa) infection in the common octopus Octopus vulgaris from the West Mediterranean Sea: The infection rates and possible effect of faunistic, environmental and ecological factors

    Science.gov (United States)

    Mayo-Hernández, E.; Barcala, E.; Berriatua, E.; García-Ayala, A.; Muñoz, P.

    2013-10-01

    Prevalence and distribution of the coccidian parasite Aggregata octopiana (Protozoa: Apicomplexa) in common octopus (Octopus vulgaris) in the Mediterranean Spanish coasts were studied. A total of 114 octopuses were sampled from 30 geographic sectors by trawl fleet, and whitish macroscopic oocysts typical of A. octopiana infection were recorded in 96% of octopuses in the digestive tract and mainly in intestine and spiral caecum. The univariate analysis showed that lesion extension varied according to specific octopus, environmental and faunistic variables. A subsequent multivariable analysis indicated that the risk of macroscopic lesions in the caecum was greater in males compared to females, in octopuses living in deeper compared to shallower waters and in hauls where the crustacean Pagurus excavatus was present. The study provides further evidence of the abundance of A. octopiana in octopus ecosystems urging for further studies to evaluate its health impact. The combined abundance of infected octopuses and P. excavatus merits attention.

  20. Continued high rates of antibiotic prescribing to adults with respiratory tract infection : survey of 568 UK general practices

    NARCIS (Netherlands)

    Gulliford, Martin C; Dregan, Alex; Moore, Michael V; Ashworth, Mark; Staa, Tjeerd van|info:eu-repo/dai/nl/304827762; McCann, Gerard; Charlton, Judith; Yardley, Lucy; Little, Paul; McDermott, Lisa

    2014-01-01

    OBJECTIVES: Overutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young

  1. Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles

    OpenAIRE

    Lemma, Martha Tibebu; Zenebe, Yohannes; Tulu, Begna; Mekonnen, Daniel; Mekonnen, Zewdie

    2015-01-01

    Background MRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care. Objectives This study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia. Methods Culture swabs were collected from the anterior nare...

  2. Healing rate and post-obturation pain of single- versus multiple-visit endodontic treatment for infected root canals: a systematic review.

    Science.gov (United States)

    Su, Yingying; Wang, Chenglin; Ye, Ling

    2011-02-01

    The choice of single- versus multiple-visit root canal treatment for infected teeth is in dispute. The purpose of this systematic review was to compare the healing rate and post-obturation pain of single- versus multiple-visit root canal treatment for teeth with infected root canals. An exhaustive literature search combined with specified inclusion criteria was performed to identify randomized or quasi-randomized controlled trials (RCTs or quasi-RCTs), comparing root canal treatment in single and multiple appointments (2 or more visits) in patients with infected root canals. Ten RCTs were identified and included in this review. Of these, 6 compared the healing rate and 5 compared the prevalence of post-obturation pain in single- and multiple-visit root canal treatment on teeth with infected root canals. No significant difference was observed in the healing rate between single- versus multiple-visit root canal treatment, as well as the incidence of medium-term post-obturation pain. As to the short-term follow up, the prevalence of post-obturation pain was significantly lower in single-visit than in multiple-visit group. On the basis of current studies, the healing rate of single- and multiple-visit root canal treatment is similar for infected teeth. Patients experience less frequency of short-term post-obturation pain after single-visit than those having multiple-visit root canal treatment. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  3. Carbapenem-resistant Enterobacteriaceae carriers in acute care hospitals and postacute-care facilities: The effect of organizational culture on staff attitudes, knowledge, practices, and infection acquisition rates.

    Science.gov (United States)

    Fedorowsky, Rina; Peles-Bortz, Anat; Masarwa, Samira; Liberman, Dvora; Rubinovitch, Bina; Lipkin, Valentina

    2015-09-01

    Carbapenem-resistant Enterobacteriaceae (CRE) carriers are frequently transferred between acute care hospitals (ACHs) and postacute-care facilities (PACFs). Compliance of health care workers with infection prevention guidelines in both care settings may be influenced by the institution's organizational culture. To assess the association between organizational culture and health care workers' attitudes, knowledge, practices, and CRE acquisition rate and to identify differences between different care settings and health care workers' sectors. Cross-sectional descriptive design. Self-administered questionnaires were distributed to a sample of 420 health care workers from 1 ACH and 1 PACF belonging to the same health maintenance organization located in central Israel. The organizational culture factor known as staff engagement was positively correlated with infection prevention attitudes and compliance with contact precaution protocols and negatively correlated with CRE acquisition rate. In the 2 care settings, health care workers' attitudes, knowledge, and practices were found to be similar, but CRE acquisition rate was lower in PACFs. Compliance with contact precaution protocols by physicians was lower than compliance reported by other health care workers. Auxiliary staff reported lower knowledge. In a setting of endemic CRE where a multifaceted intervention is already being implemented, organizational culture variables can predict health care workers' attitudes, knowledge, and practices and in turn can affect CRE acquisition rates. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Comparative efficacy of one versus two doses of praziquantel on cure rate of Schistosoma mansoni infection and re-infection in Mayuge District, Uganda

    DEFF Research Database (Denmark)

    Tukahebwa, Edridah M.; Vennervald, Birgitte J; Nuwaha, Fred

    2013-01-01

    BACKGROUND: The current recommended control strategy for schistosomiasis is annual treatment using 40 mg/kg of praziquantel. However, praziquantel is only effective on adult worms and giving a second dose may increase its efficacy. We assessed the effect of one versus two doses of praziquantel...... months after treatment. RESULTS: Those who received two doses were more likely to be cured (69.7%) compared to those who received a single dose (47.9%) (¿(2) = 18.5, p ... intensity. However, there is no added advantage on reduction of S. mansoni re-infection by administering two doses of praziquantel. CLINICAL TRIALS.GOV IDENTIFIER: NCT00215267....

  5. Pursestring Closure versus Conventional Primary Closure Following Stoma Reversal to Reduce Surgical Site Infection Rate: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Hsieh, Meng-Chiao; Kuo, Liang-Tseng; Chi, Ching-Chi; Huang, Wen-Shih; Chin, Chih-Chien

    2015-08-01

    Stoma reversal is a surgical procedure commonly used following temporary defunctioning stoma surgery. Surgical site infection is one of the most common postoperative morbidities. A few skin closure methods have been developed to decrease surgical site infection. However, the optimal skin closure method is still in debate. The aim of this study was to compare the surgical site infection rate and other postoperative outcomes between the pursestring closure and conventional primary closure techniques. We searched the MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for relevant trials. We conducted a meta-analysis of randomized controlled trials that compared the surgical outcomes following pursestring closure and conventional primary closure techniques. We conducted the meta-analysis by using the random-effects model. The primary outcome of interest was surgical site infection following stoma reversal within 30 days after operation. This meta-analysis included 4 randomized controlled trials with a total of 319 participants (162 in the pursestring closure group and 157 in the conventional primary closure group). Compared with the conventional primary closure group, the pursestring closure group had a significant decrease in surgical site infection (risk difference, -0.25; 95% CI, -0.36 to -0.15; p stoma reversal than conventional primary closure.

  6. Comparisons of causes of death and mortality rates among HIV-infected persons: analysis of the pre-, early, and late HAART (highly active antiretroviral therapy) eras.

    Science.gov (United States)

    Crum, Nancy F; Riffenburgh, Robert H; Wegner, Scott; Agan, Brian K; Tasker, Sybil A; Spooner, Katherine M; Armstrong, Adam W; Fraser, Susan; Wallace, Mark R

    2006-02-01

    Comparisons of death-related variables during the 3 eras were performed. The number of deaths declined over the study period, with 987 deaths in the pre-HAART era, 159 deaths in the early HAART era (1997-1999), and 78 deaths in the late HAART era (2000-2003) (P persons in the late HAART era (P infection decreased, but infection remained the leading cause of death in our cohort, followed by cancer. Of those who died, there was an increasing proportion of non-HIV-related deaths (32% vs. 9%; P liver disease, although the numbers are small. Despite increasing concerns regarding antiretroviral resistance, the death rate among HIV-infected persons in our cohort continues to decline. Our data show a lower death rate than that reported among many other US HIV-infected populations; this may be the result of open access to health care. A shift in the causes of death toward non-HIV-related causes suggests that a more comprehensive health care approach may be needed for optimal life expectancy; this may include enhanced screening for malignancy and heart disease as well as preventive measures for liver disease and accidents.

  7. Acute hepatitis A infection in pregnancy is associated with high rates of gestational complications and preterm labor.

    Science.gov (United States)

    Elinav, Eran; Ben-Dov, Iddo Z; Shapira, Yami; Daudi, Nilli; Adler, Ruth; Shouval, Daniel; Ackerman, Zvi

    2006-04-01

    Hepatitis A virus (HAV) infection is the most common cause of acute hepatitis but is rarely reported during pregnancy. Our aim was to evaluate the impact of acute HAV infection on pregnancy outcome. Consecutive admissions of 79,458 pregnant females during a 25-year period were retrospectively reviewed. Thirteen cases of second and third trimester HAV infection were found and evaluated. Nine of the 13 patients (69%) developed gestational complications, including premature contractions (n = 4), placental separation (n = 2), premature rupture of membranes (n = 2), and vaginal bleeding (n = 1). In 8 of these patients, complications led to preterm labor, at a median of 34 gestational weeks (range, 31-37 weeks). Delivery was vaginal in 12 of the 13 cases; fetal distress was noted in a single case, and meconium in amniotic fluid in 2 cases. Median birth weight was 1778 grams and 3040 grams in preterm and term deliveries, respectively (P Child outcome was favorable in all cases. In 4 cases, neonatal serum HAV RNA levels were measured and found negative. The presence of fever and hypoalbuminemia were associated with delivery at an earlier gestational week. There was a positive relation between gestational week at diagnosis of HAV infection and birth week (r = 0.68, P = .02), suggesting a causality relationship. All mothers featured full recovery from HAV infection. Acute HAV infection during pregnancy is associated with high risk of maternal complications and preterm labor. HAV serology and maternal vaccination during prepregnancy evaluation should be considered in areas of the world in which susceptible adult populations exist.

  8. Use of a marker plasmid to examine differential rates of growth and death between clinical and environmental strains of Vibrio vulnificus in experimentally infected mice.

    Science.gov (United States)

    Starks, Angela M; Bourdage, Keri L; Thiaville, Patrick C; Gulig, Paul A

    2006-07-01

    Vibrio vulnificus is Gram-negative bacterium that contaminates oysters, causing highly lethal sepsis after consumption of raw oysters and wound infection. We previously described two sets of V. vulnificus strains with different levels of virulence in subcutaneously inoculated iron dextran-treated mice. Both virulent, clinical strains and attenuated, environmental strains could be recovered in high numbers from skin lesions and livers; however, the attenuated environmental strains required significantly higher numbers of colony-forming units (cfu) in the inoculum to produce lethal infection. Using some of these strains and an additional clinical strain, we presently asked if the different abilities to cause infection between the clinical and environmental strains were due to differences in rates of growth or death of the bacteria in the mouse host. We therefore constructed a marker plasmid, pGTR902, that functions as a replicon only in the presence of arabinose, which is not present in significant levels in animal tissues. V. vulnificus strains containing pGTR902 were inoculated into iron dextran-treated and untreated mice. Measuring the proportion of bacteria that had maintained the marker plasmid recovered from mice enabled us to monitor the number of in vivo divisions, hence growth rate; whereas measuring the number of marker plasmid-containing bacteria recovered enabled the measurement of death of the vibrios in the mice. The numbers of bacterial divisions in vivo for all of the strains over a 12-15 h infection period were not significantly different in iron dextran-treated mice; however, the rate of death of one environmental strain was significantly higher compared with the clinical strains. Infection of non-iron dextran-treated mice with clinical strains demonstrated that the greatest effect of iron dextran-treatment was increased growth rate, while one clinical strain also experienced increased death in untreated mice. V. vulnificus inoculated into iron

  9. Role of duration of catheterization and length of hospital stay on the rate of catheter-related hospital-acquired urinary tract infections

    Directory of Open Access Journals (Sweden)

    Al-Hazmi H

    2015-03-01

    Full Text Available Hamdan Al-HazmiDivision of Urology, Department of Surgery, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi ArabiaObjective: Our aim is to prove that duration of catheterization and length of hospital stay (LOS are associated with the rate of hospital-acquired urinary tract infections (UTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis on admission, associated comorbidities, age, sex, precautions that should be taken to avoid UTI, and comparison with other studies.Methods: The study was done in a university teaching hospital with a 920-bed capacity; this hospital is a tertiary care center in Riyadh, Saudi Arabia. The study was done on 250 selected patients during the year 2010 as a retrospective descriptive study. Patients were selected as purposive sample, all of them having been exposed to urinary catheterization; hospital-acquired UTI were found in 100 patients. Data were abstracted from the archived patients' files in the medical record department using the annual infection control logbook prepared by the infection control department. The data collected were demographic information about the patients, clinical condition (diagnosis and the LOS, and possible risk factors for infection such as duration of catheterization, exposure to invasive devices or surgical procedures, and medical condition.Results: There was a statistically significant association between the rate of UTI and duration of catheterization: seven patients had UTI out of 46 catheterized patients (15% at 3 days of catheterization, while 30 patients had UTI out of 44 catheterized patients (68% at 8 days of catheterization (median 8 days in infected patients versus 3 days in noninfected patients; P-value <0.05, which means that the longer the duration of catheterization, the higher the UTI rate. There was a statistically significant association between the rate of UTI and LOS

  10. Improving the estimation of the death rate of infected cells from time course data during the acute phase of virus infections : Application to acute HIV-1 infection in a humanized mouse model

    NARCIS (Netherlands)

    Ikeda, Hiroki; De Boer, Rob J.; Sato, Kei; Morita, Satoru; Misawa, Naoko; Koyanagi, Yoshio; Aihara, Kazuyuki; Iwami, Shingo

    2014-01-01

    Background: Mathematical modeling of virus dynamics has provided quantitative insights into viral infections such as influenza, the simian immunodeficiency virus/human immunodeficiency virus, hepatitis B, and hepatitis C. Through modeling, we can estimate the half-life of infected cells, the

  11. Mosquito abundance, bed net coverage and other factors associated with variations in sporozoite infectivity rates in four villages of rural Tanzania

    DEFF Research Database (Denmark)

    Kweka, Eliningaya J; Nkya, Watoky M M; Mahande, Aneth M

    2008-01-01

    . Sporozoite infectivity rates, mosquito host blood meal source, bed net coverage and mosquito abundance were assessed in this study. METHODOLOGY: A longitudinal survey was conducted in four villages in two regions of Tanzania. Malaria vectors were sampled using the CDC light trap and pyrethrum spray catch......,628 (81.8%) Anopheles arabiensis, 1,100 (15.9%) Culex quinquefasciatus, 89 (1.4%) Anopheles funestus, and 66 (0.9%) Anopheles gambiae s.s. Of the total mosquitoes collected 3,861 were captured by CDC light trap and 3,022 by the pyrethrum spray catch method. The overall light trap: spray catch ratio was 1.......3:1. Mosquito densities per room were 96.5 and 75.5 for light trap and pyrethrum spray catch respectively. Mosquito infectivity rates between villages that have high proportion of bed net owners and those without bed nets was significant (P

  12. The Association Between Social Networks and Self-rated risk of HIV Infection among Secondary School Students in Moshi Municipality, Tanzania.

    OpenAIRE

    Lyimo, EJ; Todd, J.; Richey, LA; B. Njau

    2014-01-01

    Abstract This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15-24 years in 5 secondary schools in Moshi, Tanzania. Bonding networks were defined as social groupings of students participating in activities within the school, while bridging networks were groups that included students partici...

  13. Simultaneous vaccination with MMR and DTaP-IPV-Hib and rate of hospital admissions with any infections: A nationwide register based cohort study.

    Science.gov (United States)

    Sørup, Signe; Benn, Christine S; Poulsen, Anja; Krause, Tyra G; Aaby, Peter; Ravn, Henrik

    2016-12-07

    In Denmark, live measles, mumps, and rubella vaccine (MMR) is associated with a reduced risk of infectious disease admissions, particularly for lower respiratory tract infections. In low-income countries, simultaneous vaccination (i.e. vaccination at the same visit) with live and inactivated vaccines may increase child mortality compared with the live vaccine alone. We examined the hypothesis that simultaneous administration of MMR and the inactivated DTaP-IPV-Hib vaccine compared with MMR alone is associated with higher incidence of infectious disease admissions. Nationwide, retrospective, register based cohort study of 520,859 children born in Denmark 1997-2006, who were followed from 15months to 4years of age. Incidence rate ratios (IRRs) of hospital admissions were estimated by Cox regression and adjusted for background factors including exact age. By 2years of age, 4965 children had simultaneous MMR and DTaP-IPV-Hib as their most recent vaccination. Compared with MMR alone, simultaneous administration was associated with a higher rate of lower respiratory tract infections (adjusted incidence rate ratio (IRR), 1.27; 95% confidence interval (CI), 1.13-1.42). There was no effect on other infections. Overall, simultaneous administration was associated with a 7% (95% CI, 0-15%) increase in infectious disease admissions. Simultaneous administration of MMR and DTaP-IPV-Hib compared with MMR alone may increase the rate of hospital admissions related to lower respiratory tract infections. These findings require replication in other high-income settings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Socio-economic disparities in the burden of seasonal influenza: the effect of social and material deprivation on rates of influenza infection.

    Directory of Open Access Journals (Sweden)

    Katia M Charland

    2011-02-01

    Full Text Available There is little empirical evidence in support of a relationship between rates of influenza infection and level of material deprivation (i.e., lack of access to goods and services and social deprivation (i.e. lack of social cohesion and support.Using validated population-level indices of material and social deprivation and medical billing claims for outpatient clinic and emergency department visits for influenza from 1996 to 2006, we assessed the relationship between neighbourhood rates of influenza and neighbourhood levels of deprivation using Bayesian ecological regression models. Then, by pooling data from neighbourhoods in the top decile (i.e., most deprived and the bottom decile, we compared rates in the most deprived populations to the least deprived populations using age- and sex-standardized rate ratios.Deprivation scores ranged from one to five with five representing the highest level of deprivation. We found a 21% reduction in rates for every 1 unit increase in social deprivation score (rate ratio [RR] 0.79, 95% Credible Interval [CrI] 0.66, 0.97. There was little evidence of a meaningful linear relationship with material deprivation (RR 1.06, 95% CrI 0.93, 1.24. However, relative to neighbourhoods with deprivation scores in the bottom decile, those in the top decile (i.e., most materially deprived had substantially higher rates (RR 2.02, 95% Confidence Interval 1.99, 2.05.Though it is hypothesized that social and material deprivation increase risk of acute respiratory infection, we found decreasing healthcare utilization rates for influenza with increasing social deprivation. This finding may be explained by the fewer social contacts and, thus, fewer influenza exposure opportunities of the socially deprived. Though there was no evidence of a linear relationship with material deprivation, when comparing the least to the most materially deprived populations, we observed higher rates in the most materially deprived populations.

  15. Rates of Community-based Antibiotic Prescriptions and Hospital-treated Infections in Individuals With and Without Type 2 Diabetes

    DEFF Research Database (Denmark)

    Mor, Anil; Berencsi, Klara; Nielsen, Jens S

    2016-01-01

    BACKGROUND: The excess risk of antibiotic use and hospital-treated infections in patients with type 2 diabetes (T2D) compared with general population is poorly understood. METHODS: In a nationwide cohort of patients with incident T2D (n = 155 158) and an age-, gender-, and residence-matched compa......BACKGROUND: The excess risk of antibiotic use and hospital-treated infections in patients with type 2 diabetes (T2D) compared with general population is poorly understood. METHODS: In a nationwide cohort of patients with incident T2D (n = 155 158) and an age-, gender-, and residence.......52). The aRRs were increased particularly for urinary tract infections (UTIs, 1.41; 95% CI, 1.35 to 1.45), skin infections (1.50; 95% CI, 1.45 to 1.55), septicemia (1.60; 95% CI, 1.53 to 1.67), and tuberculosis (1.61; 95% CI, 1.25 to 2.06) and of community-based antibiotics prescribed for UTIs (1.31; 95% CI...

  16. Management of upper respiratory tract infections in Dutch general practice: antibiotic prescribing rates and incidences in 1987 and 2001.

    NARCIS (Netherlands)

    Kuyvenhoven, M.; Essen, G. van; Schellevis, F.; Verheij, T.

    2006-01-01

    Background and aim: This study aims to assess differences in antibiotic prescribing and incidence of Upper Respiratory Tract Infections (URTIs) between 1987 and 2001, before (1987) and after (2001) publication of Dutch guidelines on URTIs. Design, setting and method: Data were collected in two

  17. Mosquito Rasputin interacts with chikungunya virus nsP3 and determines the infection rate in Aedes albopictus

    NARCIS (Netherlands)

    Fros, Jelke J; Geertsema, Corinne; Zouache, Karima; Baggen, Jim; Domeradzka, Natalia; van Leeuwen, Daniël M; Flipse, Jacky; Vlak, Just M; Failloux, Anna-Bella; Pijlman, Gorben P

    2015-01-01

    BACKGROUND: Chikungunya virus (CHIKV) is an arthritogenic alphavirus (family Togaviridae), transmitted by Aedes species mosquitoes. CHIKV re-emerged in 2004 with multiple outbreaks worldwide and recently reached the Americas where it has infected over a million individuals in a rapidly expanding

  18. Mosquito Rasputin interacts with chikungunya virus nsP3 and determines the infection rate in Aedes albopictus

    NARCIS (Netherlands)

    Fros, J.J.; Geertsema, Corinne; Zouache, Karima; Baggen, Jim; Domeradzka, Natalia; Leeuwen, Van D.M.; Flipse, Jacky; Vlak, J.M.; Failloux, Anna Bella; Pijlman, G.P.

    2015-01-01

    Background: Chikungunya virus (CHIKV) is an arthritogenic alphavirus (family Togaviridae), transmitted by Aedes species mosquitoes. CHIKV re-emerged in 2004 with multiple outbreaks worldwide and recently reached the Americas where it has infected over a million individuals in a rapidly expanding

  19. Effect of a One-Off Educational Session about Enterobiasis on Knowledge, Preventative Practices, and Infection Rates among Schoolchildren in South Korea

    Science.gov (United States)

    Kim, Dong-Hee; Yu, Hak Sun

    2014-01-01

    Although health education has proven to be cost-effective in slowing the spread of enterobiasis, assessments of the effectiveness of health education to reduce infectious diseases specifically in children are rare. To evaluate the effect of health education on knowledge, preventative practices, and the prevalence of enterobiasis, 319 children from 16 classes were divided into experimental and control groups. Data were collected from May 2012 to March 2013. A 40-minute in-class talk was given once in the experimental group. There were significant differences over the time in the mean scores for children's knowledge of Enterobius vermicularis infection in the intervention group compared to the control group (pvermicularis infection increased from 60.2±2.32 to 92.7±1.19 in the experimental group; this gain was partially lost 3 months later, decreasing to 83.6±1.77 (pvermicularis egg detection rate was 4.4%; the rates for each school ranged from 0% to 12.9% at screening. The infection rate at 3 months after the treatment sharply decreased from 12.3% to 0.8% in the experimental group, compared to a decrease from 8.5% to 3.7% in the control group during the same period. We recommend that health education on enterobiasis be provided to children to increase their knowledge about enterobiasis and improve prevention practices. PMID:25372146

  20. Declining Mortality Rates in HIV-Infected People Who Inject Drugs During a Seek-and-Treat Initiative in Vancouver, Canada, 1996-2014: A Prospective Cohort Study.

