Endemic nosocomial infections and misuse of antibiotics in a maternity hospital in Saudi Arabia.

Science.gov (United States)

Bilal, Naser Eldin; Gedebou, Messele; Al-Ghamdi, Saleh

2002-02-01

Patients admitted during a 6-month period to a maternity hospital in Saudi Arabia were studied for nosocomial infections and misuse of antibiotics. Patient history and diagnosis on admission and subsequent clinical and laboratory data were analysed. Infection developing from 72 h after admission was considered nosocomial. Therapeutic and prophylactic data as recorded on the patients' charts were assessed for possible misuse of antibiotics. Of 3439 patients, 136 (4.0%) developed nosocomial infection: 2.0%, 8.9% and 37.7% in obstetric, gynaecologic and nursery patients, respectively. Infections among adults were mostly found in the urinary (44.4%) and lower genital (33.3%) tracts. Among newborns, over 70% of cases were eye and ear (29.8%), skin (26.2%) and blood (19.0%) infections. Gram-negative bacteria caused 65.7% of the infections. Over 90% of the bacterial isolates were multidrug-resistant. About 24% of patients received single or multiple antibiotics; 57.2% were misused. The minimal hospital cost estimate for both nosocomial infections and misused antibiotics was US $318,705. The findings of this study, the first of its type in this region, should prompt improved infection control measures as well as educational and antibiotic restriction interventions.

Microfluidic-Based Bacteria Isolation from Whole Blood for Diagnostics of Blood Stream Infection.

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Zelenin, Sergey; Ramachandraiah, Harisha; Faridi, Asim; Russom, Aman

2017-01-01

Bacterial blood stream infection (BSI) potentially leads to life-threatening clinical conditions and medical emergencies such as severe sepsis, septic shock, and multi organ failure syndrome. Blood culturing is currently the gold standard for the identification of microorganisms and, although it has been automated over the decade, the process still requires 24-72 h to complete. This long turnaround time, especially for the identification of antimicrobial resistance, is driving the development of rapid molecular diagnostic methods. Rapid detection of microbial pathogens in blood related to bloodstream infections will allow the clinician to decide on or adjust the antimicrobial therapy potentially reducing the morbidity, mortality, and economic burden associated with BSI. For molecular-based methods, there is a lot to gain from an improved and straightforward method for isolation of bacteria from whole blood for downstream processing.We describe a microfluidic-based sample-preparation approach that rapidly and selectively lyses all blood cells while it extracts intact bacteria for downstream analysis. Whole blood is exposed to a mild detergent, which lyses most blood cells, and then to osmotic shock using deionized water, which eliminates the remaining white blood cells. The recovered bacteria are 100 % viable, which opens up possibilities for performing drug susceptibility tests and for nucleic-acid-based molecular identification.

Nosocomial infections and related factors in southern khorasan hospitals

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Bita Bijari

2014-12-01

Full Text Available Background and Aim: Nosocomial infections are defined as infections occurring during a patient's stay at hospital (48-72h after admission.Nosocomial infections are one of the important problems of health. This study aimed was determine the prevalence of nosocomial infections, and related factors in hospitals with more than 100 beds in south Khorasan Province. Materials and Methods: In this crass-sectional study, an investigator-administered questionnaire was completed for each patient with nosocomial infections diagnosis in hospitals with more than 100 beds in South Khorasan. This questionnaire conation demographic characteristic of patients, department, duration of admission, kind of pathogen and risk factors that was designed according to standard questionnaire of Iranian Nasocomial infections surveillance system (INIS of Center for communicable Disease Control, Ministry of Health. Data were analyzed with SPSS 16 software. Results and discussion: Number of patients with nosocomial infection was 358. The incidence of nosocomial infection was 0.9%. ICU had the highest incidence rate (17.3%. The most common nosocomial infection was pneumonia (43%, and urinary tract infection (UTI (15.1%. In 33.5% culture result were negative. In other cases, culture results showed klebsiella spp. (12.8% and Pseudomonas aeruginosa (9.8% were the most prevalent bacteria. Most factors associated with nosocomial infection in patients were urinary catheters (70.4%, suction (66.8% and tracheal tube (54.2%. 24% of patients expired. The results showed lower ratio of nosocomial infection, that the main reason is failure to detection and reporting of actual cases of nosocomial infection. Promoting detection and reporting system for Prevention and control of nosocomial infection was recommended

Nosocomial infections and staff hygiene.

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Petroudi, Dimitra

2009-03-01

Nosocomial infections are a major source of morbidity and mortality in hospital settings. The most important defences against nosocomial transmission of viral, bacterial, and other infections are detailed and continuing education of staff and strict adherence to infection control policies. The issue is no longer whether hand hygiene is effective, but how to produce a sustained improvement in health workers' compliance.

Pneumonia nosocomial: Actualização terapêutica

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João Pedro Falcão Baptista

2005-08-01

Full Text Available Resumo: A pneumonia nosocomial é uma doença frequente, potencialmente fatal, e que apresenta elevada mortalidade. Neste artigo, após revisão crítica dos consensos e protocolos actuais para o tratamento da pneumonia nosocomial, são actualizadas as bases racionais da antibioterapia, revendo os aspectos epidemiológicos, microbiológicos e farmacológicos. No final faz-se referência ao posicionamento dos mais recentes antibióticos disponíveis para o seu tratamento. Abstract: Nosocomial pneumonia is a common disease with high mortality rate. In this article we review the antibiotic therapy fundamentals highlighting epidemiological, microbiological and pharmacological aspects, based on the actual consensus and protocols for the management of nosocomial pneumonia. In the end we make a short review of the current antibiotherapy practiced in this clinical situation. Palavras-chave: Pneumonia nosocomial, pneumonia associada ao ventilador, tratamento empírico, descalonamento terapêutico, antibioterapia, farmacodinâmica, farmacocinética, Key words: Nosocomial pneumonia, ventilator associated pneumonia, empirical therapy, de-escalation, antibiotherapy, pharmacodynamics, pharmacokinetics

Major Trends in the Microbial Etiiology of Nosocomial Infection

NARCIS (Netherlands)

D.R. Schaberg; D.H. Culver; R.P. Gaynes

1991-01-01

textabstractTo determine trends in the microbial etiology of nosocomial infections in the 1980s, surveillance data on the microbiology of documented nosocomial infection reported to the National Nosocomial Infections Surveillance System and from the University of Michigan Hospital were analyzed.

Nosocomial infection of CCHF among health care workers in Rajasthan, India.

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Yadav, Pragya D; Patil, Deepak Y; Shete, Anita M; Kokate, Prasad; Goyal, Pulkit; Jadhav, Santosh; Sinha, Sanjeev; Zawar, Divya; Sharma, Surendra K; Kapil, Arti; Sharma, D K; Upadhyay, Kamlesh J; Mourya, Devendra T

2016-11-03

Ever since Crimean-Congo hemorrhagic fever [CCHF] discovered in India, several outbreaks of this disease have been recorded in Gujarat State, India. During the year 2011 to 2015 several districts of Gujarat and Rajasthan state (Sirohi) found to be affected with CCHF including the positivity among ticks and livestock. During these years many infected individuals succumbed to this disease; which subsequently led to nosocomial infections. Herein, we report CCHF cases recorded from Rajasthan state during January 2015. This has affected four individuals apparently associated with one suspected CCHF case admitted in a private hospital in Jodhpur, Rajasthan. A 30-year-old male was hospitalized in a private hospital in Jodhpur, Rajasthan State, who subsequently had developed thrombocytopenia and showed hemorrhagic manifestations and died in the hospital. Later on, four nursing staff from the same hospital also developed the similar symptoms (Index case and Case A, B, C). Index case succumbed to the disease in the hospital at Jodhpur followed by the death of the case A that was shifted to AIIMS hospital, Delhi due to clinical deterioration. Blood samples of the index case and Case A, B, C were referred to the National institute of Virology, Pune, India for CCHF diagnosis from the different hospitals in Rajasthan, Delhi and Gujarat. However, a sample of deceased suspected CCHF case was not referred. Subsequently, blood samples of 5 nursing staff and 37 contacts (Case D was one of them) from Pokhran area, Jaisalmer district were referred to NIV, Pune. It clearly indicated that nursing staff acquired a nosocomial infection while attending the suspected CCHF case in an Intensive Care Unit of a private hospital in Jodhpur. However, one case was confirmed from the Pokhran area where the suspected CCHF case was residing. This case might have got the infection from suspected CCHF case or through other routes. CCHF strain associated with these nosocomial infections shares the

Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features

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Saad B. Almasaudi

2018-03-01

Full Text Available The genus Acinetobacter is a major cause of nosocomial infections; it is increasingly being associated with various epidemics and has become a widespread concern in a variety of hospitals worldwide. Multi-antibiotic resistant Acinetobacter baumannii, is now recognized to be of great clinical significance. Numerous reports relay to the spread of A. baumannii in the hospital settings which leads to enhanced nosocomial outbreaks associated with high death rates. However, many other Acinetobacter spp. also can cause nosocomial infections. This review focused on the role of Acinetobacter spp. as nosocomial pathogens in addition to their persistence, antimicrobial resistance patterns and epidemiology. Keywords: Acinetobacter, Nosocomial infections, Multi-drug resistance, Epidemiology, Characteristics

Antibiogram of nosocomial urinary tract infections in Felege Hiwot ...

African Journals Online (AJOL)

Background: Nosocomial infections increase the cost of medical care, extend hospital stay and reflect on the morbidity and mortality of the admitted patients. Urinary tract infections (UTIs) are one of the most common nosocomial infections in humans. Objectives: To determine the prevalence and antibiogram of nosocomial ...

Neonatal blood stream infections in tertiary referral hospitals in Kurdistan, Iran.

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Nikkhoo, Bahram; Lahurpur, Fariba; Delpisheh, Ali; Rasouli, Mohammad Aziz; Afkhamzadeh, Abdorrahim

2015-06-09

Bloodstream infection (BSI) is one of the most common causes of nosocomial infection in neonatal intensive care units (NICU). The aim of the present study was to determine bacterial agents and their susceptibility patterns to antibiotics and to investigate the risk factors associated with BSI. This was a nested case-control study carried out from September 2009 to June 2010 in the NICU wards in Sanandaj hospitals western Iran. Cases were patients with BSI and controls were other patients who had negative blood culture. Bacteriologic diagnosis and antibiotic susceptibility pattern was performed based on the Edward & Ewings and the National Committee of Clinical Laboratory (NCCL) Standards. Of 472 patients who hospitalized in NICU, 6.4% had BSI (n = 30) including 17girls (56.7%) and 13 boys (43.3%). Enterobacter SPP was the predominant isolated bacteria from blood culture (36.7%). The maximum antibiotic resistance and sensitivity were observed by Tetracycline and Ciprofloxacin respectively. Risk factors associated with BSI were age ≤ 7 days (p = 0.001), previous antibiotic consumption (p = 0.013), and low birth weight (LBW), (p = 0.001). Gram negative bacteria and Entrobacter in particular are the most common pathogens. Improving prenatal health care, standards of infection control and choosing accurate antibiotics are recommended to avoid BSI in neonatal intensive care units.

Nosocomial Infections Transmitted Via Computers : A Literature Review

OpenAIRE

Atanda, Angela Achieng; Nwaoha, Nkechi Naomi

2010-01-01

The purpose of this review was to discuss how current literature described nosocomial infections transmitted via computers in hospitals. It also described the various methods used to disinfect computers. The research questions in this study were; What are nosocomial infections? How do contaminated computer devices transmit nosocomial infections? and What infection control methods are applied to decontaminate computers within hospitals? The aim of conducting this study was to create an aw...

The Incidence And Risk Factors Nosocomial Pneumonia In A Neuromedical Intensive Care Unit

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Devragudi TS

2001-01-01

Full Text Available This retrospective study examined the incidence and factors influencing the occurrence of nonsocomial pneumonia (NP in a neuromedical intensive care unit (NICU. Of the 57 patients admitted to the NICU over one year, 26% developed nosocomial pneumonia. It was observed that the infected patients were significantly older than the noninfected (43+15 vs 22+18 years; p<0.001, had a longer NICU stay (33+31 vs 18+18 days: p=0.05 and needed longer duration of mechanical ventilation (20+25 vs 9 + 12 days: P<0.05. Patients with neuromuscular diseases had a trend towards higher incidence of NP than those with encephalopathy and therapeutic interventions such as plasmapheresis, blood transfusion and inotropic therapy did not influence the incidence of nosocomial pneumonia. The NICU mortality was not significantly influenced by nosocomial pneumonia. Pseudomonas aerugenosa was the predominant organism responsible for pneumonia. Nine percent of the tracheobronchial isolates were resistant to the routinely-tested antibiotics. In conclusion, nosocornial pneumonia is a common complication in a NICU and while it increases the duration of NICU stay, mortality appears to be uninfluenced.

Relationship between climate conditions and nosocomial infection ...

African Journals Online (AJOL)

Background: Nosocomial infections constitute a global health problem. Objective: To explore the relationship between nosocomial infection rates (NIRs) and climatic factors including temperature and relative humidity in Guangzhou area of China. Methods: 30892 patients in our hospital in 2009 were investigated for ...

Update on bacterial nosocomial infections.

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Bereket, W; Hemalatha, K; Getenet, B; Wondwossen, T; Solomon, A; Zeynudin, A; Kannan, S

2012-08-01

With increasing use of antimicrobial agents and advance in lifesaving medical practices which expose the patients for invasive procedures, are associated with the ever increasing of nosocomial infections. Despite an effort in hospital infection control measures, health care associated infections are associated with significant morbidity and mortality adding additional health care expenditure which may leads to an economic crisis. The problem is further complicated with the emergence of difficult to treat multidrug resistant (MDR) microorganism in the hospital environment. Virtually every pathogen has the potential to cause infection in hospitalized patients but only limited number of both gram positive and gram negative bacteria are responsible for the majority of nosocomial infection. Among them Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Enterococci takes the leading. Many intrinsic and extrinsic factors predispose hospitalized patients for these pathogens. Following simple hospital hygienic practices and strictly following standard medical procedures greatly reduces infection to a significant level although not all nosocomial infections are avoidable. The clinical spectrum caused by nosocomial pathogens depend on body site of infection, the involving pathogen and the patient's underlying condition. Structural and non structural virulence factors associated with the bacteria are responsible for the observed clinical manifestation. Bacteria isolation and characterization from appropriate clinical materials with antimicrobial susceptibility testing is the standard of laboratory diagnosis.

Nosocomial infections by respiratory syncytial virus in children

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Maren Karina Machado Echeverría

2017-01-01

Full Text Available Introduction: Acute lower respiratory infections cause high morbidity and mortality in children. Respiratory syncytial virus (RSV is the most prevalent agent. Some viruses cause serious nosocomial infections. In Uruguay, there is no knowledge about the morbidity and mortality of nosocomial infections by RSV. Objective: To determine the prevalence and characteristics of RSV nosocomial infections. Methodology: A descriptive study of acute lower respiratory infections caused by RSV in patients younger than two years, between 1/1/2005 and 31/12/2008 at the Hospital Pediátrico del Centro Hospitalario Pereira Rossell, was made. Results: Were identified 59 patients who represented an annual rate lower than 2/1000 discharges. The monthly distribution of cases was similar to the respiratory infections. No outbreaks were reported. The age of the patients had an average of 8.9 months, 39 were younger than one year, 23 had one or more risk factors for severe disease. Six patients required admission to intensive care unit, all required invasive ventilation, 3 died, none had chronic respiratory failure following the RSV nosocomial infection. Conclusions: During the study period, the RSV nosocomial infections showed a low prevalence, despite it highly contagiousness. They mainly affected young children, carriers of risk factors for severe ALRI. Their evolution was similar to that reported for RSV respiratory infections community acquired. It is important to maintain standards for the control of nosocomial infections, to prevent nosocomial transmission of RSV and prevent the onset of severe disease in hospitalized patients.

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias Morphological prognostic factors in nosocomial pneumonia: an autopsy study

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Luiz Mário Baptista Martinelli

2010-02-01

Full Text Available OBJETIVO: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. MÉTODOS: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. RESULTADOS: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02 e acometimento pulmonar bilateral (OR = 3,23; IC95%: 1,26-8,30; p = 0,01. Não houve associações significativas entre as variáveis e pneumonia aspirativa fatal. CONCLUSÕES: Em nossa amostra, a pneumonia nosocomial teve prevalência elevada e foi responsável por quase 25% das mortes. A mortalidade é favorecida por alterações estruturais tabágicas e pneumonia bilateral. Esses achados corroboram os resultados de diversos estudos clínicos sobre pneumonia nosocomial.OBJECTIVE: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal

Distribution of potential nosocomial pathogens in a hospital ...

African Journals Online (AJOL)

STORAGESEVER

2008-10-20

Oct 20, 2008 ... associated/acquired infections) are those infections that develop in a patient during ... nosocomial pathogens that cause infections can come either from ... aeruginosa is a regular cause of nosocomial pneumonia, urinary tract ...

Evaluation of efficacy of skin cleansing with chlorhexidine in prevention of neonatal nosocomial sepsis - a randomized controlled trial.

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Gupta, Basudev; Vaswani, Narain Das; Sharma, Deepak; Chaudhary, Uma; Lekhwani, Seema

2016-01-01

The aim of this study was to evaluate the efficacy of skin cleansing with chlorhexidine (CHD) in the prevention of neonatal nosocomial sepsis - a randomized controlled trial. This study design was a randomized controlled trial carried out in a tertiary care center of north India. About 140 eligible neonates were randomly allocated to either the subject area group (wiped with CHD solution till day seven of life) or the control group (wiped with lukewarm water). The primary outcome studied was to determine the decrease in the incidence of neonatal nosocomial sepsis (blood culture proven) in the intervention group. Out of 140 enrolled neonates, 70 were allocated to each group. The ratio of positive blood culture among the CHD group was 3.57%, while the ratio of positive blood culture among the control group was 6.85%. There was trending towards a reduction in blood culture proven sepsis in the intervention group, although the remainder was not statistically significant. A similar decreasing trend was observed in rates of skin colonization, duration of hospital stay, and duration of antibiotic treatment. CHD skin cleansing decreases the incidence of blood culture sepsis and could be an easy and cheap intervention for reducing the neonatal sepsis in countries where the neonatal mortality rate is high because of sepsis.

Nosocomial Infections in Nuclear Medicine Departments: some considerations

International Nuclear Information System (INIS)

Metello, L.F.; Cunha, L.; Martins, M.; Isabel, O.; Ribeiro, G.

2002-01-01

Aim: Surveillance for Nosocomial Infection has become an integral part of hospital practice. Studies conducted more than 30 years ago by the Centers for Disease Control and Prevention (CDC) documented the efficacy of these surveillance activities in reducing Nosocomial Infection occurrence. It is clear that surveillance for Nosocomial Infection involves more than just documenting infection rates. However, many times the professionals involved have tended to stop at the point where rates are reported and fail to complete the task of implementing changes based on the analysis of rates or disseminating information. Moreover specific documentation regarding Nuclear Medicine Departments is not available. We therefore decided to produce this work based in the recognition of this specific need. Methods and Conclusions: Having previously defined the 'state-of-the-art' from science and technology concerning Nosocomial Infection Control and after particular study regarding technical/clinical reality of Nuclear Medicine Departments, namely introducing the radioactivity as a factor that must be taken into account with all its implications and interactions, we have obtained a group of considerations and/or recommendations to be considered in order to accomplish the maximum Quality and Efficiency regarding the Control of Nosocomial Infection in Nuclear Medicine Departments

[Hospital hygiene - outbreak management of nosocomial infections].

Science.gov (United States)

Kerwat, Klaus; Wulf, Hinnerk

2012-04-01

According to §6, section 3 of the German Protection against Infections Act [Infektionsschutzgesetz (IfSG)] an outbreak is defined as the occurrence in large numbers of nosocomial infections for which an epidemiological relationship is probable or can be assumed. About 2-10% of nosocomial infections in hospitals (about 5% in intensive care wards) occur within the framework of an outbreak. The heaped occurrence of nosocomial infections can be declared according to the prescribed surveillance of nosocomial infections (§23 IfSG) when, in the course of this assessment, a statistically significant increase in the rate of infections becomes apparent. On the other hand, the occurrence of an outbreak can also be recognized through the vigilance of all involved personnel and a general sensibilization towards this subject. The names of patients involved in outbreaks need not be reported to the responsible health authorities. As a consequence of the report the health authorities become involved in the investigation to determine the cause and its elimination, and to provide support and advice. The outbreak management should be oriented on the respective recommendations of the Robert Koch Institute. © Georg Thieme Verlag Stuttgart · New York.

Prevention of Nosocomial Respiratory Infections

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N. A. Karpun

2007-01-01

Full Text Available Objective: to evaluate the efficiency of an extended package of preventive measures on the incidence of nosocomial respiratory infections in surgical patients at an intensive care unit (ICU. Subjects and methods. The study included 809 patients aged 35 to 80 years. A study group comprised 494 patients in whom an extended package of preventive measures was implemented during 7 months (March-September. A control group consisted of 315 patients treated in 2004 in the same period of time (March-September. The groups were stratified by age, gender, underlying diseases, and APACHE-2 and SOFA scores. The extended package of anti-infectious measures involved a high air purification in ICUs («Flow-M» technology, routine use of ventilatory filters, closed aspiration systems with a built-in antibacterial filter under artificial ventilation for over 2 days. Results. The proposed technologies could reduce the frequency of tracheobronchitis and ventilator-associated pneumonias in the groups of patients at high risk for nosocomial infections substantially (by more than twice. Conclusion. The findings have led to the conclusion that the extended package of preventive measures is effective in preventing respiratory infections in ICU patients. Of special note is the proper prevention of upper airway contamination with pathogenic microorganisms, by employing the closed aspiration systems with a built-in antibacterial filter. The routine use of high-tech consumables in the intensive care of surgical patients causes a considerable decrease in the incidence of nosocomial pneumonia, ventilator-associated pneumonia, and purulent tracheobronchitis and a reduction in the number of microbiological studies. Key words: ventilator-associated pneumonia, prevention of nosocomial infections, closed aspiration system.

[Nosocomial rotavirus gastroenteritis].

Science.gov (United States)

Marinosci, A; Doit, C; Koehl, B; Belhacel, K; Mariani Kurkdjian, P; Melki, I; Renaud, A; Lemaitre, C; Ammar Khodja, N; Blachier, A; Bonacorsi, S; Faye, A; Lorrot, M

2016-11-01

Rotavirus is the most common cause of gastroenteritis in children requiring hospitalization. It is a very resistant and contagious virus causing nosocomial gastroenteritis. In France, the vaccine against rotavirus has been available since 2006, but the vaccine is not recommended for infant vaccination. The aim of this retrospective study was to describe nosocomial rotavirus gastroenteritis (NRGE) and to assess its impact on children hospitalized in the General Pediatrics Department of Robert-Debré Hospital (Paris) between 1 January 2009 and 31 December 2013. We analyzed the demographic characteristics of children (age, term birth, underlying diseases) and the severity of the NRGE (oral or intravenous hydration), and assessed whether these children could benefit from vaccination against rotavirus. One hundred thirty-six children presented nosocomial rotavirus infection, with an incidence of 2.5 NRGE per 1000 days of hospitalization. The incidence of NRGE was stable between 2009 and 2013 despite the introduction of specific hygiene measures. The average age of the children was 7 months (range: 0.5-111 months). Most often NRGE occurred in children hospitalized for respiratory diseases (65% of cases) and requiring prolonged hospitalization (median: 18 days). One-third of children were born premature (25%). Hydration was oral in 80 patients (59%), by intravenous infusion in 18 patients (13%), and intraosseous in one patient. Half of the patients were aged less than 5 months and could benefit from the protection afforded by vaccination. NRGE are common. Rotavirus mass vaccination should have a positive impact on the incidence of NRGE by reducing the number of children hospitalized for gastroenteritis, therefore indirectly reducing the number of hospital cross-infections of hospitalized children who are too young to be vaccinated. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

STUDY OF CENTRAL VENOUS CATHETER RELATED BLOOD STREAM INFECTIONS IN PATIENTS ON HAEMODIALYSIS

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Pranjal Pankaj

2018-01-01

Full Text Available BACKGROUND Temporary and permanent central venous catheters are used in majority of patients of CKD when initiated on hemodialysis and mostly these catheters act as bridge before permanent AV fistula assess could be obtained. Blood stream infections related to these central venous catheters are an important cause of morbidity and mortality in these patients. Appropriate antiseptic precautions while inserting central venous catheter and early identification of catheter related blood stream infections (CRBSI are of utmost importance for reducing hospital stay, cost of therapy and mortality. MATERIALS AND METHODS A total of 50 patients of CKD were included in the study who had central venous catheter in situ (internal jugular or subclavian and developed symptoms related to blood stream infections. Blood cultures were obtained from the catheter lumen and a separate venous site 1 hour apart. All the culture sensitivity reports were obtained from department of microbiology of our institute. Inclusion Criteria- Known case of CKD patients aged more than 18yrs on hemodialysis with symptoms and signs of catheter related blood stream infections were included in the study. Exclusion Criteria- Patients with other associated comorbid infections like Koch’s, urinary tract infection or others mimicking symptoms of CRBSI. RESULTS The cultures were found positive in 38 patients (76% while in rest 24% cases positive cultures could not be obtained. Out of culture positive patients 52.63% cases were found to have gram positive infections while 44.74% had gram negative infections. In 2.63% patients, fungus was isolated to be the causative organism. Among the gram positive organisms 50% had CoNS, 30% had MSSA and 20% had MRSA infections. Among the gram negative group, 47.06% had klebsiella, 23.53% had acinetobacter, 17.65% had E.coli and 11.76% had pseudomonas as the causative organisms. Mortality was observed in 14% patients out of which 28.57% were culture

Prevention of nosocomial infections in intensive care unit and nursing practices

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Sevilay Yüceer

2009-01-01

Full Text Available Nosocomial infections which are considered as the primary indicator of the quality of care in hospitals, cause to prolong hospitalization at intensive care unit and hospital, increase morbidity, mortality, and the cost of treatment. Although only 5-10% of the patients are treated in the intensive care units, 20-25% of all nosocomial infections are seen in these units. Preventing nosocomial infections in intensive care units is a process started at the patient acceptance to unit that requires an interdisciplinary team approach of intensive care staffs’ and Infection Control Committee members.Intensive care nurses who are in constant contact with patients have important responsibilities in preventing nosocomial infections. Intensive care nurses should be aware that the nosocomial infections can be prevented. They should have current knowledge about universal precautions related to prevention and control of infections, which are accepted by the entire world and they reinforce this knowledge by practice and should provide the most effective care to patients.In this article, nursing practices for prevention of nosocomial infections in intensive care units are discussed based on universal precautions.

[Prevalence of nosocomial infections in two hospitals in Conakry (Guinea)].

Science.gov (United States)

Keita, Alpha Kabinet; Doumbouya, Naman; Sow, Mamadou Saliou; Konaté, Bintou; Dabo, Yacouba; Panzo, Daniel Agbo; Keita, Mamady

2016-01-01

Nosocomial infections can be prevented by applying simple hygiene rules. However, they have not been sufficiently studied in the Republic of Guinea. For this purpose, we conducted a one-day study in the Conakry University Hospital surgery wards and intensive care units. Fourteen units (12 surgical wards and 2 intensive care units) participated in the study. A total of 310 patients were included. A nosocomial infection was observed in 62 patients, [20%, 95%CI 15.9-24.8%]. Surgical site infections were significantly more frequent with 42/62 cases [67.7%, 95%CI 55.3-78.1%, p = 0.0001] than other types of infections (urinary tract, skin and digestive) with 20/62 cases [32.3% 95%CI 21.9-44.6%]. The average hospital stay of 29.1 ± 23.4 days [95%CI, 23.2 ± 35.04] for patients with nosocomial infection was significantly different (p = 0.0001) from that observed in patients without nosocomial infection: 15.9 ± 16.3 days [95%CI, 13.8 ± 17.9]. Staphylococcus aureus was the pathogen most commonly isolated: 32/62 (51.6%; 95%CI 39.5-63.6%). Escherichia coli infection was identified in the bladder catheters of 13 patients [20.9%, 95%CI 12.7-32.6%]. Finally, five deaths were observed among the 62 patients with nosocomial infection. This study shows that nosocomial infections are common in Conakry University Hospital. Further studies must be conducted to identify the risk factors for nosocomial infections and to propose solutions.

Blood vessel endothelium-directed tumor cell streaming in breast tumors requires the HGF/C-Met signaling pathway.

Science.gov (United States)

Leung, E; Xue, A; Wang, Y; Rougerie, P; Sharma, V P; Eddy, R; Cox, D; Condeelis, J

2017-05-11

During metastasis to distant sites, tumor cells migrate to blood vessels. In vivo, breast tumor cells utilize a specialized mode of migration known as streaming, where a linear assembly of tumor cells migrate directionally towards blood vessels on fibronectin-collagen I-containing extracellular matrix (ECM) fibers in response to chemotactic signals. We have successfully reconstructed tumor cell streaming in vitro by co-plating tumors cells, macrophages and endothelial cells on 2.5 μm thick ECM-coated micro-patterned substrates. We found that tumor cells and macrophages, when plated together on the micro-patterned substrates, do not demonstrate sustained directional migration in only one direction (sustained directionality) but show random bi-directional walking. Sustained directionality of tumor cells as seen in vivo was established in vitro when beads coated with human umbilical vein endothelial cells were placed at one end of the micro-patterned 'ECM fibers' within the assay. We demonstrated that these endothelial cells supply the hepatocyte growth factor (HGF) required for the chemotactic gradient responsible for sustained directionality. Using this in vitro reconstituted streaming system, we found that directional streaming is dependent on, and most effectively blocked, by inhibiting the HGF/C-Met signaling pathway between endothelial cells and tumor cells. Key observations made with the in vitro reconstituted system implicating C-Met signaling were confirmed in vivo in mammary tumors using the in vivo invasion assay and intravital multiphoton imaging of tumor cell streaming. These results establish HGF/C-Met as a central organizing signal in blood vessel-directed tumor cell migration in vivo and highlight a promising role for C-Met inhibitors in blocking tumor cell streaming and metastasis in vivo, and for use in human trials.

Pediatric mortality due to nosocomial infection: a critical approach

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Julia Marcia Maluf Lopes

Full Text Available Nosocomial infection is a frequent event with potentially lethal consequences. We reviewed the literature on the predictive factors for mortality related to nosocomial infection in pediatric medicine. Electronic searches in English, Spanish and Portuguese of the PubMed/MEDLINE, LILACS and Cochrane Collaboration Databases was performed, focusing on studies that had been published from 1996 to 2006. The key words were: nosocomial infection and mortality and pediatrics/neonate/ newborn/child/infant/adolescent. The risk factors found to be associated with mortality were: nosocomial infection itself, leukemia, lymphopenia, neutropenia, corticosteroid therapy, multiple organ failure, previous antimicrobial therapy, catheter use duration, candidemia, cancer, bacteremia, age over 60, invasive procedures, mechanical ventilation, transport out of the pediatric intensive care unit, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Burkholderia cepacia infections, acute physiology and chronic health evaluation (APACHE II scores over 15. Among these factors, the only one that can be minimized is inadequate antimicrobial treatment, which has proven to be an important contributor to hospital mortality in critically-ill patients. There is room for further prognosis research on this matter to determine local differences. Such research requires appropriate epidemiological design and statistical analysis so that pediatric death due to nosocomial infection can be reduced and health care quality improved in pediatric hospitals.

Frequency of nosocomial pneumonia in ICU Qazvin Razi hospital (2013

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S. Makhlogi

2016-12-01

Full Text Available Background: Nosocomial pneumonia is the most prevalent cause of hospital-acquired infection in intensive care units (ICU. The aim of this research was to detect the frequency and predisposing factors of nosocomial Ventilator Associated Pneumonia, by cross sectional study on 188 patients that were hospitalized in ICU Qazvin Razi Hospital. Using questionnaire based on the national nosocomial infection surveillance system (NNIS data collected and analyzed. The average age of patients was 51±24 years old, 37 hospitalized patients (19/6% in the fourth day of admission were affected Ventilator Associated Pneumonia. The most common pathogenesis of causing nosocomial pneumonia were klebsiella in 13 patients (35/1%, staph in 8 patients (21/6%, sodomona in 8 patients (21/6%, ecoli in 3 patients (8/1%, cetrobacter in 2 patients (5/4%, antrococus and Proteus each of them in 1 patient (each 2/7%. Considering (19/6% frequency of nosocomial pneumonia in this study, it’s necessary to act standard protocols in nursing care and medication process.

Antimicrobial susceptibility pattern in nosocomial infections caused by Acinetobacter species in Asir Region, Saudi Arabia.

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Abdalla, Nazar M; Osman, Amani A; Haimour, Waleed O; Sarhan, Mohammed A A; Mohammed, Mohammed N; Zyad, Eyhab M; Al-Ghtani, Abdalla M

2013-03-15

This study aimed at evaluating the sensitivity of antibiotics towards nosocomial infections caused by Acinetobacter species. The study took place during the period Dec. 2011- Dec. 2012 at Assir Central Hospital in collaboration with the department of microbiology, college of medicine, King Khalid University, Abha. A prospective study involving 150 patients presented with nosocomial infections due to Acinetobacter species detected by bacteriological tests; direct microscopy, culture in blood agar media, fermentation test in MacConkey media and MIC (minimum inhibitory concentration) for antibiotics sensitivity using Muller Hinton media and Chemical test using API 20. A 150 nosocomial infections in this study showed gram-negative coccobacilli, non motile, glucose-negative fermentor and oxidase negative. All isolates showed 100% sensitivity to: Imipramine, Meropenem, Colistin. From the rest of tested antibiotics the higher resistant ones were; Nitrofurantoin 87% and Cefoxitin 85%. The least resistant antibiotics; Imipenem 3% and Ticarcillin 7%. While variable resistance in the rest of tested antimicrobials. A 47 patients (31.3%) have used antibiotics prior to this study. The high rate of usage occurred in elder patients. The frequency of Acinetobacter calcoaceticus baumannii complex multi-drugs resistance ABCMDR is rising including almost all commonly used antibiotics. Only few antibiotics exert 100% sensitivity towards these bacteria.

Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002

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Djoko Widodo

2004-06-01

Full Text Available Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107

Daily antibiotic cost of nosocomial infections in a Turkish university hospital

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Yalcin Ata

2005-01-01

Full Text Available Abstract Background Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. Methods All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. Results Among the 8460 study patients, 817 (16.6% developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7% presented with only one nosocomial infection. Mean daily antibiotic cost was $89.64. Daily antibiotic cost was $99.02 for pneumonia, $94.32 for bloodstream infection, $94.31 for surgical site infection, $52.37 for urinary tract infection, and $162.35 for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. Conclusions Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.

Coagulase-negative staphylococci causing blood stream infection at an Indian tertiary care hospital: Prevalence, antimicrobial resistance and molecular characterisation

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S Singh

2016-01-01

Full Text Available Introduction: Recent years have seen a rise of coagulase-negative staphylococci (CoNS from common contaminants to agents of nosocomial blood stream infections (BSI's. Molecular typing and establishing a correlation with antibiotic resistance is essential particularly in countries like India where genotyping studies for drug-resistant CoNS are sparse. Methods: A prospective study was done over 18 months, wherein 42,693 blood samples were received, and 59 patients with BSI due to CoNS were evaluated. The isolates recovered were identified by a biochemical test panel and matrix-assisted laser desorption ionization – time of flight mass spectrometry followed by antimicrobial susceptibility testing by Kirby–Baur disc diffusion method and E-test strips. Staphylococcal chromosomal cassette mec (SCCmec element was characterised by multiplex polymerase chain reaction for all methicillin-resistant (MR isolates. Results: The majority of CoNS isolated were constituted by Staphylococcus haemolyticus (47.5% followed by Staphylococcus epidermidis (33.9%, Staphylococcus hominis (11.86%, Staphylococcus cohnii (5.08% and Staphylococcus warneri (1.69%. Among all isolates 57.6% were MR with statistically significant higher resistance versus methicillin sensitive-CoNS. This difference was significant for erythromycin (76% vs. 44%, P = 0.011, rifampicin (50% vs. 12%,P= 0.002 and amikacin (26.5% vs. 4%, P = 0.023, ciprofloxacin (64.7% vs. 20%, P = 0.001 and cotrimoxazole (55.9% vs. 20%, P = 0.006. SCCmec type I was predominant (61.8%, P = 0.028 and exhibited multidrug resistance (76.2%. Coexistence of SCCmec type I and III was seen in 8.82% MR isolates. Conclusion: CoNS exhibit high antimicrobial resistance thereby limiting treatment options. The presence of new variants of SCCmec type in hospital-acquired CoNS may predict the antibiotic resistance pattern. This is the first evaluation of the molecular epidemiology of CoNS causing BSI from India and can serve as a

Coagulase-negative staphylococci causing blood stream infection at an Indian tertiary care hospital: Prevalence, antimicrobial resistance and molecular characterisation.

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Singh, S; Dhawan, B; Kapil, A; Kabra, S K; Suri, A; Sreenivas, V; Das, B K

2016-01-01

Recent years have seen a rise of coagulase-negative staphylococci (CoNS) from common contaminants to agents of nosocomial blood stream infections (BSI's). Molecular typing and establishing a correlation with antibiotic resistance is essential particularly in countries like India where genotyping studies for drug-resistant CoNS are sparse. A prospective study was done over 18 months, wherein 42,693 blood samples were received, and 59 patients with BSI due to CoNS were evaluated. The isolates recovered were identified by a biochemical test panel and matrix-assisted laser desorption ionization - time of flight mass spectrometry followed by antimicrobial susceptibility testing by Kirby-Baur disc diffusion method and E-test strips. Staphylococcal chromosomal cassette mec (SCCmec) element was characterised by multiplex polymerase chain reaction for all methicillin-resistant (MR) isolates. The majority of CoNS isolated were constituted by Staphylococcus haemolyticus (47.5%) followed by Staphylococcus epidermidis (33.9%), Staphylococcus hominis (11.86%), Staphylococcus cohnii (5.08%) and Staphylococcus warneri (1.69%). Among all isolates 57.6% were MR with statistically significant higher resistance versus methicillin sensitive-CoNS. This difference was significant for erythromycin (76% vs. 44%, P = 0.011), rifampicin (50% vs. 12%,P= 0.002) and amikacin (26.5% vs. 4%, P = 0.023), ciprofloxacin (64.7% vs. 20%, P = 0.001) and cotrimoxazole (55.9% vs. 20%, P = 0.006). SCCmec type I was predominant (61.8%, P = 0.028) and exhibited multidrug resistance (76.2%). Coexistence of SCCmec type I and III was seen in 8.82% MR isolates. CoNS exhibit high antimicrobial resistance thereby limiting treatment options. The presence of new variants of SCCmec type in hospital-acquired CoNS may predict the antibiotic resistance pattern. This is the first evaluation of the molecular epidemiology of CoNS causing BSI from India and can serve as a guide in the formulation of hospital infection

NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

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F. S. Sadulloev

2015-01-01

Full Text Available Abstract:Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%.

Prevalence of Nosocomial Infection in Different Wards of Ghaem Hospital, Mashhad

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Jamal Falahi

2017-04-01

Full Text Available Background The CDC defines a nosocomial infection as a localized or systemic condition caused by an adverse reaction to the presence of an infectious agent(s or its toxin(s. It is an infection that occurs between 48 to 72 hours after admission of patients in the hospital or as soon after the hospital discharge and on the admission time, patients don't have this infection. Objectives This study aimed to characterize the prevalence of nosocomial infection in Ghaem hospital, Mashhad, Iran. Methods This retrospective study was conducted in all wards of the Ghaem hospital, Mashhad during the 1 year period (2013; the data were collected from the wards records and HIS system and analyzed by the SPSS software (version16. Results In the present study, of total 35979 hospitalized patients in different wards of the Ghaem hospital was reported 1.1% of nosocomial infection. In the meantime, overall, the most prevalent organism was Acinetobacter baumannii with a prevalence of 37.2% and the minimum was linked to the Bacillus species with a prevalence 0.3%. The highest and lowest prevalence of the nosocomial infection was in the ICU and CCU with 49.9% and 0.3%, respectively. In general, among all wards of the mentioned hospital, the most frequent nosocomial infection was pneumonia (47.4% and the lowest belonged to CSF (2.3%. Conclusions In our study, the ICU ward was accounted for the highest rate of nosocomial infection, due to the critical importance of this ward. Preventive measures and survivelance system for reduction of nosocomial infections is needed.

Early Expansion of Circulating Granulocytic Myeloid-derived Suppressor Cells Predicts Development of Nosocomial Infections in Patients with Sepsis.

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Uhel, Fabrice; Azzaoui, Imane; Grégoire, Murielle; Pangault, Céline; Dulong, Joelle; Tadié, Jean-Marc; Gacouin, Arnaud; Camus, Christophe; Cynober, Luc; Fest, Thierry; Le Tulzo, Yves; Roussel, Mikael; Tarte, Karin

2017-08-01

Sepsis induces a sustained immune dysfunction responsible for poor outcome and nosocomial infections. Myeloid-derived suppressor cells (MDSCs) described in cancer and inflammatory processes may be involved in sepsis-induced immune suppression, but their clinical impact remains poorly defined. To clarify phenotype, suppressive activity, origin, and clinical impact of MDSCs in patients with sepsis. Peripheral blood transcriptomic analysis was performed on 29 patients with sepsis and 15 healthy donors. A second cohort of 94 consecutive patients with sepsis, 11 severity-matched intensive care patients, and 67 healthy donors was prospectively enrolled for flow cytometry and functional experiments. Genes involved in MDSC suppressive functions, including S100A12, S100A9, MMP8, and ARG1, were up-regulated in the peripheral blood of patients with sepsis. CD14 pos HLA-DR low/neg monocytic (M)-MDSCs were expanded in intensive care unit patients with and without sepsis and CD14 neg CD15 pos low-density granulocytes/granulocytic (G)-MDSCs were more specifically expanded in patients with sepsis (P sepsis. G-MDSCs, made of immature and mature granulocytes expressing high levels of degranulation markers, were specifically responsible for arginase 1 activity. High initial levels of G-MDSCs, arginase 1, and S100A12 but not M-MDSCs were associated with subsequent occurrence of nosocomial infections. M-MDSCs and G-MDSCs strongly contribute to T-cell dysfunction in patients with sepsis. More specifically, G-MDSCs producing arginase 1 are associated with a higher incidence of nosocomial infections and seem to be major actors of sepsis-induced immune suppression.

Pentaglobin as an adjunct therapy in very low birthweight neonates with nosocomial sepsis

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Salihoglu, O.; Can, E.; Koc, M.O.; Durmus, E.; Hatipoglu, S.

2013-01-01

To evaluate the effect of pentaglobin treatment on clinical and laboratory parametres and the major morbidities in very low birthweight neonates with nosocomial sepsis before and after pentaglobin treatment. Methods: The prospective interventional study was conducted from January 1 to December 31, 2010, at the neonatal intensive care unit (NICU) of the Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Pentaglobin was initiated on the day of diagnosis of nosocomial sepsis to 13 pre-term neonates as a support therapy in addition to antibiotics; 5 ml/kg per day of pentaglobin was infused over a 4-hour period on 3 consecutive days. Clinical and laboratory parametres and major morbidities were recorded before and after pentaglobin treatment and compared using NCSS software. Results: Of the total, 8(66%) were females and 5 (40%) males. Following pentaglobin therapy, the immature-to-total neutrophil ratio and C-reactive protein levels were significantly decreased, and the capillary pH and base excess were significantly increased (p 0.05). Coagulase-negative staphylococci (n=3; 23%), Klebsiella pneumoniae (n=2; 15.3%), and Pseudomonas aeruginosa (n=1; 7.7%) were identified in blood cultures. The presence of intraventricular haemorrhages, necrotising enterocolitis, periventricular leukomalacia, and patent ductus arteriosus was not changed following the treatment. Adverse effects and mortality were not observed during or after the therapy. Conclusion: Pentaglobin treatment of nosocomial sepsis could be used as an adjunct therapy without any adverse short-term reactions, even in very low birthweight pre-term infants. (author)

Pathogens causing blood stream infections and their drug susceptibility profile in immunocompromised patients.

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Fayyaz, Muhammad; Mirza, Irfan Ali; Ikram, Aamer; Hussain, Aamir; Ghafoor, Tahir; Shujat, Umer

2013-12-01

To determine the types of pathogens causing blood stream infections and their drug susceptibility profile in immunocompromised patients. Cross-sectional, observational study. Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi, from January to September 2012. Blood culture bottles received from immunocompromised patients were dealt by two methods, brain heart infusion (BHI) broth based manual method and automated BACTEC system. The samples yielding positive growth from either of two methods were further analyzed. The identification of isolates was done with the help of biochemical reactions and rapid tests. Antimicrobial susceptibility of the isolates was carried out as per recommendations of Clinical and Laboratory Standards Institute (CLSI). Out of the 938 blood culture specimens received from immunocompromised patients, 188 (20%) yielded positive growth. Out of these, 89 (47.3%) isolates were Gram positive and Gram negative each, while 10 (5.3%) isolates were fungi (Candida spp.). In case of Gram positive isolates, 75 (84.3%) were Staphylococcus spp. and 51 (67%) were Methicillin resistant. Amongst Gram negative group 49 (55.1%) isolates were of enterobacteriaceae family, while 40 (44.9%) were non-lactose fermenters (NLF). In vitro antimicrobial susceptibility of Staphylococci revealed 100% susceptibility to vancomycin and linezolid. The enterobacteriaceae isolates had better susceptibility against amikacin 85.7% compared to tigecycline 61.2% and imipenem 59.2%. For NLF, the in vitro efficacy of aminoglycosides was 72.5%. The frequency of Gram positive and Gram negative organisms causing blood stream infections in immunocompromised patients was equal. Vancomycin in case of Gram positive and amikacin for Gram negative organisms revealed better in vitro efficacy as compared to other antibiotics.

Pathogens Causing Blood Stream Infections and their Drug Susceptibility Profile in Immunocompromised Patients

International Nuclear Information System (INIS)

Fayyaz, M.; Mirza, I.A.; Ikram, A.; Hussain, A.; Ghafoor, T.; Shujat, U.

2013-01-01

Objective: To determine the types of pathogens causing blood stream infections and their drug susceptibility profile in immunocompromised patients. Study Design: Cross-sectional, observational study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi, from January to September 2012. Methodology: Blood culture bottles received from immunocompromised patients were dealt by two methods, brain heart infusion (BHI) broth based manual method and automated BACTEC system. The samples yielding positive growth from either of two methods were further analyzed. The identification of isolates was done with the help of biochemical reactions and rapid tests. Antimicrobial susceptibility of the isolates was carried out as per recommendations of Clinical and Laboratory Standards Institute (CLSI). Results: Out of the 938 blood culture specimens received from immunocompromised patients, 188 (20%) yielded positive growth. Out of these, 89 (47.3%) isolates were Gram positive and Gram negative each, while 10 (5.3%) isolates were fungi (Candida spp.). In case of Gram positive isolates, 75 (84.3%) were Staphylococcus spp. and 51 (67%) were Methicillin resistant. Amongst Gram negative group 49 (55.1%) isolates were of enterobacteriaceae family, while 40 (44.9%) were non-lactose fermenters (NLF). In vitro antimicrobial susceptibility of Staphylococci revealed 100% susceptibility to vancomycin and linezolid. The enterobacteriaceae isolates had better susceptibility against amikacin 85.7% compared to tigecycline 61.2% and imipenem 59.2%. For NLF, the in vitro efficacy of aminoglycosides was 72.5%. Conclusion: The frequency of Gram positive and Gram negative organisms causing blood stream infections in immunocompromised patients was equal. Vancomycin in case of Gram positive and amikacin for Gram negative organisms revealed better in vitro efficacy as compared to other antibiotics. (author)

Prevention of nosocomial infections in developing countries, a systematic review.

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Murni, Indah; Duke, Trevor; Triasih, Rina; Kinney, Sharon; Daley, Andrew J; Soenarto, Yati

2013-05-01

Prevention of nosocomial infection is key to providing good quality, safe healthcare. Infection control programmes (hand-hygiene campaigns and antibiotic stewardship) are effective in reducing nosocomial infections in developed countries. However, the effectiveness of these programmes in developing countries is uncertain. To evaluate the effectiveness of interventions for preventing nosocomial infections in developing countries. A systematic search for studies which evaluated interventions to prevent nosocomial infection in both adults and children in developing countries was undertaken using PubMed. Only intervention trials with a randomized controlled, quasi-experimental or sequential design were included. Where there was adequate homogeneity, a meta-analysis of specific interventions was performed using the Mantel-Haenzel fixed effects method to estimate the pooled risk difference. Thirty-four studies were found. Most studies were from South America and Asia. Most were before-and-after intervention studies from tertiary urban hospitals. Hand-hygiene campaigns that were a major component of multifaceted interventions (18 studies) showed the strongest effectiveness for reducing nosocomial infection rates (median effect 49%, effect range 12.7-100%). Hand-hygiene campaigns alone and studies of antibiotic stewardship to improve rational antibiotic use reduced nosocomial infection rates in three studies [risk difference (RD) of -0.09 (95%CI -0.12 to -0.07) and RD of -0.02 (95% CI -0.02 to -0.01), respectively]. Multifaceted interventions including hand-hygiene campaigns, antibiotic stewardship and other elementary infection control practices are effective in developing countries. The modest effect size of hand-hygiene campaigns alone and negligible effect size of antibiotic stewardship reflect the limited number of studies with sufficient homogeneity to conduct meta-analyses.

Reducing nosocomial infections in neonatal intensive care.

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Rogers, Eileen; Alderdice, Fiona; McCall, Emma; Jenkins, John; Craig, Stanley

2010-09-01

Nosocomial infection is a common problem in neonatal intensive care. A pilot quality improvement initiative focussing on hand hygiene and aimed at reducing nosocomial infection in very low birth weight (VLBW) infants was introduced in five Neonatal Intensive Care Units. Line associated laboratory confirmed bloodstream infection (LCBSI) and ventilator associated pneumonia (VAP) were chosen as main outcome measures. In VLBW infants, the rate of line associated LCBSI per 1000 central venous catheter days fell by 24%. The rate of VAP per 1000 ventilator days in VLBW infants fell by 38%. Pre- and post-intervention questionnaires showed a statistically significant increase in use of alcohol-based gels and increased knowledge of hand hygiene.

Nosocomial infections at Clinical Centre in Kragujevac: Prevalence study

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Ilić Milena

2010-01-01

Full Text Available Introduction Nosocomial infections (NIs are a serious health problem in hospitals worldwide and are followed by a series of consequences, medical, judicial, ethical and economic. Objective The main aim of this study was to assess the magnitude of NIs at the Clinical Centre in Kragujevac. Methods A prevalence study of nosocomial infections was conducted from 16th till 20th May, 2005, within Second National Prevalence Study of Niš in the Republic of Serbia. Results The study included 866 patients. 40 patients had a NI, thus the prevalence of patients with NIs and prevalence of NIs was the same, 4.6%. Among NIs, the most frequent were urinary infections (45.0% followed by surgical-site infections (17.5%, skin and soft tissue infections (15% and pneumonia (12.5%. The rate of NIs was highest at departments of orthopaedics and traumatological surgery (12.0%, followed by intensive care units (8.0%. Overall, 67.5% (27/40 NIs were culture-proved; the leading pathogens were Escherichia coli (40.0%, followed by gram-negative bacteria (Pseudomonas species, Proteus mirabilis, Enterobacteriaceae with equal frequency of 8.0%. Nosocomial infections were significantly more frequent in patients aged ≥65 years (p<0.05, with longer hospitalization ≥8 days (p<0.00, in intensive care patients (p<0.05, patients with an intravenous catheter (p<0.00, urinary catheter (p<0.00, and those under antibiotic therapy (p<0.00. Conclusion This study showed that the prevalence of nosocomial infections in our hospital is similar to the prevalence in the developed countries. The study of prevalence provides a prompt insight into basic epidemiological and ethiological characteristics of nosocomial infections, hence identification of hospital priorities and the need to undertake appropriate prevention measures. .

Monitoring of nosocomial infections as an element of prevention

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Izabela Gąska

2017-10-01

Full Text Available Introduction. Hospital infections are one of the most serious threats to the hospitalised patient and their monitoring is recognised as one of the most important criteria of care quality for modern hospitals. The aim of the work was to present the problem of nosocomial infections and desired behaviours and activities in the field of infection prophylaxis. Material and method. The analysis of the current scientific literature was carried out with particular attention to the prevention of infections in treatment wards and the need to monitor the patient's condition and the environment in the case of an infection. Results. The lack of developed and implemented programmes for the control of nosocomial infections is a fundamental element that increases the risk of nosocomial infections. This disrupts the proper functioning of the hospital and causes additional health problems for the patient and the ward staff. In addition, the hospital suffers losses instead of savings, which is a priority aim in the current funding system. Conclusions. The basis for eliminating or minimising the incidence of nosocomial infections is a well-developed and implemented programme of hospital infection control based on the education of medical personnel in the field of infection prevention. Constant, comprehensive assessment of the procedures used and the standards of conduct, epidemiological data as well as microbiological data can ensure quick identification and elimination of the threat.

Streaming flow from ultrasound contrast agents by acoustic waves in a blood vessel model.

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Cho, Eunjin; Chung, Sang Kug; Rhee, Kyehan

2015-09-01

To elucidate the effects of streaming flow on ultrasound contrast agent (UCA)-assisted drug delivery, streaming velocity fields from sonicated UCA microbubbles were measured using particle image velocimetry (PIV) in a blood vessel model. At the beginning of ultrasound sonication, the UCA bubbles formed clusters and translated in the direction of the ultrasound field. Bubble cluster formation and translation were faster with 2.25MHz sonication, a frequency close to the resonance frequency of the UCA. Translation of bubble clusters induced streaming jet flow that impinged on the vessel wall, forming symmetric vortices. The maximum streaming velocity was about 60mm/s at 2.25MHz and decreased to 15mm/s at 1.0MHz for the same acoustic pressure amplitude. The effect of the ultrasound frequency on wall shear stress was more noticeable. Maximum wall shear stress decreased from 0.84 to 0.1Pa as the ultrasound frequency decreased from 2.25 to 1.0MHz. The maximum spatial gradient of the wall shear stress also decreased from 1.0 to 0.1Pa/mm. This study showed that streaming flow was induced by bubble cluster formation and translation and was stronger upon sonication by an acoustic wave with a frequency near the UCA resonance frequency. Therefore, the secondary radiant force, which is much stronger at the resonance frequency, should play an important role in UCA-assisted drug delivery. Copyright © 2015 Elsevier B.V. All rights reserved.

[Invasive nosocomial pulmonary aspergillosis].