    Science.gov (United States)

    Hayashi, Kanna; Dong, Huiru; Kerr, Thomas; Dobrer, Sabina; Guillemi, Silvia; Barrios, Rolando; Montaner, Julio S G; Wood, Evan; Milloy, M-J

    2017-12-27

    We estimated rates and predictors of death among a community-recruited prospective cohort of 961 human immunodeficiency virus (HIV)-infected people who inject drugs in Vancouver, Canada, between 1996 and 2014. The results demonstrated significant declines in age-adjusted all-cause and HIV-related mortality rates since 2010, coincident with the scale-up of a community-wide "seek-and-treat" campaign. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  1. Hepatitis C virus treatment rates and outcomes in HIV/hepatitis C virus co-infected individuals at an urban HIV clinic.

    Science.gov (United States)

    Murray, Melanie C M; Barrios, Rolando; Zhang, Wendy; Hull, Mark; Montessori, Valentina; Hogg, Robert S; Montaner, Julio S G

    2011-01-01

    The factors associated with hepatitis C virus (HCV) treatment uptake and responses were assessed among HCV/HIV co-infected individuals referred for HCV therapy at an urban HIV clinic. Retrospective review of HIV/HCV patients enrolled in the HCV treatment program at the John Ruedy Immunodeficiency Clinic in Vancouver. The factors associated with treatment uptake were assessed using multivariate analysis. A total of 134 HCV/HIV co-infected individuals were recalled for assessment for HCV therapy. Overall 64 (48%) initiated treatment, and of those treated 49 (76.6%) attained end treatment response, whereas 35 (57.8%) achieved sustained virological response (SVR). When evaluated by genotype, 53% (17/32) of those with genotype 1, and 65% (20/31) of those with genotype 2 or 3 infections attained SVR. In treated individuals, alanine aminotransferase dropped significantly after treatment (P<0.001). During treatment, CD4 counts dropped significantly (P<0.001) in all patients. The counts recovered to baseline in patients who achieved SVR, but remained lower in patients who failed the therapy (P=0.015). On multivariate analysis, history of injection drug use (odds ratio: 3.48; 95% confidence interval: 1.37-8.79; P=0.009) and low hemoglobin levels (odds ratio: 4.23; 95% confidence interval: 1.36-13.10; P=0.013) were associated with those who did not enter the treatment. Only half of treatment-eligible co-infected patients referred for the therapy initiated treatment. Of those referred for the therapy, history of injection drug use was associated with lower rates of treatment uptake. Treated HIV/HCV co-infected individuals benefitted from both decreased alanine aminotransferase (independent of SVR), and rates of SVR similar to those described in HCV monoinfected patients.

  2. Diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium: an observational study of testing patterns, prevalence and co-infection rates in northern New Zealand.

    Science.gov (United States)

    Upton, Arlo; Bissessor, Liselle; Lowe, Peter; Wang, Xiaoying; McAuliffe, Gary

    2017-12-21

    Background: This study sought to determine community prevalence, epidemiology and testing patterns for sexually transmissible infections (STI) in northern New Zealand. Methods: A total of 2643 samples submitted for STI testing between 26 November 2015 and 7 December 2015 underwent analysis by Aptima Combo 2 (Hologic, San Diego, CA, USA), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG) assays. Results were analysed by patient demographics. Results: Four hundred and eleven pathogens were detected from 359 patients, with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), TV, and MG detected in 178 (6.7%), 19 (0.7%), 80 (3%) and 134 (5.1%) samples respectively. With the exception of TV, STI prevalence was highest in people <25 years of age. Infection was more common in men for NG (odds ratio (OR) 5.05, P<0.001) and CT (OR 2.72, P<0.001). Māori and Pacific ethnicity were associated with increased risk of MG (OR 1.82, P=0.006,) TV (OR 6.1, P<0.001) and CT (OR 3.31, P<0.001) infection, and TV and NG infections were more prevalent as social deprivation increased. A mismatch between testing rates and prevalence of infection was seen, with fewer tests performed for males (OR 0.2, P<0.001) than females and no difference in testing of Māori and Pacific men (3064/100000) compared with men of European background (3181/100000, OR 0.96, P=0.76), despite an increased risk of disease. Conclusions: There are disparately low testing rates for STIs in certain high-risk groups in northern New Zealand.

  3. The рopulation сomposition of lymphocyte and the rate of infection by by the herpes simplex virus in patients ill with autoimmune autoimmune thyroiditis

    Directory of Open Access Journals (Sweden)

    E B Kravez

    2006-12-01

    Full Text Available The objective of the research is the analysis of blood lymphocyte composition and the rate of infection by the herpes simplex virus (HSV, cytomegalovirus (CMV and Epstein-Barr virus (EBV in patients with AIT. Two men and twenty six women (with the average age 44.0 ± 2.3 years ill with the disease for 6.0 ± 2.7 years were examined. 85.7% of the ill were in the euthyroid state, 14.3% were in hypothyroidism. 25% ofthe patients were diagnosed with atrophic AIT, 60,7% got the diagnoses of fibroid and fibronodular AIT and 14.3% got hypertrophic AIT diagnoses. It was found that the course of AIT was accompanied with the increase of the rate of CD20 +-lymphocytes in blood at the normal number of CD3 +-, CD4 +-, CD8 +- и CD56 + cells. The IgG to the HSV was found in 92.9% patients with AIT, to the CMV - in 96.4% cases, to the pre-early antigen (ЕА of CMV (acute infection - in 39.3% patients and to the nuclear antigen of EBV (КА (late past-infection - in 67.6% cases. In two cases we found EBV-IgG to EA and КА simultaneously (late stage of primary EBV-infection or reactivation of its chronic form. It was proved that 39.3% of the patients with AIT associate this disease with acute cytomegalovirus infection.

  4. The effects of feeding sericea lespedeza hay on growth rate of goats naturally infected with gastrointestinal nematodes.

    Science.gov (United States)

    Moore, D A; Terrill, T H; Kouakou, B; Shaik, S A; Mosjidis, J A; Miller, J E; Vanguru, M; Kannan, G; Burke, J M

    2008-09-01

    Goat production is increasing in the United States due to high ethnic demand, but infection with gastrointestinal nematode (GIN) parasites is a major constraint to the industry. Increasing GIN resistance to chemical anthelmintics worldwide has led to the development of alternative control strategies, including use of forages containing condensed tannins (CT). An experiment was designed using infected and dewormed male kids (Kiko x Spanish, 6 mo old, 18.9 +/- 3.25 kg) fed diets containing 25% concentrate and either 75% sericea lespedeza [SL; Lespedeza cuneata (Dum-Cours.) G. Don], a high CT forage (87 to 181 g of CT/kg), or 75% bermudagrass [BG; Cynodon dactylon (L.) Pers.] hay (n = 10/treatment). The kids were weighed every 14 d, and fecal and blood samples were taken weekly for fecal egg counts and packed cell volume determination, respectively. Fecal cultures were processed every 14 d to determine CT effect on larval development. At slaughter, adult GIN were collected from the abomasum and small intestines for counting and speciation. Blood samples were also analyzed for plasma urea-N, and ruminal VFA and pH were determined. The infected SL-fed kids had consistently lower (P < 0.05) fecal egg counts than the infected BG goats throughout the trial and greater (P < 0.05) packed cell volume beginning by d 77. Average daily gain was greater (P < 0.001) in kids fed SL- than BG-based diets, regardless of infection status (104.3 +/- 5.0 and 75.5 +/- 4.8 g/d, respectively). Total VFA and acetate concentrations were greater (P < 0.001) in the BG- than in SL-fed goats, whereas propionate levels were unaffected by diet. Acetate:propionate ratio (P = 0.01) and plasma urea-N (P = 0.03) levels were greater in BG-fed goats, whereas rumen pH was greater (P < 0.001) in the SL-fed goats. Feeding SL hay can reduce GIN infection levels and increase performance of goats compared with BG hay.

  5. Chest physiotherapy effectiveness to reduce hospitalization and mechanical ventilation length of stay, pulmonary infection rate and mortality in ICU patients.

    Science.gov (United States)

    Castro, Antonio A M; Calil, Suleima Ramos; Freitas, Súsi Andréa; Oliveira, Alexandre B; Porto, Elias Ferreira

    2013-01-01

    Although physiotherapy is an integral part of the multiprofessional team in most ICUs there is only limited evidence concerning the effectiveness of its procedures. The objectives of this study were to verify if physiotherapy care provided within 24 h/day for hospitalized patients in the ICU reduce the length of stay, mechanical ventilation support, pulmonary infection and mortality compared to a physiotherapy care provided within 6 h/day. A cohort study was designed to assess differences between one hospital where patients were given physiotherapy care for 24 h/day and another hospital with only 6 h/day. We considered the following as outcome measurements: clinical diagnosis, medication in use, presence of associated diseases, APACHE II and SOFA scores, ICU and mechanical ventilation length of stay, development of pulmonary infections and survival. One hundred and forty-six patients were enrolled. Patients admitted in the service A presented a lower length of stay in mechanical ventilation (p respiratory infections (p = 0.0043) than patients admitted in service B. No difference was found for APACHE II score (p = 0.8) and SOFA scores (p = 0.2) between groups. The mortality risk was OR 1.3 (1.01-2.33) (p = 0.04) for patients in the service B. The presence of a physiotherapist in the intensive care unit contributes decisively to the early recovery of the patient, reducing mechanical ventilation support need, number of hospitalization days, incidence of respiratory infection and risk of mortality. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Does antimicrobial use density at the ward level influence monthly central line-associated bloodstream infection rates?

    Directory of Open Access Journals (Sweden)

    Yoshida J

    2014-12-01

    Full Text Available Junichi Yoshida, Yukiko Harada, Tetsuya Kikuchi, Ikuyo Asano, Takako Ueno, Nobuo Matsubara Infection Control Committee, Shimonoseki City Hospital, Shimonoseki, Japan Abstract: The aim of this study was to elucidate risk factors, including ward antimicrobial use density (AUD, for central line-associated bloodstream infection (CLABSI as defined by the Centers for Disease Control and Prevention in a 430-bed community hospital using central venous lines with closed-hub systems. We calculated AUD as (total dose/(defined daily dose × patient days ×1,000 for a total of 20 drugs, nine wards, and 24 months. Into each line day data, we inputed AUD and device utilization ratios, number of central line days, and CLABSI. The ratio of susceptible strains in isolates were subjected to correlation analysis with AUD. Of a total of 9,997 line days over 24 months, CLABSI was present in 33 cases (3.3 ‰, 14 (42.4% of which were on surgical wards out of nine wards. Of a total of 43 strains isolated, eight (18.6% were methicillin-resistant Staphylococcus aureus (MRSA; none of the MRSA-positive patients had received cefotiam before the onset of infection. Receiver-operating characteristic analysis showed that central line day 7 had the highest accuracy. Logistic regression analysis showed the central line day showed an odds ratio of 5.511 with a 95% confidence interval of 1.936–15.690 as did AUD of cefotiam showing an odds ratio of 0.220 with 95% confidence interval of 0.00527–0.922 (P=0.038. Susceptible strains ratio and AUD showed a negative correlation (R2=0.1897. Thus, CLABSI could be prevented by making the number of central line days as short as possible. The preventative role of AUD remains to be investigated. Keywords: bloodstream infection, central line, antimicrobial use density

  7. Viral replication rate regulates clinical outcome and CD8 T cell responses during highly pathogenic H5N1 influenza virus infection in mice.

    Directory of Open Access Journals (Sweden)

    Yasuko Hatta

    2010-10-01

    Full Text Available Since the first recorded infection of humans with H5N1 viruses of avian origin in 1997, sporadic human infections continue to occur with a staggering mortality rate of >60%. Although sustained human-to-human transmission has not occurred yet, there is a growing concern that these H5N1 viruses might acquire this trait and raise the specter of a pandemic. Despite progress in deciphering viral determinants of pathogenicity, we still lack crucial information on virus/immune system interactions pertaining to severe disease and high mortality associated with human H5N1 influenza virus infections. Using two human isolates of H5N1 viruses that differ in their pathogenicity in mice, we have defined mechanistic links among the rate of viral replication, mortality, CD8 T cell responses, and immunopathology. The extreme pathogenicity of H5N1 viruses was directly linked to the ability of the virus to replicate rapidly, and swiftly attain high steady-state titers in the lungs within 48 hours after infection. The remarkably high replication rate of the highly pathogenic H5N1 virus did not prevent the induction of IFN-β or activation of CD8 T cells, but the CD8 T cell response was ineffective in controlling viral replication in the lungs and CD8 T cell deficiency did not affect viral titers or mortality. Additionally, BIM deficiency ameliorated lung pathology and inhibited T cell apoptosis without affecting survival of mice. Therefore, rapidly replicating, highly lethal H5N1 viruses could simply outpace and overwhelm the adaptive immune responses, and kill the host by direct cytopathic effects. However, therapeutic suppression of early viral replication and the associated enhancement of CD8 T cell responses improved the survival of mice following a lethal H5N1 infection. These findings suggest that suppression of early H5N1 virus replication is key to the programming of an effective host response, which has implications in treatment of this infection in humans.

  8. Trends in the use of laboratory tests for the diagnosis of Clostridium difficile infection and association with incidence rates in Quebec, Canada, 2010-2014.

    Science.gov (United States)

    Bogaty, C; Lévesque, S; Garenc, C; Frenette, C; Bolduc, D; Galarneau, L-A; Lalancette, C; Loo, V; Tremblay, C; Trudeau, M; Vachon, J; Dionne, M; Villeneuve, J; Longtin, J; Longtin, Y

    2017-09-01

    Several Clostridium difficile infection (CDI) surveillance programs do not specify laboratory strategies to use. We investigated the evolution in testing strategies used across Quebec, Canada, and its association with incidence rates. Cross-sectional study of 95 hospitals by surveys conducted in 2010 and in 2013-2014. The association between testing strategies and institutional CDI incidence rates was analyzed via multivariate Poisson regressions. The most common assays in 2014 were toxin A/B enzyme immunoassays (EIAs) (61 institutions, 64%), glutamate dehydrogenase (GDH) EIAs (51 institutions, 53.7%), and nucleic acid amplification tests (NAATs) (34 institutions, 35.8%). The most frequent algorithm was a single-step NAAT (20 institutions, 21%). Between 2010 and 2014, 35 institutions (37%) modified their algorithm. Institutions detecting toxigenic C difficile instead of C difficile toxin increased from 14 to 37 (P < .001). Institutions detecting toxigenic C difficile had higher CDI rates (7.9 vs 6.6 per 10,000 patient days; P = .01). Institutions using single-step NAATs, GDH plus toxigenic cultures, and GDH plus cytotoxicity assays had higher CDI rates than those using an EIA-based algorithm (P < .05). Laboratory detection of CDI has changed since 2010. There is an association between diagnostic algorithms and CDI incidence. Mitigation strategies are warranted. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Impact of Prophylactic Levofloxacin on Rates of Bloodstream Infection and Fever in Neutropenic Patients with Multiple Myeloma Undergoing Autologous Hematopoietic Stem Cell Transplantation.

    Science.gov (United States)

    Satlin, Michael J; Vardhana, Santosh; Soave, Rosemary; Shore, Tsiporah B; Mark, Tomer M; Jacobs, Samantha E; Walsh, Thomas J; Gergis, Usama

    2015-10-01

    Few studies have evaluated the role of antibacterial prophylaxis during neutropenia in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation (HSCT). At our center, levofloxacin prophylaxis was initiated in June 2006 in patients with myeloma who were undergoing autologous HSCT. We compared the incidence of bloodstream infection (BSI) and fever and neutropenia (FN) within 30 days of transplantation before (January 2003 to May 2006) and after (June 2006 to April 2010) the initiation of levofloxacin prophylaxis in patients undergoing autologous HSCT for myeloma. We also compared rates of BSI and FN during the same time periods in autologous HSCT recipients with lymphoma who did not receive antibacterial prophylaxis during either time period. After the initiation of levofloxacin prophylaxis, the BSI rate decreased from 41.2% (49 of 119) to 14.7% (23 of 156) and the rate of FN decreased from 91.6% to 60.9% in patients with myeloma (P Levofloxacin prophylaxis was independently associated with decreased odds of BSI (odds ratio, .27; 95% confidence interval, .14 to .51; P levofloxacin-resistant Enterobacteriaceae (5% versus 1%, P = .08) and Clostridium difficile infection (7% versus 3%, P = .12) after the initiation of levofloxacin prophylaxis but did not have higher rates of BSI due to other resistant bacteria. Levofloxacin prophylaxis is associated with decreased risk of BSI and FN in patients with myeloma undergoing autologous HSCT. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  10. Timely reminder interventions to improve annual Papanicolaou (Pap) smear rates among HIV-infected women in an outpatient center of southern Nevada: a short report.

    Science.gov (United States)

    Ganta, Vimala; Moonie, Sheniz; Patel, Dina; Hunt, Aaron T; Richardson, Jan; Di John, David; Ezeanolue, Echezona E

    2017-09-01

    Current guidelines recommend annual Papanicolaou (Pap) smears for human immunodeficiency virus (HIV)-infected women for cervical cancer screening. Rates for such screening in Nevada are below the national rate. Our cohort includes 485 eligible HIV-infected adult women from an outpatient center in Southern Nevada of which only 12 women had obtained a Pap smear in the past year. An intervention was conducted from June 2015 to September 2015, in which reminders to schedule a Pap smear were sent to the remaining cohort of 473 women via sequential text messaging, followed by phone call attempts. Of all subjects, 94% contacted by text messages and 41% contacted by phone calls were successfully reached. There was an increase in the rate of completed Pap smears from 2.5% (12/485) at baseline to 11.8% (56/473) after interventions (p Pap smear results, 20 (29.4%) were abnormal. Our intervention, utilizing methods of communication such as text messaging and phone calls, markedly increased the rate of completed Pap smear screening in our population.

  11. Comparative analysis of the infectivity rate of both Borrelia burgdorferi and Anaplasma phagocytophilum in humans and dogs in a New Jersey community

    Directory of Open Access Journals (Sweden)

    Gaito A

    2014-08-01

    Full Text Available Andrea Gaito,1 Vedrana Gjivoje,2 Sebastian Lutz,1 Ben Baxter2 1Private medical practice, Somerset County, NJ, USA; 2Bernardsville Animal Hospital, Somerset County, NJ, USA Abstract: Ticks are important vectors of disease and transmit an extensive array of bacterial, viral and protozoan diseases to both humans and dogs within a community. Borrelia burgdorferi, the causative agent of Lyme disease, has been extensively studied within both the human and veterinary population. Anaplasma phagocytophilum, an intracellular rickettsial pathogen also transmitted by ixodid ticks, has emerged as an important zoonotic infection with significant veterinary and medical implications, and is responsible for both canine granulocytic anaplasmosis and human granulocytic anaplasmosis. Multiple surveys exist in the international literature referencing infectivity rates of both of these diseases separately in both the dog and human populations. This is the first study to simultaneously examine the infectivity rate of both anaplasmosis and Lyme disease in humans and dogs in a community endemic for tick-borne diseases. Keywords: Lyme disease, anaplasmosis, dogs, humans 

  12. Infection rates of Enterobius vermicularis and Clonorchis sinensis of primary school children in Hamyang-gun, Gyeongsangnam-do (Province), Korea

    Science.gov (United States)

    Kim, Bong Jin; Yeon, Je Wook

    2001-01-01

    The egg positive rate of Enterobius vermicularis and Clonorchis sinensis of school children in the rural area was studied in Hamyang-gun. Gyeongsangnam-do in Korea. Cellotape anal swab and formalin ether concentration methods were performed one time to 720 primary school children. The total egg positive rate of E. vermicularis was 12.6% in two schools (Baekjeon and Wiseong). In the Baekjeon and Wiseong primary school, the egg positive rate of E. vermicularis was 4.6% and 13.4%, respectively. Pinworm egg positive rate was 17.6% in the lower grades (1st. 2nd and 3rd), and 7.7% in higher grades (4th, 5th and 6th). The total egg positive rate of male and female was 12.6% and 12.7%, respectively. The egg positive rate of C. sinensis of Baekjeon and Wiseong primary school was 1.5% and 0.46%, respectively. The total egg positive rate of C. sinensis was 0.56%. This survey showed that continuous education and chemotherapy is necessary to treat and prevent reinfection of E. vermicularis. In the case of C. sinensis, health education for school children is recommended to prevent potential infection of adolescents. PMID:11775334

  13. A CCL5 Haplotype Is Associated with Low Seropositivity Rate of HCV Infection in People Who Inject Drugs.

    Science.gov (United States)

    Huik, Kristi; Avi, Radko; Pauskar, Merit; Kallas, Eveli; Jõgeda, Ene-Ly; Karki, Tõnis; Rüütel, Kristi; Talu, Ave; Abel-Ollo, Katri; Uusküla, Anneli; Carrillo, Andrew; Ahuja, Sunil K; He, Weijing; Lutsar, Irja

    2016-01-01

    The role of CC chemokine receptor 5 (CCR5) and its ligand CCL5 on the pathogenesis of HIV infection has been well studied but not for HCV infection. Here, we investigated whether CCL5 haplotypes influence HIV and HCV seropositivity among 373 Caucasian people who inject drugs (PWID) from Estonia. Study included 373 PWID; 56% were HIV seropositive, 44% HCV seropositive and 47% co-infected. Four CCL5 haplotypes (A-D) were derived from three CCL5 polymorphisms (rs2107538/rs2280788/rs2280789) typed by Taqman allelic discrimination assays. The data of CCR5 haplotypes were used from our previous study. The association between CCL5 haplotypes with HIV and/or HCV seropositivity was determined using logistic regression analysis. Possessing CCL5 haplotype D (defined by rs2107538A/rs2280788G/rs2280789C) decreased the odds of HCV seropositivity compared to those not possessing it (OR = 0.19; 95% CI 0.09-0.40), which remained significant after adjustment to co-variates (OR = 0.08; 95% CI 0.02-0.29). An association of this haplotype with HIV seropositivity was not found. In step-wise logistic regression with backward elimination CCL5 haplotype D and CCR5 HHG*1 had reduced odds for HCV seropositivity (OR = 0.28 95% CI 0.09-0.92; OR = 0.23 95% CI 0.08-0.68, respectively) compared to those who did not possess these haplotypes, respectively. Our results suggest that among PWID CCL5 haplotype D and CCR5 HHG*1 independently protects against HCV. Our findings highlight the importance of CCL5 genetic variability and CCL5-CCR5 axis on the susceptibility to HCV.