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Germaud, P; Haloun, A

2001-04-01

Immunodepressed patients, particularly those with neutropenia or bone marrow or organ grafts, are at risk of developing nosocomial invasive pulmonary aspergilosis. The favoring factors, early diagnostic criteria and curative treatment protocols are well known. Prognosis remains however quite severe with a death rate above 50%. Preventive measures are required for the treatment of these high-risk patients and epidemiology surveillance is needed in case of aspergillosis acquired in the hospital.

Modelling the contact propagation of nosocomial infection in emergency departments

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Jaramillo, Cecilia; Taboada, Manel; Epelde, Francisco; Rexachs, Dolores; Luque Amat, Emilio

2015-01-01

The nosocomial infection is a special kind of infection that is caused by microorganisms acquired inside a hospital. In the daily care process of an emergency department, the interactions between patients and sanitary staff create the environment for the transmission of such microorganisms. Rates of morbility and mortality due to nosocomial infections areimportant indicators of the quality of hospital work. In this research, we use Agent Based Modeling and Simulation tech...

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt.

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Kishk, Rania Mohammed; Mandour, Mohamed Fouad; Farghaly, Rasha Mohamed; Ibrahim, Ahmed; Nemr, Nader Attia

2014-01-01

Introduction. Blood stream infection (BSI) is a common problem of newborn in neonatal intensive care units (NICUs). Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3%) developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value Suez Canal University Hospital was relatively high with high mortality rate (36.0%).

Predicting nosocomial lower respiratory tract infections by a risk index based system

NARCIS (Netherlands)

Chen, Yong; Shan, Xue; Zhao, Jingya; Han, Xuelin; Tian, Shuguang; Chen, Fangyan; Su, Xueting; Sun, Yansong; Huang, Liuyu; Grundmann, Hajo; Wang, Hongyuan; Han, Li

2017-01-01

Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence

[Listeria monocytogenes nosocomial infection in the maternity ward].

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Jean, D; Croize, J; Hirtz, P; Legeais, C; Pelloux, I; Favier, M; Mallaret, M R; Le Noc, P; Rambaud, P

1991-01-01

Nosocomial infection with Listeria monocytogenes 4b occurred in January 1990 in a maternity hospital in Grenoble. The 3 patients involved were born within a 24 hour-interval. The premature newborn responsible for contamination was asymptomatic. Two other newborns without any perinatal infectious risk presented with meningitis, one on the 5th day of life in the maternity hospital, the other one on the 11th day while already at home. The 3 strains of Listeria had the same serovar and lysovar. Epidemiologic investigations led to suspect a contamination in the delivery room and during the care of the children. Strict respect of hygiene orders is imperative to avoid nosocomial infections.

[Antibibiotic resistance by nosocomial infections' causal agents].

Science.gov (United States)

Salazar-Holguín, Héctor Daniel; Cisneros-Robledo, María Elena

2016-01-01

The antibibiotic resistance by nosocomial infections (NI) causal agents constitutes a seriously global problematic that involves the Mexican Institute of Social Security's Regional General Hospital 1 in Chihuahua, Mexico; although with special features that required to be specified and evaluated, in order to concrete an effective therapy. Observational, descriptive and prospective study; by means of active vigilance all along 2014 in order to detect the nosocomial infections, for epidemiologic study, culture and antibiogram to identify its causal agents and antibiotics resistance and sensitivity. Among 13527 hospital discharges, 1079 displayed NI (8 %), standed out: the related on vascular lines, of surgical site, pneumonia and urinal track; they added up two thirds of the total. We carried out culture and antibiogram about 300 of them (27.8 %); identifying 31 bacterian species, mainly seven of those (77.9 %): Escherichia coli, Staphylococcus aureus and epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Enterobacter cloacae; showing multiresistance to 34 tested antibiotics, except in seven with low or without resistance at all: vancomycin, teicoplanin, linezolid, quinupristin-dalfopristin, piperacilin-tazobactam, amikacin and carbapenems. When we contrasted those results with the recommendations in the clinical practice guides, it aroused several contradictions; so they must be taken with reserves and has to be tested in each hospital, by means of cultures and antibiograms in practically every case of nosocomial infection.

Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study

NARCIS (Netherlands)

M.C. Vos (Margreet); A. Ott (Alewijn); A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); C.M.J.E. Vandenbroucke-Grauls (Christina); M.H.M. Meester (Marlene); P.H.J. van Keulen (Peter); H.A. Verbrugh (Henri); H.F.L. Wertheim (Heiman)

2004-01-01

textabstractBACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical

Nosocomial imipenem-resistant Acinetobacter baumannii infections ...

African Journals Online (AJOL)

Imipenem-resistant Acinetobacter baumannii (A. baumannii) (IRAB) has emerged as a challenging nosocomial pathogen particularly in intensive care units (ICUs). Studying the risk factors associated with IRAB infection is of paramount importance for appropriate control of IRAB spread. The aim of this study was to assess ...

Drug-resistant post-neurosurgical nosocomial Acinetobacter ...

African Journals Online (AJOL)

Drug-resistant post-neurosurgical nosocomial Acinetobacter baumannii meningitis in two Iranian hospitals. ... Vol 11, No 17 (2012) >. Log in or Register to get access to full text downloads. ... Acinetobacter baumannii may cause meningitis and ventriculitis, particularly after head trauma and/or neurosurgery. The rate of ...

Activities of doripenem against nosocomial bacteremic drug-resistant Gram-negative bacteria in a medical center in Taiwan.

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Dong, Shao-Xing; Wang, Jann-Tay; Chang, Shan-Chwen

2012-12-01

The majority of nosocomial infections in Taiwan hospitals are caused by drug-resistant Gram-negative bacteria (GNB), including Pseudomonas aeruginosa, Acinetobacter baumannii, and various species of Enterobacteriaceae. Carbapenems are important agents for treating infections caused by these GNB. Recently, doripenem was approved for use in Taiwan in August 2009. However, data on its in vitro activity against nosocomial GNB isolated from Taiwan remain limited. The study was designed to look into this clinical issue. A total of 400 nonduplicated nosocomial blood isolates isolated in 2009, inclusive of P. aeruginosa (n = 100), A. baumannii (n = 100), and Enterobacteriaceae (n = 200), were randomly selected from the bacterial bank preserved at National Taiwan University Hospital. Susceptibilities of these 400 isolates to various antibiotics, including doripenem, imipenem, meropenem, ceftazidime, amikacin, ciprofloxacin, colistin, and tigecycline were determined by using Etest. Doripenem demonstrated similar in vitro activity to imipenem and meropenem against P. aeruginosa (87%, vs. 85% and 89%), A. baumannii (56%, vs. 60% and 60%), and Enterobacteriaceae (100%, vs. 98.5% and 99.5%). The prevalence of carbapenem-resistant (any one of three tested carbapenems) P. aeruginosa, A. baumannii, and Enterobacteriaceae isolates was 15%, 44%, and 0.5%, respectively. Doripenem was as effective as imipenem and meropenem in our study. However, there was a significant proportion of carbapenem resistance among the tested isolates. Hence, longitudinal surveillance is necessary to monitor the resistance trend. Copyright © 2012. Published by Elsevier B.V.

Nosocomial pneumonia in the ICU--year 2000 and beyond.

Science.gov (United States)

Bowton, D L

1999-03-01

Diagnostic and treatment strategies in ICU patients with ventilator-associated pneumonia (VAP) remain controversial, largely because of the paucity of well-controlled comparison trials using clinically important end points. Recent studies indicating that early appropriate antibiotic therapy significantly lowers mortality underscore the urgent need for well-designed comparative trials. When quantitatively cultured, bronchial specimens obtained by noninvasive techniques may provide clinically useful information and avoid the higher costs and risks of invasive bronchoscopic diagnostic techniques. Previous antibiotic use before onset of nosocomial pneumonia raises the likelihood of infection with highly virulent organisms, such as Pseudomonas aeruginosa and Acinetobacter sp. Thus, the empiric antibiotic regimen should be active against these Gram-negative pathogens as well as other common Gram-negative and Gram-positive causative organisms. Promising preventive modalities for nosocomial VAP include use of a semirecumbent position, endotracheal tubes that allow continuous aspiration of secretions, and heat and moisture exchangers. Rotating their standard empiric antibiotic regimens and restricting the use of third-generation cephalosporins as empiric therapy may help hospitals reduce the incidence of nosocomial pneumonia caused by resistant Gram-negative pathogens.

Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

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Ahsan Ahsan

2016-09-01

Full Text Available Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasi experimental design. The population was all of nursing staff who working in obstetrics installation in hospitals A and B as much as 46 people. Sample was the total population. Data was collected through questionnaire, observation sheets and examination of the wound culture. Data was analyzed using t test B 1.274 dan p=0.028 Result: The result showed that 1 there was difference in knowledge management implementation before and after training; 2 there was difference in nurse’s performance in preventing nosocomial infection before and after training; 3 there is significant relationship between nurse’s performance in preventing nosocomial infection and infection incidence; 4 there is no significant difference of nursing care impementation on nosocomial incidence. Discussion: In conclusion, the development of nursing care based on knowledge management as a synthesis or induction of findings directed at 1 nurses’ knowledge does not affect the performance of the prevention of nosocomial infections; 2 knowledge management has a positive effect on the performance of the prevention of nosocomial infections; 3 implementation of infection prevention is integrated capabilities between knowledge, skills and attitudes of nurses in implementing performance in care. Keywords: model prevention, nosocomial infections, nursing care, knowledge management, sectio Caesarea

[Orion (Outbreak Reports and Intervention studies of Nosocomial Infection) used for evaluating interventions and investigations of nosocomial infection outbreaks].

Science.gov (United States)

Pires-Cronenberger, S; Nicolle, M-C; Voirin, N; Giard, M; Luxemburger, C; Vanhems, P

2009-04-01

British colleagues have developed the Outbreak Reports and Intervention studies of Nosocomial Infection (Orion) guidelines with the aim to promote transparency of publications in the field of health-care associated infections and particularly for reports of outbreak investigation or intervention studies. The aim of this study was to translate the Orion criteria and to promote their use in France. The Orion guidelines include a checklist of 22 commented items related to the title, abstract, introduction, methods, results, and discussion sections of a scientific article. Specific points for each item are developed to enhance its relevance. The use of Orion guidelines by authors and editors should be encouraged and should improve the quality of standards in research, intervention studies, and publications on nosocomial infections and health-care associated infections.

Browse Title Index

African Journals Online (AJOL)

Items 101 - 150 of 641 ... SS Tomar, MD Akheel, SMD Javeed. Vol 4, No 1 ... Vol 4, No 5 (2014), Central Line Associated Blood Stream Infection Rate after Intervention and Comparing Outcome with National Healthcare Safety Network and International Nosocomial Infection Control Consortium Data, Abstract PDF. SZ Bukhari ...

Analysis on Risk Factors of Nosocomial Infection in Orthopedic Patients and Research on Nursing Strategies

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Guo Zhitao

2016-03-01

Full Text Available Orthopedic patients mostly comprise traumatic patients and elderly or sick individuals. More patients with emergency surgery suffer from open wounds and serious pollution, and operation time is relatively long. Thus, orthopedic patients with surgical incision infection account for a large proportion of incidence of hospital infection. Orthopedic patients are also bedridden for long periods, and they receive poor bone tissue blood supply. In surgical incision infections, mild cases suffer from delayed wound healing, whereas severe cases can form osteomyelitis. This study reviews progress of research on risk factors of nosocomial infection among orthopedic patients in recent years.

Antimicrobial resistance among nosocomial isolates in a teaching hospital in Goa

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Kamat U

2008-01-01

Full Text Available Background: Emergence of polyantimicrobial resistant strains of hospital pathogens has presented a challenge in the provision of good quality in-patient care. Inappropriate use of antibiotics in the hospital is largely responsible for this catastrophe. Bacteriological surveillance of the cases of nosocomial infections is crucial for framing an evidence-based antimicrobial policy for a hospital. Materials and Methods: A prospective study was undertaken among 498 patients from medicine and surgery wards in a tertiary teaching hospital in Goa. The patients were followed up clinico-bacteriologically for the occurrence of nosocomial infections (NI. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: The overall infection rate was 33.93 ± 4.16 infections per 100 patients. Urinary tract infection was the most common NI (26.63%, followed by surgical site infection (23.67%, wound infection (23% and nosocomial pneumonia (18.34%. Ninety-seven percent of the isolates were bacterial, while the others were fungal. More than 80% of the NIs were caused by Gram-negative bacteria, predominantly Pseudomonas aeruginosa, Escherichia coli and Aceinetobacter baumanii . Almost 70% of the isolates were resistant to all the antibiotics for which susceptibility was tested; the rest were sensitive to amikacin, cefoperazone-sulbactam and other antibiotics including methicillin, co-trimoxazole, teicoplenin, vancomycin and rifampicin, either singly or in combination. The proportion of MRSA was 71.4%. Resistance to a particular antibiotic was found to be directly proportional to the antibiotic usage in the study setting. Conclusion: Surveillance of nosocomial infections with emphasis on the microbiologic surveillance and frequent antimicrobial audit are critical towards curbing the evil of polyantimicrobial resistant nosocomial infections in a hospital.

Methicillin-resistant Staphylococcus aureus carrying SCCmec type II was more frequent than the Brazilian endemic clone as a cause of nosocomial bacteremia.

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Caiaffa-Filho, Helio Hehl; Trindade, Priscila A; Gabriela da Cunha, Paula; Alencar, Cecilia Salete; Prado, Gladys V B; Rossi, Flavia; Levin, Anna S

2013-08-01

Fifty consecutive MRSA blood isolates were evaluated: 30(60%) carried SCCmec type II (single PFGE clone; sequence type 5 or ST105); 12 (26%), IV; 5 (10%), III; 3 (6%), I. Brazilian endemic clone, carrying SCCmec type III, has been the main nosocomial clone in Brazil; however, this study showed that a clone carrying type II predominated. Copyright © 2013 Elsevier Inc. All rights reserved.

The Review Systematic and Meta Analysis of Prevalence and Causes of Nosocomial Infection in Iran

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Pezhman Bagheri

2014-12-01

Full Text Available Background and Aim: The variation of reported nosocomial infection is very high respectively. It seems review systematic and Meta analysis of related documents gives precise estimate of this subject for correct politisize. So tha aim of this study the review systematic and meta analysis of prevalence and causes of nosocomial infection in iran. Materials and Methods: For this study all articles published in Iranian journals and international journals, Final Report of Research Projects, related papers presented at congresses and thesis were reviewed with using standard and sensitive keywords. Then, all articles published between 1997-2010 years that had eligibility Inclusion criteria after quality control, using random model, intered to process of meta-analysis. Results: The finding show that the best estimate of total prevalence of nosocomial infection in Iran is 30.43% and the most common infections of nosocomial infection are respiratory infection 39.4%%, urinary infection 23.88%, bacteremia 21.98% and the most common factors of nosocomial infection are Pseudomonas aeroginosa 26.78%, klebsiella 31.42%, Staphylococcus 23.6% and E.coli 30.93%. The research also found a substantial heterogeneity that using meta regression method the main cause of produce of this heterogeneity, participants people, sample size, average age of the samples, time of study and gender were introduced. Conclusions: The simple review of studied documents in this survey show that prevalence rate of different nosocomial infection in Iran is high relatively. Hence make appropriate and evidence-based educational and control programs to reduce nosocomial infections prevalence rate in Iran should be considered by policy makers.

Risk factors and mortality for nosocomial bloodstream infections in elderly patients.

Science.gov (United States)

Reunes, S; Rombaut, V; Vogelaers, D; Brusselaers, N; Lizy, C; Cankurtaran, M; Labeau, S; Petrovic, M; Blot, S

2011-10-01

To determine risk factors for nosocomial bloodstream infection (BSI) and associated mortality in geriatric patients in geriatric and internal medicine wards at a university hospital. Single-center retrospective (1992-2007), pairwise-matched (1:1-ratio) cohort study. Geriatric patients with nosocomial BSI were matched with controls without BSI on year of admission and length of hospitalization before onset of BSI. Demographic, microbiological, and clinical data are collected. One-hundred forty-two BSI occurred in 129 patients. Predominant microorganisms were Escherichia coli (23.2%), coagulase-negative Staphylococci (19.4%), Pseudomonas aeruginosa (8.4%), Staphylococcus aureus (7.1%), Klebsiella pneumoniae (5.8%) and Candida spp. (5.8%). Matching was successful for 109 cases. Compared to matched control subjects, cases were more frequently female, suffered more frequently from arthrosis, angina pectoris and pressure ulcers, had worse Activities of Daily Living-scores, had more often an intravenous or bladder catheter, and were more often bedridden. Logistic regression demonstrated presence of an intravenous catheter (odds ratio [OR] 7.5, 95% confidence interval [CI] 2.5-22.9) and being bedridden (OR 2.9, 95% CI 1.6-5.3) as independent risk factors for BSI. In univariate analysis nosocomial BSI was associated with increased mortality (22.0% vs. 11.0%; P=0.029). After adjustment for confounding co-variates, however, nosocomial BSI was not associated with mortality (hazard ratio 1.3, 95% CI 0.6-2.6). Being bedridden and increasing age were independent risk factors for death. Intravenous catheters and being bedridden are the main risk factors for nosocomial BSI. Although associated with higher mortality, this infectious complication seems not to be an independent risk factor for death in geriatric patients. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

102 nosocomial infections and the challenges of control

African Journals Online (AJOL)

Dr Oboro VO

AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY MAY 2010 .... international organizations including accreditation and governmental agencies, national associations and organizations, World ... coupled with research to keep nosocomial ..... medical/dental students, student nurses and other.

Nosocomial bloodstream infection in a neonatal intensive care unit of a medical center: a three-year review.

Science.gov (United States)

Tseng, Ya-Chun; Chiu, Yu-Chiao; Wang, Jen-Hsien; Lin, Hsiao-Chuan; Lin, Hung-Chih; Su, Bai-Horng; Chiu, Hsiu-Hui

2002-09-01

Bloodstream infections are the most frequent nosocomial infections in neonatal intensive care units. This retrospective study surveyed the epidemiologic characteristics of nosocomial bloodstream infections which occurred in the neonatal intensive care unit from January 1, 1997 to December 31, 1999. The overall infection patient rate was 5.5% in the 3-year period, and the overall infection patient-day rate was 4.4 per 1000 patient-days. Low birth weight was a risk factor for bloodstream infections. The rate of infection for neonates with birth weight below 1000 g ranged from 36.6% to 45.8% (1997: 36.6%; 1998: 45.8% and 1999: 38.9%). The most common pathogens causing nosocomial bloodstream infection were: Staphylococcus aureus (18.5%) (with 92% oxacillin-resistant), Acinectobacter baumannii (16.3%), Klebsiella pneumoniae (11.9%), Escherichia coli (9.6%), and Pseudomonas aeruginosa (8.1%). The mortality due to nosocomial bloodstream infection was highest among gram-negative bacteria, especially with P. aeruginosa (45.5%). Therefore, surveillance of nosocomial bloodstream infection and successful strategies to decrease nosocomial bloodstream infection, such as infection control and optimal antibiotic use, are warranted.

Asymptomatic carriers contribute to nosocomial Clostridium difficile infection

DEFF Research Database (Denmark)

Blixt, Thomas; Gradel, Kim Oren; Homann, Christian

2017-01-01

BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects...... of of asymptomatic carriers on nosocomial C difficile infections. METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results...... were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission. RESULTS: C difficile...

Semmelweis revisited: hand hygiene and nosocomial disease transmission in the anesthesia workstation.

Science.gov (United States)

Biddle, Chuck

2009-06-01

Hospital-acquired infections occur at an alarmingly high frequency, possibly affecting as many as 1 in 10 patients, resulting in a staggering morbidity and an annual mortality of many tens of thousands of patients. Appropriate hand hygiene is highly effective and represents the simplest approach that we have to preventing nosocomial infections. The Agency for Healthcare Research and Quality has targeted hand-washing compliance as a top research agenda item for patient safety. Recent research has identified inadequate hand washing and contaminated anesthesia workstation issues as likely contributors to nosocomial infections, finding aseptic practices highly variable among providers. It is vital that all healthcare providers, including anesthesia providers, appreciate the role of inadequate hand hygiene in nosocomial infection and meticulously follow the mandates of the American Association of Nurse Anesthetists and other professional healthcare organizations.

Nosocomial infections due to Acinetobacter calcoaceticus.

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Zaer F

1989-01-01

Full Text Available Fifty four isolates of Acinetobacter calcoaceticus were studied in a period of 6 months. Maximum isolates were from burns cases and environmental sampling from burns ward also grew the same organism, indicating their role as nosocomial pathogen. Acinetobacter may initially be mistaken for Neisseria species. As the organisms show multidrug resistance to commonly used antibiotics their correct identification is important.

Nosocomial infections due to Acinetobacter calcoaceticus.

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Zaer, F; Deodhar, L

1989-01-01

Fifty four isolates of Acinetobacter calcoaceticus were studied in a period of 6 months. Maximum isolates were from burns cases and environmental sampling from burns ward also grew the same organism, indicating their role as nosocomial pathogen. Acinetobacter may initially be mistaken for Neisseria species. As the organisms show multidrug resistance to commonly used antibiotics their correct identification is important.

Bacterial infections in burn patients at a burn hospital in Iran.

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Ekrami, Alireza; Kalantar, Enayat

2007-12-01

The major challenge for a burn team is nosocomial infection in burn patients, which is known to cause over 50% of burn deaths. Most studies on infection in burn patients focus on burn wound infection, whereas other nosocomial infections in these patients are not well described. We undertook this study to determine three types of nosocomial infections viz., burn wound infection, urinary tract infection, and blood stream infection in burn patients in a burn hospital in Iran. During the one year period (May 2003 to April 2004), 182 patients were included in this study. Blood, urine and wound biopsy samples were taken 7 and 14 days after admission to Taleghani Burn hospital. Isolation and identification of microorganisms was done using the standard procedure. Disk diffusion test were performed for all the isolates for antimicrobial susceptibility. Of the 182 patients, 140 (76.9%) acquired at least one type of infection of the 140, 116 patients (82.8%) were culture positive on day 7 while 24 (17.2%) on 14 days after admission. Primary wound infection was most common (72.5%), followed by blood stream (18.6%) and urinary tract infections (8.9 %). The microorganisms causing infections were Pseudomonas aeruginosa (37.5%), Staphylococcus aureus (20.2%), and Acinetobacter baumanni (10.4%). Among these isolates P. aeruginosa was found to be 100 per cent resistant to amikacin, gentamicin , carbenicillin, ciprofloxacin, tobramycin and ceftazidime; 58 per cent of S. aureus and 60 per cent of coagulase negative Staphylococcus were methicillin resistant. High prevalence of nosocomial infections and the presence of multidrug resistant bacteria, and methicillin resistant S. aureus in patients at Taleghani Burn Hospital suggest continuous surveillance of burn infections and develop strategies for antimicrobial resistance control and treatment of infectious complications.

The Study of Nosocomial Infections in Neonatal Intensive Care Unit, A prospective study in Northwest Iran

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Mohammad Bagher Hosseini

2014-08-01

Full Text Available Background: Nosocomial infections are an important cause of mortality in neonatal intensive care units (NICUs. Therefore, in this study, the incidence and prevalence of nosocomial infections were determined in NICUs of the three largest neonatal centers in northwest Iran, and the causative bacteria were identified in order to provide potential solutions to control the infections in these hospitals. Materials and Methods: This is a descriptive-prospective study in which the cases of nosocomial infections were examined in the three largest hospitals in Tabriz in northwest Iran during 1 year (from June 2012 until May 2013 based on clinical findings, medical and nursing reports of patients, and laboratory results. Results: Of the 3129 patients hospitalized in NICUs of the three hospitals, 208 patients were diagnosed with nosocomial infections. The incidence rate of nosocomial infections was 11.34%.per 100 patient days with 52.4% bacteremia, 32.69% pneumonia, 5.77% urinary tract infections, 5.29% wound infections, and 3.85% necrotizing enterocolitis. There was a statistically significant relationship between invasive procedures (such as umbilical catheters, central venous catheters, surgery, and TPN and sepsis (P = 0.001. The relationships between urinary tract infection and urinary catheter (P = 0.000, and aggressive procedures (such as suctioning and intubation and pneumonia (P = 0.001 were also statistically significant. Conclusion: Incidence of nosocomial infections in premature and low birth weight newborns is considered as a health threat. The findings of this research reiterate the importance of giving further attention to prevention and control of nosocomial infections in the NICU.

Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections

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Gajović Olgica

2011-01-01

Full Text Available Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30% patients developed nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%, Pseudomonas aeruginosa (24.1%, Acinetobacter spp. (16.6% and Staphylococcus aureus (25.9%. Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

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Rania Mohammed Kishk

2014-01-01

Full Text Available Introduction. Blood stream infection (BSI is a common problem of newborn in neonatal intensive care units (NICUs. Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3% developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value < 0.001. The overall mortality rates among infected and noninfected neonates were 38.9% and 34.8%, respectively, with a significant difference. Klebsiella spp. were the most common pathogen (27.8% followed by Pseudomonas (21.6% and Staphylococcus aureus (15.4%. Conclusion. The rate of BSIs in NICU at Suez Canal University Hospital was relatively high with high mortality rate (36.0%.

Nosocomial oral myiasis in ICU patients: occurrence of three sequential cases

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Leylabadlo, Hamed Ebrahimzadeh

2015-12-01

Full Text Available Myiasis is the infestation of living vertebrates or humans tissues by dipterous larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene. Such infestations have been reported mainly in developing countries such as in Asia. Although rare, nosocomial myiasis must be noted carefully, especially in case of hospitalized patients. This report describes three cases of nosocomial oral myiasis in hospitalized patients in ICU (intensive care unit in Tabriz, North West of Iran.

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.

Bacterial Clearance and Cytokine Profiles in a Murine Model of Postsurgical Nosocomial Pneumonia

OpenAIRE

Manderscheid, Patricia A.; Bodkin, Ryan P.; Davidson, Bruce A.; Jensen, Erik; Russo, Thomas A.; Knight, Paul R.

2004-01-01

The development of a nosocomial pneumonia is facilitated by alterations in host innate pulmonary antibacterial defenses following surgical trauma, which can result in decreased pulmonary bacterial clearance and increased morbidity and mortality. In a murine model of postoperative nosocomial infection, surgical stress (laparotomy) decreased Escherichia coli clearance from the lungs of animals that underwent surgery. Consistent with previous studies, (i) pulmonary levels of tumor necrosis facto...

NURSING CARE KNOWLEDGE MANAGEMENT BASED TRAINING DECREASE NOSOCOMIAL INFECTION INCIDEN IN POST SECTIO CESAREA PATIENTS

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Ahsan Ahsan

2017-04-01

Full Text Available Introduction: Model of nursing care based on knowledge management can reduce the incidence of nosocomial infections through the performance of nurses in the prevention of infection. Nursing care based on knowledge management is established from identi fi cation knowledge which is required, prevention performance of nosocomial infections post caesarean section. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasy experimental design. The population were all of nursing staff who working in obstetrics installation and a number of patients who is treated in hospitals A and B post sectio caesarea. Sample is comparised a total population all the nursing staff who worked in obstetrics installation according to criteria of the sample, and most of patients were taken care by nursing staff post caesarean section which is taken by random sampling 15 patients. Data was collected through observation sheets and examination of the wound culture. Data analysis which is used the t test. Result: The result was showed that there was signi fi cant difference in the incidence of nosocomial infection in patients with post sesctio caesarea in hospital before and after nursing care training based on knowledge management (tvalue = 2.316 and p = 0.028 < α = 0.05 level, and the incidence of nosocomial infection was lower after training than before training. Discussion: It can be concluded that training knowledge management based on nursing care effectives to reduce Incidence of Nosocomial Infections in Patients after Sectio Caesarea.

Epidemiological markers of Serratia marcescens isolates causing nosocomial infections in Spain (1981-1991).

Science.gov (United States)

Boquete, T; Vindel, A; Martin-Bourgon, C; Azañedo, L; Sáez-Nieto, J A

1996-12-01

The distribution of epidemiological markers (serotyping and phage-typing) of Serratia marcescens isolates from nosocomial episodes (63 nosocomial cutbreaks with 475 isolates, and 1208 sporadic cases) received in our laboratory during the period 1981-1991 was studied. The records for 1683 isolates from Spanish hospitals have been analyzed. In relation with the sporadic cases, the predominant types were serotype O6 (13.4%) and serotype O14 (11.4%); polyagglutinable strains accounted for 15.6%; in outbreaks, type O14 is clearly predominant (27.4%). Phage-typing was a good secondary marker, with a 87.9% of typability; the number of lytic patterns was very high, extended patterns (six or more phages) being the most frequent. We have studied the characteristics of S. marcescens isolates causing infections in the nosocomial environment in Spain.

Dental hygiene intervention to prevent nosocomial pneumonias.

Science.gov (United States)

Barnes, Caren M

2014-06-01

Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias. Copyright © 2014 Elsevier Inc. All rights reserved.

Nosocomial infections: knowledge and source of information among clinical health care students in Ghana

Directory of Open Access Journals (Sweden)

Bello AI

2011-08-01

Full Text Available Ajediran I Bello1, Eunice N Asiedu1, Babatunde OA Adegoke2, Jonathan NA Quartey1, Kwadwo O Appiah-Kubi1, Bertha Owusu-Ansah11Department of Physiotherapy, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana; 2Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, NigeriaBackground: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana.Methods: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal–Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05Results: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05 between course of study and knowledge of

[Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

Science.gov (United States)

Vincent-Boulétreau, A; Caillat-Vallet, E; Dumas, A M; Ayzac, L; Chapuis, C; Emery, M N; Girard, R; Haond, C; Lafarge-Leboucher, J; Tissot-Guerraz, F; Fabry, J

2005-04-01

In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

Association Between Antimicrobial Resistance in Escherichia coli Isolates from Food Animals and Blood Stream Isolates from Humans in Europe: An Ecological Study

DEFF Research Database (Denmark)

Vieira, Antonio; Collignon, Peter; Aarestrup, Frank Møller

2011-01-01

Background: In addition to medical antimicrobial usage, the use of antimicrobials in food animals contributes to the occurrence of resistance among some bacterial species isolated from infections in humans. Recently, several studies have indicated that a large proportion of Escherichia coli causing...... infections in humans, especially those resistant to antimicrobials, have an animal origin.Methods: We analyzed the correlation between the prevalence of antimicrobial resistance in E. coli isolates from blood stream infections in humans and in E. coli isolates from poultry, pigs, and cattle between 2005...... and 2008 for 11 countries, using available surveillance data. We also assessed the correlation between human antimicrobial usage and the occurrence of resistance in E. coli isolates from blood stream infections.Results: Strong and significant correlations between prevalences of resistance to ampicillin (r...

Neonatal intensive care unit: Reservoirs of Nosocomial pathogens ...

African Journals Online (AJOL)

Improvement in the care and treatment of neonates had contributed to their increased survival. Nosocomial infection remains an important problem in intensive care units. Hospital wards had been shown to act as reservoirs of pathogenic microorganisms associated with infection. To assess the prevalence of pathogenic ...

Emerging Trend of Acinetobacter Nosocomial Infection in Northeast of Iran

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Samaneh Saed

2015-10-01

Full Text Available Background: Acinetobacter spp. emerged as an opportunistic pathogen for hospital-acquired infections. Recently, increasing antibiotic resistance among Acinetobacter spp. has worsened the problem. The aim of this study was to investigate  the  emerging  trend  of  infection  due  to Acinetobacter  in Ghaem University Hospital, Mashhad during 2006-2012.Methods: The demographic data and information about redisposing factors was collected. Appropriate bacteriological samples were collected and Acinetobacter spp. was isolated. Antibiotics susceptibility pattern of these isolates againstdifferent antimicrobials agents was determined.Results: Results confirmed that Acinetobacter spp. cause 20.9% of nosocomial infection during this period. The trend of Acinetobacter nosocomial infection was increasing and patients with risk factors such as COPD, bronchectasia, diabetes   mellitus   were   more   prone   to   infection.  There   was   significant association   between   these   infections   and   invasive   procedures   such   as catheterization, mechanical ventilation and broad-spectrum antibiotics usage. Conclusion:  Understanding  trends  in  causative  organisms  of  nosocomial infection can help us to better define our infection control policy.

Hand hygiene for the prevention of nosocomial infections.

Science.gov (United States)

Kampf, Günter; Löffler, Harald; Gastmeier, Petra

2009-10-01

The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

Low Compliance to Handwashing Program and High Nosocomial Infection in a Brazilian Hospital

OpenAIRE

Borges, Lizandra Ferreira de Almeida e; Rocha, Lilian Alves; Nunes, Maria José; Gontijo Filho, Paulo Pinto

2012-01-01

Background. It is a fact that hand hygiene prevents nosocomial infection, but compliance with recommended instructions is commonly poor. The purpose of this study was to implement a hand hygiene program for increase compliance with hand hygiene and its relationship with nosocomial infection (NI) and MRSA infection/colonization rates. Methods. Compliance to hand hygiene was evaluated in a hospital by direct observation and measured of health care-associated infections, including methicillin re...

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

Science.gov (United States)

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.

[Role of donor human milk feeding in preventing nosocomial infection in very low birth weight infants].

Science.gov (United States)

Bi, Hong-Juan; Xu, Jing; Wei, Qiu-Fen

2018-02-01

To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices. Compared with the preterm formula feeding group, the donor human milk feeding group and the mother's own milk feeding group had significantly lower incidence rates of nosocomial infection and necrotizing enterocolitis and shorter time to full enteral feeding (Pmilk can be used in case of a lack of mother's own milk and may help to reduce nosocomial infection.

A computational study for investigating acoustic streaming and tissue heating during high intensity focused ultrasound through blood vessel with an obstacle

Science.gov (United States)

Parvin, Salma; Sultana, Aysha

2017-06-01

The influence of High Intensity Focused Ultrasound (HIFU) on the obstacle through blood vessel is studied numerically. A three-dimensional acoustics-thermal-fluid coupling model is employed to compute the temperature field around the obstacle through blood vessel. The model construction is based on the linear Westervelt and conjugate heat transfer equations for the obstacle through blood vessel. The system of equations is solved using Finite Element Method (FEM). We found from this three-dimensional numerical study that the rate of heat transfer is increasing from the obstacle and both the convective cooling and acoustic streaming can considerably change the temperature field.

Risk factors for postoperative nosocomial infections among patients ...

African Journals Online (AJOL)

Objectives: The aim of this study was to identify possible risk factors for post operative nosocomial infections among operated patients at Felege Hiwot Referral ... Bacterial culture confirmation was done for all patients who developed clinical signs and symptoms of surgical site and/or bloodstream infection starting from the ...

Nosocomial infections in HIV-infected and HIV-uninfected children ...

African Journals Online (AJOL)

Twenty-five nosocomial infections (23%) among the HIV-infected children, but only ... candidiasis in seven and zero, urinary tract infection in four and one and .... tant or multidrug-resistant TB received ... bacterial infections, 96 hours in the case.

Nosocomial outbreak of Pseudomonas aeruginosa endophthalmitis.

Science.gov (United States)

Mateos, I; Valencia, R; Torres, M J; Cantos, A; Conde, M; Aznar, J

2006-11-01

We describe an outbreak of nosocomial endophthalmitis due to a common source, which was determined to be trypan blue solution prepared in the hospital's pharmacy service. We assume that viable bacteria probably gained access to the trypan blue stock solution during cooling after autoclaving. The temporal cluster of Pseudomonas aeruginosa endophthalmitis was readily perceived on the basis of clinical and microbiological findings, and an exogenous source of contamination was unequivocally identified by means of DNA fingerprinting.

The impact of nosocomially-acquired resistant Pseudomonas aeruginosa infection in a burn unit.

Science.gov (United States)

Armour, Alexis D; Shankowsky, Heather A; Swanson, Todd; Lee, Jonathan; Tredget, Edward E

2007-07-01

Nosocomially-acquired Pseudomonas aeruginosa remains a serious cause of infection and septic mortality in burn patients. This study was conducted to quantify the impact of nosocomially-transmitted resistant P. aeruginosa in a burn population. Using a TRACS burn database, 48 patients with P. aeruginosa resistant to gentamicin were identified (Pseudomonas group). Thirty-nine were case-matched to controls without resistant P. aeruginosa cultures (control group) for age, total body surface area, admission year, and presence of inhalation injury. Mortality and various morbidity endpoints were examined, as well as antibiotic costs. There was a significantly higher mortality rate in the Pseudomonas group (33% vs. 8%, p products used (packed cells 51.1 +/- 8.0 vs. 21.1 +/- 3.4, p < 0.01; platelets 11.9 +/- 3.0 vs. 1.4 +/- 0.7, p < 0.01) were all significantly higher in the Pseudomonas group. Cost of antibiotics was also significantly higher ($2,658.52 +/- $647.93 vs. $829.22 +/- $152.82, p < 0.01). Nosocomial colonization or infection, or both, of burn patients with aminoglycoside-resistant P. aeruginosa is associated with significantly higher morbidity, mortality, and cost of care. Increased resource consumption did not prevent significantly higher mortality rates when compared with that of control patients. Thus, prevention, identification, and eradication of nosocomial Pseudomonas contamination are critical for cost-effective, successful burn care.

The level of nurses’ knowledge of the prevention of nosocomial infections – a pilot study

Directory of Open Access Journals (Sweden)

Izabela Gąska

2017-08-01

Full Text Available Introduction. A basic element in preventing and combating nosocomial infections is the medical personnel knowledge. It is up to health care workers to determine whether the hospital environment will be safe for both patients and those employed in this sector. The aim of the study was to present the level of nursing staff knowledge of nosocomial infections. Materials and methods. The research was carried out in the Podkarpackie Center of Cardiovascular Interventions in Sanok. The study group consisted of all nurses working in the Hemodynamic Department - 20 people. The tests were carried out using the diagnostic survey method. The research tool was the author's questionnaire. Results. The nurses were aware that the scale of the problem of nosocomial infections was important. Almost all nurses rated their level of knowledge of hospital-acquired infections very well. However, the full definition of the term "nosocomial infections" was not given by about a quarter of respondents. In hospitals nurses did not always follow the rules of aseptic and antiseptic treatment. In addition, they did not see the need to educate patients and their families about the prevention of infections. Conclusions. Hospitals should carry out monitoring of nurses’ compliance with the procedures that are aimed at the elimination of ward infections and should consistently strive at their best to apply these procedures at their workplace. The ward staff should be involved in the education of patients and their families in the prevention of nosocomial infections.

Nosocomial outbreak of hepatitis B virus infection involving two hospitals in the Republic of Ireland.

LENUS (Irish Health Repository)

Burns, K

2012-02-01

The routes of nosocomial hepatitis B virus (HBV) transmission have changed over the years. Initiatives to prevent transfusion-associated HBV and healthcare worker-to-patient transmission have had a positive impact on these transmission routes. Recent reports of outbreaks of nosocomial HBV have implicated breaches in standard precautions as important causes of HBV transmission. This report describes a nosocomial outbreak of HBV infection in the Republic of Ireland, which occurred between January 2005 and March 2006. The outbreak was detected following identification of a case of acute HBV infection in a patient whose only risk factor was a recent surgical procedure. The extensive multi-agency investigation that followed revealed that the patient was one of five cases of acute HBV infection and that four separate transmission events between infectious cases had occurred in two different hospitals over a 15-month period. A definitive cause for each transmission event was not identified, although lapses in adherence to standard precautions, safe injection and phlebotomy practices could not be ruled out. Two secondary cases of acute HBV infection in community contacts of two of the nosocomial cases were identified. Phylogenetic analysis proved a useful tool in confirming infection with a pre-core HBV mutant and viral transmission between the seven patients. A patient notification exercise involving 1028 potentially exposed patients found no evidence of additional cases of nosocomial HBV infection. These findings highlight the importance of consistent application of standard precautions.

Association between gene expression biomarkers of immunosuppression and blood transfusion in severely injured polytrauma patients.

Science.gov (United States)

Torrance, Hew Dt; Brohi, Karim; Pearse, Rupert M; Mein, Charles A; Wozniak, Eva; Prowle, John R; Hinds, Charles J; OʼDwyer, Michael J

2015-04-01

To explore the hypothesis that blood transfusion contributes to an immunosuppressed phenotype in severely injured patients. Despite trauma patients using disproportionately large quantities of blood and blood products, the immunomodulatory effects of blood transfusion in this group are inadequately described. A total of 112 ventilated polytrauma patients were recruited. Messenger RNA (mRNA) was extracted from PAXGene tubes collected within 2 hours of the trauma, at 24 hours, and at 72 hours. T-helper cell subtype specific cytokines and transcription factors were quantified using real-time polymerase chain reaction. Median injury severity score was 29. Blood transfusion was administered to 27 (24%) patients before the 2-hour sampling point. Transfusion was associated with a greater immediate rise in IL-10 (P = 0.003) and IL-27 (P = 0.04) mRNA levels. Blood products were transfused in 72 (64%) patients within the first 24 hours. There was an association between transfusion at 24 hours and higher IL-10 (P < 0.0001), lower Foxp3 (P = 0.01), GATA3 (P = 0.006), and RORγt (P = 0.05) mRNA levels at 24 hours. There were greater reductions in T-bet (P = 0.03) mRNA levels and lesser increases in TNFα (P = 0.015) and IFNγ (P = 0.035) at 24 hours in those transfused. Multiple regression models confirmed that the transfusion of blood products was independently associated with altered patterns of gene expression. Blood stream infections occur in 15 (20.8%) of those transfused in the first 24 hours, compared with 1 patient (2.5%) not transfused (OR = 10.3 [1.3-81], P = 0.008). The primarily immunosuppressive inflammatory response to polytrauma may be exacerbated by the transfusion of blood products. Furthermore, transfusion was associated with an increased susceptibility to nosocomial infections.

Nosocomial epidemic of Serratia marcescens septicemia ascribed to contaminated blood transfusion bags

DEFF Research Database (Denmark)

Heltberg, Ole; Skov, F; Gerner-Smidt, P

1993-01-01

isolates was performed. For comparison, a strain from the production plant and eight other, unrelated bacteremia isolates were examined. In addition, a retrospective national survey was carried out. S. marcescens was cultured from 11 (0.73%) of 1515 blood units, and an additional (third) bacteremic patient...... was identified. The clinical isolates from three patients, the three units of blood transfused, and the plant-derived strain shared a unique ribotype. The incident is interpreted as a sporadic, bacterial contamination of blood bags with the S. marcescens epidemic strain, occurring during the manufacturing...... or packaging. A similar incident has not previously been reported. Attention is drawn to the possibility of significant contamination during the complex production of multiple-bag blood collection systems. Guidelines for improved registration and handling of transfusion complications in wards are suggested...

Inherent Risk Factors for Nosocomial Infection in the Long Stay Critically Ill Child Without Known Baseline Immunocompromise: A Post Hoc Analysis of the CRISIS Trial.

Science.gov (United States)

Carcillo, Joseph A; Dean, J Michael; Holubkov, Richard; Berger, John; Meert, Kathleen L; Anand, Kanwaljeet J S; Zimmerman, Jerry; Newth, Christopher J; Harrison, Rick; Burr, Jeri; Willson, Douglas F; Nicholson, Carol; Bell, Michael J; Berg, Robert A; Shanley, Thomas P; Heidemann, Sabrina M; Dalton, Heidi; Jenkins, Tammara L; Doctor, Allan; Webster, Angie

2016-11-01

Nosocomial infection remains an important health problem in long stay (>3 days) pediatric intensive care unit (PICU) patients. Admission risk factors related to the development of nosocomial infection in long stay immune competent patients in particular are not known. Post-hoc analysis of the previously published Critical Illness Stress induced Immune Suppression (CRISIS) prevention trial database, to identify baseline risk factors for nosocomial infection. Because there was no difference between treatment arms of that study in nosocomial infection in the population without known baseline immunocompromise, both arms were combined and the cohort that developed nosocomial infection was compared with the cohort that did not. There were 254 long stay PICU patients without known baseline immunocompromise. Ninety (35%) developed nosocomial infection, and 164 (65%) did not. Admission characteristics associated with increased nosocomial infection risk were increased age, higher Pediatric Risk of Mortality version III score, the diagnoses of trauma or cardiac arrest and lymphopenia (P risk of developing nosocomial infection (P risk factors (P < 0.05); whereas trauma tended to be related to nosocomial infection development (P = 0.07). These data suggest that increasing age, cardiac arrest and lymphopenia predispose long stay PICU patients without known baseline immunocompromise to nosocomial infection. These findings may inform pre-hoc stratification randomization strategies for prospective studies designed to prevent nosocomial infection in this population.

Comparison of the Nosocomial Pneumonia Mortality Prediction (NPMP) model with standard mortality prediction tools.

Science.gov (United States)

Srinivasan, M; Shetty, N; Gadekari, S; Thunga, G; Rao, K; Kunhikatta, V

2017-07-01

Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included. The Nosocomial Pneumonia Mortality Prediction (NPMP) model, developed in our hospital, was compared with Acute Physiology and Chronic Health Evaluation II (APACHE II), Mortality Probability Model II (MPM 72  II), Simplified Acute Physiology Score II (SAPS II), Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), Clinical Pulmonary Infection Score (CPIS), Ventilator-Associated Pneumonia Predisposition, Insult, Response, Organ dysfunction (VAP-PIRO). Data and clinical variables were collected on the day of pneumonia diagnosis. The outcome for the study was ICU mortality. The sensitivity and specificity of the various scoring systems was analysed by plotting receiver operating characteristic (ROC) curves and computing the area under the curve for each of the mortality predicting tools. NPMP, APACHE II, SAPS II, MPM 72  II, SOFA, and VAP-PIRO were found to have similar and acceptable discrimination power as assessed by the area under the ROC curve. The AUC values for the above scores ranged from 0.735 to 0.762. CPIS and MODS showed least discrimination. NPMP is a specific tool to predict mortality in nosocomial pneumonia and is comparable to other standard scores. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

On a computational study for investigating acoustic streaming and heating during focused ultrasound ablation of liver tumor

International Nuclear Information System (INIS)

Solovchuk, Maxim A.; Sheu, Tony W.H.; Thiriet, Marc; Lin, Win-Li

2013-01-01

The influences of blood vessels and focused location on temperature distribution during high-intensity focused ultrasound (HIFU) ablation of liver tumors are studied numerically. A three-dimensional acoustics-thermal-fluid coupling model is employed to compute the temperature field in the hepatic cancerous region. The model construction is based on the linear Westervelt and bioheat equations as well as the nonlinear Navier–Stokes equations for the liver parenchyma and blood vessels. The effect of acoustic streaming is also taken into account in the present HIFU simulation study. Different blood vessel diameters and focal point locations were investigated. We found from this three-dimensional numerical study that in large blood vessels both the convective cooling and acoustic streaming can considerably change the temperature field and the thermal lesion near blood vessels. If the blood vessel is located within the beam width, both acoustic streaming and blood flow cooling effects should be addressed. The temperature rise on the blood vessel wall generated by a 1.0 MHz focused ultrasound transducer with the focal intensity 327 W/cm 2 was 54% lower when acoustic streaming effect was taken into account. Subject to the applied acoustic power the streaming velocity in a 3 mm blood vessel is 12 cm/s. Thirty percent of the necrosed volume can be reduced, when taking into account the acoustic streaming effect. -- Highlights: • 3D three-field coupling physical model for focused ultrasound tumor ablation is presented. • Acoustic streaming and blood flow cooling effects on ultrasound heating are investigated. • Acoustic streaming can considerably affect the temperature distribution. • The lesion can be reduced by 30% due to the acoustic streaming effect. • Temperature on the blood vessel wall is reduced by 54% due to the acoustic streaming effect

Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina.

Science.gov (United States)

Rosenthal, Victor D; Guzman, Sandra; Safdar, Nasia

2005-09-01

Hand hygiene is a fundamental measure for the control of nosocomial infection. However, sustained compliance with hand hygiene in health care workers is poor. We attempted to enhance compliance with hand hygiene by implementing education, training, and performance feedback. We measured nosocomial infections in parallel. We monitored the overall compliance with hand hygiene during routine patient care in intensive care units (ICUs); 1 medical surgical ICU and 1 coronary ICU, of 1 hospital in Buenos Aires, Argentina, before and during implementation of a hand hygiene education, training, and performance feedback program. Observational surveys were done twice a week from September 2000 to May 2002. Nosocomial infections in the ICUs were identified using the National Nosocomial Infections Surveillance (NNIS) criteria, with prospective surveillance. We observed 4347 opportunities for hand hygiene in both ICUs. Compliance improved progressively (handwashing adherence, 23.1% (268/1160) to 64.5% (2056/3187) (RR, 2.79; 95% CI: 2.46-3.17; P nosocomial infection in both ICUs decreased from 47.55 per 1000 patient-days (104/2187) to 27.93 per 1000 patient days (207/7409) RR, 0.59; 95% CI: 0.46-0.74, P hand hygiene, coinciding with a reduction in nosocomial infection rates in the ICUs.

[The risk of infection to the mother prior, during and after delivery. A registration of nosocomial infections].

Science.gov (United States)

Hirsch, H A; Niehues, U

1982-09-01

During 5 1/2 years all infections arising in the hospital (nosocomial infections) were registered prospectively by an infection control nurse. The incidence of all nosocomial infections in 3192 maternity patients was 2.1%. In 10,569 women following vaginal deliveries 2.6% and in 1,353 women following Caesarean section 21.1%. The commonest infections were urinary tract infections, endometritis, infections of the abdominal wound or the episiotomy, and a phlebitis of the intravenous infusion site. Measures to prevent infection resulted in a steadily decreasing incidence of infections during the 6 years of registration of nosocomial infections.

Experience With Nosocomial Infection in Children Under 5 Treated in an Urban Diarrheal Treatment Center in Bangladesh

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K. M. Shahunja MBBS

2016-03-01

Full Text Available We aimed to evaluate the factors associated with nosocomial infections (NIs in under-5 children and in bacterial isolates from their blood, urine, and stool. We reviewed all under-5 hospitalized children with clinically diagnosed NIs in the inpatient ward at Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh, between January and December 2012. Comparison was made among the children with (cases = 71 and without NI (controls = 142. NI was defined as the development of new infection 48 hours after admission. Bacterial isolates in urine, blood, and stool were found in 11/52 (21%, 9/69 (13%, and 2/16 (12% respectively. In logistic regression analysis, the children with NI were independently associated with severe acute malnutrition, congenital anomaly, invasive diarrhea, urinary tract infection on admission, and use of intravenous cannula during hospitalization. Thus, identification of these simple clinical parameters may help in preventive measures being taken to reduce the rate of NIs in such children.

Nosocomial infections in HIV-infected and HIV-uninfected children ...

African Journals Online (AJOL)

The interaction between tuberculosis and HIV-infected infection is well known and is responsible for the increase in the incidence of tuberculosis ... This retrospective case-control study evaluated the occurrence of nosocomial infections in (HIV)-infected children and age- and time of ... complicated disease, or whose social.

Frequency and antimicrobial susceptibility of acinetobacter species isolated from blood samples of paediatric patients

International Nuclear Information System (INIS)

Javed, A.; Zafar, A.; Ejaz, H.; Zubair, M.

2012-01-01

Objective: Acinetobacter species is a major nosocomial pathogen causing serious infections in immuno-compromised and hospitalized patients. The aim of this study was to determine the frequency and antimicrobial susceptibility pattern of Acinetobacter species in blood samples of paediatric patients. Methodology: This cross sectional observational study was conducted during January to October, 2011 at The Children's Hospital and Institute of Child Health, Lahore. A total number of 12,032 blood samples were analysed during the study period. Acinetobacter species were Bauer disc diffusion method. Results: The blood cultures showed growth in 1,141 cultures out of which 46 (4.0%) were Acinetobacter species. The gender distribution of Acinetobacter species was 29 (63.0%) in males and 17 (37.0%) in females. A good antimicrobial susceptibility pattern of Acinetobacter species was seen with sulbactam-cefoperazone (93.0%), imepenem and meropenem (82.6% (30.4%) was poor. Conclusion: The results of the present study shows high rate of resistance of Acinetobacter species with cephalosporins in nosocomial infections. The sulbactam-cefoperazone, carbapenems and piperacillin-tazobactam showed effective antimicrobial susceptibility against Acinetobacter species. (author)

Nosocomial infections in HIV-infected and HIV-uninfected children ...

African Journals Online (AJOL)

One HIV-infected child died of varicella pneumonia. Other common nosocomial infections encountered in HIV-infected and HIV-uninfected children respectively were upper respiratory tract infections (pharyngitis, tonsillitis or rhinitis) affecting 21 and four, otitis media in five and one, oral candidiasis in seven and zero, urinary ...

Prevalence and Antibiogram of Microbial Agents Causing Nosocomial Urinary Tract Infection in Surgical Ward of Dhaka Medical College Hospital

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Tashmin Afroz Binte Islam

2016-05-01

Full Text Available Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Bangladesh, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints and lack of awareness regarding nosocomial infections. Objective: We carried out this study to determine the prevalence of different microorganisms from urine in surgery ward and antimicrobial susceptibility pattern against various antibiotics. Materials and Methods: This cross sectional study was carried out in Department of Microbiology, Dhaka Medical College, Dhaka over a period of 12 months from July 2011 to June 2012. A total of 52 urine specimens were collected from catheterized patients admitted in general surgery ward of Dhaka Medical College Hospital (DMCH and incubated in blood agar, MacConkey agar media and the isolates were identified by different biochemical tests – oxidase test and reaction in MIU (motility indole urease and Simmon’s citrate and TSI (triple sugar iron media. ESBL producers were detected by double-disk synergy test (DDST. Results: Bacteria were isolated from 35 specimens and Escherichia coli was the commonest isolate (23, 65.71% followed by Pseudomonas aeruginosa 6 (17.14%, Klebsiella pneumoniae 3 (8.57%, Acinetobacter baumannii 2 (5.72% and Proteus vulgaris 1 (2.86% respectively. Among the isolates, 10 (28.57% ESBL producers were detected and the highest ESBL production was observed in Escherichia coli (8, 22.85% followed by Klebsiella pneumoniae 1 (2.86% and Pseudomonas aeruginosa 1 (2.86%. The isolates were resistant to most of the commonly used antimicrobial agents. Conclusion: The emergence of multi-drug resistant (MDR bacteria poses a difficult task for physicians who have limited therapeutic options. However, the high rate of nosocomial infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

[Nosocomial infections after cardiac surgery in infants and children with congenital heart disease].