  14. High postpartum rates of sexually transmitted infections among teens: pregnancy as a window of opportunity for prevention.

    Science.gov (United States)

    Ickovics, J R; Niccolai, L M; Lewis, J B; Kershaw, T S; Ethier, K A

    2003-12-01

    To identify incidence and predictors of Chlamydia trachomatis and Neisseria gonorrhoeae among postpartum adolescents. These estimates are compared to similar estimates among a cohort of non-pregnant, sexually active teens. 203 pregnant and 208 non-pregnant adolescents aged 14-19 years were recruited from 10 community based health clinics in Connecticut, United States. Structured interviews and sexually transmitted infection (STI) testing using ligase chain reaction (LCR) were conducted at a baseline visit (during the third trimester for the pregnant adolescents), and at 6 and 12 month follow up visits (3 and 9 months post partum, for those pregnant at baseline). Among pregnant teens, new infections of C trachomatis and N gonorrhoeae increased from 7.1% at the 6 month follow up interview to 14.3% at the 12 month follow up interview; among non-pregnant teens, new infections remained relatively stable over the 6 and 12 month follow up interviews (9.0% to 8.3%) (group by time interaction, p = 0.005). C trachomatis and N gonorrhoeae prevalence was 1.9 times higher (95% CI: 0.97 to 3.89, p = 0.06) among teens in the late postpartum follow up compared to the non-pregnant teens, controlling for baseline STIs. Predictors of postpartum STIs included having a new partner and number of partners per year of sexual activity. Postpartum adolescents are vulnerable to STIs. Routine prenatal and postpartum care provide unique opportunities to promote condom use and other risk reduction interventions among adolescents. If sustained post partum, long term reproductive health can be promoted.

  15. Clinical relevance and effect of surgical wound classification in appendicitis: Retrospective evaluation of wound classification discrepancies between surgeons, Swissnoso-trained infection control nurse, and histology as well as surgical site infection rates by wound class.

    Science.gov (United States)

    Wang-Chan, Anastasija; Gingert, Christian; Angst, Eliane; Hetzer, Franc Heinrich

    2017-07-01

    Surgical wound classification (SWC) is used for risk stratification of surgical site infection (SSI) and serves as the basis for measuring quality of care. The objective was to examine the accuracy and reliability of SWC. This study was purposed to evaluate the discrepancies in SWC as assessed by three groups: surgeons, an infection control nurse, and histopathologic evaluation. The secondary aim was to compare the risk-stratified SSI rates using the different SWC methods for 30 d postoperatively. An analysis was performed of the appendectomies from January 2013 to June 2014 in the Cantonal Hospital of Schaffhausen. SWC was assigned by the operating surgeon at the end of the procedure and retrospectively reviewed by a Swissnoso-trained infection control nurse after reading the operative and pathology report. The level of agreement among the three different SWC assessment groups was determined using kappa statistic. SSI rates were analyzed using a chi-square test. In 246 evaluated cases, the kappa scores for interrater reliability among the SWC assessments across the three groups ranged from 0.05 to 0.2 signifying slight agreement between the groups. SSIs were more frequently associated with trained infection control nurse-assigned SWC than with surgeons based SWC. Our study demonstrated a considerable discordance in the SWC assessments performed by the three groups. Unfortunately, the currently practiced SWC system suffers from ambiguity in definition and/or implementation of these definitions is not clearly stated. This lack of reliability is problematic and may lead to inappropriate comparisons within and between hospitals and surgeons. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  16. Effects of Darwinian Selection and Mutability on Rate of Broadly Neutralizing Antibody Evolution during HIV-1 Infection

    Science.gov (United States)

    Sheng, Zizhang; Schramm, Chaim A.; Connors, Mark; Morris, Lynn; Mascola, John R.; Kwong, Peter D.; Shapiro, Lawrence

    2016-01-01

    Accumulation of somatic mutations in antibody variable regions is critical for antibody affinity maturation, with HIV-1 broadly neutralizing antibodies (bnAbs) generally requiring years to develop. We recently found that the rate at which mutations accumulate decreases over time, but the mechanism governing this slowing is unclear. In this study, we investigated whether natural selection and/or mutability of the antibody variable region contributed significantly to observed decrease in rate. We used longitudinally sampled sequences of immunoglobulin transcripts of single lineages from each of 3 donors, as determined by next generation sequencing. We estimated the evolutionary rates of the complementarity determining regions (CDRs), which are most significant for functional selection, and found they evolved about 1.5- to 2- fold faster than the framework regions. We also analyzed the presence of AID hotspots and coldspots at different points in lineage development and observed an average decrease in mutability of less than 10 percent over time. Altogether, the correlation between Darwinian selection strength and evolutionary rate trended toward significance, especially for CDRs, but cannot fully explain the observed changes in evolutionary rate. The mutability modulated by AID hotspots and coldspots changes correlated only weakly with evolutionary rates. The combined effects of Darwinian selection and mutability contribute substantially to, but do not fully explain, evolutionary rate change for HIV-1-targeting bnAb lineages. PMID:27191167

  17. Early Results Show Reduced Infection Rate Using No-touch Technique for Expander/ADM Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Henry B. Wilson, MD, FACS

    2015-03-01

    Full Text Available Summary: Infection is a common complication of immediate breast reconstruction that often leads to device removal, a result emotionally devastating to the patient and frustrating for her surgeon. “No-touch” techniques have been used in other surgical disciplines and plastic surgery, but they have not been reported for breast reconstruction with tissue expanders or implants and acellular dermis. We report a novel technique of tissue expander and acellular dermis placement using no-touch principles with a self-retaining retractor system that holds promise to decrease infectious complications of breast reconstruction.

  18. Intramammary infection rate during the dry period in cows that received blanket dry cow therapy : efficacy of 6 different dry-cow intra-mammary antimicrobial products

    Directory of Open Access Journals (Sweden)

    I-M. Petzer

    2009-05-01

    Full Text Available The objectives of this study were to compare the efficacy of 6 different dry-cow intramammary antimicrobial products for the treatment and prevention of mastitis during the dry period in a well-managed high producing Friesland dairy herd, and the influence of treatment on the somatic cell count (SCC of cows during early lactation. One of 6 dry-cow intramammary antimicrobial products was randomly allocated to 162 cows due for drying off over a period of 14 months. All cows were sampled twice prior to drying off, and twice after calving for the determination of SCC and presence of microorganisms. The quarter prevalence of pathogens at drying off and post-calving, the overall quarter cure rate and the rate of new intramammary infections occurring during the dry period were determined. The overall quarter prevalence of intramammary infections (IMIs at drying off was 29.78 % and after calving 22.22 %.There was a statistically significant difference (P < 0.05 between the prevalence of major and minor pathogens at drying off (7.87 % and 21.91 % and at calving (4.47 % and 17.75 %. The most prevalent pathogens isolated at drying off (21.14 % and at calving (16.98 % were coagulase-negative staphylococci (CNS. The quarter cure rate during the dry period was 83.94 %. The cure rate for the major pathogens (98% was significantly better (P < 0.05 than that for minor pathogens (78.9 %.The overall quarter cure rate varied from 72.3 % to 93.9 % for the various products. The rate of new quarter infections during the dry period was 17.44 % with a significant difference (P<0.05, between the prevalence of new quarter infections with major (4.32 % and minor pathogens (13.12 %. CNS was the most prevalent pathogen causing new quarter infections (12.34 % and the rate o f new quarter infections varied from 13.4 % to 24.1 % for the various products.It is concluded that there is a difference in efficacy between antimicrobial intramammary dry-cow products in their ability to

  19. High Rates of Anal High-Grade Squamous Intraepithelial Lesions in HIV-Infected Women Who Do Not Meet Screening Guidelines.

    Science.gov (United States)

    Gaisa, Michael; Ita-Nagy, Fanny; Sigel, Keith; Arens, Yotam; Hennessy, Mary Ann; Rodriguez-Caprio, Gabriela; Mullen, Michael; Aberg, Judith A; Cespedes, Michelle

    2017-02-01

    Human immunodeficiency virus (HIV)-infected women have a higher burden of anal high-grade squamous intraepithelial lesions (HSIL) and anal cancer (AC) compared with HIV-uninfected women. Guidelines for AC screening in this population are heterogeneous. Here we report outcomes and risk factors for anal HSIL following implementation of universal AC screening offered to all HIV-infected women. Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed. Routine clinical data included anal and cervical cytology, demographic/behavioral data, and high-resolution anoscopy (HRA) results. We evaluated the association of cytology with HRA results, and predictors of HSIL pathology, and compared rates of HSIL pathology among women meeting screening guidelines to those who did not. Seven hundred forty-five HIV-infected women were screened with anal cytology. Thirty-nine percent had abnormal anal cytology on initial screen and 15% on secondary screen; 208 women underwent HRA following abnormal anal cytology. HSIL was found in 26% and 18% of anal biopsies following initial and secondary screening, respectively. One woman had AC. Cigarette smoking more than doubled HSIL risk. Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy. Neither meeting criteria for screening nor history of receptive anal sex was significantly associated with HSIL. Anal HSIL is common in HIV-infected women. Substantial numbers of HSIL would have been missed by strictly adhering to existing AC screening guidelines. These results support routine screening of all HIV-infected women regardless of human papillomavirus history or sexual practices. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  20. Investigating source water Cryptosporidium concentration, species and infectivity rates during rainfall-runoff in a multi-use catchment.

    Science.gov (United States)

    Swaffer, Brooke A; Vial, Hayley M; King, Brendon J; Daly, Robert; Frizenschaf, Jacqueline; Monis, Paul T

    2014-12-15

    Protozoan pathogens present a significant human health concern, and prevention of contamination into potable networks remains a key focus for drinking water providers. Here, we monitored the change in Cryptosporidium concentration in source water during high flow events in a multi-use catchment. Furthermore, we investigated the diversity of Cryptosporidium species/genotypes present in the source water, and delivered an oocyst infectivity fraction. There was a positive and significant correlation between Cryptosporidium concentration and flow (ρ = 0.756) and turbidity (ρ = 0.631) for all rainfall-runoff events, despite variable source water pathogen concentrations. Cell culture assays measured oocyst infectivity and suggested an overall source water infectious fraction of 3.1%. No infectious Cryptosporidium parvum or Cryptosporidium hominis were detected, although molecular testing detected C. parvum in 7% of the samples analysed using PCR-based molecular techniques. Twelve Cryptosporidium species/genotypes were identified using molecular techniques, and were reflective of the host animals typically found in remnant vegetation and agricultural areas. The inclusion of molecular approaches to identify Cryptosporidium species and genotypes highlighted the diversity of pathogens in water, which originated from various sources across the catchment. We suggest this mixing of runoff water from a range of landuses containing diverse Cryptosporidium hosts is a key explanation for the often-cited difficulty forming strong pathogen-indicator relationships. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Self-rated quality of life and school performance in relation to helminth infections: case study from Yunnan, People's Republic of China

    Directory of Open Access Journals (Sweden)

    Fürst Thomas

    2010-07-01

    Full Text Available Abstract Background Expert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries. For chronic diseases such as soil-transmitted helminthiasis and schistosomiasis, it has been suggested that a patient-based quality of life (QoL approach should be considered for a more accurate appraisal of disability weights. Methods and Results We carried out a cross-sectional survey and assessed the prevalence and intensity of soil-transmitted helminth infections as well as self-rated QoL indicators among 252 students attending grades 5-8 in two schools (Bulangshan and Pu'er in Yunnan province, People's Republic of China. Each student provided a single stool sample, which was subjected to duplicate Kato-Katz thick smear readings and a single FLOTAC examination for parasitological diagnosis. Prevalence rates for hookworm, Trichuris trichiura and Ascaris lumbricoides were high in Bulangshan (75.9%, 70.0% and 68.2%, while the respective prevalence rates in Pu'er were 66.9%, 56.5% and 9.2%. Students were interviewed with two standardised questionnaires, the EuroQoL-5 Dimensions (EQ-5D and ShortForm-12 (SF-12 Health Survey. Impairment in any of the five dimensions of the EQ-5D was reported by 87% of the students. However, no clear differences could be observed between individuals with and those without helminth infections, and there were discrepancies between the two schools. A multivariate logistic regression model revealed no differences between students with varying infection status in the domains of the SF-12 (odds ratio close to 1.0. Somewhat more pronounced, yet not statistically significant differences were observed when end-of-school-term marks were compared with students' helminth infection status: infected individuals had lower marks in Chinese, English and mathematics, but not in sports, compared to their helminth-free counterparts. Conclusions Our results point to unresolved issues and challenges

  2. Self-rated quality of life and school performance in relation to helminth infections: case study from Yunnan, People's Republic of China.

    Science.gov (United States)

    Ziegelbauer, Kathrin; Steinmann, Peter; Zhou, Hui; Du, Zun-Wei; Jiang, Jin-Yong; Fürst, Thomas; Jia, Tie-Wu; Zhou, Xiao-Nong; Utzinger, Jürg

    2010-07-23

    Expert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries. For chronic diseases such as soil-transmitted helminthiasis and schistosomiasis, it has been suggested that a patient-based quality of life (QoL) approach should be considered for a more accurate appraisal of disability weights. We carried out a cross-sectional survey and assessed the prevalence and intensity of soil-transmitted helminth infections as well as self-rated QoL indicators among 252 students attending grades 5-8 in two schools (Bulangshan and Pu'er) in Yunnan province, People's Republic of China. Each student provided a single stool sample, which was subjected to duplicate Kato-Katz thick smear readings and a single FLOTAC examination for parasitological diagnosis. Prevalence rates for hookworm, Trichuris trichiura and Ascaris lumbricoides were high in Bulangshan (75.9%, 70.0% and 68.2%), while the respective prevalence rates in Pu'er were 66.9%, 56.5% and 9.2%. Students were interviewed with two standardised questionnaires, the EuroQoL-5 Dimensions (EQ-5D) and ShortForm-12 (SF-12) Health Survey. Impairment in any of the five dimensions of the EQ-5D was reported by 87% of the students. However, no clear differences could be observed between individuals with and those without helminth infections, and there were discrepancies between the two schools. A multivariate logistic regression model revealed no differences between students with varying infection status in the domains of the SF-12 (odds ratio close to 1.0). Somewhat more pronounced, yet not statistically significant differences were observed when end-of-school-term marks were compared with students' helminth infection status: infected individuals had lower marks in Chinese, English and mathematics, but not in sports, compared to their helminth-free counterparts. Our results point to unresolved issues and challenges regarding the cultural appropriateness of the widely used

  3. Relatively low HIV infection rates in rural Uganda, but with high potential for a rise: a cohort study in Kayunga District, Uganda.

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    David Guwatudde

    Full Text Available BACKGROUND: Few studies have been conducted in Uganda to identify and quantify the determinants of HIV-1 infection. We report results from a community-based cohort study, whose primary objectives were to determine HIV-1 prevalence, incidence, and determinants of these infections, among other objectives. METHODOLOGY: Consenting volunteers from the rural district of Kayunga in Uganda aged 15-49 years were enrolled between March and July 2006. Participants were evaluated every six months. A questionnaire that collected information on behavioral and other HIV-1 risk factors was administered, and a blood sample obtained for laboratory analysis at each study visit. PRINCIPAL FINDINGS: HIV-1 prevalence among the 2025 participants was 9.9% (95% CI = 8.6%-11.2%. By the end of 12 months of follow-up, 1689.7 person-years had been accumulated, with a median follow-up time of 11.97 months. Thirteen HIV-1 incident cases were detected giving an annual HIV-1 incidence of 0.77% (95% CI = 0.35-1.19. Prevalence of HSV-2 infection was 57% and was strongly associated with prevalent HIV-1 infection (adjusted Odds Ratio = 3.9, 95% CI = 2.50-6.17; as well as incident HIV-1 infection (adjusted Rate Ratio (RR = 8.7, 95% CI = 1.11-67.2. The single most important behavioral characteristic associated with incident HIV infection was the number of times in the past 6 months, a participant had sex with person(s they suspected/knew were having sex with others; attaining statistical significance at 10 times and higher (adjusted RR = 6.3, 95% CI = 1.73-23.1. By the end of 12 months of follow-up, 259 participants (13% were lost to follow-up, 13 (0.6% had died, and 2 (0.1% had withdrawn consent. CONCLUSIONS: Despite relatively low HIV-1 incidence observed in this community, prevalence remains relatively high. In the presence of high prevalence of HSV-2 infection and the behavioral characteristic of having sex with more than one partner, there is potential for increase in HIV-1

  4. Rates and Correlates of Antiretroviral Therapy Use and Virologic Suppression among Perinatally and Behaviorally Infected HIV+ Youth Linked to Care in the United States

    Science.gov (United States)

    Kahana, Shoshana Y.; Fernandez, Maria Isabel; Wilson, Patrick A.; Bauermeister, Jose A.; Lee, Sonia; Wilson, Craig M.; Hightow-Weidman, Lisa B.

    2015-01-01

    Objective To measure rates of ART use and virologic suppression among perinatally infected (PIY) and behaviorally infected youth (BIY) linked to care in the United States, and examine the effects of demographic, biomedical, and psychosocial factors on those rates. Methods Between 2009–2012, 649 PIY and 1,547 BIY in 20 Adolescent Medicine Trials Network for HIV/AIDS Interventions sites completed cross-sectional surveys via audio computer- assisted self-interviews. Viral load data were collected from chart abstraction or blood draw. Results Overall 82.4% of PIY and 49.1% of BIY reported current ART use. Only 37.0% of PIY and 27.1% of BIY were virologically suppressed. Virologic suppression rates did not vary as a function of time since HIV diagnosis in either group. Consistent HIV care and no current substance abuse were significant correlates of ART use among PIY. These variables and non-African American race were some factors associated with virologic suppression for PIY (ORs Ps ART use (ORs Ps ART use >6 months, >90% ART adherence, and consistent HIV care (ORs Ps youth reported unprotected sex in the past 3 months. Conclusions There are continued challenges with successfully treating youth even once diagnosed and linked to HIV care. Strategies targeting barriers to ART access, use and virologic suppression are needed to optimize the impact of the "Treatment as Prevention" paradigm among PIY and BIY. PMID:25590270

  5. Rates and correlates of antiretroviral therapy use and virologic suppression among perinatally and behaviorally HIV-infected youth linked to care in the United States.

    Science.gov (United States)

    Kahana, Shoshana Y; Fernandez, Maria Isabel; Wilson, Patrick A; Bauermeister, Jose A; Lee, Sonia; Wilson, Craig M; Hightow-Weidman, Lisa B

    2015-02-01

    To measure rates of antiretroviral therapy (ART) use and virologic suppression among perinatally HIV-infected youth (PIY) and behaviorally HIV-infected youth (BIY) linked to care in the United States and examine the effects of demographic, biomedical, and psychosocial factors on those rates. Between 2009 and 2012, 649 PIY and 1547 BIY in 20 Adolescent Medicine Trials Network for HIV/AIDS Interventions sites completed cross-sectional surveys through audio computer-assisted self-interviews. Viral load data were collected from chart abstraction or blood draw. Overall 82.4% of PIY and 49.1% of BIY reported current ART use. Only 37.0% of PIY and 27.1% of BIY were virologically suppressed. Virologic suppression rates did not vary as a function of time since HIV diagnosis in either group. Consistent HIV care and no current substance abuse were significant correlates of ART use among PIY. These variables and non-African American race were some factors associated with virologic suppression for PIY [odds ratios (ORs) P ART use (ORs: P ART use ≥6 months, ≥90% ART adherence, and consistent HIV care (ORs: P youth reported unprotected sex in the past 3 months. There are continued challenges with successfully treating youth even once diagnosed and linked to HIV care. Strategies targeting barriers to ART access, use, and virologic suppression are needed to optimize the impact of the "Treatment as Prevention" paradigm among PIY and BIY.

  6. Prevalence of acute toxoplasmosis infection among 41,112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil

    Directory of Open Access Journals (Sweden)

    Ivana S Varella

    2009-03-01

    Full Text Available Untreated acute toxoplasmosis among pregnant women can lead to serious sequelae among newborns, including neurological impairment and blindness. In Brazil, the risk of congenital toxoplasmosis (CTox has not been fully evaluated. Our aim was to evaluate trends in acute toxoplasmosis prevalence from 1998-2005, the incidence of CTox and the rate of mother-to-child transmission (MTCT. A cross-sectional study was undertaken to dentify patients who fit the criteria for acute toxoplasmosis during pregnancy. Exposed newborns were included in a historical cohort, with a median follow-up time of 11 months, to establish definite diagnosis of CTox. Diagnoses for acute infection in pregnancy and CTox were based on European Research Network on Congenital Toxoplasmosis criteria. In 41,112 pregnant women, the prevalence of acute toxoplasmosis was 4.8/1,000 women. The birth prevalence of CTox was 0.6/1,000 newborns [95% confidence interval (CI: 0.4-0.9]. During the follow-up study, 12 additional cases were detected, increasing the CTox rate to 0.9/1,000 newborns (95% CI: 0.6-1.3. Among the 200 newborns exposed to Toxoplasma gondii,there were 37 babies presenting diagnostic criteria of CTox, leading to an MTCT rate of 18.5% (95% CI: 13.4-24.6%. The additional cases identified during follow-up reinforce the need for serological monitoring during the first year of life, even in the absence of evidence of congenital infection at birth.

  7. Prevalence of acute toxoplasmosis infection among 41,112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil.

    Science.gov (United States)

    Varella, Ivana S; Canti, Ivete C T; Santos, Breno R; Coppini, Angela Z; Argondizzo, Luciana C; Tonin, Carina; Wagner, Mário B

    2009-03-01

    Untreated acute toxoplasmosis among pregnant women can lead to serious sequelae among newborns, including neurological impairment and blindness. In Brazil, the risk of congenital toxoplasmosis (CTox) has not been fully evaluated. Our aim was to evaluate trends in acute toxoplasmosis prevalence from 1998-2005, the incidence of CTox and the rate of mother-to-child transmission (MTCT). A cross-sectional study was undertaken to dentify patients who fit the criteria for acute toxoplasmosis during pregnancy. Exposed newborns were included in a historical cohort, with a median follow-up time of 11 months, to establish definite diagnosis of CTox. Diagnoses for acute infection in pregnancy and CTox were based on European Research Network on Congenital Toxoplasmosis criteria. In 41,112 pregnant women, the prevalence of acute toxoplasmosis was 4.8/1,000 women. The birth prevalence of CTox was 0.6/1,000 newborns [95% confidence interval (CI): 0.4-0.9]. During the follow-up study, 12 additional cases were detected, increasing the CTox rate to 0.9/1,000 newborns (95% CI: 0.6-1.3). Among the 200 newborns exposed to Toxoplasma gondii,there were 37 babies presenting diagnostic criteria of CTox, leading to an MTCT rate of 18.5% (95% CI: 13.4-24.6%). The additional cases identified during follow-up reinforce the need for serological monitoring during the first year of life, even in the absence of evidence of congenital infection at birth.