Science.gov (United States)

Barriga, José; Cerda, Jaime; Abarca, Katia; Ferrés, Marcela; Fajuri, Paula; Riquelme, María; Carrillo, Diego; Clavería, Cristián

2014-02-01

Nosocomial infections generate high morbidity and mortality in children undergoing cardiac surgery. To determine risk factors for nosocomial infections in children after congenital heart surgery. A retrospective case-control study, in patients younger than 15 years undergoing surgery for congenital heart disease from January 2007 to December 2011 admitted to the Pediatric Critical Patient Unit (UPC-P) in a university hospital. For cases, the information was analyzed from the first episode of infection. 39 patients who develop infections and 39 controls who did not develop infection were enrolled. The median age of cases was 2 months. We identified a number of factors associated with the occurrence of infections, highlighting in univariate analysis: age, weight, univentricular heart physiology, complexity of the surgical procedure according to RACHS-1 and cardiopulmonary bypass (CPB) time ≥ 200 minutes. Multivariate analysis identified CPB time ≥ 200 minutes as the major risk factor, with an OR of 11.57 (CI: 1.04 to 128.5). CPB time ≥ 200 minutes was the mayor risk factor associated with the development of nosocomial infections.

Clinical and antimicrobial profile of Acinetobacter spp.: An emerging nosocomial superbug

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Purti C Tripathi

2014-01-01

Conclusion: Acinetobacter nosocomial infections resistant to most antimicrobials have emerged, especially in ICU. Early identification and continued surveillance of prevalent organism will help prevent the spread of Acinetobacter in hospital environment.

Cost-analysis of seven nosocomial outbreaks in an academic hospital

NARCIS (Netherlands)

Dik, Jan-Willem H.; Dinkelacker, Ariane D.; Vemer, Pepijn; Lo-Ten-Foe, Jerome R.; Lokate, Mariette; Sinha, Bhanu; Friedrich, Alex W.; Postma, Maarten J.

2016-01-01

Objectives Nosocomial outbreaks, especially with (multi-)resistant microorganisms, are a major problem for health care institutions. They can cause morbidity and mortality for patients and controlling these costs substantial amounts of funds and resources. However, how much is unclear. This study

Association between antimicrobial resistance in Escherichia coli isolates from food animals and blood stream isolates from humans in Europe: an ecological study.

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Vieira, Antonio R; Collignon, Peter; Aarestrup, Frank M; McEwen, Scott A; Hendriksen, Rene S; Hald, Tine; Wegener, Henrik C

2011-12-01

In addition to medical antimicrobial usage, the use of antimicrobials in food animals contributes to the occurrence of resistance among some bacterial species isolated from infections in humans. Recently, several studies have indicated that a large proportion of Escherichia coli causing infections in humans, especially those resistant to antimicrobials, have an animal origin. We analyzed the correlation between the prevalence of antimicrobial resistance in E. coli isolates from blood stream infections in humans and in E. coli isolates from poultry, pigs, and cattle between 2005 and 2008 for 11 countries, using available surveillance data. We also assessed the correlation between human antimicrobial usage and the occurrence of resistance in E. coli isolates from blood stream infections. Strong and significant correlations between prevalences of resistance to ampicillin (r=0.94), aminoglycosides (r=0.72), third-generation cephalosporins (r=0.76), and fluoroquinolones (r=0.68) were observed for human and poultry E. coli isolates. Similar significant correlations were observed for ampicillin (r=0.91), aminoglycosides (r=0.73), and fluoroquinolone resistance (r=0.74) in pig and human isolates. In cattle isolates, only ampicillin resistance (r=0.72) was significantly correlated to human isolates. When usage of antimicrobials in humans was analyzed with antimicrobial resistance among human isolates, only correlations between fluoroquinolones (r=0.90) and third-generation cephalosporins (r=0.75) were significant. Resistance in E. coli isolates from food animals (especially poultry and pigs) was highly correlated with resistance in isolates from humans. This supports the hypothesis that a large proportion of resistant E. coli isolates causing blood stream infections in people may be derived from food sources.

Blood stream infection by an emerging pathogen Oligella ureolytica in a cancer patient: Case report and review of literature

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Frincy K Baruah

2014-01-01

Full Text Available Oligella ureolytica is an emerging bacteria rarely implicated as a human pathogen. It is infrequently recovered from clinical specimens probably because of inadequate processing of non-fermenting oxidase positive Gram negative bacilli. We present here a case of a 30 year old male suffering from right lung adenocarcinoma (moderately differentiated with multiple abdominal lymph node metastasis with Syringohydromyelia whose blood culture yielded Oligella ureolytica in pure culture. Oligella ureolytica isolation in pure culture and the patient′s response to targeted treatment supported that Oligella ureolytica was the true causative agent of the blood stream infection. Early suspicion, diagnosis and treatment with potent antibiotics are needed to prevent further complications resulting from infection with this emerging pathogen.

Epidemiology of nosocomial colonization/infection caused by Acinetobacter spp. in patients of six surgical clinics in war and peacetime.

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Suljagić, Vesna; Jevtić, Miodrag; Djordjević, Boban; Romić, Predrag; Ilić, Radoje; Stanković, Nebojsa; Milović, Novak; Novaković, Marijan; Kozarski, Jefta; Roganović, Zoran; Popović, Zoran; Jovelić, Aleksandra

2011-08-01

Acinetobacter spp. has emerged as nosocomial pathogen during the past few decades in hospitals all over the world, but it has increasingly been implicated as a serious nosocomial pathogen in military hospitals. The aim of this study was to analyse and compare the surveillance data on Acinetobacter nosocomial colonization/infection (NCI) collected during the wartime with the data collected in peacetime. We conducted a prospective study of incidence of Acinetobacter spp. colonization/infection. Also, the two nested case-control studies were conducted. The patients with nosocomial infection (cases) were compared with those with nosocomial colonization (controls) during the two different periods, wartime and peacetime. The patients with NCI by Acinetobacter spp. were identified by the case-based surveillance. The surveillance covered all the patients in 6 surgical clinics. During the study periods a total of 166 patients had cultures that grew Acinetobacter spp. and the pooled rates of Acinetobacter spp. colonization and infection were significantly higher in wartime. When patients with NCI in wartime were compared with those with NCI in peacetime significant differences were observed. In the war year, the patients were more significantly males (p war and peace period.

The percentage of nosocomial-related out of total hospitalizations for rotavirus gastroenteritis and its association with hand hygiene compliance.

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Waisbourd-Zinman, Orith; Ben-Ziony, Shiri; Solter, Ester; Chodick, Gabriel; Ashkenazi, Shai; Livni, Gilat

2011-03-01

Because the absolute numbers of both community-acquired and nosocomial rotavirus gastroenteritis (RVGE) vary, we studied the percentage of hospitalizations for RVGE that were transmitted nosocomially as an indicator of in-hospital acquisition of the infection. In a 4-year prospective study, the percentage of nosocomial RVGE declined steadily, from 20.3% in 2003 to 12.7% in 2006 (P = .001). Concomitantly, the rate of compliance with hand hygiene increased from 33.7% to 49% (P = .012), with a significant (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

A NOSOCOMIAL INFECTION MANIFESTED AS ERYSIPELAS IN PEMPHIGUS FOLIACEUS PATIENT UNDER INTRAVENOUS DEXAMETHASONE TREATMENT

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Achmad Yudha Pranata

2016-05-01

Full Text Available Introduction: Puncture wound in diagnostic interventions permits the entry of bacteria into the skin or soft tissue, thus precipitating nosocomial infection, such as erysipelas. There are other risk factors of nosocomial infections including old age, immunosuppressive drugs, and underlying diseases. Pemphigus foliaceus (PF is an autoimmune disease with corticosteroid treatment as the mainstay therapy, which could cause immunosuppression and predispose patients to infection. The objective of this paper was to report erysipelas as one of the manifestations of nosocomial infection in patients under immunosuppressive therapy. Case: A case of erysipelas acquired on the 9th day of hospitalization in a PF patient underwent intravenous dexamethasone injection, with history of puncture wounds on the previous day on the site of erysipelas was reported. The clinical findings of erysipelas were well defined, painful erythema and edema that felt firm and warm on palpation, with blisters and pustules on top. Gram staining from the pustules and blisters fluid revealed Gram (+ cocci. Patient was given 2 grams intravenous ceftriaxone for 7 days and saline wet compress. Improvement on the erysipelas was seen the day after ceftriaxone injection. The patient was discharged after 12 days of hospitalization with improvement both on the PF and the erysipelas. On the next visit 7 days later, the erysipelas lesion disappeared. Conclusion: Puncture wound and immunosuppresive treatment are the factors that could cause erysipelas as a nosocomial infection, and an appropriate treatment of the infection would decrease the functional disability of the patient.

Kinetic bed therapy to prevent nosocomial pneumonia in mechanically ventilated patients: a systematic review and meta-analysis.

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Delaney, Anthony; Gray, Hilary; Laupland, Kevin B; Zuege, Danny J

2006-01-01

Nosocomial pneumonia is the most important infectious complication in patients admitted to intensive care units. Kinetic bed therapy may reduce the incidence of nosocomial pneumonia in mechanically ventilated patients. The objective of this study was to investigate whether kinetic bed therapy reduces the incidence of nosocomial pneumonia and improves outcomes in critically ill mechanically ventilated patients. We searched Medline, EMBASE, CINAHL, CENTRAL, and AMED for studies, as well as reviewed abstracts of conference proceedings, bibliographies of included studies and review articles and contacted the manufacturers of medical beds. Studies included were randomized or pseudo-randomized clinical trials of kinetic bed therapy compared to standard manual turning in critically ill mechanically ventilated adult patients. Two reviewers independently applied the study selection criteria and extracted data regarding study validity, type of bed used, intensity of kinetic therapy, and population under investigation. Outcomes assessed included the incidence of nosocomial pneumonia, mortality, duration of ventilation, and intensive care unit and hospital length of stay. Fifteen prospective clinical trials were identified, which included a total of 1,169 participants. No trial met all the validity criteria. There was a significant reduction in the incidence of nosocomial pneumonia (pooled odds ratio (OR) 0.38, 95% confidence interval (CI) 0.28 to 0.53), but no reduction in mortality (pooled OR 0.96, 95%CI 0.66 to 1.14), duration of mechanical ventilation (pooled standardized mean difference (SMD) -0.14 days, 95%CI, -0.29 to 0.02), duration of intensive care unit stay (pooled SMD -0.064 days, 95% CI, -0.21 to 0.086) or duration of hospital stay (pooled SMD 0.05 days, 95% CI -0.18 to 0.27). While kinetic bed therapy has been purported to reduce the incidence of nosocomial pneumonia in mechanically ventilated patients, the overall body of evidence is insufficient to support this

Knowledge and Prevention of Nosocomial Infection among Ward Nurses at Federal Medical Centre, Umuahia, Nigeria

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Oti A. Aja

2017-08-01

Full Text Available This research was conducted for estimating the knowledge and prevention of nosocomial infection among ward nurses at Federal Medical Centre (FMC, Umuahia Abia state. Four objectives were set, and four questions were formulated. A descriptive survey research method was used for the study. A sample size of one hundred and fifty (150 nurses was drawn from eight wards (medical and surgical, at FMC, Umuahia. A self-developed questionnaire with seventeen (17 structured questions was the instrument of data collection. Data were collected, analyzed, and presented in tables, pie chart, bar chart, histogram, and percentages. The results revealed that the nurses were well knowledgeable about nosocomial infection, although little deficiencies existed in the area of infection control practice and compliance, such as hand washing frequency. This study therefore recommends continuing education/seminar/workshop for all health care givers, to sensitize them with the knowledge and practice of nosocomial infection.

Nosocomial Infections and Antibiotic Administration in Pediatric Department, Imam Reza Hospital, Mashhad-Iran

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Abdolkarim Hamedi

2014-04-01

Full Text Available Introduction: Nosocomial Infections (NI are a frequent and relevant problem, in other hands; those are responsible of mortality especially in pediatric ICU( Intensive Care Unit and NICUs (Neonatal Intensive Care Unit. Healthcare-associated infections are important in wide-ranging concern in the medical field. The most cause of Nosocomial infection include: bloodstream infection, urinary tract infection, pneumonia, and wound infection. The purpose of this study was to determine the epidemiology of the three most common NI in the Pediatric department.        Materials and Methods: We performed a prospective study in a single Pediatric department during 12 months. Children were assessed for 3 NI: wound infections, pneumonia and urinary tract infections (UTI, as the same method as Center of Disease Control criteria. All patients were followed up and individuals who had have NI and their treatment was entered in this study.          Results: In this study 811 patients were hospitalized that 60% of them were male and were older than 60 months. The main causes of hospitalization include: toxicity, seizure, respiratory infection and fever. Among them 15 cases had NI (1.87%. The most NI occurred in pediatric intensive care unit (PICU and it was followed in aspect of intubation. The most cultured organism was pseudomonas that they suspected to ceftazidime and isolate from blood and endotracheal tube.           Conclusion:  NI presence was associated with increased mortality and length of stay in hospital. This study highlights the importance of NIs in children admitted to a pediatric department especially PICU in a developing country. Clinical monitoring of NIs and bacterial resistance profiles are required in all pediatric units.

BACTERIAL AIR MICROFLORA ISOLATES IN TWO OBSTETRICS AND GYNAECOLOGY UNITS OF A HOSPITAL IN NIGERIA ARE POTENTIAL THREATS OF NOSOCOMIAL INFECTIONS.

OpenAIRE

2016-01-01

Ever since the history of infirmaries, nosocomial infections have been of grave threats to hospital set-ups, the deadliest being nosocomial respiratory tract infection (RTI). Nosocomial RTI was consequently investigated in two units of Obstetrics and Gynaecology department of a hospital in Nigeria using the and ldquo;Settling Plate and rdquo; technique and various culture media for bacteria isolation. Identification of the isolates was done on the basis of each isolate\\'s cultural, morpholog...

Prevalencia de infecciones nosocomiales en niños: encuesta de 21 hospitales en México Nosocomial infections in children: Prevalence survey in 21 public hospitals in Mexico

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Carlos Avila-Figueroa

1999-01-01

, associated risk factors, microbiology, use of antibiotics, and associated mortality among hospitalized children. MATERIAL AND METHODS.A 1-day prevalence survey was conducted among 1 183 children hospitalized in a nationwide network of 21 public hospitals caring for children. To attain consistency between hospitals, CDC nosocomial infection definitions were used. Adjusted relative odds of bacteremia were estimated using logistic regression analysis. RESULTS. The prevalence of nosocomial acquired infection was 9.8% (CI 95%, 8.1-11.6. The more prevalent infections were pneumonia (25%, sepsis/bacteremia (19%,and urinary tract infection (5%. The main microorganism isolated in blood cultures drown from patients with nosocomial infection was K. penumoniae (31%. The prevalence of antibiotics use was 49% with substantial variation between hospitals (range 3-83%. Using logistic regression analysis, four factors were independently associated with the risk of nosocomial infection: central venous catheters (OR 3.3; CI 95% 1.0-5.9, total parenteral nutrition (OR 2.1; CI 95%1.0-4.5 mechanical ventilation (OR 2.3; CI 95% 1.2-4.1, and low birth weight (OR 2.6; CI 95% 1.0-6.8. The overall mortality was 4.8%; however, patients with nosocomial infection had two times greater risk to die as compared to non-infected children (OR 2.6; CI 95% 1.3-5.1. CONCLUSIONS. This rapid assessment survey using a standard methodology allows to document the prevalence of nosocomial infections in children. The results were used to develop targeted programs on central catheters and mechanical ventilation aimed to reduce bacteremia/sepsis and pneumonia, two nosocomial infections characterized by high prevalence and mortality.

Nosocomial infection in a newborn intensive care unit (NICU, South Korea

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Jeong Jae

2006-06-01

Full Text Available Abstract Background This study aimed to determine the occurrence of nosocomial infections (NIs, including infection rates, main infection sites, and common microorganisms. Patients included in the study were taken from a newborn intensive care unit (NICU, in a hospital in South Korea. Methods A retrospective cohort study was performed by reviewing chart. The subjects were 489 neonates who were admitted to the NICU, survived longer than 72 hours, and not transferred to another unit, between Jan. 1. 1995 to Sep. 30, 1999. NIs were identified according to the NNIS definition. Data were analyzed with descriptive statistics. Results Cumulative incidence rate for NIs was 30.3 neonates out of 100 admissions, with a total of 44.6 infections. The incidence density was average 10.2 neonates and 15.1 infections per 1000 patient days. The most common infections were pneumonia (28%, bloodstream infection (26%, and conjunctivitis (22%. Major pathogens were Gram-positives such as Staphylococcus aureus and coagulase-negative staphylococci. The factors associated with NI was less than 1500 g of birth weight, less than 32 weeks of gestational age, and less than 8 of apgar score. There's no statistical difference in discharge status between two groups, but hospital stay was longer in subjects with nosocomial infection than those without infection. Conclusion Although the distribution of pathogens was similar to previous reports, a high rate of nosocomial infection and in particular conjunctivitis was observed in this study that merits further evaluation.

The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

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Norakhoda Sadeghifard

2010-10-01

Full Text Available Clostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P

Comparison of two nosocomial infection surveillance in a neonatal ward

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Masomeh Abedini

2014-01-01

Conclusion: It seems that a large part of this considerable differences between the results of this study compared to NNIS based study, is this fact that, for nosocomial infection surveillance in the neonatal field, the presence of a specialist as a performer and leader of the team, is necessary.

The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

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Norakhoda Sadeghifard

2010-09-01

Full Text Available "nClostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P<0.05. Among the wards of selected hospitals, in gastroenterology of Children clinical center, Toxigenic C. difficile was isolated from patients most frequently. The sensitivity of isolates to vancomycin, Chloramphenicol and ceftriaxone were higher than other antibiotics. Toxigenic C. difficile is a common hospital-acquired infection. The organism was found in 6.1% hospitalized patients. Further studies to evaluate the rate and role of toxigenic C. difficile in nosocomial diarrheal processes, ecological and pathogenic terms are suggested.

Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition.

Science.gov (United States)

Morales, Eva; Cots, Francesc; Sala, Maria; Comas, Mercè; Belvis, Francesc; Riu, Marta; Salvadó, Margarita; Grau, Santiago; Horcajada, Juan P; Montero, Maria Milagro; Castells, Xavier

2012-05-23

We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain). All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros). In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively). P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit.

Science.gov (United States)

Swoboda, Sandra M; Earsing, Karen; Strauss, Kevin; Lane, Stephen; Lipsett, Pamela A

2004-02-01

To determine whether electronic monitoring of hand hygiene and voice prompts can improve hand hygiene and decrease nosocomial infection rates in a surgical intermediate care unit. Three-phase quasi-experimental design. Phase I was electronic monitoring and direct observation; phase II was electronic monitoring and computerized voice prompts for failure to perform hand hygiene on room exit; and phase III was electronic monitoring only. Nine-room, 14-bed intermediate care unit in a university, tertiary-care institution. All patient rooms, utility room, and staff lavatory were monitored electronically. All healthcare personnel including physicians, nurses, nursing support personnel, ancillary staff, all visitors and family members, and any other personnel interacting with patients on the intermediate care unit. All patients with an intermediate care unit length of stay >48 hrs were followed for nosocomial infection. Electronic monitoring during all phases, computerized voice prompts during phase II only. We evaluated a total of 283,488 electronically monitored entries into a patient room with 251,526 exits for 420 days (10,080 hrs and 3,549 patient days). Compared with phase I, hand hygiene compliance in patient rooms improved 37% during phase II (odds ratio, 1.38; 95% confidence interval, 1.04-1.83) and 41% in phase III (odds ratio, 1.41; 95% confidence interval, 1.07-1.84). When adjusting for patient admissions during each phase, point estimates of nosocomial infections decreased by 22% during phase II and 48% during phase III; when adjusting for patient days, the number of infections decreased by 10% during phase II and 40% during phase III. Although the overall rate of nosocomial infections significantly decreased when combining phases II and III, the association between nosocomial infection and individual phase was not significant. Electronic monitoring provided effective ongoing feedback about hand hygiene compliance. During both the voice prompt phase and post

Nosocomial transmission of Cupriavidus pauculus during extracorporeal membrane oxygenation.

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Stovall, S H; Wisdom, C; McKamie, W; Ware, W; Dedman, H; Fiser, R T

2010-01-01

Patients undergoing extracorporeal membrane oxygenation (ECMO) are at increased risk of infection. We present the first known report of nosocomial infection with Cupriavidus pauculus attributable to contamination from ECMO equipment and describe the measures taken to halt subsequent infections. A cluster of infections in ECMO patients should prompt team members to consider contamination of equipment with environmental pathogens as a possible cause.

Electrolytically generated hydrogen warm water cleanses the keratin-plug-clogged hair-pores and promotes the capillary blood-streams, more markedly than normal warm water does

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Yoshiharu Tanaka

2018-01-01

Full Text Available Biomedical properties of hydrogen water have been extensively investigated, but the effect of hydrogen on good healthy subjects remains unclear. This study was designed to explore the hygiene improvement by electrolytically generated hydrogen warm water (40°C on capillary blood streams, skin moisture, and keratin plugs in skin pores in normal good healthy subjects with their informed consents. Fingertip-capillary blood stream was estimated after hand-immersing in hydrogen warm water by videography using a CCD-based microscope, and the blood flow levels increased to about 120% versus normal warm water, after 60 minutes of the hand-immersing termination. Skin moisture of subjects was assessed using an electro-conductivity-based skin moisture meter. Immediately after taking a bath filled with hydrogen warm water, the skin moisture increased by 5–10% as compared to before bathing, which was kept on for the 7-day test, but indistinct, because of lower solubility of hydrogen in “warm” water than in room-temperature water. Cleansing of keratin plugs in skin-pores was assessed by stereoscopic microscopy and scanning electron microscopy. After hydrogen warm water bathing, the numbers of cleansed keratin plugs also increased on cheek of subjects 2.30- to 4.47-fold as many as the control for normal warm water. And areas of cleansed keratin plugs in the cheeks increased about 1.3-fold as much as the control. More marked improvements were observed on cheeks than on nostrils. Hydrogen warm water may thoroughly cleanse even keratin-plugs of residual amounts that could not be cleansed by normal warm water, through its permeability into wide-ranged portions of hair-pores, and promote the fingertip blood streams more markedly than merely through warmness due to normal warm water.

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

Science.gov (United States)

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

2011-10-01

Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Punit, simple, low-cost and sustainable interventions led to the control of a high incidence of bacterial nosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

Science.gov (United States)

Fu, Chuanxi; Wang, Shengyong

2016-04-12

The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

Nosocomial bloodstream infections in a Turkish university hospital: study of Gram-negative bacilli and their sensitivity patterns.

Science.gov (United States)

Köseoğlu , O; Kocagöz, S; Gür, D; Akova, M

2001-06-01

Treatment of nosocomial bacteraemia is usually governed by the surveillance results of the particular unit. Such results are especially important when antimicrobial resistance rates are high. Multiresistant isolates including Gram-negatives producing extended-spectrum beta-lactamases have been frequently reported in tertiary care units in Turkey. In this study, antimicrobial susceptibilities of Gram-negative blood isolates (n=348) were determined by microbroth dilution tests. The results showed carbapenems (meropenem and imipenem) to be uniformly more potent in vitro than any other drug against the Enterobacteriaceae. Quinolone antibiotics were more active in vitro than aminoglycosides against a range of bacteria. Gram-negative bloodstream isolates were highly resistant to many antimicrobial agents in the hospital. In order to prevent hospital infection and antimicrobial resistance, surveillance of aetiological agents must be performed regularly.

Use of proton pump inhibitors is associated with increased mortality due to nosocomial pneumonia in bedridden patients receiving tube feeding.

Science.gov (United States)

Hamai, Kosuke; Iwamoto, Hiroshi; Ohshimo, Shinichiro; Wakabayashi, Yu; Ihara, Daisuke; Fujitaka, Kazunori; Hamada, Hironobu; Ono, Koichi; Hattori, Noboru

2018-05-22

To investigate the association between the use of proton pump inhibitors (PPI) and nosocomial pneumonia and gastrointestinal bleeding in bedridden patients receiving tube feeding. A total of 116 bedridden hospitalized patients receiving tube feeding, of which 80 were supported by percutaneous endoscopic gastrostomy and 36 by nasogastric tube, were included in the present study. The patients were divided into two groups: 62 patients treated with PPI (PPI group) and 54 patients without PPI (non-PPI group). Mortality due to nosocomial pneumonia was evaluated using the Kaplan-Meier approach and the log-rank test. A total of 36 patients (31%) died of nosocomial pneumonia during the observation period; the mortality rate due to nosocomial pneumonia was significantly higher in the PPI group than in the non-PPI group (P = 0.0395). Cox proportional hazard analysis showed that the use of PPI and lower levels of serum albumin were independent predictors of 2-year mortality due to nosocomial pneumonia. Gastrointestinal bleeding was observed in four patients in the non-PPI group (7.7%) and in one patient in the PPI group (1.6%); there was no significant difference between the two groups. The use of PPI in bedridden tube-fed patients was independently associated with mortality due to nosocomial pneumonia, and the PPI group had a non-significant lower incidence of gastrointestinal bleeding than the non-PPI group. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

The Evaluation of Nosocomial Infections in Pediatric Patients with Extracorporeal Membrane Oxygenation Support

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Pelin Ayyıldız

Full Text Available Abstract Introduction: Extracorporeal membrane oxygenation (ECMO has become a standard technique over the past few decades in intensive care unit (ICU. Objective: A review of pediatric patients who received ECMO support in the pediatric cardiac ICU was conducted to determine the incidence, risk factors and causal organisms related to acquired infections and assess the survival rates of ECMO patients with nosocomial infections. Methods: Sixty-six patients who received ECMO support in the pediatric cardiac ICU between January 2011 and June 2014 were included in the study. Demographic, echocardiographic, hemodynamic features and surgical procedures were reviewed. Results: Sixty-six patients received a total of 292.5 days of venoarterial ECMO support. Sixty were postoperative patients. Forty-five patients were weaned from ECMO support with an ECMO survival rate of 68.2%. The rate of infection was 116.2/1000 ECMO days. Prolonged ICU stay, duration of ventilation and ECMO were found associated with development of nosocomial infection and only the duration of ECMO was an independent risk factor for nosocomial infections in ECMO patients. Conclusion: The correction of the underlying process leading to ECMO support and shortening the length of ECMO duration together with stricter application of ECMO indications would improve the infection incidence and hospital surveillance of the patient group.

Nosocomial infections after aneurysmal subarachnoid hemorrhage : time course and causative pathogens

NARCIS (Netherlands)

Laban, Kamil G.; Rinkel, Gabriel J. E.; Vergouwen, Mervyn D. I.

BackgroundNosocomial infections after aneurysmal subarachnoid hemorrhage (aSAH) are associated with prolonged length of stay and poor functional outcome. It remains unclear if infections result in prolonged length of stay or, vice versa, if prolonged length of stay results in more infections. Before

Risk Factors for Nosocomial Bacterremia Due to Methicillin-Resistant Staphylococcus Aureus

NARCIS (Netherlands)

M. Pujol (Miquel); C. Pena; R. Pallares (Roman); J. Ayats (Josefina); J. Ariza (Javier); F. Gudiol (Francesc)

1994-01-01

textabstractIn a prospective surveillance study (February 1990–December 1991) performed at a 1000-bed teaching hospital to identify risk factors for nosocomial methicillin-resistantStaphylococcus aureus (MRSA) bacteremia, 309 patients were found to be colonized (n=103; 33 %) or infected (n=206; 67

THE “CHALLENGING” MULTIDRUG-RESISTANT PATHOGENS OF NOSOCOMIAL INFECTIONS IN CRITICALLY ILL PATIENTS (A LITERATURE REVIEW

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T. V. Chernenkaya

2015-01-01

Full Text Available ABSTRACT. Changes in the structure of the main causative agents of nosocomial infections and significant spread of multidrug­resistant strains of bacteria are a natural biological response for antibiotics that selectively inhibit pathogens and contribute to selection, survival and growth of drug resistant strains of bacteria. In this literature review we present the change of structure of the major causative microorganisms of nosocomial septic infections and theirs resistance to antibiotics for the last 70 years. 

Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition

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Morales Eva

2012-05-01

Full Text Available Abstract Background We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. Methods A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain. All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Results Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros. In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively. Conclusions P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

[Nosocomial virus infections].

Science.gov (United States)

Eggers, H J

1986-12-01

Enveloped viruses, e.g. influenza- or varicella viruses may cause highly contagious airborne infections. Their spread is difficult to control, also in hospitals. In the case of influenza and varicella immune prophylaxis and chemotherapy/chemoprophylaxis are possible. This is of particular significance, since varicella and zoster are of increasing importance for immunocompromized patients. Diarrhea is caused to a large extent by viruses. Rotavirus infections play an important role in infancy, and are frequently acquired in the hospital. In a study on infectious gastroenteritis of infants in a hospital we were able to show that 30 percent of all rotavirus infections were of nosocomial origin. Admission of a rotavirus-excreting patient (or personnel) may start a long chain of rotavirus infections on pediatric wards. Even careful hygienic measures in the hospital can hardly prevent the spread of enterovirus infections. Such infections may be severe and lethal for newborns, as shown by us in a study on an outbreak of echovirus 11 disease on a maternity ward. We have recently obtained data on the "stickiness" of enteroviruses on human skin. This could explain essential features of the spread of enteroviruses in the population.

Usefulness of estimation of blood procalcitonin concentration versus C-reactive protein concentration and white blood cell count for therapeutic monitoring of sepsis in neonates

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Agnieszka Kordek

2014-12-01

Full Text Available Aim: This study was intended to assess the clinical usefulness of blood procalcitonin (PCT concentrations for the diagnosis and therapeutic monitoring of nosocomial neonatal sepsis.Material/Methods: The enrolment criterion was sepsis clinically manifesting after three days of life. PCT concentrations were measured in venous blood from 52 infected and 88 uninfected neonates. The results were interpreted against C-reactive protein (CRP concentrations and white blood cell counts (WBC.Results: Differences between the two groups in PCT and CRP concentrations were highly significant. No significant differences between the groups were noted for WBC. The threshold value on the receiver operator characteristic curve was 2.06 ng/mL for PCT (SE 75%; SP 80.68%; PPV 62.22%; NPV 88.75%; AUC 0.805, 5.0 mg/L for CRP (SE 67.44%; SP 73.68%; PPV 42.02%; NPV 88.89%; AUC 0.801, and 11.9 x109/L for WBC (SE 51.16%; SP 50.68%; PPV 23.16%; NPV 78.13%; AUC 0.484. Procalcitonin concentrations decreased 24 hours after initiation of antibiotic therapy and reverted to the control level after 5-7 days. C-reactive protein concentrations began to decline after two days of antibiotic therapy but were still higher than in the control group after 5-7 days of treatment. No significant changes in WBC during the treatment were observed.Conclusions: Procalcitonin concentrations in blood appear to be of use for the diagnosis and therapeutic monitoring of nosocomial infections in neonates as this parameter demonstrates greater sensitivity and specificity than C-reactive protein. White blood cell counts appear to be of little diagnostic value in the early phase of infection or for therapeutic monitoring.

Nosocomial outbreak of Enterobacter gergoviae bacteraemia in a neonatal intensive care unit.

Science.gov (United States)

Ganeswire, R; Thong, K L; Puthucheary, S D

2003-04-01

A nosocomial outbreak of bacteraemia, caused by Enterobacter gergoviae infected 11 babies, nine of whom were premature, and was investigated in the neonatal intensive care unit (NICU) of a general hospital in Johor Bahru, Malaysia. The strain that was isolated from the babies was also isolated from the dextrose saline used for the dilution of parenteral antibiotics and from the hands of a healthcare worker on duty in the nursery. Pulsed-field gel electrophoresis (PFGE) of Xba I-digested chromosomal DNA confirmed a possible cross-contamination of parenteral dextrose saline and the healthcare worker. Prompt and effective control measures were initiated within NICU and the nosocomial infection of E. gergoviae was brought to an abrupt end. To the best of our knowledge, this is the first documented outbreak of E. gergoviae in the NICU in a hospital in the state of Johor, Malaysia.

Nosocomial transmission of community-associated methicillin-resistant Staphylococcus aureus in Danish Hospitals

DEFF Research Database (Denmark)

Hetem, David J; Westh, Henrik; Boye, Kit

2012-01-01

exposure. Despite obvious epidemiological differences, it is unknown whether differences in nosocomial transmissibility exist. We have, therefore, quantified the transmissibility, expressed by the single admission reproduction number (R(A)), of CA-MRSA and HA-MRSA in hospital settings in Denmark....

Pattern of nosocomial infections in the special care baby unit of the ...

African Journals Online (AJOL)

PROF. EZECHUKWU

2013-09-27

Sep 27, 2013 ... -risk infants delivered in the maternity unit of the hospi- tal as well as infants referred ..... In the present study, the risk of nosocomial infection was not significantly higher ... German surveillance system for very low birth weight ...

Study of nosocomial isolates of Staphylococcus aureus with special reference to methicillin resistant S. aureus in a tertiary care hospital in Nepal.

Science.gov (United States)

Shrestha, B; Pokhrel, B; Mohapatra, T

2009-06-01

To find out the prevalence of Staphylococcus aureus nosocomial infection and methicillin resistant S. aureus (MRSA), clinical samples from nosocomially infected patients were processed by following standard methodology in microbiology laboratory, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Of 149 S. aureus isolates, skin infection isolates contributed a major part 72.5% making nosocomial infection by S. aureus most prevalent in skin infection followed by lower respiratory tract infection 11.41% and urinary tract infection 8.7%. Overall MRSA prevalence was 45.0%. MRSA prevalence was 42.6% in skin infection, 82.3% in lower respiratory tract infection and 30.8% in urinary tract infection. MRSA infection was found associated with lower respiratory tract infection only. Highest occurrence of nosocomial infection was observed in female surgical ward, surgical out patient department, orthopedic ward, male surgical ward and maternity ward. MRSA isolation was high from lower respiratory tract of patients admitted in intensive care unit, coronary care unit, Sub-acute intensive care unit, intermediate coronary care unit, neurology ward and post-operative ward. Whereas methicillin sensitive S. aureus (MSSA) occurrence was higher in patients admitted in orthopedic, Surgical out patient department, and female surgical ward. The occurrence of MRSA did not differ with age but MRSA was found associated with male patients and MSSA was associated with female patients. Since MRSA prevalence was high, regular surveillance of MRSA and nosocomial infections should be done and universal precautions to control nosocomial infections should be followed.

Application of protein typing in molecular epidemiological investigation of nosocomial infection outbreak of aminoglycoside-resistant Pseudomonas aeruginosa.

Science.gov (United States)

Song, Min; Tang, Min; Ding, Yinghuan; Wu, Zecai; Xiang, Chengyu; Yang, Kui; Zhang, Zhang; Li, Baolin; Deng, Zhenghua; Liu, Jinbo

2017-12-16

Pseudomonas aeruginosan has emerged as an important pathogen elated to serious infections and nosocomial outbreaks worldwide. This study was conducted to understand the prevalence of aminoglycoside (AMG)-resistant P. aeruginosa in our hospital and to provide a scientific basis for control measures against nosocomial infections. Eighty-two strains of P. aeruginosa were isolated from clinical departments and divided into AMG-resistant strains and AMG-sensitive strains based on susceptibility test results. AMG-resistant strains were typed by drug resistance gene typing (DRGT) and protein typing. Five kinds of aminoglycoside-modifying enzyme (AME) genes were detected in the AMG-resistant group. AMG-resistant P. aeruginosa strains were classified into three types and six subtypes by DRGT. Four protein peaks, namely, 9900.02, 7600.04, 9101.25 and 10,372.87 Da, were significantly and differentially expressed between the two groups. AMG-resistant P. aeruginosa strains were also categorised into three types and six subtypes at the distance level of 10 by protein typing. AMG-resistant P. aeruginosa was cloned spread in our hospital; the timely implementation of nosocomial infection prevention and control strategies were needed in preventing outbreaks and epidemic of AMG-resistant P. aeruginosa. SELDI-TOF MS technology can be used for bacterial typing, which provides a new method of clinical epidemiological survey and nosocomial infection control.

Norovirus Genotypes in Hospital Settings - Differences between Nosocomial and Community-Acquired Infections

DEFF Research Database (Denmark)

Franck, Kristina Træholt; Nielsen, Rikke Thoft; Holzknecht, Barbara Juliane

2015-01-01

BACKGROUND:  Norovirus is a major cause of gastroenteritis and hospital outbreaks, leading to substantial morbidity and direct healthcare expenses as well as indirect societal costs. The aim of the study was to estimate the proportion of nosocomial norovirus infections among inpatients tested...

Biomonitoring of lead-contaminated Missouri streams with an assay for erythrocyte δ-aminolevulinic acid dehydratase activity in fish blood

Science.gov (United States)

Schmitt, C.J.; Wildhaber, M.L.; Hunn, J.B.; Nash, T.; Tieger, M. N.; Steadman, B. L.

1993-01-01

The activity of the enzyme δ-aminolevulinic acid dehydratase (ALA-D) in erythrocytes has long been used as a biomarker of lead exposure in humans and waterfowl and, more recently, in fishes. The assay was tested for ALA-D activity in fishes from streams affected by lead in combination with other metals from lead-zinc mining and related activities. Fishes (mostly catostomids) were collected from sites affected by historic and current mining activities, and from sites considered to be unaffected by mining (reference sites). A group of potentially toxic elements was measured in blood and carcass samples of individual fish, as were ALA-D activity, total protein (TP), and hemoglobin (Hb) in blood. Concentrations of mining-related metals (lead, zinc, and cadmium) were significantly greater (P<0.05) in fish blood and carcass at sites affected by historic mining activities than at reference and active mining sites. When analyzed by multiple regression, ALA-D activity, Hb, and TP accounted for 66% of blood-lead and 69% of carcass-lead variability. Differences among species were small. ALA-D activity as a biomarker adequately distinguished sites affected by bioavailable environmental lead. Zinc was the only other metal that affected ALA-D activity; it appeared to ameliorate the inactivation of ALA-D by lead.

[Characteristic situation on prevention of nosocomial infection in the hospital for the severely multi-disabled--experiences in care and treatment of 4 kinds of viral hepatitis].

Science.gov (United States)

Machida, Y; Tanaka, H; Yano, Y; Yano, T; Yoshida, K

1997-12-01

We experienced Hepatitis A, B, C and fulminant hepatitis due to Herpes simplex virus type 1 (HSV-1) in our hospital for the severely multi-disabled (SMD) who had both severe motor and intellectual disabilities, and some of whom might be further complicated by blindness and/or deafness. In this hospital, 100 SMDs are hospitalized. Case 1: The disabled, 25 year old male, was transmitted Hepatitis A from a nurse. Case 2: The disabled, 60 year old female carrier of Hepatitis B virus (HBV) who has been cared for more than 10 years. Case 3: The disabled, 46 year old male carrier of Hepatitis C virus (HCV) (RNA type 3), has been cared for more than 4 years. Case 4: The disabled, 39 year old male, had a fever of 39 degrees C for 9 days and suddenly died. He was diagnosed as fulminant hepatitis due to HSV-1 by necropsy. The hospitals for SMD are characteristic in prevention of nosocomial infections; 1) The disabled infected is not aware of the fact that he or she is the source of infection and that the other disabled living with him or her are in risk of infection, because of their severe mental condition. 2) All of the disabled need complete or incomplete helps for activities of daily life (ADL), so that the disabled who is the carrier of some pathogen constantly gives risk of infection to staffs, including medical staffs (doctor, nurse and therapist), psychologist and helpers by bloody secretion from wounds, saliva, urine, feces as well as menstrual blood. 3) If a carrier of some pathogen is hospitalized, the staffs should serve under risk of infection involving blood-mediated infectious disease for many years, because SMDs are permitted lifelong stay in the hospitals for SMD, which also play a role of care house or institution, by public expense in Japan. In case of an outbreak of Hepatitis A, nosocomial infection ended in the original case (a nurse), another nurse and a case of the disabled by general treatment and care against communicable diseases of the digestive

A Descriptive Study of Nosocomial Infections in an Adult Intensive Care Unit in Fiji: 2011-12

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Keshni Naidu

2014-01-01

Full Text Available Nosocomial infections in an intensive care unit (ICU are common and associated with a high mortality but there are no published data from the Oceania region. A retrospective study in Fiji’s largest ICU (2011-12 reported that 114 of a total 663 adult ICU admissions had bacteriological culture-confirmed nosocomial infection. The commonest sites of infection were respiratory and bloodstream. Gram negative bacteria were the commonest pathogens isolated, especially Klebsiella pneumoniae (extended-spectrum β-Lactamase-producing, Acinetobacter, and Pseudomonas species. Mortality for those with a known outcome was 33%. Improved surveillance and implementation of effective preventive interventions are needed.

Use of 99mTc-Mononuclear Leukocyte Scintigraphy in Nosocomial Fever

International Nuclear Information System (INIS)

Gutfilen, B.; Lopes de Souza, S.A.; Martins, F.P.P.; Cardoso, L.R.; Pinheiro Pessoa, M.C.; Fonseca, L.M.B.

2006-01-01

Purpose: To determine the overall diagnostic accuracy of mononuclear leukocyte- 99m Tc scintigraphy in the routine detection of infectious lesions and fever of unknown origin (FUO) in inpatients. Material and Methods: The use of mononuclear leukocyte 99m Tc scintigraphy is presented in 87 patients who fulfilled the Durack and Street diagnostic criteria of nosocomial FUO; 66 patients were suspected of having infectious lesions (myocarditis, endocarditis, infected catheters, diabetic foot, and osteomyelitis) and 21 patients presented with unknown causes of FUO. Scans were carried out 1, 3, and 24 h after injection of labeled leukocytes. Results: In three cases (3/27) where scintigraphs were negative, biopsies were positive. There were two (2/87) false-positive scintigrams. We found a 95.8% sensitivity and 92.3% specificity. PPV was 93.8%, PPN 94.7%, and accuracy 94.2%. Conclusion: Mononuclear leukocyte 99m Tc scintigraphy showed high sensitivity, specificity, positive and negative predictive values in patients with nosocomial FUO. These results suggest an important role for nuclear medicine in the management of patients with infection/inflammation

[Primary pneumonic plague with nosocomial transmission in La Libertad, Peru 2010].

Science.gov (United States)

Donaires, Luis F; Céspedes, Manuel; Valencia, Pedro; Salas, Juan Carlos; Luna, María E; Castañeda, Alex; Peralta, Víctor; Cabezas, César; Pachas, Paul E

2010-09-01

Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person. To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru. The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed. The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50% (2/4). Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.

[Use of antagonistic Bacillus subtilis bacteria for treatment of nosocomial urinary tract infections].

Science.gov (United States)

Pushkarev, A M; Tuĭgunova, V G; Zaĭnullin, R R; Kuznetsova, T N; Gabidullin, Iu Z

2007-01-01

Effect of Bactisporin--a probiotic, containing spores of aerobic Bacillus subtilis 3H bacterium--for complex treatment of patients with nosocomial urinary tract infections was studied. 68 Cultures of different species of conditionally pathogenic bacteria were isolated from urine of the patients. Susceptibility of the isolated cultures to antibiotics before and after application of B. subtilis 3H metabolites was determined. The metabolites were accumulated on potato-glucose agar (PGA) while bacterium was cultivated on kapron membranes placed on surface of the medium. Influence of obtained metabolites on isolated strains was assessed by cultivation of each strain in metabolites-rich PGA during 24 h. Metabolites of B. subtilis led to decrease in resistance of isolated uropathogenic microflora to antibiotics. Use of Bactisporin in complex treatment of nosocomial urinary tract infections resulted in accelerated elimination of causative microorganism.

Does disinfection of environmental surfaces influence nosocomial infection rates? A systematic review.

Science.gov (United States)

Dettenkofer, Markus; Wenzler, Sibylle; Amthor, Susanne; Antes, Gerd; Motschall, Edith; Daschner, Franz D

2004-04-01

To review the evidence on the effects of disinfection of environmental surfaces in hospitals (as compared with cleaning without use of disinfectants) on the occurrence of nosocomial infections. Systematic review of experimental and nonexperimental intervention studies dealing with environmental disinfection or cleaning in different health care settings. A total of 236 scientific articles were identified. None described a meta-analysis, systematic review, or randomized controlled trial. Only 4 articles described completed cohort studies matching the inclusion criteria. None of these studies showed lower infection rates associated with routine disinfection of surfaces (mainly floors) versus cleaning with detergent only. Disinfectants may pose a danger to staff, patients, and the environment and require special safety precautions. However, targeted disinfection of certain environmental surfaces is in certain instances an established component of hospital infection control. Given the complex, multifactorial nature of nosocomial infections, well-designed studies that systematically investigate the role of surface disinfection are required.

Nosocomial Pandemic (H1N1) 2009, United Kingdom, 2009–2010

Science.gov (United States)

Myles, Puja R.; Openshaw, Peter J.M.; Gadd, Elaine M.; Lim, Wei Shen; Semple, Malcolm G.; Read, Robert C.; Taylor, Bruce L.; McMenamin, James; Armstrong, Colin; Bannister, Barbara; Nicholson, Karl G.; Nguyen-Van-Tam, Jonathan S.

2011-01-01

To determine clinical characteristics of patients hospitalized in the United Kingdom with pandemic (H1N1) 2009, we studied 1,520 patients in 75 National Health Service hospitals. We characterized patients who acquired influenza nosocomially during the pandemic (H1N1) 2009 outbreak. Of 30 patients, 12 (80%) of 15 adults and 14 (93%) of 15 children had serious underlying illnesses. Only 12 (57%) of 21 patients who received antiviral therapy did so within 48 hours after symptom onset, but 53% needed escalated care or mechanical ventilation; 8 (27%) of 30 died. Despite national guidelines and standardized infection control procedures, nosocomial transmission remains a problem when influenza is prevalent. Health care workers should be routinely offered influenza vaccine, and vaccination should be prioritized for all patients at high risk. Staff should remain alert to the possibility of influenza in patients with complex clinical problems and be ready to institute antiviral therapy while awaiting diagnosis during influenza outbreaks. PMID:21470446

Ultra-Fast Low Concentration Detection of Candida Pathogens Utilizing High Resolution Micropore Chips

OpenAIRE

Mulero, Rafael; Lee, Dong Heun; Kutzler, Michele A.; Jacobson, Jeffrey M.; Kim, Min Jun

2009-01-01

Although Candida species are the fourth most common cause of nosocomial blood stream infections in the United States, early diagnostic tools for invasive candidemia are lacking. Due to an increasing rate of candidemia, a new screening system is needed to detect the Candida species in a timely manner. Here we describe a novel method of detection using a solid-state micro-scale pore similar to the operational principles of a Coulter counter. With a steady electrolyte current flowing through the...

Control de bacteriemia nosocomial pediátrica mediante un programa de cultivo de soluciones parenterales en uso Pediatric nosocomial bacteremia control program based on culturing in use parenteral infusions

Directory of Open Access Journals (Sweden)

Juan M. Muñoz

1999-01-01

Full Text Available OBJETIVO. Dado que Klebsiella, Enterobacter y Serratia se multiplican en soluciones parenterales y son responsables de una elevada proporción de bacteriemias en los hospitales de México, se propone una estrategia de control mediante la vigilancia microbiológica de las soluciones en uso. MATERIAL Y MÉTODOS. Hospital de enseñanza de segundo nivel con 193 camas. Atiende principalmente pacientes de escasos recursos. En 1992 se inició la vigilancia de la esterilidad de las soluciones parenterales en los servicios pediátricos mediante cuatro estrategias: durante la primera etapa se cultivó el total de soluciones en uso. Durante la segunda se cultivaron muestras aleatoriamente elegidas. Tercera y cuarta etapas con muestreo controlado y dirigido, respectivamente. RESULTADOS. Se han cultivado 1940 infusiones. Se ha observado una reducción de la tasa de contaminación (de 29.6% en 1992 a 12.9% en 1997, pOBJECTIVES. As Klebsiella, Enterobacter and Serratia are capable of growth in IV fluids and these bacteria are commonly implicated in nosocomial bacteremia, a control strategy through microbiological surveilance of in-use parenteral solutions is proposed. MATERIAL AND METHODS. A second level general teaching hospital, serving low-income patients. Through four consecutive strategies, a continous surveillance program of IV fluids sterility in pediatric wards was stablished in 1992. During the first stage all of the in -use solutions were cultured. During the second stage randomly selected samples were studied. Third stage was designed as a case-control study. The last stage included samples drawn in convenience. Positive cultures point out eventual infusion mishandling, as well as high-risk areas and patients. RESULTS. After culturing 1940 parenteral solutions, infusion contamination rates decreased from 29.6% in 1992 to 12.9% in 1997 (p< 0.001. The proportion of Gram-negative rods isolated from blood cultures went from 72.7% to 40.85% (p< 0

Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin

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Moro Serrano Manuel

2006-05-01

Full Text Available Abstract Background It has recently been suggested that serum procalcitonin (PCT is of value in the diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to assess the usefulness of PCT as a marker of neonatal sepsis of nosocomial origin. Methods One hundred infants aged between 4 and 28 days of life admitted to the Neonatology Services of 13 acute-care teaching hospitals in Spain over 1-year with clinical suspicion of neonatal sepsis of nosocomial origin were included in the study. Serum PCT concentrations were determined by a specific immunoluminometric assay. The reliability of PCT for the diagnosis of nosocomial neonatal sepsis at the time of suspicion of infection and at 12–24 h and 36–48 h after the onset of symptoms was calculated by receiver-operating characteristics (ROC curves. The Youden's index (sensitivity + specificity - 1 was used for determination of optimal cutoff values of the diagnostic tests in the different postnatal periods. Sensitivity, specificity, and the likelihood ratio of a positive and negative result with the 95% confidence interval (CI were calculated. Results The diagnosis of nosocomial sepsis was confirmed in 61 neonates. Serum PCT concentrations were significantly higher at initial suspicion and at 12–24 h and 36–48 h after the onset of symptoms in neonates with confirmed sepsis than in neonates with clinically suspected but not confirmed sepsis. Optimal PCT thresholds according to ROC curves were 0.59 ng/mL at the time of suspicion of sepsis (sensitivity 81.4%, specificity 80.6%; 1.34 ng/mL within 12–24 h of birth (sensitivity 73.7%, specificity 80.6%, and 0.69 ng/mL within 36–48 h of birth (sensitivity 86.5%, specificity 72.7%. Conclusion Serum PCT concentrations showed a moderate diagnostic reliability for the detection of nosocomial neonatal sepsis from the time of suspicion of infection. PCT is not sufficiently reliable to be the sole marker of

Fact-finding survey of nosocomial infection control in hospitals in Vietnam and application to training programs.

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Ohara, Hiroshi; Hung, Nguyen Viet; Thu, Truong Anh

2009-12-01

Nosocomial infection control is crucial for improving the quality of medical care. It is also indispensable for implementing effective control measures for severe acute respiratory syndrome (SARS) and the possible occurrence of a human influenza pandemic. The present authors, in collaboration with Vietnamese hospital staff, performed a fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously. Remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals. In the local hospitals, basic techniques and the systems for infection control were regarded as insufficient, and it is necessary to improve these techniques and systems under the guidance of hospitals in the central area. Based on the results of the survey, programs were prepared and training courses were organized in local hospitals. Evaluation conducted after the training courses showed a high degree of satisfaction among the trainees. The results of the survey and the training courses conducted during the study period are expected to contribute to the improvement of nosocomial infection control in remote areas of Vietnam.

Decreased rates of nosocomial endometritis and urinary tract infection after vaginal delivery in a French surveillance network, 1997-2003.

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Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Chapuis, Catherine; Depaix, Florence; Dumas, Anne-Marie; Gignoux, Chantal; Haond, Catherine; Lafarge-Leboucher, Joëlle; Launay, Carine; Tissot-Guerraz, Françoise; Vincent, Agnès; Fabry, Jacques

2008-06-01

To identify independent risk factors for endometritis and urinary tract infection (UTI) after vaginal delivery, and to monitor changes in nosocomial infection rates and derive benchmarks for prevention. Prospective study. We analyzed routine surveillance data for all vaginal deliveries between January 1997 and December 2003 at 66 maternity units participating in the Mater Sud-Est surveillance network. Adjusted odds ratios for risk of endometritis or UTI were obtained using a logistic regression model. The overall incidence rates were 0.5% for endometritis and 0.3% for UTI. There was a significant decrease in the incidence and risk of endometritis but not of UTI during the 7-year period. Significant risk factors for endometritis were fever during labor, parity of 1, and instrumental delivery and/or manual removal of the placenta. Significant risk factors for UTI were urinary infection on admission, premature rupture of membranes (more than 12 hours before admission), blood loss of more than 800 mL, parity of 1, instrumental delivery, and receipt of more than 5 vaginal digital examinations. Each maternity unit received a poster showing graphs of the number of expected and observed cases of UTI and endometritis associated with vaginal deliveries, which enabled each maternity unit to determine their rank within the network and to initiate prevention programs. Although routine surveillance means additional work for maternity units, our results demonstrate the usefulness of regular targeted monitoring of risk factors and of the most common nosocomial infections in obstetrics. Most of the information needed for monitoring is already present in the patients' records.

Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.

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Pfaller, Michael A; Castanheira, Mariana

2016-01-01

Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

High Mortality from Blood Stream Infection in Addis Ababa, Ethiopia, Is Due to Antimicrobial Resistance.

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Teshale Seboxa

Full Text Available Managing blood stream infection in Africa is hampered by lack of bacteriological support needed for antimicrobial stewardship, and background data needed for empirical treatment. A combined pro- and retrospective approach was used to overcome thresholds in clinical research in Africa.Outcome and characteristics including age, HIV infection, pancytopenia and bacteriological results were studied in 292 adult patients with two or more SIRS criteria using univariate and confirming multivariate logistic regression models. Expected randomly distributed resistance covariation was compared with observed co-resistance among gram-negative enteric bacteria in 92 paediatric blood culture isolates that had been harvested in the same hospital during the same period of time.Mortality was fivefold increased among patients with positive blood culture results [50.0% vs. 9.8%; OR 11.24 (4.38-25.88, p < 0.0001], and for this group of patients mortality was significantly associated with antimicrobial resistance [OR 23.28 (3.3-164.4, p = 0.002]. All 11 patients with Enterobacteriaceae resistant to 3rd. generation cephalosporins died. Eighty-nine patients had pancytopenia grade 3-4. Among patients with negative blood culture results, mortality was significantly associated with pancytopenia [OR 3.12 (1.32-7.39, p = 0.01]. HIV positivity was not associated with increased mortality. Antimicrobial resistance that concerned gram-negative enteric bacteria, regardless of species, was characterized by co-resistance between third generation cephalosporins, gentamicin, chloramphenicol, and co-trimoxazole.Mortality was strongly associated with growth of bacteria resistant to empirical treatment, and these patients were dead or dying when bacteriological reports arrived. Because of co-resistance, alternative efficient antibiotics would not have been available in Ethiopia for 8/11 Enterobacteriaceae-infected patients with isolates resistant to third generation cephalosporins

Impact of an Infection Control Program on the Prevalence of Nosocomial Infections at a Tertiary Care Center in Switzerland

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Ebnöther, Corina; Tanner, Beate; Schmid, Flavia; Rocca, Vittoria La; Heinzer, Ivo; Bregenzer, Thomas

2017-01-01

Objective. To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center. Methods. Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in time-interval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared ...