  8. Association of State-Mandated Abstinence-only Sexuality Education with Rates of Adolescent HIV Infection and Teenage Pregnancy.

    Science.gov (United States)

    Elliot, L M; Booth, M M; Patterson, G; Althoff, M; Bush, C K; Dery, M A

    2017-01-01

    Abstinence-only sexuality education (AOSE); is required in the public school systems of many states, raising public health concerns and perpetuating health disparities through school systems. This study aimed to determine the correlations between state-mandated AOSE and the rates of adolescent HIV and teen pregnancy. Using publicly available data on all 50 United States' laws and policies on AOSE, states were ranked according to their level of abstinence emphasis on sexuality education (Level 0 - Level 3);. We calculated the relative proportion of Black students in public schools and the proportion of families below the federal poverty line then ranked them by state. We compared the states' ranks to the incidence of adolescent HIV and teen pregnancy in those states to identify associations between variables. The majority of states (~44 percent ); have legally mandated AOSE policies (Level 3); and adolescent HIV and teen pregnancy rates were highest in these Level 3 states. There were significant, positive correlations between HIV incidence rates of 13-19 year olds, HIV rates of 20-24 year olds, teen pregnancy rates, and AOSE level, with the proportion of the population that lives below the federal poverty level, and whether they attended schools that had a greater than 50 percent of an African American population. These data show a clear association between state sexuality education policies and adolescent HIV and teen pregnancy rates not previously demonstrated. Our data further show that states that have higher proportions of at-risk populations, with higher adolescent HIV and teen pregnancy rates, are more likely to also have restrictive AOSE policies. These populations may be more likely to attend public schools where AOSE is taught, increasing their risk for HIV and teen pregnancy. The World Health Organization considers fact-based Comprehensive Sexuality Education a human right, and the authors believe it is past time to end harmful, discriminatory sexuality

  9. Impact on malaria parasite multiplication rates in infected volunteers of the protein-in-adjuvant vaccine AMA1-C1/Alhydrogel+CPG 7909.

    Directory of Open Access Journals (Sweden)

    Christopher J A Duncan

    Full Text Available Inhibition of parasite growth is a major objective of blood-stage malaria vaccines. The in vitro assay of parasite growth inhibitory activity (GIA is widely used as a surrogate marker for malaria vaccine efficacy in the down-selection of candidate blood-stage vaccines. Here we report the first study to examine the relationship between in vivo Plasmodium falciparum growth rates and in vitro GIA in humans experimentally infected with blood-stage malaria.In this phase I/IIa open-label clinical trial five healthy malaria-naive volunteers were immunised with AMA1/C1-Alhydrogel+CPG 7909, and together with three unvaccinated controls were challenged by intravenous inoculation of P. falciparum infected erythrocytes.A significant correlation was observed between parasite multiplication rate in 48 hours (PMR and both vaccine-induced growth-inhibitory activity (Pearson r = -0.93 [95% CI: -1.0, -0.27] P = 0.02 and AMA1 antibody titres in the vaccine group (Pearson r = -0.93 [95% CI: -0.99, -0.25] P = 0.02. However immunisation failed to reduce overall mean PMR in the vaccine group in comparison to the controls (vaccinee 16 fold [95% CI: 12, 22], control 17 fold [CI: 0, 65] P = 0.70. Therefore no impact on pre-patent period was observed (vaccine group median 8.5 days [range 7.5-9], control group median 9 days [range 7-9].Despite the first observation in human experimental malaria infection of a significant association between vaccine-induced in vitro growth inhibitory activity and in vivo parasite multiplication rate, this did not translate into any observable clinically relevant vaccine effect in this small group of volunteers.ClinicalTrials.gov [NCT00984763].

  10. Ten-day Quadruple therapy comprising proton-pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a high eradication rate for Helicobacter pylori infection after failure of sequential therapy.

    Science.gov (United States)

    Hsu, Ping-I; Chen, Wen-Chi; Tsay, Feng-Woei; Shih, Chih-An; Kao, Sung-Shuo; Wang, Huay-Min; Yu, Hsien-Chung; Lai, Kwok-Hung; Tseng, Hui-Hwa; Peng, Nan-Jing; Chen, Angela; Kuo, Chao-Hung; Wu, Deng-Chyang

    2014-02-01

    Sequential therapy has been recommended in the Maastricht IV/Florence Consensus Report as the first-line treatment for Helicobacter pylori eradication in regions with high clarithromycin resistance. However, it fails in 5-24% of infected subjects, and the recommended levofloxacin-containing triple rescue therapy only achieves a 77% eradication rate after failure of sequential therapy. To investigate the efficacy of a novel quadruple therapy comprising proton-pump inhibitor, bismuth, tetracycline, and levofloxacin for rescue treatment of sequential therapy. This was a multicenter study in which H. pylori-infected patients who had failed sequential therapy received a 10-day quadruple therapy (esomeprazole (40 mg b.d), tripotassium dicitrato bismuthate (120 mg q.d.s.), tetracycline (500 mg q.d.s.), and levofloxacin (500 mg o.d.) for 10 days). H. pylori status was examined 6 weeks after the end of treatment. From July 2007 to June 2012, twenty-four subjects received 10-day quadruple therapy. The eradication rates according to intention-to-treat and per-protocol analyses were both 95.8% (23 of 24; 95% confidence interval, 87.8-103.8%). Adverse events were seen in 25.0% (6 of 24) of the patients. Drug compliance was 100.0% (24/24). The 10-day quadruple therapy comprising proton-pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a very high eradication rate for H. pylori infection after failure of sequential therapy. It is well tolerated and has great potential to become a good choice of rescue treatment following non-bismuth-containing quadruple therapy in regions with high clarithromycin resistance. © 2013 John Wiley & Sons Ltd.

  11. Impact on Malaria Parasite Multiplication Rates in Infected Volunteers of the Protein-in-Adjuvant Vaccine AMA1-C1/Alhydrogel+CPG 7909

    Science.gov (United States)

    Duncan, Christopher J. A.; Sheehy, Susanne H.; Ewer, Katie J.; Douglas, Alexander D.; Collins, Katharine A.; Halstead, Fenella D.; Elias, Sean C.; Lillie, Patrick J.; Rausch, Kelly; Aebig, Joan; Miura, Kazutoyo; Edwards, Nick J.; Poulton, Ian D.; Hunt-Cooke, Angela; Porter, David W.; Thompson, Fiona M.; Rowland, Ros; Draper, Simon J.; Gilbert, Sarah C.; Fay, Michael P.; Long, Carole A.; Zhu, Daming; Wu, Yimin; Martin, Laura B.; Anderson, Charles F.; Lawrie, Alison M.; Hill, Adrian V. S.; Ellis, Ruth D.

    2011-01-01

    Background Inhibition of parasite growth is a major objective of blood-stage malaria vaccines. The in vitro assay of parasite growth inhibitory activity (GIA) is widely used as a surrogate marker for malaria vaccine efficacy in the down-selection of candidate blood-stage vaccines. Here we report the first study to examine the relationship between in vivo Plasmodium falciparum growth rates and in vitro GIA in humans experimentally infected with blood-stage malaria. Methods In this phase I/IIa open-label clinical trial five healthy malaria-naive volunteers were immunised with AMA1/C1-Alhydrogel+CPG 7909, and together with three unvaccinated controls were challenged by intravenous inoculation of P. falciparum infected erythrocytes. Results A significant correlation was observed between parasite multiplication rate in 48 hours (PMR) and both vaccine-induced growth-inhibitory activity (Pearson r = −0.93 [95% CI: −1.0, −0.27] P = 0.02) and AMA1 antibody titres in the vaccine group (Pearson r = −0.93 [95% CI: −0.99, −0.25] P = 0.02). However immunisation failed to reduce overall mean PMR in the vaccine group in comparison to the controls (vaccinee 16 fold [95% CI: 12, 22], control 17 fold [CI: 0, 65] P = 0.70). Therefore no impact on pre-patent period was observed (vaccine group median 8.5 days [range 7.5–9], control group median 9 days [range 7–9]). Conclusions Despite the first observation in human experimental malaria infection of a significant association between vaccine-induced in vitro growth inhibitory activity and in vivo parasite multiplication rate, this did not translate into any observable clinically relevant vaccine effect in this small group of volunteers. Trial Registration ClinicalTrials.gov [NCT00984763] PMID:21799809

  12. Mapping the distribution of Anopheles funestus across Benin highlights a sharp contrast of susceptibility to insecticides and infection rate to Plasmodium between southern and northern populations.

    Science.gov (United States)

    Djouaka, Rousseau; Akoton, Romaric; Tchigossou, Genevieve M; Atoyebi, Seun M; Irving, Helen; Kusimo, Michael O; Djegbe, Innocent; Riveron, Jacob M; Tossou, Eric; Yessoufou, Akadiri; Wondji, Charles S

    2016-12-14

    Background. Malaria remains an important public health issue in Benin, with Anopheles gambiae s.l. and Anopheles funestus s.s being the predominant vectors. This study was designed to generate information on An. funestus distribution, molecular speciation, Plasmodium infection rate and insecticide susceptibility status across Benin. Methods. Mosquito samples were collected from December 2014 to January 2016 in 46 localities in Benin. These samples were mapped and An. funestus collected were speciated to the molecular level. Plasmodium infection rate was determined using a Taqman assay and susceptibility to insecticides was assessed using the WHO guidelines. The genotyping of the L119F- Gste2 mutation was also carried out.  Results.  An. funestus was found in 8 out of the 46 localities surveyed with a high presence in Tanongou (wet Sudanese ecological zone), Kpome, Doukonta and Pahou (sub-equatorial ecological zone). Molecular identifications revealed that only An. funestuss.s was present in southern Benin, whereas in Tanongou (northern Benin) An. funestus s.s. and An. leesoni were found in sympatry at proportions of 77.7% and 22.3% respectively. Plasmodium infection rate of An. funestus was higher in southern Benin at a range of 13 to 18% compared to 5.6% recorded in Tanongou. High DDT (8±0.5%) and permethrin (11±0.5%) resistance were observed in Doukonta, Kpome and Pahou, contrasting with relatively low resistance profiles: mortality-DDT=90±3.18% and mortality-permethrin=100% in Tanongou. Genotyping analysis revealed  high frequency  of the resistant 119F allele in the South (Kpome and Doukonta) compared to the North (Tanongou).  Discussion and Conclusion. The high presence of   An. funestus in the South compared to the North  could be due to favorable environmental and climatic conditions found in both regions. A significant Plasmodium infection rate was recorded across the country. A high resistance profile was recorded in the southern Benin; this

  13. Low rates of antibiotic resistance and infectious mortality in a cohort of high-risk hematology patients: A single center, retrospective analysis of blood stream infection.

    Directory of Open Access Journals (Sweden)

    Jason R Conn

    Full Text Available Febrile neutropenia (FN is a medical emergency and can represent a life-threatening complication for hematology patients treated with intensive chemotherapy regimens. In clinical practice, the diagnostic yield of blood cultures and other investigations which aim to identify a causative organism or site of infection is low. We have retrospectively examined all blood cultures collected in a "real world" cohort of patients receiving chemotherapy for acute leukemia and patients with aggressive lymphoma treated with Hyper-CVAD/MTX-cytarabine, at a single tertiary center over a five-year period. In this cohort, the 30-day mortality following confirmed blood stream infection (BSI was 5.9%, which is lower than most reports in the recent literature. We compared the blood culture results of inpatients undergoing induction chemotherapy and outpatients presenting with fevers and found a significantly higher rate of proven BSI in the outpatient group. In all settings, gram-negative organisms were most common. The rate of resistance to first-line empiric antibiotics among pathogenic isolates was 11.6% in the whole cohort, independent of blood culture circumstances. There was a trend to higher resistance rates among inpatients undergoing induction chemotherapy compared to patients presenting to the emergency department (17.4% vs 7.5% but this did not reach statistical significance. We also report low rates of ciprofloxacin resistance (5% of isolates, in a center where universal fluoroquinolone prophylaxis is not employed. Our low resistance and mortality rates support our current therapeutic strategies, however presence of resistant organisms across the spectrum of indications for BC collection highlights the importance of surveilling local patterns, escalating antimicrobial therapy in the deteriorating patient, and considering advanced techniques for the rapid identification of resistance in this patient population.

  14. Racial/ethnic differences in patterns of sexual risk behavior and rates of sexually transmitted infections among female young adults.

    Science.gov (United States)

    Pflieger, Jacqueline C; Cook, Emily C; Niccolai, Linda M; Connell, Christian M

    2013-05-01

    We examined patterns of sexual behavior and risk for sexually transmitted infections (STIs) in young adulthood for Black, Hispanic, and White females. We used a nationally representative sample of 7015 female young adults from wave III of the National Longitudinal Study of Adolescent Health. Sexual risk items assessed behaviors occurring in the previous 6 years and past year to determine classes of sexual risk and links to STIs in young adulthood. Latent class analysis revealed 3 sexual risk classes for Black and Hispanic youths and 4 sexual risk classes for White youths. The moderate and high risk classes had the highest probabilities of risky sexual partners, inconsistent condom use, and early age of sexual initiation, which significantly increased odds for STIs compared with recent abstainers. We found different classes of sexual behavior by race/ethnicity, with Black and Hispanic young women most at risk for STIs in young adulthood. Preventive efforts should target younger adolescents and focus on sexual partner behavior.

  15. Genotype x environmental interaction for mature size and rate of maturing for Angus, Brahman, and reciprocal-cross cows grazing bermudagrass or endophyte infected fescue.

    Science.gov (United States)

    Sandelin, B A; Brown, A H; Brown, M A; Johnson, Z B; Kellogg, D W; Stelzleni, A M

    2002-12-01

    Mature weight and rate of maturing were estimated in 177 Angus, Brahman, and reciprocal-cross cows grazing bermudagrass or endophyte-infected tall fescue over a 4-yr period to evaluate genotype x environment interactions. Data were collected every 28 d until cows were approximately 18 mo of age and then at prebreeding, postcalving, and weaning of calf. All cows with weight data to at least 42 mo of age were included in the analysis. Mature weight and rate of maturing were estimated using the three-parameter growth curve model described by Brody (1945). Data were pooled over year and analyzed by the general linear model procedure of SAS. Included in the models for mature weight and rate of maturing were the independent variables of genotype, environment, and genotype x environment interaction. There was a genotype x environment interaction (P pastures had greater (P < 0.01) mean mature BW than Angus x Brahman cows grazing bermudagrass (611 +/- 17 vs 546 +/- 16 kg). Angus x Brahman cows grazing bermudagrass had lower (P < 0.05) mean mature BW than Brahman x Angus cows grazing bermudagrass or endophyte-infected fescue and Brahman cows grazing bermudagrass (546 +/- 16 vs 624 +/- 19, 614 +/- 22 and 598 +/- 20 kg, respectively). Brahman cows grazing endophyte-infected fescue had smaller (P < 0.05) mean mature BW than all genotype x forage combinations except for Angus x Brahman cows grazing bermudagrass. Angus cows had a smaller (P < 0.05) mean rate of maturing than Angus x Brahman and Brahman x Angus cows (0.039 +/- 0.002 vs 0.054 +/- 0.002 and 0.049 +/- 0.002%/mo, respectively), respectively, and Angus x Brahman cows had a larger (P < 0.05) mean rate of maturing than Brahman x Angus and Brahman cows (0.054 +/- 0.002 vs 0.049 +/- 0.002 and 0.041 +/- 0.002 %/mo, respectively). There was a direct breed x forage interaction (P < 0.05) for mature BW. These data suggest that the choice of breed type is important in maintaining a crossbreeding program, in that mature BW and

  16. A Novel Stool PCR Test for Helicobacter pylori May Predict Clarithromycin Resistance and Eradication of Infection at a High Rate.

    Science.gov (United States)

    Beckman, Erin; Saracino, Ilaria; Fiorini, Giulia; Clark, Courtney; Slepnev, Vladimir; Patel, Denise; Gomez, Clarissa; Ponaka, Reddy; Elagin, Vecheslav; Vaira, Dino

    2017-08-01

    Clarithromycin-based regimens are commonly used as a first-line therapy for Helicobacter pylori-positive patients; however, resistance to clarithromycin has led to treatment failures. The aim of this study was to evaluate the feasibility of using stool samples to detect the presence of H. pylori DNA while concurrently detecting mutations associated with resistance to clarithromycin. For this purpose, total DNA was extracted from 294 raw stool specimens from H. pylori-positive and -negative patients. TaqMan real-time PCR amplification was used to detect the presence of H. pylori as well as to predict the phenotype of the organism and the related outcome for patients treated with clarithromycin. Clarithromycin resistance was determined upon analysis of the PCR result. Patients were also tested by a urea breath test and were subjected to esophagogastroduodenoscopy, followed by histology, culture, and a rapid urease test, in order to obtain a consensus patient infection status. Of 294 total stool samples, 227 were deemed true positive. The sensitivity of H. pylori detection by PCR was 93.8%. Of 213 true-positive samples that were sequenced, 36.2% showed point mutations associated with clarithromycin resistance (A2142C, A2142G, A2143G). The final correlation of the mutant genotypes as determined by sequencing with the eradication of infection was 86%. We found that Helicobacter pylori DNA can be detected in human stool specimens with high sensitivity and can therefore be used to determine the presence of the bacterium without obtaining a biopsy sample. Moreover, genotypic resistance to clarithromycin can be predicted without obtaining a biopsy sample, facilitating the choice of the right therapeutic approach. Copyright © 2017 American Society for Microbiology.

  17. High Rates of Baseline Drug Resistance and Virologic Failure Among ART-naive HIV-infected Children in Mali.

    Science.gov (United States)

    Crowell, Claudia S; Maiga, Almoustapha I; Sylla, Mariam; Taiwo, Babafemi; Kone, Niaboula; Oron, Assaf P; Murphy, Robert L; Marcelin, Anne-Geneviève; Traore, Ban; Fofana, Djeneba B; Peytavin, Gilles; Chadwick, Ellen G

    2017-11-01

    Limited data exist on drug resistance and antiretroviral treatment (ART) outcomes in HIV-1-infected children in West Africa. We determined the prevalence of baseline resistance and correlates of virologic failure (VF) in a cohort of ART-naive HIV-1-infected children Reverse transcriptase and protease genes were sequenced at baseline (before ART) and at 6 months. Resistance was defined according to the Stanford HIV Genotypic Resistance database. VF was defined as viral load ≥1000 copies/mL after 6 months of ART. Logistic regression was used to evaluate factors associated with VF or death >1 month after enrollment. Post hoc, antiretroviral concentrations were assayed on baseline samples of participants with baseline resistance. One-hundred twenty children with a median age 2.6 years (interquartile range: 1.6-5.0) were included. Eighty-eight percent reported no prevention of mother-to-child transmission exposure. At baseline, 27 (23%), 4 (3%) and none had non-nucleoside reverse transcriptase inhibitor (NNRTI), nucleoside reverse transcriptase inhibitor or protease inhibitor resistance, respectively. Thirty-nine (33%) developed VF and 4 died >1 month post-ART initiation. In multivariable analyses, poor adherence [odds ratio (OR): 6.1, P = 0.001], baseline NNRTI resistance among children receiving NNRTI-based ART (OR: 22.9, P < 0.001) and protease inhibitor-based ART initiation among children without baseline NNRTI resistance (OR: 5.8, P = 0.018) were significantly associated with VF/death. Ten (38%) with baseline resistance had detectable levels of nevirapine or efavirenz at baseline; 7 were currently breastfeeding, but only 2 reported maternal antiretroviral use. Baseline NNRTI resistance was common in children without reported NNRTI exposure and was associated with increased risk of treatment failure. Detectable NNRTI concentrations were present despite few reports of maternal/infant antiretroviral use.

  18. Regional differences in treatment rates for patients with chronic hepatitis C infection: Systematic review and meta-analysis.

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    Philip Vutien

    Full Text Available Treatment rates with interferon-based therapies for chronic hepatitis C have been low. Our aim was to perform a systematic review of available data to estimate the rates and barriers for antiviral therapy for chronic hepatitis C.We conducted a systematic review and meta-analysis searching MEDLINE, SCOPUS through March 2016 and abstracts from recent major liver meetings for primary literature with available hepatitis C treatment rates. Random-effects models were used to estimate effect sizes and meta-regression to test for potential sources of heterogeneity.We included 39 studies with 476,443 chronic hepatitis C patients. The overall treatment rate was 25.5% (CI: 21.1-30.5% and by region 34% for Europe, 28.3% for Asia/Pacific, and 18.7% for North America (p = 0.008. On multivariable meta-regression, practice setting (tertiary vs. population-based, p = 0.04, region (Europe vs. North America p = 0.004, and data source (clinical chart review vs. administrative database, p = 0.025 remained significant predictors of heterogeneity. The overall treatment eligibility rate was 52.5%, and 60% of these received therapy. Of the patients who refused treatment, 16.2% cited side effects, 13.8% cited cost as reasons for treatment refusal, and 30% lacked access to specialist care.Only one-quarter of chronic hepatitis C patients received antiviral therapy in the pre-direct acting antiviral era. Treatment rates should improve in the new interferon-free era but, cost, co-morbidities, and lack of specialist care will likely remain and need to be addressed. Linkage to care should even be of higher priority now that well-tolerated cure is available.

  19. The Effect of Removing Potentially Infectious Dogs on the Numbers of Canine Leishmania infantum Infections in an Endemic Area with High Transmission Rates

    Science.gov (United States)

    Grimaldi, Gabriel; Teva, Antonio; Santos, Claudiney B.; Ferreira, Adelson L.; Falqueto, Aloísio

    2012-01-01

    To assess the effect of the rapid removal of potentially infectious dogs on the prevalence and incidence of canine infections, a prospective study was undertaken in an area endemic for Leishmania infantum. We used serological testing based on the rapid DPP rK28 fusion protein chromatographic immunoassay for this dog screening-and-culling intervention trial. The outcome was evaluated by measuring seropositivity and sero-conversion/-reversion rates for canine infection. Our estimates indicated that concomitant detection and elimination of seropositive dogs with active disease may affect the numbers of canine infections and disease burden temporarily, although it is insufficient as a measure to interrupt the zoonotic L. infantum transmission. However, most of the asymptomatic, seropositive dogs continuously exhibit low levels of antibodies and/or reverted, remaining seronegative thereafter. In the process of waiting for an effective vaccine, one option for canine reservoir control may be to identify these possibly genetically resistant animals and promote their expansion in the population. PMID:22665602

  20. Development of conventional and real-time multiplex PCR-based assays for estimation of natural infection rates and Trypanosoma cruzi load in triatomine vectors.

    Science.gov (United States)

    Moreira, Otacilio C; Verly, Thaiane; Finamore-Araujo, Paula; Gomes, Suzete A O; Lopes, Catarina M; de Sousa, Danielle M; Azevedo, Lívia R; da Mota, Fabio F; d'Avila-Levy, Claudia M; Santos-Mallet, Jacenir R; Britto, Constança

    2017-08-29

    Chagas disease is a complex anthropozoonosis with distinct domestic and sylvatic mammal species acting as potential reservoirs. The diversity of vector species and their habitats are among the factors that hinder the control of the disease. Control programs periodically monitor the prevalence of T. cruzi infection in insect bugs through microscopical observation of diluted feces. However, microscopy presents limited sensitivity in samples with low parasite numbers, difficulties in examining all evolutionary stages of the insect and may in turn be limited to differentiate T. cruzi from other morphologically similar trypanosomatids. Here, we report two highly sensitive and accurate methodologies to infer T. cruzi infection rates and to quantify parasite load in the gut of field-collected triatomines. Triatomines were manually collected in the period 2011-2012 and 2014-2015, in domestic, peridomestic or sylvatic habitats in rural areas of 26 municipalities, encompassing three distinct Brazilian biomes: Caatinga, Cerrado and Atlantic Rainforest. Following morphological and taxonomical identification, the search for flagellated protozoa was performed by optical microscopy. A conventional PCR targeting T. cruzi kDNA and a TaqMan qPCR directed to the parasite nuclear satellite DNA (SAT) were developed, both in multiplex, with the triatomine 12S subunit ribosomal RNA gene, used as internal amplification control. Both methods were used for detection (kDNA-PCR) and parasite load quantification (SAT-DNA-qPCR), to investigate T. cruzi infection in captured triatomines. The combined methods were assayed on a panel of 205 field-collected triatomine samples. Diagnostic analysis revealed 21% positivity for the kDNA-PCR, whereas microscopic examination enabled identification of T. cruzi in only 7.0% of the PCR-positive samples. Negative PCR results were confirmed by the absence of T. cruzi flagellates using microscopy. Caatinga biome yielded the highest T. cruzi infection rate (60

  1. Absence of dry season Plasmodium parasitaemia, but high rates of reported acute respiratory infection and diarrhoea in preschool-aged children in Kaédi, southern Mauritania

    Directory of Open Access Journals (Sweden)

    Touray Sunkaru

    2012-09-01

    Full Text Available Abstract Background The epidemiology of malaria in the Senegal River Gorgol valley, southern Mauritania, requires particular attention in the face of ongoing and predicted environmental and climate changes. While “malaria cases” are reported in health facilities throughout the year, past and current climatic and ecological conditions do not favour transmission in the dry season (lack of rainfall and very high temperatures. Moreover, entomological investigations in neighbouring regions point to an absence of malaria transmission in mosquito vectors in the dry season. Because the clinical signs of malaria are non-specific and overlap with those of other diseases (e.g. acute respiratory infections and diarrhoea, new research is needed to better understand malaria transmission patterns in this region to improve adaptive, preventive and curative measures. Methods We conducted a multipurpose cross-sectional survey in the city of Kaédi in April 2011 (dry season, assessing three major disease patterns, including malaria. Plasmodium spp. parasite rates were tested among children aged 6–59 months who were recruited from a random selection of households using a rapid diagnostic test and microscopic examination of Giemsa-stained thick and thin blood films. Acute respiratory infection and diarrhoea were the two other diseases investigated, administering a parental questionnaire to determine the reported prevalence among participating children. Findings No Plasmodium infection was found in any of the 371 surveyed preschool-aged children using two different diagnostic methods. Acute respiratory infections and diarrhoea were reported in 43.4% and 35.0% of the participants, respectively. About two thirds of the children with acute respiratory infections and diarrhoea required medical follow-up by a health worker. Conclusions Malaria was absent in the present dry season survey in the capital of the Gorgol valley of Mauritania, while acute respiratory

  2. High rates of Leishmania infantum and Trypanosoma nabiasi infection in wild rabbits (Oryctolagus cuniculus) in sympatric and syntrophic conditions in an endemic canine leishmaniasis area: epidemiological consequences.

    Science.gov (United States)

    Díaz-Sáez, V; Merino-Espinosa, G; Morales-Yuste, M; Corpas-López, V; Pratlong, F; Morillas-Márquez, F; Martín-Sánchez, J

    2014-05-28

    Leishmania infantum infection has been reported in various host species, both domestic and wild, in some cases with high prevalence rates. However, until the recent discovery of infected hares, no studies had provided clear evidence of any significant reservoir other than domestic dogs. Our focus was on another lagomorph, Oryctolagus cuniculus or wild rabbit. This species is native to the Iberian Peninsula and its presence and abundance gave rise to the name of Spain. In an endemic area for canine leishmaniasis in the southeast of Spain, 150 rabbits were captured over a period of three years. Samples of blood, bone marrow, liver, spleen, heart and skin were taken and analysed through parasitological, serological and molecular techniques in order to detect Leishmania and Trypanosoma. 20.7% of the rabbits were infected with L. infantum and 82.4% with Trypanosoma nabiasi, and 14.8% of mixed infections were detected. Both parasites were found in all the animal organs analysed, a factor which, along with the presence of serological cross-reactions, must be taken into account in epidemiological studies on leishmaniasis. O. cuniculus is an abundant and gregarious species, with a long enough average lifespan to ensure L. infantum transmission. The presence of the parasite in the skin and blood of these rabbits with no acute manifestation of disease ensures its contact with the vector, which finds in their warrens a suitable biotope to inhabit. The rabbit therefore seems to meet the most of conditions for being considered a reservoir host of L. infantum. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Detecting Mutations in the Mycobacterium tuberculosis Pyrazinamidase Gene pncA to Improve Infection Control and Decrease Drug Resistance Rates in Human Immunodeficiency Virus Coinfection

    Science.gov (United States)

    Dudley, Matthew Z.; Sheen, Patricia; Gilman, Robert H.; Ticona, Eduardo; Friedland, Jon S.; Kirwan, Daniela E.; Caviedes, Luz; Rodriguez, Richard; Cabrera, Lilia Z.; Coronel, Jorge; Grandjean, Louis; Moore, David A. J.; Evans, Carlton A.; Huaroto, Luz; Chávez-Pérez, Víctor; Zimic, Mirko

    2016-01-01

    Hospital infection control measures are crucial to tuberculosis (TB) control strategies within settings caring for human immunodeficiency virus (HIV)–positive patients, as these patients are at heightened risk of developing TB. Pyrazinamide (PZA) is a potent drug that effectively sterilizes persistent Mycobacterium tuberculosis bacilli. However, PZA resistance associated with mutations in the nicotinamidase/pyrazinamidase coding gene, pncA, is increasing. A total of 794 patient isolates obtained from four sites in Lima, Peru, underwent spoligotyping and drug resistance testing. In one of these sites, the HIV unit of Hospital Dos de Mayo (HDM), an isolation ward for HIV/TB coinfected patients opened during the study as an infection control intervention: circulating genotypes and drug resistance pre- and postintervention were compared. All other sites cared for HIV-negative outpatients: genotypes and drug resistance rates from these sites were compared with those from HDM. HDM patients showed high concordance between multidrug resistance, PZA resistance according to the Wayne method, the two most common genotypes (spoligotype international type [SIT] 42 of the Latino American-Mediterranean (LAM)-9 clade and SIT 53 of the T1 clade), and the two most common pncA mutations (G145A and A403C). These associations were absent among community isolates. The infection control intervention was associated with 58–92% reductions in TB caused by SIT 42 or SIT 53 genotypes (odds ratio [OR] = 0.420, P = 0.003); multidrug-resistant TB (OR = 0.349, P < 0.001); and PZA-resistant TB (OR = 0.076, P < 0.001). In conclusion, pncA mutation typing, with resistance testing and spoligotyping, was useful in identifying a nosocomial TB outbreak and demonstrating its resolution after implementation of infection control measures. PMID:27928075

  4. Influence of prolonged use of intravenous administration sets in paediatric cancer patients on CVAD-related bloodstream infection rates and hospital resources.

    Science.gov (United States)

    Simon, A; Fleischhack, G; Wiszniewsky, G; Hasan, C; Bode, U; Kramer, M H

    2006-10-01

    To assess the effects of extending the routine intravenous administration set (IVAS) change-interval from 72 h (group 1) to 7 days (group 2) on the incidence density for central venous access device (CVAD)-related bloodstream infections (BSIs) and on resource expenditures in a singlecentre pilot study. Prospective pre-/post-intervention comparison of two consecutive 12-month surveillance periods (2001-2003) in a 17-bed paediatric oncology tertiary care unit. IVAS changes and nosocomial infections (NIs) were prospectively analysed using a standardized unit-based surveillance system (Oncopaed NI). All 175 eligible patients were enrolled, 96 in group 1 and 79 in group 2. Both groups had similar distributions of primary diagnoses and risk factors. The proportion of IVAS changes performed after 3 days increased from 5.6% to 22.5%, but only 8% of IVASs in group 2 were changed after 7 days. Most IVAS changes (64.8% in group 1 and 92.9% in group 2) were done because of therapeutic interventions (blood products, parenteral nutrition [TNP]) before the scheduled endpoint. Overall, the rates and incidence densities of NIs were significantly lower during the second period. The corresponding results for CVAD-related BSIs did not show significant differences. No death attributable to a NI occurred. The '7-day' strategy resulted in cost savings for devices (3,300 dollars/year) and of nursing time (23 working days/year). Extending the routine IVAS change-interval from 3 days to 7 days appears to be safe and cost-effective in a paediatric oncology unit with high infection control standards and continuous surveillance for NIs. These results do not prove that 7-day intervals prevent infections, but they do suggest that this policy probably is not harmful and that a prospectively randomized study with sufficient power is needed.

  5. Nanoporous silica coatings as a drug delivery system for ciprofloxacin: outcome of variable release rates in the infected middle ear of rabbits.

    Science.gov (United States)

    Hesse, Daniela; Ehlert, Nina; Lüenhop, Tammo; Smoczek, Anna; Glage, Silke; Behrens, Peter; Müller, Peter Paul; Esser, Karl-Heinz; Lenarz, Thomas; Stieve, Martin; Bleich, André; Prenzler, Nils Kristian

    2013-08-01

    The present study was performed to examine the impact of the release rate of ciprofloxacin from prostheses coated with nanoporous silica layers on the outcome of an acute bacterial infection of the middle ear of rabbits. Middle ear prostheses are often implanted in an infectious environment because of chronic otitis media and cholesteatoma. Bacterial colonization leads to healing disorders after surgery and may lead to the extrusion of the implants. Nanoporous silica layers appear promising as a drug delivery system for antibiotics placed on implants. Before clinical applications can be envisioned, it is necessary to find an optimal release rate. White New Zealand rabbits were provided unilaterally with either a "slow release" or a "burst release" ciprofloxacin-containing middle ear Bioverit II prosthesis. After implantation, the middle ears were infected with a solution of Pseudomonas aeruginosa. Afterwards, animals were monitored clinically and, after 3 months, sacrificed to perform necropsy and microbiologic examinations. In the "slow release" group, 7 of 12 animals had to be euthanized preterm because of their poor clinical condition compared with 2 of 12 animals of the "burst release" group (p rabbit.

  6. Correlation between Positive Rate and Number of Biopsy Samples on Urease Test in Childhood Helicobacter pylori Infection

    Science.gov (United States)

    Seo, Ji-Hyun; Park, Ji Sook; Yeom, Jung Sook; Lim, Jae-Young; Park, Chan-Hoo; Woo, Hyang-Ok; Baik, Seung-Chul; Lee, Woo-Kon; Cho, Myung-Je; Rhee, Kwang-Ho

    2014-01-01

    To identify the correlation between the number of gastric biopsy samples and the positive rate, we compared the results of urease test using one and three biopsy samples from each 255 children who underwent gastroduodenoscopy at Gyeongsang National University Hospital. The children were divided into three age groups: 0-4, 5-9, and 10-15 yr. The gastric endoscopic biopsies were subjected to the urease test. That is, one and three gastric antral biopsy samples were collected from the same child. The results of urease test were classified into three grades: Grade 0 (no change), 1 (6-24 hr), 2 (1-6 hr), and 3 (<1 hr). The positive rate of urease test was increased by the age with no respect to the number of gastric biopsy samples (one biopsy P = 0.001, three biopsy P < 0.001). The positive rate of the urease test was higher on three biopsy samples as compared with one biopsy sample (P < 0.001). The difference between one and three biopsy samples was higher in the children aged 0-9 yr. Our results indicate that the urease test might be a more accurate diagnostic modality when it is performed on three or more biopsy samples in children. PMID:24431913

  7. The lowest X4 Geno2Pheno false-positive rate is associated with greater CD4 depletion in HIV-1 infected patients.

    Science.gov (United States)

    Santoro, M M; Armenia, D; Fabeni, L; Santoro, M; Gori, C; Forbici, F; Svicher, V; Bertoli, A; Dori, L; Surdo, M; Balestra, E; Palamara, G; Girardi, E; Angarano, G; Andreoni, M; Narciso, P; Antinori, A; Ceccherini-Silberstein, F; Perno, C F

    2012-08-01

    Through this study we evaluated whether the HIV-1 tropism determined by genotypic analysis correlates with HIV-1 markers, such as CD4 cell count and plasma HIV-RNA. The analysis was performed on 1221 HIV-1 B-subtype infected patients with an available V3 sequence (all maraviroc naive). Of them, 532 were antiretroviral therapy (ART) naive and 689 ART experienced. Tropism determination was performed by using the geno2pheno (co-receptor) algorithm set at a false-positive rate (FPR) of 10% and 2%. Potential associations of FPR with CD4 cell count and viraemia were evaluated. Association of V3 mutations with genotypic-determined tropism was also evaluated according to different FPR ranges. About 26% of patients (either ART naive or ART experienced) were infected by X4-tropic viruses (using the classical 10% FPR cut-off). However, a significantly lower proportion of ART-naive patients had FPR ≤ 2% in comparison with ART-experienced patients (4.9% vs. 12.6%, respectively, p HIV-1 infection (with CD4 cell count ≤ 200 cells/mm(3)) was significantly greater in X4-infected patients, either ART-naive (OR (95% CI)), 4.2 (1.8-9.2); p 0.0006) or ART-experienced (2.3 (1.4-3.6); p 0.0003), with FPR set at 2% (but not at 10%). This finding was confirmed by multivariable logistic analysis. No relationship was found between viraemia and FPR ≤2%. Some X4-related mutations were significantly associated with FPR ≤2% (ART-naive patients, S11R, Y21V, G24K and G24R, p ≤0.001; ART-experienced patients, Y7K, S11R, H13Y, p ≤0.002). In conclusion, these findings show that within the context of genotypically-assessed CXCR4 tropism, FPR ≤2% defines (far better than 10%-FPR) a viral population associated with low CD4 rank, with potentially greater cytopathic effect, and with more advanced disease. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  8. Violation of prophylactic vancomycin administration timing is a potential risk factor for rate of surgical site infections in cardiac surgery patients: a prospective cohort study.

    Science.gov (United States)

    Cotogni, Paolo; Barbero, Cristina; Passera, Roberto; Fossati, Lucina; Olivero, Giorgio; Rinaldi, Mauro

    2017-03-08

    Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections (SSIs) due to increasing length of stay (LOS), costs and mortality. The antimicrobial prophylaxis is one of the most important tools in the prevention of SSIs. The objective of this study was to investigate the relationship between the timing of antimicrobial prophylaxis administration and the rate of SSIs. A prospective cohort study was carried out over 1-year period in all consecutive adult patients undergoing elective cardiac surgery. The population was stratified in patients whose antimicrobial prophylaxis administration violated or not the vancomycin timing protocol (i.e., when the first skin incision was performed before the end of vancomycin infusion). To compare SSI rates, the cohort was further stratified in patients at low and high risk of developing SSIs. Over the study period, 1020 consecutive adult patients underwent cardiac surgery and according to study inclusion criteria, 741 patients were prospectively enrolled. A total of 60 SSIs were identified for an overall infection rate of 8.1%. Vancomycin prophylaxis timing protocol was violated in 305 (41%) out of 741 enrolled patients. SSIs were observed in 3% of patients without violation of the antimicrobial prophylaxis protocol (13/436) compared with 15.4% of patients with a violation of the timing protocol (47/305) (P violation had a higher occurrence of SSIs (P = 0.004) and mortality (P = 0.03) versus patients at low risk without protocol violation. Similarly, patients at high risk with protocol violation had a higher occurrence of SSIs (P violation. The logistic regression analysis showed that internal mammary artery use (P = 0.025), surgical time (P violation (P violation (P violation of the timing of prophylactic vancomycin administration significantly increased the probability of SSIs and mortality from infectious cause in cardiac surgery patients.

  9. Effect of Influenza Vaccination of Children on Infection Rate in Hutterite Communities: Follow-Up Study of a Randomized Trial.

    Directory of Open Access Journals (Sweden)

    Biao Wang

    Full Text Available An earlier cluster randomized controlled trial (RCT of Hutterite colonies had shown that if more than 80% of children and adolescents were immunized with influenza vaccine there was a statistically significant reduction in laboratory-confirmed influenza among all unimmunized community members. We assessed the impact of this intervention for two additional influenza seasonal periods.Follow-up data for two influenza seasonal periods of a cluster randomized trial involving 1053 Canadian children and adolescents aged 36 months to 15 years in Season 2 and 1014 in Season 3 who received the study vaccine, and 2805 community members in Season 2 and 2840 in Season 3 who did not receive the study vaccine. Follow-up for Season 2 began November 18, 2009 and ended April 25, 2010 while Season 3 extended from December 6, 2010 and ended May 27, 2011. Children were randomly assigned in a blinded manner according to community membership to receive either inactivated trivalent influenza vaccine or hepatitis A. The primary outcome was confirmed influenza A and B infection using RT-PCR assay. Due to the outbreak of 2009 H1N1 pandemic, data in Season 2 were excluded for analysis.For an analysis of the combined Season 1 and Season 3 data, among non-recipients (i.e., participants who did not receive study vaccines, 66 of the 2794 (2.4% participants in the influenza vaccine colonies and 121 of the 2301 (5.3% participants in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 60% (95% CI, 6% to 83%; P = 0.04; among all study participants (i.e., including both those who received study vaccine and those who did not, 125 of the 3806 (3.3% in the influenza vaccine colonies and 239 of the 3243 (7.4% in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 63% (95% CI, 5% to 85%; P = 0.04.Immunizing children and adolescents with inactivated influenza vaccine can offer a protective effect among

  10. 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.

  11. Measuring the Rate of Conjugal Plasmid Transfer and Phage Infection in a Bacterial Population Using Quantitative PCR

    Science.gov (United States)

    Wan, Zhenmao; Goddard, Noel

    2012-02-01

    Horizontal gene transfer between species is an important mechanism for bacterial genome evolution. In Escherichia coli, conjugation is the transfer from a donor(F^+) to a recipient(F^-) cell through cell-to-cell contact. We demonstrate a novel qPCR method for quantifying the transfer kinetics of the F plasmid in a population by enumerating the relative abundance of genetic loci unique to the plasmid and the chromosome. This approach allows us to query the plasmid transfer rate without the need for selective culturing with unprecedented single locus resolution. It also allows us to investigate the inhibition of conjugation in the presence of filamentous bacteriophages M13. Experimental data is then compared with numerical simulation using a mass action, resource limited model.

  12. Azadirachta indica extract-artesunic acid combination produces an increased cure rate of Plasmodium berghei-infected mice.

    Science.gov (United States)

    Anagu, Onyeka Linda; Attama, Anthony Amaechi; Okore, Vincent Chima; Gugu, Harrison Thaddeus; Ngene, Augustine Arinze; Esimone, Charles Okechukwu

    2014-07-01

    Available artemisinin-combination therapies (ACTs) are expensive. Various traditional herbal remedies for malaria involve plants, proven scientifically to have antiplasmodial effects, e.g., Azadirachta indica A. Juss. (Meliaceae). Combination of an artemisinin-based compound and a medicinal herb extract will provide an indigenous alternative/herb-based ACT. The in vivo schizontocidal activity of the crude aqueous extract of 100, 500, and 1000 mg/kg of A. indica fresh leaves (NCE) and 6, 15, and 20 mg/kg of artesunic acid were determined, alone and in combination, while keeping the dose of artesunic acid constant at 15 mg/kg, using the Peter's 4-day suppressive test and Swiss albino mice. The ED50 was calculated from the dose-response relationships. Percentage survival and cure were also determined. The average yield of two extractions of NCE was 8.33 ± 1.67%. Combination of 1000 mg/kg of NCE and 15 mg/kg of artesunic acid, produced a significant reduction of parasitemia (96.87%), compared to 20 mg/kg of artesunic acid alone (68.14%). The combination had an ED50 of 0.58 mg/kg while that of artesunic acid alone was 8.814 mg/kg. The combinations of NCE with artesunic acid produced a cure, although the artesunic acid did not produce a cure in 30 d. NCE increased the activity of artesunic acid in terms of reduction in parasitemia, and increased survival time and cure rate. The combination of an artemisinin and aqueous extract of neem leaf is possible, providing a potentiated reduction of parasitemia, and increased cure rate.

  13. The effect of triclosan coated sutures on rate of surgical site infection after hip and knee replacement: a protocol for a double-blind randomised controlled trial.

    Science.gov (United States)

    Sprowson, Andrew P; Jensen, Cyrus D; Parsons, Nick; Partington, Paul; Emmerson, Kevin; Carluke, Ian; Asaad, Seif; Pratt, Roland; Muller, Scott; Reed, Mike R

    2014-07-14

    187,000 hip and knee joint replacements are performed every year in the National Health Service (NHS). One of the commonest complications is surgical site infection (SSI), and this represents a significant burden in terms of patient morbidity, mortality and cost to health services around the world. The aim of this randomised controlled trial (RCT) is to determine if the addition of triclosan coated sutures to a standard regimen can reduce the rate of SSI after total knee replacement (TKR) and total hip replacement (THR). 2400 patients due to undergo a total hip or knee replacement are being recruited into this two-centre RCT. Participants are recruited before surgery and randomised to either standard care or intervention group. Participants, outcome assessors and statistician are blind to treatment allocation throughout the study. The intervention consists of triclosan coated sutures vs. standard non-coated sutures. The primary outcome is the Health protection Agency (HPA) defined superficial surgical site infection at 30 days. Secondary outcomes include HPA defined deep surgical site infection at 12 months, length of hospital stay, critical care stay, and payer costs. To date there are no orthopaedic randomised controlled trials on this scale assessing the effectiveness of a surgical intervention, particularly those that can be translated across the surgical specialities. The results from this trial will inform evidence-based recommendations for suture selection in the management of patients undergoing total hip or knee replacement. If triclosan coated sutures are found to be an effective intervention, implementation into clinical practice could improve long-term outcomes for patients undergoing hip and knee replacement. Current Controlled Trials ISRCTN 17807356.

  14. Abundance of the Quorum-Sensing Factor Ax21 in Four Strains of Stenotrophomonas maltophilia Correlates with Mortality Rate in a New Zebrafish Model of Infection.