Mechanical Dissociation of Platelet Aggregates in Blood Stream

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Hoore, Masoud; Fedosov, Dmitry A.; Gompper, Gerhard; Complex; Biological Fluids Group Team

2017-11-01

von Willebrand factor (VWF) and platelet aggregation is a key phenomenon in blood clotting. These aggregates form critically in high shear rates and dissolve reversibly in low shear rates. The emergence of a critical shear rate, beyond which aggregates form and below which they dissolve, has an interesting impact on aggregation in blood flow. As red blood cells (RBCs) migrate to the center of the vessel in blood flow, a RBC free layer (RBC-FL) is left close to the walls into which the platelets and VWFs are pushed back from the bulk flow. This margination process provides maximal VWF-platelet aggregation probability in the RBC-FL. Using mesoscale hydrodynamic simulations of aggregate dynamics in blood flow, it is shown that the aggregates form and grow in RBC-FL wherein shear rate is high for VWF stretching. By growing, the aggregates penetrate to the bulk flow and get under order of magnitude lower shear rates. Consequently, they dissolve and get back into the RBC-FL. This mechanical limitation for aggregates prohibits undesired thrombosis and vessel blockage by aggregates, while letting the VWFs and platelets to aggregate close to the walls where they are actually needed. The support by the DFG Research Unit FOR 1543 SHENC and CPU time Grant by the Julich Supercomputing Center are acknowledged.

Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

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Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

2016-10-01

Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

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Meaghen Hyland

2001-01-01

Full Text Available BACKGROUND: A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC sites revealed variations in the prevention, detection, management and surveillance of Clostridium difficile-associated diarrhea (CDAD. Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.

Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features

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Pereira, Carlos Alberto Pires; Marra, Alexandre R.; Camargo, Luis Fernando Aranha; Pignatari, Antônio Carlos Campos; Sukiennik, Teresa; Behar, Paulo Renato Petersen; Medeiros, Eduardo Alexandrino Servolo; Ribeiro, Julival; Girão, Evelyne; Correa, Luci; Guerra, Carla; Carneiro, Irna; Brites, Carlos; Reis, Marise; de Souza, Marta Antunes; Tranchesi, Regina; Barata, Cristina U.; Edmond, Michael B.

2013-01-01

Background Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. Methods We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age) in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project). Results In our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age). Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS) (21.3%), Klebsiella spp. (15.7%), Staphylococcus aureus (10.6%), and Acinetobacter spp. (9.2%). The crude mortality was 21.6% (74 of 342). Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 95 patients (27.8%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%). Methicillin resistance was detected in 37 S. aureus isolates (27.1%). Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem. Conclusions In our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients. PMID:23861860

Linezolid Versus Vancomycin in the Empiric Treatment of Nosocomial Pneumonia: A Cost-Utility Analysis Incorporating Results from the ZEPHyR Trial.

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Collins, Curtis D; Schwemm, Ann K

2015-07-01

To examine the cost-effectiveness of vancomycin versus linezolid in the empiric treatment of nosocomial pneumonias incorporating results from a recent prospective, double-blind, multicenter, controlled trial in adults with suspected methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. A decision-analytic model examining the cost-effectiveness of linezolid versus vancomycin for the empiric treatment of nosocomial pneumonia was created. Publicly available cost, efficacy, and utility data populated relevant model variables. A probabilistic sensitivity analysis varied parameters in 10,000 Monte-Carlo simulations, and univariate sensitivity analyses assessed the impact of model uncertainties and the robustness of our conclusions. Results indicated that the cost per quality-adjusted life-year (QALY) increased 6% ($22,594 vs. $23,860) by using linezolid versus vancomycin for nosocomial pneumonia. The incremental cost per QALY gained by using linezolid over vancomycin was $6,089, and the incremental cost per life saved was $68,615 with the use of linezolid. Vancomycin dominated linezolid in the subset of patients with documented MRSA. The incremental cost per QALY gained using linezolid if no mortality benefit exists between agents or a 60-day time horizon was analyzed was $19,608,688 and $443,662, respectively. Linezolid may be a cost-effective alternative to vancomycin in the empiric treatment of patients with suspected MRSA nosocomial pneumonia; however, results of our model were highly variable on a number of important variables and assumptions including mortality differences and time frame analyzed. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

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Tan, S G; Lim, S H; Malathi, I

1995-11-01

A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

Validación de un programa de vigilancia de infecciones nosocomiales Validation of a nosocomial infections surveillance program

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M. Sigfrido Rangel-Frausto

1999-01-01

Full Text Available OBJETIVO. Validar el programa de vigilancia de infecciones nosocomiales y conocer la morbilidad y la mortalidad. MATERIAL Y MÉTODOS. Un médico especialmente capacitado, realizó vigilancia intensiva de todos los pacientes admitidos en el hospital. Los casos de infección fueron discutidos con otros dos médicos y el resultado se comparó con la vigilancia rutinaria. Se incluyó a todos los pacientes hospitalizados del 11 de julio al 12 de agosto de 1995, que no tenían un proceso infeccioso activo o que no manifestaban un periodo de incubación a su ingreso. Se siguieron diariamente y se registraron datos de: edad, sexo y padecimiento de ingreso. Se recabó información sobre tratamiento antimicrobiano, microrganismo aislado y susceptibilidad. Se evaluó el estado clínico final y se estimó el tiempo de estancia hospitalaria. RESULTADOS. De 429 pacientes, 45 desarrollaron infección nosocomial (casos y 384 no lo hicieron (controles. La incidencia de infecciones nosocomiales fue de 10.48/100. La sensibilidad y la especificidad del programa fueron de 93.3 y 98.7%, respectivamente. La mortalidad en los infectados fue de 11.11%, y en el grupo de los no infectados, de 2.4%. El promedio de estancia hospitalaria fue de 20 y 11 días, para infectados y no infectados, respectivamente (pOBJECTIVES. To validate the nosocomial infections surveillance system, establish its impact in morbi-mortality. MATERIAL AND METHODS. Surveillance of every single patient admited during a one month period was done by one of us (DMG. Each posibile case was discussed with two other hospital epidemiologists (SPLR, MSRF. This intensive surveillance was compared against the routinely surveillance performed by the nurses. We included all hospitalized patients between 11th July and 12th of August according to CDC (Atlanta, GA nosocomial infections definitions. Patients were followed everyday and information about age, gender, underlying diagnosis, microorganisms responsible

Use of {sup 99m}Tc-Mononuclear Leukocyte Scintigraphy in Nosocomial Fever

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Gutfilen, B.; Lopes de Souza, S.A.; Martins, F.P.P.; Cardoso, L.R.; Pinheiro Pessoa, M.C.; Fonseca, L.M.B. [Univ. Federal do Rio de Janeiro (Brazil). Dept. de Radiologia

2006-09-15

Purpose: To determine the overall diagnostic accuracy of mononuclear leukocyte-{sup 99m}Tc scintigraphy in the routine detection of infectious lesions and fever of unknown origin (FUO) in inpatients. Material and Methods: The use of mononuclear leukocyte {sup 99m}Tc scintigraphy is presented in 87 patients who fulfilled the Durack and Street diagnostic criteria of nosocomial FUO; 66 patients were suspected of having infectious lesions (myocarditis, endocarditis, infected catheters, diabetic foot, and osteomyelitis) and 21 patients presented with unknown causes of FUO. Scans were carried out 1, 3, and 24 h after injection of labeled leukocytes. Results: In three cases (3/27) where scintigraphs were negative, biopsies were positive. There were two (2/87) false-positive scintigrams. We found a 95.8% sensitivity and 92.3% specificity. PPV was 93.8%, PPN 94.7%, and accuracy 94.2%. Conclusion: Mononuclear leukocyte {sup 99m}Tc scintigraphy showed high sensitivity, specificity, positive and negative predictive values in patients with nosocomial FUO. These results suggest an important role for nuclear medicine in the management of patients with infection/inflammation.

Low Compliance to Handwashing Program and High Nosocomial Infection in a Brazilian Hospital

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Lizandra Ferreira de Almeida e Borges

2012-01-01

Full Text Available Background. It is a fact that hand hygiene prevents nosocomial infection, but compliance with recommended instructions is commonly poor. The purpose of this study was to implement a hand hygiene program for increase compliance with hand hygiene and its relationship with nosocomial infection (NI and MRSA infection/colonization rates. Methods. Compliance to hand hygiene was evaluated in a hospital by direct observation and measured of health care-associated infections, including methicillin resistant Staphylococcus aureus, before and after an educational intervention, using visual poster, colorful stamps, and feedback of the results. Results. Overall compliance did not increase during intervention, only handwashing before and after patient contact has improved from 40% to 76% (=0.01 for HCWs, but NI and MRSA rates remained high and stable. Conclusion. In a combination of high prevalence of NI and low compliance to hand hygiene, the programme of measure does not motivate the HCW hand hygiene. Future interventions should employ incremental evaluation to develop effective hand hygiene initiatives.

Antibacterial Therapy for Nosocomial Pneumonias Caused by Multidrug-Resistant Microorganisms in Critical 1ll Patients

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V. V. Moroz

2007-01-01

Full Text Available The paper presents the results of using the fourth-generation cephalosporin maxicef in the treatment of 20 patients with nosocomial pneumonia and severe concomitant injury. A control group comprised 20 patients receiving a combination of ceftazidime and amikacin. The total efficiency of the antibacterial therapy was 68.5% in the maxicef group and 40.9% in the control group (р<0.05. The therapy had to be modified in 42% of the maxicef group and in 72.7% in the control group (р<0.05. The average treatment cost was US $518 (429—606 and US $482 (368—596 in the maxicef and control groups, respectively. Nephrotoxicity was observed in 9% of the patients receiving a combination of the antibiotics. The activity of maxicef was also analyzed in vitro. Results. Maxicef was demonstrated to be highly active against the majority of gram-negative and gram-positive bacteria in vitro. Its efficacy against the most common bacteria (P.aeruginosa, S.aureus, E.coli, K.pneumonia causing infections in severe injury was in vitro significantly higher than that of ceftazidime. The comparative study indicates that the fourth-generation cephalosporin maxicef may be used as an alternative to the standard combined therapy. Key words: concomitant injury, maxicef, nosocomial pneumonia, a combination of ceftazidime and aminoglycoside, nosocomial infection pathogens.

Hospital-acquired influenza: a synthesis using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement.

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Voirin, N; Barret, B; Metzger, M-H; Vanhems, P

2009-01-01

Nosocomial influenza outbreaks occur in almost all types of hospital wards, and their consequences for patients and hospitals in terms of morbidity, mortality and costs are considerable. The source of infection is often unknown, since any patient, healthcare worker (HCW) or visitor is capable of transmitting it to susceptible persons within hospitals. Nosocomial influenza outbreak investigations should help to identify the source of infection, prevent additional cases, and increase our knowledge of disease control to face future outbreaks. However, such outbreaks are probably underdetected and underreported, making routes of transmission difficult to track and describe with precision. In addition, the absence of standardised information in the literature limits comparison between studies and better understanding of disease dynamics. In this study, reports of nosocomial influenza outbreaks are synthesised according to the ORION guidelines to highlight existing knowledge in relation to the detection of influenza cases, evidence of transmission between patients and HCWs and measures of disease incidence. Although a body of evidence has confirmed that influenza spreads within hospitals, we should improve clinical and virological confirmation and initiate active surveillance and quantitative studies to determine incidence rates in order to assess the risk to patients.

The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant enterococci- an ecologic study

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Cornelius Remschmidt

2017-09-01

Full Text Available Abstract Background Vancomycin-resistant enterococci (VRE are among the most common antimicrobial-resistant pathogens causing nosocomial infections. Although antibiotic use has been identified as a risk factor for VRE, it remains unclear which antimicrobial agents particularly facilitate VRE selection. Here, we assessed whether use of specific antimicrobial agents is independently associated with healthcare-associated (HA VRE rates in a university hospital setting in Berlin, Germany. Methods We conducted the study between January 2014 and December 2015 at the Charité-university hospital of Berlin, Germany. From the hospital pharmacy, we extracted data for all antibacterials for systemic use (anatomical therapeutic chemical (ATC-classification J01 and calculated ward specific antibiotic consumption in defined daily doses (DDDs per 100 patient-days (PD. We used the microbiology laboratory database to identify all patients with isolation of invasive or non-invasive VRE and calculated HA-VRE incidence as nosocomial VRE-cases per 100 patients and HA-VRE incidence density as nosocomial VRE-cases per 1000 PD. We defined VRE isolates as hospital-acquired if they were identified three days or later after hospital admission and otherwise as community-acquired (CA-VRE. We performed univariable and multivariable regression analyses to estimate the association of the frequency of HA-VRE per month with antibiotic use and other parameters such as length of stay, type of ward or presence of at least one CA-VRE on ward. In a second analysis, we considered only patients with VRE infections. Results We included data from 204,054 patients with 948,380 PD from 61 wards. Overall, 1430 VRE-cases were identified of which 409 (28.6% were considered hospital-acquired (HA. We found that carbapenem use in the current month and prior-month use of glycopeptides increased the risk for HA-VRE by 1% per 1 DDD/100 PD and 3% per 1 DDD/100 PD, respectively. However, when only VRE

Três anos de avaliação das taxas de infecção nosocomial em UTI Tres años de evaluación de las tasas de infección nosocomial en UCI Three-year evaluation of nosocomial infection rates of the ICU

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Necla Dereli

2013-02-01

intensive care units of different hospitals and different units in the same hospital. MATERIAL AND METHODS: A retrospective surveillance study was performed to identify nosocomial infections, device-related infections rates, and causal agents from January 2007 through December 2010 in the Anesthesiology Intensive care unit (ICU. HAI were defined according to the CDC (Centers for Disease Control and Prevention criteria, and invasive device-related infections were defined according to National Nosocomial Infection Surveillance System (NNIS criteria. RESULTS: During a two-year period, 939 patients were analyzed throughout a total of 7,892 patientdays. The rates of HAI were 53% in 2007, 29.15% in 2008, 28.85% in 2009 while 16.62% in 2010. Most common HAI was blood stream infection. The rate of soft tissue and skin infection was the second most common. Overall, the most common agents were Gram(- 56.68 %, Gram(+ 31.02% and Candida spp 12.3% among patients with nosocomial infections. CONCLUSIONS: The incidence of HAI in the ICU of our hospital was high, compared to the Turkish overall rates obtained at the Refik Saydam Center in 2007. When the rates of device-related infections between 2007 and 2008 were compared, they were higher in 2007. The rates of devicerelated infections were diminished in 2008 to below-national mean rates by infection control measures. Since the rate of urinary catheter-related infections are still high, we should exert continuous efforts for infection control.

Effects of depletion sampling by standard three-pass pulsed DC electrofishing on blood chemistry parameters of fishes from Appalachian streams

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Densmore, Christine L.; Panek, Frank M.

2013-01-01

Adverse effects on fishes captured by electrofishing techniques have long been recognized, although the extent of associated physical injury and behavioral alterations are highly variable and dependent on a number of factors. We examined the effects of three-pass pulsed DC (PDC) electrofishing on two salmonid species (Rainbow Trout Oncorhynchus mykiss and Brook Trout Salvelinus fontinalis) and five other genera (Green Sunfish Lepomis cyanellus, Potomac Sculpin Cottus girardi, Fathead Minnow Pimephales promelas, Largemouth Bass Micropterus salmoides, and Channel Catfish Ictalurus punctatus) common to Appalachian streams. We examined the corresponding effects of PDC electroshock on the following physiological indicators of stress and trauma: blood glucose and serum lactate, as well as on other blood chemistry, namely, enzymes, electrolytes, minerals, and proteins. All species demonstrated physiological responses to PDC electroshock, indicated by the biochemical differences in blood parameters in unshocked and shocked groups of fish with or without gross evidence of hemorrhagic trauma. Serum lactate was the most consistent indicator of these effects. Significant differences in whole blood glucose levels were also noted in treatment groups in all species except Green Sunfish, although the patterns observed were not as consistent as for serum lactate. Elevations in the serum enzymes, aspartate aminotransferase and creatine kinase, in the electroshocked fish occurred only in the two salmonid species. In many instances, although blood parameters were elevated in electroshocked fish compared with the unshocked controls for a given species, there were no differences in those levels in electroshocked fish based on the presence of gross hemorrhagic trauma to axial musculature. While some of the blood parameters examined correlated with both the occurrence of electroshock and the resultant tissue injury, there was no apparent link between the altered blood chemistry and

[Nosocomial infection due to Trichosporon asahii in a critical burned patient].

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Tamayo Lomas, Luis; Domínguez-Gil González, Marta; Martín Luengo, Ana Isabel; Eiros Bouza, José María; Piqueras Pérez, José María

2015-01-01

Invasive fungal infection is an important cause of morbimortality in patients with severe burns. The advances in burn care therapy have considerably extended the survival of seriously burned patients, exposing them to infectious complications, notably fungal infections, with increased recognition of invasive infections caused by Candida species. However, some opportunistic fungi, like Trichosporon asahii, have emerged as important causes of nosocomial infection. A case of nosocomial infection due to T. asahii in a severely ill burned patient successfully treated with voriconazole is presented. The management of invasive fungal infections in burned patients, from diagnosis to selection of the therapeutic protocol, is often a challenge. Early diagnosis and treatment are associated with a better prognosis. In this case report, current treatment options are discussed, and a review of previously published cases is presented. Due to the difficulty in the diagnosis of invasive mycoses and their high associated mortality rates, it is advisable to keep a high degree of clinical suspicion of trichosporonosis in susceptible patients, including burned patients. The isolation of T. asahii in clinical specimens of this type of host must raise clinical alert, since it may precede an invasive infection. Copyright © 2014 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

International Nuclear Information System (INIS)

Kweon, Dae Cheol; Jeon, Yong Woong; Cho, Am

2001-01-01

The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes

Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

Energy Technology Data Exchange (ETDEWEB)

Kweon, Dae Cheol [Seoul National Univ. Hospital, Seoul (Korea, Republic of); Jeon, Yong Woong; Cho, Am [Dongguk Univ., Seoul (Korea, Republic of)

2001-06-01

The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes.

Nosocomial outbreak of cryptosporidiosis in AIDS patients

DEFF Research Database (Denmark)

Ravn, Pernille; Lundgren, Jens Dilling; Kjaeldgaard, P

1991-01-01

OBJECTIVE--To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. SETTING--A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. SUBJECTS--73 HIV antibody negative subjects and 60 antibody positive subjects...... admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...... out ice for cold drinks. The mean incubation time was at least 13 days-that is, twice that in HIV-negative patients. Of the 18 patients with AIDS who developed cryptosporidiosis, five recovered, two were symptomless carriers, three died of unrelated causes, and eight died after prolonged diarrhoea...

[Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

Science.gov (United States)

Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

2016-06-01

To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

Science.gov (United States)

Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

Weekly screening supports terminating nosocomial transmissions of vancomycin-resistant enterococci on an oncologic ward – a retrospective analysis

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Stefanie Kampmeier

2017-05-01

Full Text Available Abstract Background To investigate the impact of weekly screening within the bundle of infection control measures to terminate vancomycin-resistant enterococci (VRE transmissions on an oncologic ward. Methods A cluster of 12 VRE colonisation and five infections was detected on an oncologic ward between January and April 2015. Subsequently, the VRE point prevalence was detected and, as part of a the bundle of infection control strategies to terminate the VRE cluster, we isolated affected patients, performed hand hygiene training among staff on ward, increased observations by infection control specialists, intensified surface disinfection, used personal protective equipment and initiated an admission screening in May 2015. After a further nosocomial VRE infection in August 2015, a weekly screening strategy of all oncology patients on the respective ward was established while admission screening was continued. Whole genome sequencing (WGS-based typing was applied to determine the clonal relationship of isolated strains. Results Initially, 12 of 29 patients were VRE colonised; of these 10 were hospital-acquired. During May to August, on average 7 of 40 patients were detected to be VRE colonised per week during the admission screening, showing no significant decline compared to the initial situation. WGS-based typing revealed five different clusters of which three were due to vanB- and two vanA-positive enterococci. After an additional weekly screening was established, the number of colonised patients significantly declined to 1/53 and no further nosocomial cases were detected. Conclusions Weekly screening helped to differentiate between nosocomial and community-acquired VRE cases resulting in earlier infection control strategies on epidemic situations for a successful termination of nosocomial VRE transmissions.

Typing of vancomycin-resistant enterococci with MALDI-TOF mass spectrometry in a nosocomial outbreak setting

DEFF Research Database (Denmark)

Holzknecht, B J; Dargis, R; Pedersen, M

2018-01-01

OBJECTIVES: To investigate the usefulness of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) typing as a first-line epidemiological tool in a nosocomial outbreak of vancomycin-resistant Enterococcus faecium (VREfm). METHODS: Fifty-five VREfm isolates...

Staphylococcal Blood Stream Infections in Cancer Patients

African Journals Online (AJOL)

All blood culture samples received from patients suspected of having ... previously reported by Silvia et al.[2] All the CoNS ... Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editor. Harrison's Manual of Medicine. 17th ed.

Caracterización de las infecciones nosocomiales Characterization of nosocomial infections

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Lucía López Méndez

2013-04-01

Full Text Available Introducción: las infecciones nosocomiales constituyen un importante problema de salud relacionado con la calidad de la atención y la eficacia del trabajo. Objetivo: caracterizar las infecciones nosocomiales en el Hospital Pediátrico Provincial Docente "Pepe Portilla" durante el período 2010-2011. Material y método: se realizó una investigación observacional, descriptiva, transversal y aplicada. El universo estuvo conformado por los 22652 egresados y la muestra por los 516 casos. Para la obtención de la información se revisaron los registros del departamento de estadística y las historias clínicas, utilizándose para su análisis las frecuencias absolutas, relativas porcentuales y la prueba de X² al 95 % de certeza. Resultados: el sistema respiratorio es el sitio de mayor localización, donde predominaron los hemocultivos negativos. Los gérmenes más aislados fueron: el Staphylococcus epidermidis, la Pseudomonas sp y el Acinetobacter, entre otros. Conclusiones: las infecciones nosocomiales en pediatría constituyen una problema de salud que requiere el fortalecimiento de las actividades de prevención y control, con especial énfasis en su vigilancia sistemática.Introduction: nosocomial infections constitute an important problem related to the quality and efficiency of the health services. Objective: to characterize nosocomial infections at “Pepe Portilla” Provincial Children Hospital during 2010-2011. Material and method: an observational, descriptive, cross-sectional and applied research was conducted, which target group was comprised of 22652 patients discharged from the hospital and the sample included 516 patients. To collect the information, the records of the statistics department and the clinical histories were reviewed; where absolute frequencies and relative percentages plus chi square test up to 95% of certainty were used to complete its analysis. Results: respiratory tract was the most affected site, where negative

Nanoparticle encapsulation in red blood cells enables blood-pool magnetic particle imaging hours after injection

International Nuclear Information System (INIS)

Rahmer, J; Gleich, B; Borgert, J; Antonelli, A; Sfara, C; Magnani, M; Tiemann, B; Weizenecker, J

2013-01-01

Magnetic particle imaging (MPI) is a new medical imaging approach that is based on the nonlinear magnetization response of super-paramagnetic iron oxide nanoparticles (SPIOs) injected into the blood stream. To date, real-time MPI of the bolus passage of an approved MRI SPIO contrast agent injected into the tail vein of living mice has been demonstrated. However, nanoparticles are rapidly removed from the blood stream by the mononuclear phagocyte system. Therefore, imaging applications for long-term monitoring require the repeated administration of bolus injections, which complicates quantitative comparisons due to the temporal variations in concentration. Encapsulation of SPIOs into red blood cells (RBCs) has been suggested to increase the blood circulation time of nanoparticles. This work presents first evidence that SPIO-loaded RBCs can be imaged in the blood pool of mice several hours after injection using MPI. This finding is supported by magnetic particle spectroscopy performed to quantify the iron concentration in blood samples extracted from the mice 3 and 24 h after injection of SPIO-loaded RBCs. Based on these results, new MPI applications can be envisioned, such as permanent 3D real-time visualization of the vessel tree during interventional procedures, bleeding monitoring after stroke, or long-term monitoring and treatment control of cardiovascular diseases. (paper)

Nosocomial infections—a new approach towards preventive medicine using plasmas

Science.gov (United States)

Morfill, G. E.; Shimizu, T.; Steffes, B.; Schmidt, H.-U.

2009-11-01

A new, very efficient, large area scalable and robust electrode design for plasma production in air at atmosphere pressures has been developed and tested. This has made the development of a 'plasma dispenser' for hospital disinfection possible, which has certain advantages over current fluid disinfection systems. The properties of this device are presented, in particular the bactericidal and fungicidal efficiency, and the advantages are described. Such plasma dispensers could play an important role in the future fight against the alarming and growing threat posed by nosocomial (=hospital and community associated) bacterial infections.

Nosocomial infections-a new approach towards preventive medicine using plasmas

International Nuclear Information System (INIS)

Morfill, G E; Shimizu, T; Steffes, B; Schmidt, H-U

2009-01-01

A new, very efficient, large area scalable and robust electrode design for plasma production in air at atmosphere pressures has been developed and tested. This has made the development of a 'plasma dispenser' for hospital disinfection possible, which has certain advantages over current fluid disinfection systems. The properties of this device are presented, in particular the bactericidal and fungicidal efficiency, and the advantages are described. Such plasma dispensers could play an important role in the future fight against the alarming and growing threat posed by nosocomial (=hospital and community associated) bacterial infections.

Modeling the economic impact of linezolid versus vancomycin in confirmed nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus.