    Directory of Open Access Journals (Sweden)

    Mario Ferrer-Navarro

    Full Text Available Stenotrophomonas maltophilia is a Gram-negative pathogen with emerging nosocomial incidence. Little is known about its pathogenesis and the genomic diversity exhibited by clinical isolates complicates the study of pathogenicity and virulence factors. Here, we present a strategy to identify such factors in new clinical isolates of S. maltophilia, incorporating an adult-zebrafish model of S. maltophilia infection to evaluate relative virulence coupled to 2D difference gel electrophoresis to explore underlying differences in protein expression. In this study we report upon three recent clinical isolates and use the collection strain ATCC13637 as a reference. The adult-zebrafish model shows discrimination capacity, i.e. from very low to very high mortality rates, with clinical symptoms very similar to those observed in natural S. maltophilia infections in fish. Strain virulence correlates with resistance to human serum, in agreement with previous studies in mouse and rat and therefore supporting zebrafish as a replacement model. Despite its clinical origin, the collection strain ATCC13637 showed obvious signs of attenuation in zebrafish, with null mortality. Multilocus-sequence-typing analysis revealed that the most virulent strains, UV74 and M30, exhibit the strongest genetic similitude. Differential proteomic analysis led to the identification of 38 proteins with significantly different abundance in the three clinical strains relative to the reference strain. Orthologs of several of these proteins have been already reported to have a role in pathogenesis, virulence or resistance mechanisms thus supporting our strategy. Proof of concept is further provided by protein Ax21, whose abundance is shown here to be directly proportional to mortality in the zebrafish infection model. Indeed, recent studies have demonstrated that this protein is a quorum-sensing-related virulence factor.

  15. Comparison of surgical site infection rates in clean and clean-contaminated wounds in dogs and cats after minimally invasive versus open surgery: 179 cases (2007-2008).

    Science.gov (United States)

    Mayhew, Philipp D; Freeman, Lynetta; Kwan, Toni; Brown, Dorothy C

    2012-01-15

    To report and compare the surgical site infection (SSI) rates for clean and clean-contaminated procedures performed by either a minimally invasive surgical or open surgical approach in a large population of dogs and cats. Prospective case series. 179 patients (dogs and cats) undergoing minimally invasive abdominal or thoracic surgery. Case information from all animals that underwent minimally invasive abdominal or thoracic surgery was prospectively collected and compared with an existing database of the same information collected from 379 patients undergoing laparotomy or thoracotomy via an open surgical approach. For both groups, an SSI was defined as any surgical wound in which purulent discharge was observed within 14 days after the procedure. Follow-up for all patients was obtained by direct examination or telephone interviews. Overall SSI rate in the minimally invasive surgery (MIS) group was 1.7% and in the open surgery (OS) group was 5.5%. On univariate analysis, there was a significantly lower SSI rate in the MIS group, compared with the SSI rate for the OS group. On multivariable logistic regression analysis, this difference appeared to be a result of the fact that surgery times were longer (median, 105 vs 75 minutes) and hair was clipped ≥ 4 hours prior to surgery for more animals (23% vs 11 %) in the OS group, compared with the MIS group. MIS may be associated with a lower SSI rate, compared with OS, but confounding factors such as differences in surgery time and preoperative preparation contributed in part to this finding. As such, surgical approach cannot be categorized as an independent risk factor for SSIs in small animals until further studies are performed.

  16. Simian malaria at two sites in the Brazilian Amazon: I-The infection rates of Plasmodium brasilianum in non-human primates

    Directory of Open Access Journals (Sweden)

    Ricardo Lourenço-de-Oliveira

    1995-06-01

    Full Text Available The parasite that causes simian malaria in the Brazilian Amazon, Plasmodium brasilianum, is infective to man. In this region, where humans live within and in close proximity to the forest, it was suspected that this parasite could be the cause of a zoonosis. A study was performed in the areas surrounding two hydroelectric plants in the Amazon, Balbina and Samuel, aiming at determining the zoonotic potential of this parasite. P. brasilianum was detected in, respectively, 15.8% and 9.9% of 126 and 252 primates belonging to seven and eight species examined from Balbina and Samuel. The highest malaria infection rates were found among the red-howler monkey Alouatta seniculus straminea (32.3%, the bearded-saki Chiropotes satanas chiropotes (50% and the spider-monkey Ateles paniscus paniscus (2[1+] from Balbina and in the squirrel-monkey Saimiri ustus (21% and the black-faced-spider-monkey Ateles paniscus chamek (28.6% from Samuel.

  17. Clinical benefits of using inulin clearance and cystatin C for determining glomerular filtration rate in HIV-1-infected individuals treated with dolutegravir.

    Science.gov (United States)

    Yukawa, Satomi; Watanabe, Dai; Uehira, Tomoko; Shirasaka, Takuma

    2017-11-14

    Dolutegravir may inhibit creatinine transporters in renal tubules and elevate serum creatinine levels. We investigated the usefulness of glomerular filtration rate (GFR) measured using inulin clearance (Cin), creatinine clearance (Ccr), and estimated GFR based on both serum creatinine (eGFRcre) and serum cystatin C (eGFRcys). HIV-1-infected Japanese patients with suppressed viremia and whose antiretroviral drug was switched to dolutegravir from other drugs were included (n = 108, Study 1). We compared eGFRcre and eGFRcys at the start and after 48 weeks of dolutegravir administration. For the patients providing consent, we measured Cin and Ccr (n = 15, Study 2). We assessed biases and accuracy and compared Cin with eGFRcre, eGFRcys, and Ccr. There were no differences in serum cystatin C and eGFRcys between baseline and at 48 weeks. Moreover, eGFRcre was significantly less accurate (within 30% of measured GFR) than both eGFRcys and Ccr (40% accuracy compared to 93% and 93%, respectively). eGFRcys was significantly less biased than eGFRcre and Ccr (p inulin clearance and eGFRcys. This is the first study performing inulin clearance for HIV-1-infected individuals and to show data for eGFRcys from a large cohort following a switch to dolutegravir from other antiretroviral agents. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Infection of a French Population of Aedes albopictus and of Aedes aegypti (Paea Strain with Zika Virus Reveals Low Transmission Rates to These Vectors’ Saliva

    Directory of Open Access Journals (Sweden)

    Faustine Ryckebusch

    2017-11-01

    Full Text Available Disease caused by the Zika virus (ZIKV is a public health emergency of international concern. Recent epidemics have emerged in different regions of the world and attest to the ability of the virus to spread wherever its vector, Aedes species mosquitoes, can be found. We have compared the transmission of ZIKV by Ae. aegypti (PAEA strain originating from Tahiti and by a French population of Ae. albopictus to better assess their competence and the potential risk of the emergence of ZIKV in Europe. We assessed the transmission of ZIKV by Ae. albopictus in temperatures similar to those in Southern France during the summer. Our study shows that the extrinsic incubation period of Ae. aegypti for transmission was shorter than that of Ae. albopictus. Both vectors were able to transmit ZIKV from 10 to 14 days post-infection. Ae. aegypti, however, had a longer transmission period than the French population of Ae. albopictus. Although the salivary glands of both vectors are highly infected, transmission rates of ZIKV to saliva remain relatively low. These observations may suggest that the risk of emergence of ZIKV in Europe could be low.

  19. Social-, age- and gender differences in testing and positive rates for Chlamydia trachomatis urogenital infection – a register-based study

    DEFF Research Database (Denmark)

    Andersen, John Sahl

    2014-01-01

    Background: Chlamydia Trachomatis (CT) is suspected of causing female infertility. It is the most widespread STD with an estimated general prevalence of about 5-10 % with a peak in younger individuals.CT infection is more prevalent among lower social classes. Objective: In this study the associat......Background: Chlamydia Trachomatis (CT) is suspected of causing female infertility. It is the most widespread STD with an estimated general prevalence of about 5-10 % with a peak in younger individuals.CT infection is more prevalent among lower social classes. Objective: In this study......,887 people tested by general practitioners (GPs) and 3,177 people tested at a venereological clinic (VC). The age range was 15-24 years in 2011. These data were linked with the parental educational status delivered by Statistics Denmark, which also delivered a matched control group. The data were analyzed...... using a case-control design. Results: Testing was more frequent in the following groups: age range 20-24 years, females and patients with higher parental educational status. 87.3% of patient had been tested by GPs. Positive rates were highest among males at the GP: 17.1% vs. 10.6%, younger individuals...

  20. Chlamydia trachomatis infection positivity rates determined by nucleic acid amplification test in patients of hospitals in the northeastern region of Ukraine.

    Science.gov (United States)

    Belozorov, Alexei; Fedets, Olga; Chastii, Tatjana; Milutina, Elena; Sokol, Oksana; Grigorova, Ritsa; Unuchko, Sergey

    2017-12-01

    There are no accurate data regarding the prevalence of Chlamydia trachomatis infection in Ukraine. This study aims to estimate the prevalence in the northeastern region of the country through reviewing nucleic acid amplification test results in patients of medical institutions in the Kharkov region during 2014-2016. Samples from 6920 patients (5028 women and 1892 men) aged 12-76 years were tested. The overall positivity rate was 4.5% (95% CI 4.0-5.0): 3.9% (95% CI 3.4-4.5) in women and 6.1% (95% CI 5.1-7.3) in men. The highest prevalence was found in the 16-20 (8.5%, CI 6.3-11.4) and 21-25 (8.0%, CI 6.7-9.4) year age groups. The prevalence in men was higher than in women in all investigated groups. The results show the need for more attention to the prevention, diagnosis, and treatment of chlamydial infection in these age groups of women and men in this region.

  1. Long-Term Follow-Up of Proteinuria and Estimated Glomerular Filtration Rate in HIV-Infected Patients with Tubular Proteinuria.

    Science.gov (United States)

    Peyriere, Hélène; Cournil, Amandine; Casanova, Marie-Laure; Badiou, Stéphanie; Cristol, Jean-Paul; Reynes, Jacques

    2015-01-01

    The objective of this prospective observational study was to describe the evolution of tubular proteinuria detected in HIV-infected patients, and to evaluate the impact of tenofovir disoproxil fumarate (TDF) discontinuation. Proteinuria and estimated glomerular filtration rate (eGFR) were followed during a median duration of 32 months, in 81 HIV-infected patients with tubular proteinuria and eGFR ≥ 60 ml/min/1.73 m2 (determined using the Chronic Kidney Disease Epidemiology (CKD-EPI) Collaboration equation). Tubular proteinuria was defined by urine protein to creatinine ratio (uPCR) ≥200 mg/g and albumin to protein ratio (uAPR) proteinuria: TDF continuation was the main factor associated with this persistence [OR 9.0; 95%CI: 1.9-41.4; p = 0.01]. Among the 23 patients who discontinued TDF, uPCR returned below the threshold of 200 mg/g in 11 patients. Overall, eGFR decreased with a mean rate of decline of 3.8 ml/min/1.73m2/year. The decline in eGFR was lesser after discontinuation of TDF (5.8 ml/min/1.73m2/year during TDF exposure versus 3 ml/min/1.73m2/year after TDF discontinuation; p = 0.01). The continuation of TDF was the main factor associated with the persistence of proteinuria. Moreover, proteinuria was normalized in only half of the patients who discontinued TDF. The clinical significance of TDF-related low level of proteinuria as a factor associated with renal disease progression and bone loss remains poorly understood.

  2. Efficacy of praziquantel on Schistosoma haematobium and re-infection rates among school-going children in the Ndumo area of uMkhanyakude district, KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Kabuyaya, Muhubiri; Chimbari, Moses John; Manyangadze, Tawanda; Mukaratirwa, Samson

    2017-04-07

    Despite its low cure rates and possible resistance, praziquantel (PZQ) is the only drug available for schistosomiasis treatment. Hence, monitoring its efficacy is crucial. This study assessed the efficacy of PZQ, determined re-infection and incidence rates of Schistosoma haematobium infection among school-going children in the Ndumo area, KwaZulu-Natal. A cohort of 320 school-going children (10 - 15 years) in 10 primary schools was screened for S. haematobium infection using the filtration technique. Infected children were treated at different times and hence were divided into two sub-cohorts; A1 and A2. Non-infected children constituted the sub-cohort B. Children who continued excreting viable eggs 4 weeks post-treatment received a second dose of PZQ. Re-infection rates were determined in sub-cohort A1 and A2 at 28 and 20 weeks post-treatment, respectively. Cure rates (CR) and egg reduction rates (ERR) were calculated. Incidence rate was assessed 28 weeks post baseline survey using children that were negative for schistosome eggs at that survey. Analysis of data was done using the Chi square and the Wilcoxon rank test. A 95% confidence interval with a P-value Schistosoma haematobium. Heavy infections accounted for 36.7%. The calculated cure rates were 88.07% and 82.92% for females and males, respectively. Egg Reduction Rates of 80% and 64% for females and males were observed 4 weeks after the initial treatment. After the second treatment, CR was 100% in females and 50% in males with an ERR of 100% in females and 70% in males. At 20 and 28 weeks post treatment, reinfection rates of 8.03% and 8.00% were observed, respectively, giving an overall rate of 8.1%. An incidence rate of 4.1% was observed 28 weeks after the baseline screening. The study indicated high CR while the ERR was low suggesting a reduced PZQ efficacy. The efficacy improved among females after the second dose. Re-infection rates at 20 and 28 weeks post-treatment were low. The study also

  3. Prevalence of drug resistance and culture-positive rate among microorganisms isolated from patients with ocular infections over a 4-year period

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    Shimizu Y

    2013-04-01

    Full Text Available Yusuke Shimizu,1 Hiroshi Toshida,1 Rio Honda,1 Asaki Matsui,1 Toshihiko Ohta,1 Yousuke Asada,2 Akira Murakami2 1Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka, Japan; 2Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan Purpose: To investigate the microbial isolates from patients with ocular infections and the trend in the emergence of levofloxacin-resistant strains over the past four years from 2006 to 2009 retrospectively. Patients and methods: The subjects were 242 patients with ocular infections or traumas treated in our hospital including outpatients, inpatients, and emergency room patients. Most of them needed urgent care presenting with eye complaints, traumas, or decreased vision. Clinical samples were obtained from discharges, corneal, conjunctival tissues or vitreous fluid or aqueous humor, and cultured. Items for assessment included the patient’s age, the diagnosis, the prevalence of isolated bacteria, and the results of susceptibility tests for levofloxacin (LVFX cefamezin (CEZ, gentamicin (GM and vancomycin. This information was obtained from the patients’ medical records. Results: There were 156 male patients and 86 female patients who were aged from 2 months old to 94 years old and mean age was 56.8 ± 24.2 years. Of the 242 patients, 78 (32.2% had positive cultures. The culture-positive rate was significantly higher in male patients than female in total (P = 0.002 and in patients with corneal perforation (P = 0.005. Corneal perforation was the highest culture-positive rate (60.0%, followed by orbital cellulitis (56.5%, blepharitis (50.0%, dacryoadenitis (45.5%, conjunctivitis (38.2%, infectious corneal ulcer (28.5% and endophthalmitis (24.7%. LVFX-resistant strains accounted for 40 out of a total of 122 strains (32.8%, and the minimum inhibitory concentration (MIC was significantly higher in LVFX and GM compared with the other antibiotics. There were no vancomycin

  4. In nondiabetic, human immunodeficiency virus-infected patients with lipodystrophy, hepatic insulin extraction and posthepatic insulin clearance rate are decreased in proportion to insulin resistance

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Hansen, Birgitte R

    2005-01-01

    , human immunodeficiency virus (HIV)-infected patients with and without lipodystrophy. We studied 18 HIV-infected patients with lipodystrophy (LIPO) on antiretroviral therapy and 25 HIV-infected patients without lipodystrophy (controls) of whom 18 were on antiretroviral therapy and 7 were not. Posthepatic...... > .1). Our data suggest that HEXi and MCRi are decreased in proportion to the degree of insulin resistance in nondiabetic HIV-infected patients with lipodystrophy....

  5. Eradication of Helicobacter pylori infection in patients with duodenal ulcer and non-ulcer dyspepsia and analysis of one-year reinfection rates

    Directory of Open Access Journals (Sweden)

    Della Libera E.

    2001-01-01

    Full Text Available Helicobacter pylori (HP infection is endemic worldwide. The proposed treatment is expensive and there are few reports regarding reinfection rates in Brazil. The aim of this study was to compare the eradication rates obtained with two therapeutic options and to evaluate reinfection one year after treatment. This was a prospective randomized trial with 55 patients. Thirty-nine patients had active duodenal ulcer (DU and 16 non-ulcer dyspepsia (NUD, and all tested positive for HP. Diagnosis was based on at least two positive tests: ultrarapid urease test, histology and/or culture. Patients were randomized to two groups: group OMC treated with 40 mg omeprazole (once a day, 500 mg metronidazole and 250 mg clarithromycin (twice daily for 7 days, or group NA treated with 300 mg nizatidine (once a day and 1000 mg amoxicillin (twice daily for 14 days. Those patients in whom HP was eradicated were followed up for one year to evaluate reinfection. Twenty-five patients were randomized for OMC and 30 for NA. HP eradication occurred in 20/25 patients (80% treated with OMC and 13/30 (43% treated with NA (P = 0.01. After reallocation because of initial treatment failure, the overall eradication rate was 44/51 patients (86%. After an average follow-up of one year, we evaluated 34 patients (23 with DU and 11 with NUD. Reinfection occurred in 3/34 patients (7.6%. We conclude that OMC is effective for HP eradication, and that NA should not be used. Reinfection occurs in 7.6% of the patients in the first year after eradication.

  6. Correlation between HBsAg, prothrombin time activity, and indocyanine green retention rate at 15 minutes in patients with HBeAg-positive chronic HBV infection

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    FAN Wenhai

    2016-11-01

    Full Text Available ObjectiveTo investigate the correlation between HBsAg, prothrombin time activity (PTA, and indocyanine green retention rate at 15 minutes (ICG R15 in patients with HBeAg-positive chronic HBV infection. MethodsA total of 92 patients with HBeAg-positive chronic HBV infection who were admitted to The First Hospital of Lanzhou University from December 2015 to April 2016 were enrolled and divided into chronic hepatitis B (CHB group (24 patients, compensated liver cirrhosis group (38 patients, and decompensated liver cirrhosis group (30 patients. Serum HBsAg quantitation, PTA test, and liver reserve function test (ICG R15 were performed for all patients. The chi-square test was used for comparison of categorical data between groups, an analysis of variance was used for comparison of continuous data between multiple groups, and a Pearson correlation analysis was also performed. ResultsThere were significant differences between the three groups in serum HBsAg quantitation (3.82±0.43 log10IU/ml vs 2.88±0.36 log10IU/ml vs 2.60±0.27 log10IU/ml, F=25.19, P<0.001, ICG R15 (7.51%±3.10% vs 9.57%±8.18% vs 24.13%±14.28%, F=24.00, P=0.001, and PTA (8100%±1762% vs 83.08%±9.64% vs 62.32%±16.90%, F=13.42, P=0.009. The correlation analysis showed that PTA was negatively correlated with ICG R15 in all three groups (r=-0.948, -0.602, and -0.735, all P<0.01. In the compensated liver cirrhosis group and decompensated liver cirrhosis group, HBsAg was positively correlated with PTA (r=0.410 and 0.473, both P<0.05 and negatively correlated with ICG R15 (r=-0.427 and -0.768, P<0.01. ConclusionIn HBeAg positive patients, there are certain correlations between HBsAg, PTA, and ICG R15, which, to a certain degree, reflects the liver reserve function in patients with chronic HBV infection.

  7. Screening for decreased glomerular filtration rate and associated risk factors in a cohort of HIV-infected patients in a middle-income country.

    Directory of Open Access Journals (Sweden)

    Patrícia Santiago

    Full Text Available With the introduction of combined active antiretroviral therapy and the improved survival of HIV-infected patients, degenerative diseases and drug toxicity have emerged as long-term concerns. We studied the prevalence of decreased glomerular filtration rate (GFR and associated risk factors in a cohort of HIV-infected patients from a middle-income country. Our cross-sectional study included all adult patients who attended an urban outpatient clinic in 2008. GFR was estimated using the CKD-EPI equation. The prevalence ratio (PR of decreased GFR (defined as <60 mL/min/1.73 m(2 was estimated using generalizing linear models assuming a Poisson distribution. We analyzed data from 1,970 patients, of which 82.9% had been exposed to ART. A total of 249 patients (12.6% had a GFR between 60 and 89 mL/min/1.73 m(2, 3.1% had a GFR between 30 and 59, 0.3% had a GFR between 15 and 29, and 0.4% had a GFR <15. Decreased GFR was found in only 74 patients (3.8%. In the multivariate regression model, the factors that were independently associated with a GFR below 60 mL/min/1.73 m(2 were as follows: age ≥ 50 years (PR = 3.4; 95% CI: 1.7-6.8, diabetes (PR = 2.0; 95% CI: 1.2-3.4, hypertension (PR = 2.0; 95% CI: 1.3-3.2, current CD4+ cell count <350 cells/mm3 (PR = 2.1; 95% CI: 1.3-3.3, past exposure to tenofovir (PR = 4.7; 95% CI: 2.3-9.4 and past exposure to indinavir (PR =1.7; 95% CI: 1.0-2.8. As in high-income countries, CKD was the predominant form of kidney involvement among HIV-infected individuals in our setting. The risk factors associated with decreased glomerular filtration were broad and included virus-related factors as well as degenerative and nephrotoxic factors. Despite the potential for nephrotoxicity associated with some antiretroviral drugs, in the short-term, advanced chronic renal disease remains very rare.

  8. High Hepatitis C Infection Rate Among Baby Boomers in an Urban Primary Care Clinic: Results from the HepTLC Initiative.

    Science.gov (United States)

    Geboy, Alexander G; Mahajan, Sandeep; Daly, Allison P; Sewell, Candice F; Fleming, Ike C; Cha, Hyun A; Perez, Idene E; Cole, Carmella A; Ayodele, Adebisi A; Fishbein, Dawn A

    2016-01-01

    CDC recommends that all people born between 1945 and 1965 be tested for hepatitis C virus (HCV). We hypothesized that HCV testing in a large, urban primary care clinic would reveal higher rates of HCV infection than previously published. Through the Hepatitis Testing and Linkage to Care initiative, the primary care clinic at MedStar Washington Hospital Center in Washington, DC, provided HCV antibody (anti-HCV) testing and linkage to care from October 2012 through September 2013 for patients born between 1945 and 1965 without previously noted risk factors. We collected data on age, race/ethnicity, sex, anti-HCV and HCV ribonucleic acid (RNA) results, risk factors in those who tested anti-HCV positive, and health insurance type and made comparisons using c(2) and Student's t-tests. Of 1,123 patients tested, the mean age was 57 years, 742 (66.1%) were women, 969 (86.3%) were black/African American, and 654 (58.2%) had public health insurance. Of the 99 (8.8%) patients who tested anti-HCV positive, the mean age was 58 years, 54 were men, and 93 were black/African American; 41 of 74 anti-HCV-positive patients were intravenous drug users. Of 82 anti-HCV-positive patients, 51 were HCV RNA positive. Of the black/African American patients tested, 49 of 317 men (15.5%) and 44 of 652 women (6.7%) were anti-HCV positive (p,0.001). The HCV prevalence rate in the birth cohort (8.8%) was significantly higher than the U.S. (3.3%) and DC (2.5%) rates (p,0.001), and the HCV prevalence rate among black/African American men in DC (15.5%) was substantially higher than the prevalence rate reported by CDC (8.1%). Testing initiatives in primary care settings need to be more rigorously upheld, and internal champions are needed to advocate for increased screening to ensure linkage to care and engagement in the HCV care cascade.

  9. Sialylation of prion protein controls the rate of prion amplification, the cross-species barrier, the ratio of PrPSc glycoform and prion infectivity.

    Science.gov (United States)

    Katorcha, Elizaveta; Makarava, Natallia; Savtchenko, Regina; D'Azzo, Alessandra; Baskakov, Ilia V

    2014-09-01

    The central event underlying prion diseases involves conformational change of the cellular form of the prion protein (PrP(C)) into the disease-associated, transmissible form (PrP(Sc)). Pr(PC) is a sialoglycoprotein that contains two conserved N-glycosylation sites. Among the key parameters that control prion replication identified over the years are amino acid sequence of host PrP(C) and the strain-specific structure of PrPSc. The current work highlights the previously unappreciated role of sialylation of PrP(C) glycans in prion pathogenesis, including its role in controlling prion replication rate, infectivity, cross-species barrier and PrP(Sc) glycoform ratio. The current study demonstrates that undersialylated PrP(C) is selected during prion amplification in Protein Misfolding Cyclic Amplification (PMCAb) at the expense of oversialylated PrP(C). As a result, PMCAb-derived PrP(Sc) was less sialylated than brain-derived PrP(Sc). A decrease in PrPSc sialylation correlated with a drop in infectivity of PMCAb-derived material. Nevertheless, enzymatic de-sialylation of PrP(C) using sialidase was found to increase the rate of PrP(Sc) amplification in PMCAb from 10- to 10,000-fold in a strain-dependent manner. Moreover, de-sialylation of PrP(C) reduced or eliminated a species barrier of for prion amplification in PMCAb. These results suggest that the negative charge of sialic acid controls the energy barrier of homologous and heterologous prion replication. Surprisingly, the sialylation status of PrP(C) was also found to control PrP(Sc) glycoform ratio. A decrease in Pr(PC) sialylation levels resulted in a higher percentage of the diglycosylated glycoform in PrP(Sc). 2D analysis of charge distribution revealed that the sialylation status of brain-derived PrP(C) differed from that of spleen-derived PrP(C). Knocking out lysosomal sialidase Neu1 did not change the sialylation status of brain-derived PrP(C), suggesting that Neu1 is not responsible for desialylation of Pr

  10. Sialylation of prion protein controls the rate of prion amplification, the cross-species barrier, the ratio of PrPSc glycoform and prion infectivity.

    Directory of Open Access Journals (Sweden)

    Elizaveta Katorcha

    2014-09-01

    Full Text Available The central event underlying prion diseases involves conformational change of the cellular form of the prion protein (PrP(C into the disease-associated, transmissible form (PrP(Sc. Pr(PC is a sialoglycoprotein that contains two conserved N-glycosylation sites. Among the key parameters that control prion replication identified over the years are amino acid sequence of host PrP(C and the strain-specific structure of PrPSc. The current work highlights the previously unappreciated role of sialylation of PrP(C glycans in prion pathogenesis, including its role in controlling prion replication rate, infectivity, cross-species barrier and PrP(Sc glycoform ratio. The current study demonstrates that undersialylated PrP(C is selected during prion amplification in Protein Misfolding Cyclic Amplification (PMCAb at the expense of oversialylated PrP(C. As a result, PMCAb-derived PrP(Sc was less sialylated than brain-derived PrP(Sc. A decrease in PrPSc sialylation correlated with a drop in infectivity of PMCAb-derived material. Nevertheless, enzymatic de-sialylation of PrP(C using sialidase was found to increase the rate of PrP(Sc amplification in PMCAb from 10- to 10,000-fold in a strain-dependent manner. Moreover, de-sialylation of PrP(C reduced or eliminated a species barrier of for prion amplification in PMCAb. These results suggest that the negative charge of sialic acid controls the energy barrier of homologous and heterologous prion replication. Surprisingly, the sialylation status of PrP(C was also found to control PrP(Sc glycoform ratio. A decrease in Pr(PC sialylation levels resulted in a higher percentage of the diglycosylated glycoform in PrP(Sc. 2D analysis of charge distribution revealed that the sialylation status of brain-derived PrP(C differed from that of spleen-derived PrP(C. Knocking out lysosomal sialidase Neu1 did not change the sialylation status of brain-derived PrP(C, suggesting that Neu1 is not responsible for desialylation of Pr

  11. Impact of infection control activities on the rate of needle stick injuries at a tertiary care hospital of Pakistan over a period of six years: an observational study

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    Khowaja Khurshid

    2009-05-01

    Full Text Available Abstract Background Accidental exposure to blood and body fluids is frequent among health care workers. They are at high risk of nosocomial transmission of blood borne pathogens due to injuries caused by used sharps. We are reporting impact of surveillance and educational program on the rate of needle stick injuries among health care workers at a tertiary care hospital in Pakistan. Methods At Aga Khan University Hospital sharp injuries are reported to infection control office. To reduce these incidents a quality improvement project was inducted in the year 2005. Health care workers were educated; surveillance data from 2002 to 2007 was analyzed and compared with various risk factors. Results During study period 1382 incidents were reported. Junior doctors sustained highest number of injuries (n = 394; 28.5% followed by registered nurses (n = 283; 20.4%. Highest number of incidents was reported during blood collection (19%. An increasing trend was observed in the pre intervention years (2002–04. However noticeable fall was noted in the post intervention period that is in year 2006 and 2007. Major decline was noted among nurses (from 13 to 5 NSI/100 FTE/year. By relating and comparing the rates with various activities directly linked with the use of syringes a significant reduction in incidents were found including; hospital admissions (p-value 0.01, surgeries and procedures performed (p = 0.01, specimens collected in the laboratory (p = 0.001 and patients visits in clinics (p = 0.01. Conclusion We report significant reduction in needle stick injuries especially during post intervention study period. This is being achieved by constant emphasis on improving awareness by regular educational sessions, implemented as a quality improvement project.

  12. Circular closure is associated with the lowest rate of surgical site infection following stoma reversal: a systematic review and multiple treatment meta-analysis.

    Science.gov (United States)

    Li, L T; Hicks, S C; Davila, J A; Kao, L S; Berger, R L; Arita, N A; Liang, M K

    2014-06-01

    Stoma reversal is frequently complicated by surgical site infection (SSI). To reduce SSI, several techniques for skin closure have been studied, with no agreement on which is best. The aim of this study was to identify the skin closure technique associated with the lowest rate of SSI following stoma reversal. We systematically searched MEDLINE (PubMed and OvidSP), Scopus and clinical registries from 1 January 1980 to 24 March 2012, and included original reports on adult patients following stoma reversal. A network of treatments was created to map the comparisons between skin closure techniques, including primary closure, primary closure with a drain, secondary closure, delayed primary closure, loose primary closure and circular closure. Pairwise meta-analyses were performed for all available direct comparisons of closure types and heterogeneity was assessed. A multiple-treatments meta-analysis was conducted to estimate relative treatment effects between competing closure types (reported as an odds ratio with 95% credible interval, and a probability that each treatment is best). Several sensitivity analyses were performed. Fifteen studies were identified with a total of 2921 cases of stoma reversal. Overall, study quality was poor with observed low (one study), moderate (seven studies) and high (seven studies) risk of bias. Circular closure was associated with the lowest SSI risk (OR 0.12; 95% CI 0.02-0.40) and was the best of six skin closure techniques (probability of being best = 68.9%). Circular closure remained the best after sensitivity analyses. This study showed that circular closure is the best skin closure technique after stoma reversal in terms of SSI rate, but the quality of supporting evidence is limited, precluding definite conclusions. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  13. Obtaining blood cultures by venipuncture versus from central lines: impact on blood culture contamination rates and potential effect on central line-associated bloodstream infection reporting.

    Science.gov (United States)

    Boyce, John M; Nadeau, Jacqueline; Dumigan, Diane; Miller, Debra; Dubowsky, Cindy; Reilly, Lenore; Hannon, Carla V

    2013-10-01

    Reduce the frequency of contaminated blood cultures that meet National Healthcare Safety Network definitions for a central line-associated bloodstream infection (CLABSI). An observational study. A 500-bed university-affiliated hospital. A new blood culture policy discouraged drawing blood samples from central lines. Phlebotomists were reeducated regarding aseptic technique when obtaining blood samples by venipuncture. The intravenous therapy team was taught how to draw blood samples by venipuncture and served as a backup when phlebotomists were unable to obtain blood samples. A 2-nurse protocol and a special supply kit for obtaining blood samples from catheters were developed. Rates of blood culture contamination were monitored by the microbiology laboratory. The proportion of blood samples obtained for culture from central lines decreased from 10.9% during January-June 2010 to 0.4% during July-December 2012 (P cultures that were contaminated decreased from 84 (1.6%) of 5,274 during January-June 2010 to 21 (0.5%) of 4,245 during January-June 2012 (P culture, the reduction in blood culture contaminants yielded an estimated annualized savings of $378,000 in 2012 when compared to 2010. In mid-2010, 3 (30%) of 10 reported CLABSIs were suspected to represent blood culture contamination compared with none of 6 CLABSIs reported from mid-November 2010 through June 2012 (P = 0.25). Multiple interventions resulted in a reduction in blood culture contamination rates and substantial cost savings to the hospital, and they may have reduced the number of reportable CLABSIs.

  14. Estimated Glomerular Filtration Rate Trajectories in HIV-Infected Subjects Treated With Different Ritonavir-Boosted Protease Inhibitors and Tenofovir Disoproxil Fumarate or Abacavir.

    Science.gov (United States)

    Gianotti, Nicola; Galli, Laura; Poli, Andrea; Salpietro, Stefania; Nozza, Silvia; Carbone, Alessia; Merli, Marco; Ripa, Marco; Lazzarin, Adriano; Castagna, Antonella

    2016-05-01

    The aim of the study was to evaluate in human immunodeficiency virus (HIV)-infected patients estimated glomerular filtration rate (eGFR) trajectories during treatment with different protease inhibitors (PIs) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus tenofovir (TDF) or abacavir (ABC) and lamivudine or emtricitabine (xTC).Retrospective study of patients followed at a single clinical center; all patients who started TDF or ABC for the first time with a NNRTI or lopinavir/r (LPV/r) or atazanavir/r (ATV/r) or darunavir/r (DRV/r), for whom at least 1 eGFR value before the start and during the studied treatment was known, were included in this analysis. eGFR was calculated by means of the CKD-EPI formula. Univariate and multivariate mixed linear model (MLM) was applied to estimate eGFR slope with the considered antiretroviral treatment.In the 1658 patients treated with TDF/xTC (aged 43 [37-48] years, with an eGFR of 105 [96; 113] mL/min/1.73 m, 80% males, 92% Caucasians, 10% coinfected with HCV, 4% with diabetes, 11% with hypertension, 38% naive for antiretroviral therapy (ART), 37% with HIV-RNA xTC, eGFR trajectories were small for all regimens and declined less in patients receiving DRV/r or NNRTIs than in those treated with ATV/r or LPV/r.

  15. Should hip fractures be operated upon only by specialist hip unit surgeons in order to lower rates of surgical site infection?

    Science.gov (United States)

    Guerado, Enrique; Cano, Juan R; Cruz, Encarnacion; Bertrand, María Luisa; Hirschfeld, Miguel; Benitez-Parejo, Nicolas

    2015-01-01

    The purpose of this study was to compare outcomes of hip fractures treated by orthopaedic surgeons, performed by specialist vs. non-specialist surgeons. The rate of surgical site infection (SSI) obtained is taken as the main variable. This was a prospective controlled cohort study of 814 patients presenting with hip fractures, operated on by a group of orthopaedic surgeons within the same hospital department. Patients were classified according to whether the surgeons belonged to a specialist hip unit (group A = 212 cases) or not (group B = 602 cases). Multivariate logistic regression showed that there was no relation between gender, SSI, Charlson's index, preoperative period, surgical technique or study groups (A or B). Only age was a determinant factor (rank-sum test p = 0.03; OR 95% CI = 1.07, p = 0.005). Since there were no differences in the SSI outcome between surgeons working in a specialist hip unit and the general orthopaedic surgeons, delaying operative treatment for hip fractures to enable treatment in such a unit or creating a new unit of this type is not necessary. In this respect, the only significant variable is the patient's age.

  16. Transmissibility and Pathogenicity of Ebola Virus: A Systematic Review and Meta-analysis of Household Secondary Attack Rate and Asymptomatic Infection.

    Science.gov (United States)

    Dean, Natalie E; Halloran, M Elizabeth; Yang, Yang; Longini, Ira M

    2016-05-15

    Factors affecting our ability to control an Ebola outbreak include transmissibility of the virus and the proportion of transmissions occurring asymptomatically. We performed a meta-analysis of Ebola household secondary attack rate (SAR), disaggregating by type of exposure (direct contact, no direct contact, nursing care, direct contact but no nursing care). The estimated overall household SAR is 12.5% (95% confidence interval [CI], 8.6%-16.3%). Transmission was driven by direct contact, with little transmission occurring in its absence (SAR, 0.8% [95% CI, 0%-2.3%]). The greatest risk factor was the provision of nursing care (SAR, 47.9% [95% CI, 23.3%-72.6%]). There was evidence of a decline in household SAR for direct contact between 1976 and 2014 (P = .018). We estimate that 27.1% (95% CI, 14.5%-39.6%) of Ebola infections are asymptomatic. Our findings suggest that surveillance and containment measures should be effective for controlling Ebola. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  17. [Low rate of oropharyngeal human papillomavirus infection among women with cervical lesion. Preliminary results from the South-Eastern Hungarian population].

    Science.gov (United States)

    Vanya, Melinda; Jakó, Mária; Terhes, Gabriella; Szakács, László; Kaiser, László; Deák, Judit; Bártfai, György

    2016-01-10

    Although the natural history of cervical and oral human papillomavirus infection has been intensively investigated in the past years, the ability of this virus to infect oral and genital mucosae in the same individual and its potential to co-infect both cervical and oral mucosa are still unclear. The aim of the authors was to assess the presence of oropharyngeal human papillomavirus infection in women with cervical lesions in the South-Eastern Hungarian population. The total of 103 women have been included in the study between March 1, 2013 and January 1, 2015. Brushing was used to collect cells from the oropharyngeal mucosa. Human papillomavirus DNA was detected using polymerase chain reaction, and Amplicor line blot test was used for genotyping. Oropharyngeal human papillomavirus infection was detected in 2 cases (3%). The detected genotypes were 31, 40/61 and 73 in the oropharyngeal region. The results indicate that in women with cervical lesions oropharyngeal human papillomavirus infection rarely occurs.

  18. Conception rate, uterine infection and embryo quality after artificial insemination and natural breeding with a stallion carrier of Pseudomonas aeruginosa: a case report

    Directory of Open Access Journals (Sweden)

    Tiago Guimarães

    2012-03-01

    Full Text Available Abstract Background Pseudomonas aeruginosa may cause venereal disease and infertility in horses. A Pseudomonas aeruginosa - carrier stallion, often unresponsive to artificial vagina collection, was used to naturally breed mares. Semen collected from the same stallion was also used to perform artificial inseminations. Pregnancy rates, embryo quality and incidence of uterine infection were compared between inseminated or naturally-bred mares. Methods P. aeruginosa was isolated from swabbing of the penis, prepuce and distal urethra of the stallion. Before being bred or inseminated, clitoral/vestibular samples were collected from all mares, and cultured for isolation of P. aeruginosa. At the first observed estrus, endometrial swabs were also collected. All mares subjected to natural mating (NS were re-evaluated for P.aeruginosa by culture of clitoral and endometrial swabs. Artificial inseminations (AI were performed either with fresh-extended semen (11 AI/7 mares or frozen semen (10 AI/7 mares. The stallion was also used to breed 3 mares (4 services. For embryo collection, 2 mares were inseminated with fresh-extended semen (1 AI/mare, and 2 additional mares were inseminated with frozen semen (2 AI/mare. Two mares were naturally-bred with a total of 9 services, for embryo collection. All mares were examined after AI or natural service (NS, for uterine pathologies. Embryo recoveries were attempted passing a catheter with inflatable cuff connected to a sterile flexible 2-way flushing catheter, through the cervix. Flushed media was recovered into an Em-Con filter, and embryos searched using a stereoscope. Embryos were graded from 1 (excellent to 4 (degenerated/dead. Results Pregnancy rates obtained after NS was 50% per cycle. However, more than half of the NS resulted in uterine disease, while uterine pathology was seen only in 22% of the time following AI. Half of the mares bred by NS got positive to P. aeruginosa. Percentage of embryo recovery rates

  19. Conception rate, uterine infection and embryo quality after artificial insemination and natural breeding with a stallion carrier of Pseudomonas aeruginosa: a case report.

    Science.gov (United States)

    Tiago, Guimarães; Júlio, Carvalheira; António, Rocha

    2012-03-29

    Pseudomonas aeruginosa may cause venereal disease and infertility in horses. A Pseudomonas aeruginosa - carrier stallion, often unresponsive to artificial vagina collection, was used to naturally breed mares. Semen collected from the same stallion was also used to perform artificial inseminations. Pregnancy rates, embryo quality and incidence of uterine infection were compared between inseminated or naturally-bred mares. P. aeruginosa was isolated from swabbing of the penis, prepuce and distal urethra of the stallion. Before being bred or inseminated, clitoral/vestibular samples were collected from all mares, and cultured for isolation of P. aeruginosa. At the first observed estrus, endometrial swabs were also collected. All mares subjected to natural mating (NS) were re-evaluated for P.aeruginosa by culture of clitoral and endometrial swabs. Artificial inseminations (AI) were performed either with fresh-extended semen (11 AI/7 mares) or frozen semen (10 AI/7 mares). The stallion was also used to breed 3 mares (4 services). For embryo collection, 2 mares were inseminated with fresh-extended semen (1 AI/mare), and 2 additional mares were inseminated with frozen semen (2 AI/mare). Two mares were naturally-bred with a total of 9 services, for embryo collection. All mares were examined after AI or natural service (NS), for uterine pathologies. Embryo recoveries were attempted passing a catheter with inflatable cuff connected to a sterile flexible 2-way flushing catheter, through the cervix. Flushed media was recovered into an Em-Con filter, and embryos searched using a stereoscope. Embryos were graded from 1 (excellent) to 4 (degenerated/dead). Pregnancy rates obtained after NS was 50% per cycle. However, more than half of the NS resulted in uterine disease, while uterine pathology was seen only in 22% of the time following AI. Half of the mares bred by NS got positive to P. aeruginosa. Percentage of embryo recovery rates was identical after AI or NS (66.7%). The 4

  20. Antibiotic policies in acute English NHS trusts: implementation of 'Start Smart-Then Focus' and relationship with Clostridium difficile infection rates.

    Science.gov (United States)

    Llewelyn, Martin J; Hand, Kieran; Hopkins, Susan; Walker, A Sarah

    2015-04-01

    The objective of this study was to establish how antibiotic prescribing policies at National Health Service (NHS) hospitals match the England Department of Health 'Start Smart-Then Focus' recommendations and relate to Clostridium difficile infection (CDI) rates. Antibiotic pharmacists were surveyed regarding recommendations for empirical treatment of common syndromes ('Start Smart') and antimicrobial prescription reviews ('Focus') at their hospital trusts. If no response was provided, policy data were sought from trust websites and the MicroGuide app (Horizon Strategic Partners, UK). Empirical treatment recommendations were categorized as broad spectrum (a β-lactam penicillin/β-lactamase inhibitor, cephalosporin, quinolone or carbapenem) or narrow spectrum. CDI rates were gathered from the national mandatory surveillance system. Data were obtained for 105/145 English acute hospital trusts (72%). β-Lactam/β-lactamase inhibitor combinations were recommended extensively. Only for severe community-acquired pneumonia and pyelonephritis were narrow-spectrum agents recommended first line at a substantial number of trusts [42/105 (40%) and 50/105 (48%), respectively]. Policies commonly recommended dual therapy with aminoglycosides and β-lactams for abdominal sepsis [40/93 trusts (43%)] and undifferentiated severe sepsis [54/94 trusts (57%)]. Most policies recommended treating for ≥ 7 days for most indications. Nearly all policies [100/105 trusts (95%)] recommended antimicrobial prescription reviews, but only 46/96 respondents (48%) reported monitoring compliance. Independent predictors of higher CDI rates were recommending a broad-spectrum regimen for community-acquired pneumonia (P=0.06) and, counterintuitively, a recommended treatment duration of <48 h for nosocomial pneumonia (P=0.01). Hospital antibiotic policies in the NHS 'Start Smart' by recommending broad-spectrum antibiotics for empirical therapy, but this may have the unintended potential to increase the

  1. Comparison of Rates of Death Having any Death-Certificate Mention of Heart, Kidney, or Liver Disease Among Persons Diagnosed with HIV Infection with those in the General US Population, 2009-2011.

    Science.gov (United States)

    Whiteside, Y Omar; Selik, Richard; An, Qian; Huang, Taoying; Karch, Debra; Hernandez, Angela L; Hall, H Irene

    2015-01-01

    Compare age-adjusted rates of death due to liver, kidney, and heart diseases during 2009-2011 among US residents diagnosed with HIV infection with those in the general population. Numerators were numbers of records of multiple-cause mortality data from the national vital statistics system with an ICD-10 code for the disease of interest (any mention, not necessarily the underlying cause), divided into those 1) with and 2) without an additional code for HIV infection. Denominators were 1) estimates of persons living with diagnosed HIV infection from national HIV surveillance system data and 2) general population estimates from the US Census Bureau. We compared age-adjusted rates overall (unstratified by sex, race/ethnicity, or region of residence) and stratified by demographic group. Overall, compared with the general population, persons diagnosed with HIV infection had higher age-adjusted rates of death reported with hepatitis B (rate ratio [RR]=42.6; 95% CI: 34.7-50.7), hepatitis C (RR=19.4; 95% CI: 18.1-20.8), liver disease excluding hepatitis B or C (RR=2.1; 95% CI: 1.8-2.3), kidney disease (RR=2.4; 95% CI: 2.2-2.6), and cardiomyopathy (RR=1.9; 95% CI: 1.6-2.3), but lower rates of death reported with ischemic heart disease (RR=0.6; 95% CI: 0.6-0.7) and heart failure (RR=0.8; 95% CI: 0.6-0.9). However, the differences in rates of death reported with the heart diseases were insignificant in some demographic groups. Persons with HIV infection have a higher risk of death with liver and kidney diseases reported as causes than the general population.

  2. Postoperative Infection Rates in Patients with a Negative Baseline Urine Culture Undergoing Ureteroscopic Stone Removal: A Matched Case-Control Analysis on Antibiotic Prophylaxis from the CROES URS Global Study

    NARCIS (Netherlands)

    Martov, Alexey; Gravas, Stavros; Etemadian, Masoud; Unsal, Ali; Barusso, Gabriel; D'Addessi, Alessandro; Krambeck, Amy; de la Rosette, Jean

    2015-01-01

    Purpose: To examine the effects of antibiotic prophylaxis on postoperative infection rate in patients with negative urine cultures undergoing ureteroscopy (URS). Patients and Methods: Using the Clinical Research Office of the Endourological Society (CROES) URS Global Study database, patients with a

  3. Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses.

    Science.gov (United States)

    Pease, Christopher; Hutton, Brian; Yazdi, Fatemeh; Wolfe, Dianna; Hamel, Candyce; Quach, Pauline; Skidmore, Becky; Moher, David; Alvarez, Gonzalo G

    2017-04-11

    We conducted a systematic review and network meta-analysis (NMA) to examine the efficacy and completion rates of treatments for latent tuberculosis infection (LTBI). While a previous review found newer, short-duration regimens to be effective, several included studies did not confirm LTBI, and analyses did not account for variable follow-up or assess completion. We searched MEDLINE, Embase, CENTRAL, PubMed, and additional sources to identify RCTs in patients with confirmed LTBI that involved a regimen of interest and reported on efficacy or completion. Regimens of interest included isoniazid (INH) with rifapentine once weekly for 12 weeks (INH/RPT-3), 6 and 9 months of daily INH (INH-6; INH-9), 3-4 months daily INH plus rifampicin (INH/RFMP 3-4), and 4 months daily rifampicin alone (RFMP-4). NMAs were performed to compare regimens for both endpoints. Sixteen RCTs (n = 44,149) and 14 RCTs (n = 44,128) were included in analyses of efficacy and completion. Studies were published between 1968 and 2015, and there was diversity in patient age and comorbidities. All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo. Comparisons between active regimens did not reveal significant differences. While definitions of regimen completion varied across studies, regimens of 3-4 months were associated with a greater likelihood of adequate completion. Most of the active regimens showed an ability to reduce the risk of active TB relative to no treatment, however important differences between active regimens were not found. Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens. Regimens of 3-4 months duration are more likely to be completed than longer regimens.

  4. Variation in species composition and infection rates of Anopheles mosquitoes at different altitudinal transects, and the risk of malaria in the highland of Dirashe Woreda, south Ethiopia.

    Science.gov (United States)

    Daygena, Taye Yohannes; Massebo, Fekadu; Lindtjørn, Bernt

    2017-07-19

    The transmission of malaria is heterogeneous, and varies due to altitude. The information on whether the transmission of malaria is indigenous or imported to highland areas is scarce. Therefore, this study aimed to assess the species composition and infection rates of Anopheles at different altitudinal transects, and the risk of malaria if any in the highland of Dirashe Woreda, South Ethiopia. This study was conducted in Gato (low altitude; average elevation of 1273 m), Onota (mid-altitude; average elevation of 1707 m) and Layignaw-Arguba (high altitude; average elevation of 2337 m) from August 2015 to April 2016. Anopheles mosquitoes were sampled using Centers for Disease Control and Prevention (CDC) light traps from thirty houses (ten houses from each village). The circum-sporozoite proteins (CSPs) rate and entomological inoculation rate (EIR) of Anopheles mosquitoes were estimated. For the epidemiological survey, malaria cases were collected from laboratory registration books of selected health facilities from (August 2015-April 2016). A cross-sectional survey was done to collect data on malaria vector control activities in each village (August-September 2015). One thousand two hundred sixty-eight Anopheles mosquitoes comprising Anopheles arabiensis, An. demeilloni, An. cinereus, An. pharoensis, An. funestus-group, An. pretoriensis, An. christyi, An. ardensis and An. tenebrosus were identified in the study area. Anopheles arabiensis was the dominant species in Gato, whereas An. demeilloni was the dominant species in Layignaw-Arguba. Five mosquitoes, three An. arabiensis from Gato and two An. demeilloni from Layignaw-Arguba, were positive for Plasmodium falciparum CSPs. Plasmodium falciparum CSP rate was 0.4% (95% CI: 0.08-1.15) for An. arabiensis in Gato, and it was 0.64% (95% CI: 0.08-2.3) for An. demeilloni from Layignaw-Arguba. The P. falciparum EIR of An. arabiensis was 8.6 (95% CI: 2.4-33.4) infectious bites/person/nine-months in Gato. Plasmodium

  5. Impact of a mandatory infection control education program on nosocomial acquisition of methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Lee, Todd C; Moore, Christine; Raboud, Janet M; Muller, Matthew P; Green, Karen; Tong, Agnes; Dhaliwal, Jastej; McGeer, Allison

    2009-03-01

    To assess the impact of an institution-wide infection control education program on the rate of transmission of methicillin-resistant Staphylococcus aureus (MRSA). Before-and-after study. A 472-bed, urban, university-affiliated hospital.Intervention. During the period March-May 2004, all hospital staff completed a mandatory infection control education program, including the receipt of hospital-specific MRSA data and case-based practice with additional precautions. The rate of nosocomial MRSA acquisition was calculated as the number of cases of nosocomial MRSA acquisition per 100 days that a person with MRSA colonization or infection detected at admission is present in the hospital ("admission MRSA" exposure-days) for 3 time periods: June 2002-February 2003 (before the Toronto outbreak of severe acute respiratory syndrome [SARS]), June 2003-February 2004 (after the outbreak of SARS), and June 2004-February 2005 (after education). A case of nosocomial acquisition of MRSA colonization or infection represented a patient first identified as colonized or infected more than 72 hours after admission or at admission after a previous hospitalization. The rate of nosocomial acquisition of MRSA colonization or infection was 8.8 cases per 100 admission MRSA exposure-days for the period before SARS, 3.8 cases per 100 admission MRSA exposure-days for the period after SARS (Pcases per 100 admission MRSA exposure-days for the period after education (P=.02 for after education vs before education). The volume of alcohol-based handrub purchased was apparently stable, with 4,010 L during fiscal year 2003-2004 (April 2003-March 2004) compared with 3,780 L during fiscal year 2004-2005. The observed rate of compliance with hand washing did not change significantly (40.9% during education vs 44.2% after education; P=.23). The total number of patients screened for MRSA colonization was not different in the 3 periods. The rate of nosocomial acquisition of MRSA colonization or infection

  6. Normal Thymic Size and Low Rate of Infections in Human Donor Milk Fed HIV-Exposed Uninfected Infants from Birth to 18 Months of Age

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Ersbøll, Annette Kjær; Hoppe, Tine Ursula

    2013-01-01

    fewer infections than other healthy infants. This finding along with fewer infections in exclusively breastfed infants compared to formula-fed infants supports the beneficial effect of human milk on the immune system. We suggest, when breastfeeding is not possible, that providing human donor milk......Objective. To evaluate the immune function in HIV-exposed uninfected (HIV-EU) infants fed human donor milk. Methods. Ultrasound-obtained thymic index (Ti), T-lymphocyte subsets, and the number of infections were examined from birth to 18 months of age in 18 HIV-EU infants. The infants were compared...... (P donor milk have normal growth of thymus and contract...

  7. Plasmodium falciparum infection rates for some Anopheles spp. from Guinea-Bissau, West Africa [v2; ref status: indexed, http://f1000r.es/4n3

    Directory of Open Access Journals (Sweden)

    Michelle R. Sanford

    2014-11-01

    Full Text Available Presence of Plasmodium falciparum circumsporozoite protein (CSP was detected by enzyme linked immunosorbent assay (ELISA in a sample of Anopheles gambiae s.s., A. melas and A. pharoensis collected in Guinea-Bissau during October and November 2009. The percentage of P. falciparum infected samples (10.2% overall; confidence interval (CI: 7.45-13.6% was comparable to earlier studies from other sites in Guinea-Bissau (9.6-12.4%. The majority of the specimens collected were identified as A. gambiae which had an individual infection rate of 12.6 % (CI: 8.88-17.6 across collection sites. A small number of specimens of A. coluzzii, A. coluzzii x A. gambiae hybrids, A. melas and A. pharoensis were collected and had infection rates of 4.3% (CI:0.98-12.4, 4.1% (CI:0.35-14.5, 11.1% (CI:1.86-34.1 and 33.3% (CI:9.25-70.4 respectively. Despite being present in low numbers in indoor collections, the exophilic feeding behaviors of A. melas (N=18 and A. pharoensis (N=6 and high infection rates observed in this survey suggest falciparum-malaria transmission potential outside of the protection of bed nets.

  8. High Rates of Hepatitis B and C and HIV Infections among Blood Donors in Cameroon: A Proposed Blood Screening Algorithm for Blood Donors in Resource-Limited Settings

    Directory of Open Access Journals (Sweden)

    Florent Fouelifack Ymele

    2012-01-01

    , 4.44%  (n=206, and 1.44%  (n=67, respectively. Coinfection with HIV and HBV was observed among 0.77% donors, followed by hepatitis B and C co-infection (0.21% and HIV and HCV coinfection (0.06%. Co-infection with HIV-HBV-HCV was encountered in 2 donors. The HIV, HBV, and HCV infections lead to a destruction of one out of six sets of blood collected. Conclusion. There is a need to review policies for blood collection from donors, by modifying the algorithm of blood donors testing. Pretesting potential donors using rapid tests could help to avoid collection and destruction of (infected blood.

  9. The use of saliva as a practical and feasible alternative to urine in large-scale screening for congenital cytomegalovirus infection increasesinclusion and detection rates

    Directory of Open Access Journals (Sweden)

    Emanuelle Santos de Carvalho Cardoso

    2015-04-01

    Full Text Available INTRODUCTION: Although urine is considered the gold-standard material for the detection of congenital cytomegalovirus (CMV infection, it can be difficult to obtain in newborns. The aim of this study was to compare the efficiency of detection of congenital CMV infection in saliva and urine samples. METHODS: One thousand newborns were included in the study. Congenital cytomegalovirus deoxyribonucleic acid (DNA was detected by polymerase chain reaction (PCR. RESULTS: Saliva samples were obtained from all the newborns, whereas urine collection was successful in only 333 cases. There was no statistically significant difference between the use of saliva alone or saliva and urine collected simultaneously for the detection of CMV infection. CONCLUSIONS: Saliva samples can be used in large-scale neonatal screening for CMV infection.

  10. Successful use of gentamycin as an antibiotic prophylaxis regimen to reduce the rate of healthcare-associated infections after renal transplantation

    OpenAIRE

    Abboud,Cely S.; Bergamasco,Maria Daniela; Sousa,Ercilia Evangelista de; de Cássia Zandonadi, Eliana; Cortez,Doralice

    2013-01-01

    At our institution, we observed an increase in the incidence of healthcare-associated infections (HAI) due to Gram-negative bacilli, including three cases of carbapenem-resistant Klebsiella pneumoniae, among patients who underwent renal transplantation. In addition to strengthening infection control measures, we chose to add gentamycin to the antibiotic prophylaxis regimen of patients undergoing renal transplantation. We assessed the number of HAI occurring within 30 days of renal transplanta...

  11. Rates and reasons for early change of first HAART in HIV-1-infected patients in 7 sites throughout the Caribbean and Latin America.

    Science.gov (United States)

    Cesar, Carina; Shepherd, Bryan E; Krolewiecki, Alejandro J; Fink, Valeria I; Schechter, Mauro; Tuboi, Suely H; Wolff, Marcelo; Pape, Jean W; Leger, Paul; Padgett, Denis; Madero, Juan Sierra; Gotuzzo, Eduardo; Sued, Omar; McGowan, Catherine C; Masys, Daniel R; Cahn, Pedro E

    2010-06-01

    HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 in 2003 to 390,000 patients in 2007, covering 62% (51%-70%) of eligible patients, with considerable variation among countries. No multi-cohort study has examined rates of and reasons for change of initial HAART in this region. Antiretroviral-naïve patients >or= 18 years who started HAART between 1996 and 2007 and had at least one follow-up visit from sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Time from HAART initiation to change (stopping or switching any antiretrovirals) was estimated using Kaplan-Meier techniques. Cox proportional hazards modeled the associations between change and demographics, initial regimen, baseline CD4 count, and clinical stage. Of 5026 HIV-infected patients, 35% were female, median age at HAART initiation was 37 years (interquartile range [IQR], 31-44), and median CD4 count was 105 cells/uL (IQR, 38-200). Estimated probabilities of changing within 3 months and one year of HAART initiation were 16% (95% confidence interval (CI) 15-17%) and 28% (95% CI 27-29%), respectively. Efavirenz-based regimens and no clinical AIDS at HAART initiation were associated with lower risk of change (hazard ratio (HR) = 1.7 (95% CI 1.1-2.6) and 2.1 (95% CI 1.7-2.5) comparing neverapine-based regimens and other regimens to efavirenz, respectively; HR = 1.3 (95% CI 1.1-1.5) for clinical AIDS at HAART initiation). The primary reason for change among HAART initiators were adverse events (14%), death (5.7%) and failure (1.3%) with specific toxicities varying among sites. After change, most patients remained in first line regimens. Adverse events were the leading cause for changing initial HAART. Predictors for change due to any reason were AIDS at baseline and the use of a non-efavirenz containing regimen. Differences between participant sites were observed and require further investigation.

  12. Rates and Reasons for Early Change of First HAART in HIV-1-Infected Patients in 7 Sites throughout the Caribbean and Latin America

    Science.gov (United States)

    Cesar, Carina; Shepherd, Bryan E.; Krolewiecki, Alejandro J.; Fink, Valeria I.; Schechter, Mauro; Tuboi, Suely H.; Wolff, Marcelo; Pape, Jean W.; Leger, Paul; Padgett, Denis; Madero, Juan Sierra; Gotuzzo, Eduardo; Sued, Omar; McGowan, Catherine C.; Masys, Daniel R.; Cahn, Pedro E.

    2010-01-01

    Background HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 in 2003 to 390,000 patients in 2007, covering 62% (51%–70%) of eligible patients, with considerable variation among countries. No multi-cohort study has examined rates of and reasons for change of initial HAART in this region. Methodology Antiretroviral-naïve patients > = 18 years who started HAART between 1996 and 2007 and had at least one follow-up visit from sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Time from HAART initiation to change (stopping or switching any antiretrovirals) was estimated using Kaplan-Meier techniques. Cox proportional hazards modeled the associations between change and demographics, initial regimen, baseline CD4 count, and clinical stage. Principal Findings Of 5026 HIV-infected patients, 35% were female, median age at HAART initiation was 37 years (interquartile range [IQR], 31–44), and median CD4 count was 105 cells/uL (IQR, 38–200). Estimated probabilities of changing within 3 months and one year of HAART initiation were 16% (95% confidence interval (CI) 15–17%) and 28% (95% CI 27–29%), respectively. Efavirenz-based regimens and no clinical AIDS at HAART initiation were associated with lower risk of change (hazard ratio (HR) = 1.7 (95% CI 1.1–2.6) and 2.1 (95% CI 1.7–2.5) comparing neverapine-based regimens and other regimens to efavirenz, respectively; HR = 1.3 (95% CI 1.1–1.5) for clinical AIDS at HAART initiation). The primary reason for change among HAART initiators were adverse events (14%), death (5.7%) and failure (1.3%) with specific toxicities varying among sites. After change, most patients remained in first line regimens. Conclusions Adverse events were the leading cause for changing initial HAART. Predictors for change due to any reason were AIDS at baseline and the use of a non-efavirenz containing regimen. Differences between participant sites were observed

  13. Survival Rate and Transcriptional Response upon Infection with the Generalist Parasite Beauveria bassiana in a World-Wide Sample of Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Francesco Paparazzo

    Full Text Available The ability to cope with infection by a parasite is one of the major challenges for any host species and is a major driver of evolution. Parasite pressure differs between habitats. It is thought to be higher in tropical regions compared to temporal ones. We infected Drosophila melanogaster from two tropical (Malaysia and Zimbabwe and two temperate populations (the Netherlands and North Carolina with the generalist entomopathogenic fungus Beauveria bassiana to examine if adaptation to local parasite pressures led to differences in resistance. Contrary to previous findings we observed increased survival in temperate populations. This, however, is not due to increased resistance to infection per se, but rather the consequence of a higher general vigor of the temperate populations. We also assessed transcriptional response to infection within these flies eight and 24 hours after infection. Only few genes were induced at the earlier time point, most of which are involved in detoxification. In contrast, we identified more than 4,000 genes that changed their expression state after 24 hours. This response was generally conserved over all populations with only few genes being uniquely regulated in the temperate populations. We furthermore found that the American population was transcriptionally highly diverged from all other populations concerning basal levels of gene expression. This was particularly true for stress and immune response genes, which might be the genetic basis for their elevated vigor.

  14. Parasitological and molecular surveys reveal high rates of infection with vector-borne pathogens and clinical anemia signs associated with infection in cattle from two important livestock areas in Colombia.

    Science.gov (United States)

    Jaimes-Dueñez, Jeiczon; Triana-Chávez, Omar; Mejía-Jaramillo, Ana M

    2017-02-01

    In Colombia, vector-borne diseases are one of the most important problems in the livestock industry. The present study reports parasitological and molecular surveys of vector-borne pathogens in cattle from two high-value livestock areas in Colombia. A total of 464 samples (226 from Antioquia and 238 from Arauca) were analyzed. While the blood smear analysis identified 98 (21.1%), 14 (3.0%) and 30 (6.5%) positive samples for Anaplasma spp., Babesia spp. and Trypanosoma spp., respectively, the molecular methods indicated that 275 (59.3%), 146 (31.5%), 64 (13.8%), 236 (50.9%) and 43 (9.3%) of the samples were positive for Anaplasma marginale, Babesia bigemina, Babesia bovis, Trypanosoma theileri and T. evansi, respectively. Mixed infections were detected in 250 (53.9%) samples. Interestingly, animals aged ≤1 year had higher probabilities of being infected with A. marginale and Babesia spp., and lower probabilities of being infected with Trypanosoma spp., while the animals raised under intensive system breeding had higher probabilities of being infected with all pathogens. Additionally, T. theileri infection was found in higher prevalence in anemic animals than animals with normal packed cell volume (PCV). This is the first molecular report that evaluated the infection with three genders of vector-borne pathogens in cattle in Colombia and provides useful information for a better understanding of the epidemiologic aspects, as well as for the management and control, of these diseases. Copyright © 2016 Elsevier GmbH. All rights reserved.

  15. NATURAL HISTORY OF HIV-INFECTION IN CHILDREN WITH THE ROUTE OF INFECTION

    Directory of Open Access Journals (Sweden)

    V. B. Denisenko

    2014-01-01

    Full Text Available Natural history of HIV infection in 91 vertically HIV infected patients and in 101 parenterally HIV infected children were investigated. High relative incidence rates regardless of the route of HIV transmission have demonstrated HIV-related symptoms — generalized lymphadenopathy, hepatomegaly, splenomegaly, underweight, anemia, prolonged unmotivated fever, and opportunistic infections — bacterial infections, candidiasis, herpes simplex, cytomegalovirus infection. Vertically HIV infected children had higher relative incidence rates of HIV-related symptoms, opportunistic infections and generalized forms of opportunistic infections.

  16. Infection Rate and Tissue Localization of Murine IL-12p40-Producing Monocyte-Derived CD103+ Lung Dendritic Cells during Pulmonary Tuberculosis

    Science.gov (United States)

    Leepiyasakulchai, Chaniya; Taher, Chato; Chuquimia, Olga D.; Mazurek, Jolanta; Söderberg-Naucler, Cecilia; Fernández, Carmen; Sköld, Markus

    2013-01-01

    Non-hematopoietic cells, including lung epithelial cells, influence host immune responses. By co-culturing primary alveolar epithelial cells and monocytes from naïve donor mice, we show that alveolar epithelial cells support monocyte survival and differentiation in vitro, suggesting a role for non-hematopoietic cells in monocyte differentiation during the steady state in vivo. CD103+ dendritic cells (αE-DC) are present at mucosal surfaces. Using a murine primary monocyte adoptive transfer model, we demonstrate that αE-DC in the lungs and pulmonary lymph nodes are monocyte-derived during pulmonary tuberculosis. The tissue localization may influence the functional potential of αE-DC that accumulate in Mycobacterium tuberculosis-infected lungs. Here, we confirm the localization of αE-DC in uninfected mice beneath the bronchial epithelial cell layer and near the vascular wall, and show that αE-DC have a similar distribution in the lungs during pulmonary tuberculosis and are detected in the bronchoalveolar lavage fluid from infected mice. Lung DC can be targeted by M. tuberculosis in vivo and play a role in bacterial dissemination to the draining lymph node. In contrast to other DC subsets, only a fraction of lung αE-DC are infected with the bacterium. We also show that virulent M. tuberculosis does not significantly alter cell surface expression levels of MHC class II on infected cells in vivo and that αE-DC contain the highest frequency of IL-12p40+ cells among the myeloid cell subsets in infected lungs. Our results support a model in which inflammatory monocytes are recruited into the M. tuberculosis-infected lung tissue and, depending on which non-hematopoietic cells they interact with, differentiate along different paths to give rise to multiple monocyte-derived cells, including DC with a distinctive αE-DC phenotype. PMID:23861965

  17. Infection rate and tissue localization of murine IL-12p40-producing monocyte-derived CD103(+) lung dendritic cells during pulmonary tuberculosis.

    Science.gov (United States)

    Leepiyasakulchai, Chaniya; Taher, Chato; Chuquimia, Olga D; Mazurek, Jolanta; Söderberg-Naucler, Cecilia; Fernández, Carmen; Sköld, Markus

    2013-01-01

    Non-hematopoietic cells, including lung epithelial cells, influence host immune responses. By co-culturing primary alveolar epithelial cells and monocytes from naïve donor mice, we show that alveolar epithelial cells support monocyte survival and differentiation in vitro, suggesting a role for non-hematopoietic cells in monocyte differentiation during the steady state in vivo. CD103(+) dendritic cells (αE-DC) are present at mucosal surfaces. Using a murine primary monocyte adoptive transfer model, we demonstrate that αE-DC in the lungs and pulmonary lymph nodes are monocyte-derived during pulmonary tuberculosis. The tissue localization may influence the functional potential of αE-DC that accumulate in Mycobacterium tuberculosis-infected lungs. Here, we confirm the localization of αE-DC in uninfected mice beneath the bronchial epithelial cell layer and near the vascular wall, and show that αE-DC have a similar distribution in the lungs during pulmonary tuberculosis and are detected in the bronchoalveolar lavage fluid from infected mice. Lung DC can be targeted by M. tuberculosis in vivo and play a role in bacterial dissemination to the draining lymph node. In contrast to other DC subsets, only a fraction of lung αE-DC are infected with the bacterium. We also show that virulent M. tuberculosis does not significantly alter cell surface expression levels of MHC class II on infected cells in vivo and that αE-DC contain the highest frequency of IL-12p40(+) cells among the myeloid cell subsets in infected lungs. Our results support a model in which inflammatory monocytes are recruited into the M. tuberculosis-infected lung tissue and, depending on which non-hematopoietic cells they interact with, differentiate along different paths to give rise to multiple monocyte-derived cells, including DC with a distinctive αE-DC phenotype.