Science.gov (United States)

Patel, Dipen A; Shorr, Andrew F; Chastre, Jean; Niederman, Michael; Simor, Andrew; Stephens, Jennifer M; Charbonneau, Claudie; Gao, Xin; Nathwani, Dilip

2014-07-22

We compared the economic impacts of linezolid and vancomycin for the treatment of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA)-confirmed nosocomial pneumonia. We used a 4-week decision tree model incorporating published data and expert opinion on clinical parameters, resource use and costs (in 2012 US dollars), such as efficacy, mortality, serious adverse events, treatment duration and length of hospital stay. The results presented are from a US payer perspective. The base case first-line treatment duration for patients with MRSA-confirmed nosocomial pneumonia was 10 days. Clinical treatment success (used for the cost-effectiveness ratio) and failure due to lack of efficacy, serious adverse events or mortality were possible clinical outcomes that could impact costs. Cost of treatment and incremental cost-effectiveness per successfully treated patient were calculated for linezolid versus vancomycin. Univariate (one-way) and probabilistic sensitivity analyses were conducted. The model allowed us to calculate the total base case inpatient costs as $46,168 (linezolid) and $46,992 (vancomycin). The incremental cost-effectiveness ratio favored linezolid (versus vancomycin), with lower costs ($824 less) and greater efficacy (+2.7% absolute difference in the proportion of patients successfully treated for MRSA nosocomial pneumonia). Approximately 80% of the total treatment costs were attributed to hospital stay (primarily in the intensive care unit). The results of our probabilistic sensitivity analysis indicated that linezolid is the cost-effective alternative under varying willingness to pay thresholds. These model results show that linezolid has a favorable incremental cost-effectiveness ratio compared to vancomycin for MRSA-confirmed nosocomial pneumonia, largely attributable to the higher clinical trial response rate of patients treated with linezolid. The higher drug acquisition cost of linezolid was offset by lower treatment failure

Infección nosocomial en la terapia intensiva neonatal. Factores de riesgo. Pinar del Río 2001-2003 Nosocomial infection in the neonatal intensive care unit. Risk factors, Pinar del Río

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Ivón Aimé Sánchez Monterrey

2007-03-01

Full Text Available Con el objetivo de evaluar los factores de riesgo de las infecciones nosocomiales en la Unidad de Terapia Intensiva Neonatal del Hospital General Universitario "Abel Santamaría Cuadrado" de Pinar del Río, se realizó una investigación observacional, analítica, de tipo caso-control, para ello se estudiaron 170 niños ingresados en esta unidad en el período comprendido de abril de 2001 a diciembre de 2003. Se recogió en una planilla tipo y momento de adquisición de la infección, abordaje vascular, ventilación mecánica y gérmenes aislados, entre otros. Se elaboró una base de datos en Microsoft Excel-97, se aplicaron los Test de Chi cuadrado y test de Student, ambos con un intervalo de confianza de p With the purpose of evaluating risk factors of nosocomial infections in the Intensive Care Unit of the "Abel Santamaría Cuadrado" General Hospital in Pinar del Río, an observational, analytical and a case-control research was performed in 170 children admitted at this Unit from April 1st., 2001, to December 31st., 2003. The nosocomial infection and time of being infected were recorded in a form, as well as the vascular approach, artificial ventilation and isolated germs, among others. A data base using the Microsoft Excel 97 software was designed, and chi-square test was used, both of them with a confidence interval of p<0,05. It was observed that birth weight, sex, gestational age, stay at ICU, artificial ventilation and deep vascular approach were related significantly with the onset of the nosocomial infection versus a control group showing similar characteristics. E. Coli and negative coagulase were the most frequent isolated germs.

Quorum sensing molecules production by nosocomial and soil isolates Acinetobacter baumannii.

Science.gov (United States)

Erdönmez, Demet; Rad, Abbas Yousefi; Aksöz, Nilüfer

2017-12-01

Acinetobacter species remain alive in hospitals on various surfaces, both dry and moist, forming an important source of hospital infections. These bacteria are naturally resistant to many antibiotic classes. Although the role of the quorum sensing system in regulating the virulence factors of Acinetobacter species has not been fully elucidated, it has been reported that they play a role in bacterial biofilm formation. The biofilm formation helps them to survive under unfavorable growth conditions and antimicrobial treatments. It is based on the accumulation of bacterial communication signal molecules in the area. In this study, we compared the bacterial signal molecules of 50 nosocomial Acinetobacter baumannii strain and 20 A. baumannii strain isolated from soil. The signal molecules were detected by the biosensor bacteria (Chromobacterium violaceum 026, Agrobacterium tumefaciens A136, and Agrobacterium tumefaciens NTL1) and their separation was determined by thin-layer chromatography. As a result, it has been found that soil-borne isolates can produce 3-oxo-C8-AHL and C8-AHL, whereas nosocomial-derived isolates can produce long-chain signals such as C10-AHL, C12-AHL, C14-AHL and C16-AHL. According to these results, it is possible to understand that these signal molecules are found in the infection caused by A. baumannii. The inhibition of this signaling molecules in a communication could use to prevent multiple antibiotic resistance of these bacteria.

Antibacterial properties of Chinese herbal medicines against nosocomial antibiotic resistant strains of Pseudomonas aeruginosa in Taiwan.

Science.gov (United States)

Liu, Ching-Shen; Cham, Thau-Ming; Yang, Cheng-Hong; Chang, Hsueh-Wei; Chen, Chia-Hong; Chuang, Li-Yeh

2007-01-01

Pseudomonas aeruginosa is well-recognized as a nosocomial pathogen, which exhibits inherent drug resistance. In this study, the antibacterial activity of ethanol extracts of 58 Chinese herbal medicines used in Taiwan were tested against 89 nosocomial antibiotic resistant strains of Pseudomonas aeruginosa. The results gathered by the disc diffusion method showed that 26 out of the 58 herbal extracts exhibited antibacterial activity. Among the 26 herbal extracts, 10 extracts showed broad-spectrum antibacterial activities and were selected for further antibacterial property assay. The minimum inhibitory concentrations (MIC) of the active partition fractions ranged from 0.25 to 11.0 mg/L. The presence of flavonoid compounds in the active fractions of test herbal extracts was observed by the TLC-bioautography. The results from the time-kill assay revealed that most of the herbal extracts completely killed the test organisms within 4 hours. Exposure of the test strains to a sub-MIC level of the herbal extracts for 10 consecutive subcultures did not induce resistance to the active components. A combination of the active herbal fractions with antibiotics showed that one of the herbal medicines, the hexane fraction of Ramulus Cinnamomi, possessed a synergistic effect with tetracycline, gentamycin, and streptomycin. In conclusion, the tested Chinese medical herbs have the potential to be developed into natural antibiotics. This is the first evaluation for screening large amounts of medical plants against nosocomial antibiotic resistant bacteria in Taiwan.

Streams with Strahler Stream Order

Data.gov (United States)

Minnesota Department of Natural Resources — Stream segments with Strahler stream order values assigned. As of 01/08/08 the linework is from the DNR24K stream coverages and will not match the updated...

[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.

Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

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Vajihe Karbasizade

2016-02-01

Full Text Available "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nosocomial infections in Isfahan hospitals.Methods: A total number of 456 clinical specimens were collected from nosocomial infections andevaluated in order to isolate A. baumannii strains. After identification of the isolates, the antibioticsensitivity to carbapenems was assessed using disk diffusion method. The resistance genes of blaOXA-23, 24, 51, and 58 were detected by multiplex PCR method.Results: Fifty A. baumannii isolates were isolated from clinical specimens. Fifty two percent ofthe isolates showed phenotypic resistance to the carbapenems (imipenem and meropenem.According to PCR results, 88% of resistant isolates had ≥1 blaOXA gene. The frequency of resistantisolates bearing blaOXA-23, blaOXA-24 and blaOXA-58 were 77%, 38% and 15% respectively.Conclusions: This study showed the high frequency of carbapenem resistance genes among A.baumannii isolates. Therefore, adopting an appropriate strategy to confine the spreading of thesestrains and also implementing new treatment regimens are necessary.

Nosocomial klebsiella infection in neonates in a tertiary care hospital: Protein profile by SDS-page and klebocin typing as epidemiological markers

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Malik A

2003-01-01

Full Text Available PURPOSE: To find out the prevalence of Klebsiella in hospital acquired neonatal infections in a tertiary care set up and to evaluate the role of klebocin typing and protein profile by SDS-PAGE in epidemiological typing of the isolates. METHODS: Hospital born neonates transferred to the neonatal unit after birth and available in the unit 48 hours later comprised the study group. Two hundred and three neonates were found eligible for inclusion in the study. Repeated blood cultures, other relevant clinical specimens and environmental samples were collected and identified according to the standard techniques. Isolated clinical and environmental Klebsiella pneumoniae strains were subjected to klebocin typing and protein profiling by SDS-PAGE at regular intervals. RESULTS: Multi drug resistant K. pneumoniae were the commonest organism isolated in 30 neonates leading to the incidence of Klebsiella nosocomial infection to be 14.7%. Klebocin typing of the K. pneumoniae isolates showed four patterns with type 312 being the commonest (43.4%. Whole cell protein analysis by SDS-PAGE of K. pneumoniae isolates revealed four types of banding pattern. Analysis of the typing method showed that the typeability and reproducibility of klebocin was 83.3% and 73.3% respectively whereas typeability and reproducibility of SDS-PAGE was 100%. CONCLUSIONS: Based on the present study it is concluded that SDS-PAGE typing method is better than klebocin typing in neonatal nosocomial infection. It is also suggested that protein profile by SDS-PAGE may be used as a tool for epidemiological typing of Klebsiella pneumoniae isolates in laboratories where genomic based molecular typing technique is not available.

Legionella pneumophila: risk assessment and strategy for the prevention and control of nosocomial infections

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Salvo Torrisi

2012-06-01

Full Text Available The term “Legionellosis” includes all forms of disease caused by microorganisms of the genus Legionella; it may manifest as a flu-like shape (Pontiac fever, or with severe pneumonia with high mortality (Legionnaires Disease. The causative agent was Legionella pneumophila in the literature although other strains of the genus Legionella are classified as pathogens, mode of transmission is through inhalation of aerosol particles produced by hot water or air conditioning systems: for this reason in community settings and nosocomial L. pneumophila represents a serious public health problem. In the light of epidemiological data since the year 2000 the Italian State has issued a series of provisions laws concerning the prevention and control of nosocomial Legionellosis environment and community.The present work aims to evaluate the presence of Legionella species and L. pneumophila comparing the different approaches proposed by the Guidelines of the regions of Lombardy and Piedmont in terms of assessment and prevention of risk “Legionellosis” in the field of nosocomial infection. The analytical methods used are those provided by the Regional Guidelines: the official method in the second CSR April 4 Method 2000 and UNI EN ISO 11731-1: 2008. Checks have been performed on equipment for the comparison of cold water, hot water and air conditioning in nursing homes, retirement homes and hospitals.The results obtained show that the method CSR April 4, 2000 restricts the search to L. pneumophila permitting, than the method EN ISO 11731-1: 2008, to carry out a risk assessment well targeted to the actual pathogen.The culture method for the detection of L. pneumophila allows you to not only prevention, but also to implement a series of targeted interventions following the directions of the legislation.

Controlling nosocomial infection based on structure of hospital social networks.

Science.gov (United States)

Ueno, Taro; Masuda, Naoki

2008-10-07

Nosocomial infection (i.e. infection in healthcare facilities) raises a serious public health problem, as implied by the existence of pathogens characteristic to healthcare facilities such as methicillin-resistant Staphylococcus aureus and hospital-mediated outbreaks of influenza and severe acute respiratory syndrome. For general communities, epidemic modeling based on social networks is being recognized as a useful tool. However, disease propagation may occur in a healthcare facility in a manner different from that in a urban community setting due to different network architecture. We simulate stochastic susceptible-infected-recovered dynamics on social networks, which are based on observations in a hospital in Tokyo, to explore effective containment strategies against nosocomial infection. The observed social networks in the hospital have hierarchical and modular structure in which dense substructure such as departments, wards, and rooms, are globally but only loosely connected, and do not reveal extremely right-skewed distributions of the number of contacts per individual. We show that healthcare workers, particularly medical doctors, are main vectors (i.e. transmitters) of diseases on these networks. Intervention methods that restrict interaction between medical doctors and their visits to different wards shrink the final epidemic size more than intervention methods that directly protect patients, such as isolating patients in single rooms. By the same token, vaccinating doctors with priority rather than patients or nurses is more effective. Finally, vaccinating individuals with large betweenness centrality (frequency of mediating connection between pairs of individuals along the shortest paths) is superior to vaccinating ones with large connectedness to others or randomly chosen individuals, which was suggested by previous model studies.

[Perception of nosocomial risk among healthcare workers at "Hopital Principal" in Dakar, Senegal (survey 2004)].

Science.gov (United States)

Chevalier, B; Margery, J; Wade, B; Ka, S; Diatta, B; Gueye, M; Mbaye, P S; Debonne, J M

2008-12-01

Nosocomial Infection (NI) is also observed in healthcare facilities in non-Western countries. The purpose of this report is to describe the findings of a survey undertaken to evaluate hygiene procedures implemented at the "Hopital Principal" in Dakar, Senegal and to assess perception and awareness of nosocomial risk among the hospital staff. A total of 264 healthcare workers were interviewed. Mean age was 39 years (range, 18-60) and the sex ratio was 1.3 (150 men/114 women). Sixty (22.7%) had university degrees, 106 (40.2%) had secondary school diplomas, 50 (18.9%) had attended middle school, and 13 (4.9%) had no schooling. Analysis of interview data showed that 56.1% (157/264) defined NI as infection acquired at the hospital but that only 9.8% (n=26) knew that a minimum 48-hour delay was necessary to distinguish nosocomial from community acquired infection. While understanding about NI was correlated with education level, data showed that 1 out of 3 physicians (13/39) failed to give the exact definition. Hand contact was cited as the second route of transmission. Isolation precautions were understood by 22.7% of personnel (60/264). Systematic handwashing was reported by 363% (96/264) but observation demonstrated that it was not performed properly regardless of the category of personnel. Care protocols were understood by 54.6% of persons interviewed (144/264). A hygiene-training course had been attended by 52.2% (n=138). Two thirds of the staff (69.7%: 54/264) was able to identify the hygiene nurse. Ninety-eight health care providers (37.1%) were familiar with the CLIN (Comités de Lutte contre les Infections Nosocomiales).

Point-of-care controls for nosocomial legionellosis combined with chlorine dioxide potable water decontamination: a two-year survey at a Welsh teaching hospital.

Science.gov (United States)

Hosein, I K; Hill, D W; Tan, T Y; Butchart, E G; Wilson, K; Finlay, G; Burge, S; Ribeiro, C D

2005-10-01

This study reports a two-year programme of attempted eradication of Legionella colonization in the potable water supply of a 1000-bed tertiary care teaching hospital in Wales. There was a simultaneous, point-of-care, sterile-water-only policy for all intensive care units (ICU) and bone marrow and renal transplant units in order to prevent acquisition of nosocomial Legionnaires' disease. The programme was initiated following a case of nosocomial pneumonia caused by Legionella pneumophila serogroup 1-Bellingham-like genotype A on the cardiac ICU. The case occurred 14 days after mitral and aortic valve replacement surgery. Clinical and epidemiological investigations implicated aspiration of hospital potable water as the mechanism of infection. Despite interventions with chlorine dioxide costing over 25000 UK pounds per annum, Legionella has remained persistently present in significant numbers (up to 20000 colony forming units/L) and with little reduction in the number of positive sites. Two further cases of nosocomial disease occurred over the following two-year period; in one case, aspiration of tap water was implicated again, and in the other case, instillation of contaminated water into the right main bronchus via a misplaced nasogastric tube was implicated. These cases arose because of inadvertent non-compliance with the sterile-water-only policy in high-risk locations. Enhanced clinical surveillance over the same two-year period detected no other cases of nosocomial disease. This study suggests that attempts at eradication of Legionella spp. from complex water systems may not be a cost-effective measure for prevention of nosocomial infections, and to the best of our knowledge is the first study from the UK to suggest that the introduction of a sterile-water-only policy for ICUs and other high-risk units may be a more cost-effective approach.

Prevention and control of blood stream infection using the balanced scorecard approach.

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Rohsiswatmo, Rinawati; Rafika, Sarah; Marsubrin, Putri M T

2014-07-01

to obtain formulation of an effective and efficient strategy to overcome blood stream infection (BSI). operational research design with qualitative and quantitative approach. The study was divided into two stages. Stage I was an operational research with problem solving approach using qualitative and quantitative method. Stage II was performed using quantitative method, a form of an interventional study on strategy implementation, which was previously established in stage I. The effective and efficient strategy for the prevention and control of infection in neonatal unit Cipto Mangunkusumo (CM) Hospital was established using Balanced Scorecard (BSC) approach, which involved several related processes. the BSC strategy was proven to be effective and efficient in substantially reducing BSI from 52.31°/oo to 1.36°/oo in neonates with birth weight (BW) 1000-1499 g (p=0.025), and from 29.96°/oo to 1.66°/oo in BW 1500-1999 g (p=0.05). Gram-negative bacteria still predominated as the main cause of BSI in CMH Neonatal Unit. So far, the sources of the microorganisms were thought to be from the environment of treatment unit (tap water filter and humidifying water in the incubator). Significant reduction was also found in neonatal mortality rate weighing 1000-1499 g at birth, length of stay, hospitalization costs, and improved customer satisfaction. effective and efficient infection prevention and control using BSC approach could significantly reduce the rate of BSI. This approach may be applied for adult patients in intensive care unit with a wide range of adjustment.

Field inversion gel electrophoretic analysis of Legionella pneumophila strains associated with nosocomial legionellosis in children.

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Green, M; Wald, E R; Dashefsky, B; Barbadora, K; Wadowsky, R M

1996-01-01

Two nosocomial cases of Legionnaires' disease occurred in children. Legionella pneumophila serogroup 1 was isolated from both patients and 30 of 39 plumbing system sites in the hospital. The patient and hospital environmental isolates yielded identical field inversion gel electrophoretic patterns which differed from patterns observed with epidemiologically unrelated strains.

A cluster of cases of nosocomial legionnaires disease linked to a contaminated hospital decorative water fountain.

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Palmore, Tara N; Stock, Frida; White, Margaret; Bordner, MaryAnn; Michelin, Angela; Bennett, John E; Murray, Patrick R; Henderson, David K

2009-08-01

Nosocomial outbreaks of Legionnaires disease have been linked to contaminated water in hospitals. Immunocompromised patients are particularly vulnerable and, when infected, have a high mortality rate. We report the investigation of a cluster of cases of nosocomial pneumonia attributable to Legionella pneumophila serogroup 1 that occurred among patients on our stem cell transplantation unit. We conducted a record review to identify common points of potential exposure, followed by environmental and water sampling for Legionella species from those sources. We used an air sampler to in an attempt to detect aerosolized Legionella and pulsed-field gel electrophoresis to compare clinical and environmental isolates. The most likely sources identified were the water supply in the patients' rooms and a decorative fountain in the radiation oncology suite. Samples from the patients' rooms did not grow Legionella species. Cultures of the fountain, which had been restarted 4 months earlier after being shut off for 5 months, yielded L. pneumophila serogroup 1. The isolates from both patients and the fountain were identical by pulsed-field gel electrophoresis. Both patients developed pneumonia within 10 days of completing radiation therapy, and each reported having observed the fountain at close range. Both patients' infections were identified early and treated promptly, and both recovered. This cluster was caused by contamination of a decorative fountain despite its being equipped with a filter and ozone generator. Fountains are a potential source of nosocomial Legionnaires disease despite standard maintenance and sanitizing measures. In our opinion, fountains present unacceptable risk in hospitals serving immunocompromised patients.

[In vitro antibacterial activity of Curcuma longa (Zingiberaceae) against nosocomial bacteria in Montería, Colombia].

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Méndez Álvarez, Nelson; Angulo Ortíz, Alberto; Contreras Martínez, Orfa

2016-09-01

Bacterial resistance is a growing health problem worldwide that has serious economic and social impacts, compromising public health, and the therapeutic action of current antibiotics. Therefore, the search for new compounds with antimicrobial properties is relevant in modern studies, particularly against bacteria of clinical interest. In the present study, in vitro antibacterial activity of the ethanol extract and essential oil of Curcuma longa (Zingiberaceae) was evaluated against nosocomial bacteria, using the microdilution method. Escherichia coli strains, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus sp. were used, Salmonella sp. and Bacillus sp., isolated from nosocomial infections in a hospital in the city of Monteria and reference strains of S. aureus ATCC 43300, S. aureus ATCC 29213, S. aureus ATCC 25923, P. aeruginosa ATCC 27853, E. coli ATCC 25922 and K. pneumonia ATCC 700603. The ethanol extract antibacterial profile was more efficient at higher concentrations (1 000 ppm), obtaining significant percentages of reduction of more than 50 % against K. pneumoniae ATCC 700603 and a clinical isolate of E. coli; while compared to Bacillus clinical isolate, was more active than the essential oil. For the rest of microorganisms, the reduction percentages obtained at a concentration of 1 000 ppm varied between 17 and 42 % with ethanolic extract, and 8 to 43 % with essential oil. At concentrations of 100 and 500 ppm antibacterial activity of the extracts was lower. The results indicated that the ethanolic extract and essential oil of C. longa rhizomes have active compounds with antibacterial properties that could be used in future research as a therapeutic alternative for the treatment of infections caused by nosocomial pathogens.

Direct costs associated with a nosocomial outbreak of Salmonella infection: an ounce of prevention is worth a pound of cure.

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Spearing, N M; Jensen, A; McCall, B J; Neill, A S; McCormack, J G

2000-02-01

Nosocomial outbreaks of Salmonella infections in Australia are an infrequent but significant source of morbidity and mortality. Such an outbreak results in direct, measurable expenses for acute care management, as well as numerous indirect (and less quantifiable) costs to those affected, the hospital, and the wider community. This article describes the significant direct costs incurred as a result of a nosocomial outbreak of Salmonella infection involving patients and staff. Information on costs incurred by the hospital was gathered from a number of sources. The data were grouped into 4 sections (medical costs, investigative costs, lost productivity costs, and miscellaneous) with use of an existing tool for calculating the economic impact of foodborne illness. The outbreak cost the hospital more than AU $120, 000. (US $95,000). This amount is independent of more substantial indirect costs. Salmonella infections are preventable. Measures to aid the prevention of costly outbreaks of nosocomial salmonellosis, although available, require an investment of both time and money. We suggest that dedication of limited resources toward such preventive strategies as education is a practical and cost-effective option for health care facilities.

Treatment and Outcome of Carbapenem-Resistant Gram-Negative Bacilli Blood-Stream Infections in a Tertiary Care Hospital.

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Shah, Pooja G; Shah, Sweta R

2015-07-01

Infections caused by carbapenem-resistant bacteria constitute a major challenge for current medical practice. To describe treatment and outcome of carbapenem-resistant Gram-negative bacilli (GNB) blood-stream infection (BSI) caused by these organisms at a tertiary care hospital in Mumbai. Carbapenem-resistant isolates from blood cultures were collected from January 2013 to April 2013. Identification and antimicrobial susceptibility testing were performed using Vitek 2 analyzer (Biomerieux Ltd.). Carbapenemase production was detected by modified Hodge's test (MHT). Patient's medical history, treatment and co-morbid conditions were noted. Outcomes of BSIs were evaluated. Forty-two isolates of carbapenem-resistant GNB isolated from BSIs were Enterobacteriaceae spp. (19), Acinetobacter baumannii (15), and Pseudomonas aeruginosa (8). Colistin had maximum in vitro activity with 97% against Enterobacteriaceae, 100% against Acinetobacter, and 100% activity against Pseudomonas aeruginosa isolates. Positivity of MHT was 92.9%. Outcome of colistin mono and combination therapy was comparable with 83% and 79%, respectively. Outcome of colistin and carbapenem combination therapy was found to be 100 percent. High incidences of bacteremia by carbapenem-resistant GNB including Enterobacteriaceae is a worrisome trend. Treatment options are compromised and only available option is colistin which has its own limitation. Colistin monotherapy may be non-inferior compared to combination therapy for treating BSIs caused by isolates with minimum inhibitory concentration (MIC) for colistin as ≤0.5 mg/l. Combined use of the colistin and carbapenem may provide good therapeutic options for BSI caused by carbapenem-resistant GNB and warrants further investigations.

In Vitro Assay of Ethanolic Heat Reflux Extract of Nicotiana tabacum L. var Virginia Against Nosocomial Bacteria Pathogen

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Pramono, Andri; Fauzantoro, Ahmad; Rizki Hidayati, Irma; Hygea, Arina; Puspita, Oktaviani Sandra; Muktamiroh, Hikmah; Simanjuntak, Kristina; Gozan, Misri

2018-03-01

Tobacco plays an important role in international trade as one of the export commodities. Indonesia is one of the good quality export contributors of tobacco leaves in the world. Nevertheless, tobacco is used only as a raw material for the cigarette industries, and the rise on anti-cigarette regulations prompted the exploration of alternative product from tobacco plants. The content of alkaloids, flavonoids, terpenoids and steroids in tobacco leaves were reported in literatures as antibacterial. Therefore, this study proposed in vitro assay of the ethanolic heat reflux extract (EHRE) of Nicotiana tabacum var. Virginia against nosocomial bacteria pathogen ((Pseudomonas aeruginosa (ATCC 27853), Eschericia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923), Enterococcus faecalis (ATCC 29212)). Kirby-bauer diffusion method was used for this assay. The concentration of the EHRE for Kirby-bauer assay were 20; 40; 60; 80; and 100%. The presence of clear zones on Kirby-bauer test, against the growth of each nosocomial bacteria pathogen show that tobacco extract has antibacterial effect. Statistical analysis result showed that each extract concentration had significant difference value (p steroids) of tobacco leaf extracts (N. tabacum) has potential as antibacterial against nosocomial bacteria pathogen. Nevertheless, optimization of tobacco leaf extract to obtain maximum active ingredient still needs to be done. This study is important for further development of the tobacco leaf extract as antibacterial

Estrategias para reducir a un mínimo la transmisión nosocomial del sarampión

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R. J. Biellik

1998-11-01

Full Text Available Como resultado de la gran contagiosidad del sarampión antes de salir la erupción, la transmisión nosocomial seguirá siendo un peligro hasta que se erradique la enfermedad. No obstante, varias estrategias pueden reducir a un mínimo la transmisión nosocomial. Es imprescindible, por lo tanto, hacer que el personal de salud cobre mayor conciencia de que un individuo con sarampión puede llegar en cualquier momento a un servicio de salud y de que el peligro de transmisión del sarampión en el medio hospitalario existe de continuo. La presente revisión contiene dos grupos de recomendaciones: las que suelen ser aplicables a todos los países, y ciertas recomendaciones adicionales que pueden ser apropiadas solamente para países industrializados.

Deterministic hydrodynamics: Taking blood apart

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Davis, John A.; Inglis, David W.; Morton, Keith J.; Lawrence, David A.; Huang, Lotien R.; Chou, Stephen Y.; Sturm, James C.; Austin, Robert H.

2006-10-01

We show the fractionation of whole blood components and isolation of blood plasma with no dilution by using a continuous-flow deterministic array that separates blood components by their hydrodynamic size, independent of their mass. We use the technology we developed of deterministic arrays which separate white blood cells, red blood cells, and platelets from blood plasma at flow velocities of 1,000 μm/sec and volume rates up to 1 μl/min. We verified by flow cytometry that an array using focused injection removed 100% of the lymphocytes and monocytes from the main red blood cell and platelet stream. Using a second design, we demonstrated the separation of blood plasma from the blood cells (white, red, and platelets) with virtually no dilution of the plasma and no cellular contamination of the plasma. cells | plasma | separation | microfabrication

[Incidence and risk factors associated with nosocomial infection in pediatric heart surgery].

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Duarte-Raya, Fidencia; Baeza-Zarco, Fabiola Janet

2016-01-01

Nosocomial infections are responsible for a high rate of morbidity and mortality in pediatric patients undergoing heart surgery. Our objective was to determine the incidence and associated risk factors to nosocomial infections in this group of patients. A descriptive, prospective, clinical study was conducted in a tertiary hospital for a year. We calculated the rate of incidence, accumulated incidence and devices used. Was Applied the EPIDAT 2004 version 3.1 program OPS for obtaining of Chi-square with Yates correction for p with a confidence of 95 %, alpha of 0.05 with a degree of freedom, we calculated odds ratio, besides of the identification of microorganisms, their sensitivity and resistance to antibiotics. We calculated rates of: 45 % the incidence, 80.6 % cumulative incidence, 7.4 % of mortality, 13.3 % of case-fatality rate of infected and 2.7 % non-infected. The 44.4 % with pneumonia, 74 % associated with mechanical ventilation, 100 % nasogastric tube. The most frequently isolated microorganisms are: Acinetobacter baumanni, Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa with high resistance to antibiotics. Pediatric patients undergoing heart surgery have high risk of infection heart disease, cyanogen's have 5 times more risk. We observed a statistically significant association with infection using nasogastric probe and endotracheal tube, the risk increases to increased hospital stay. Infected patients have 4 times the risk of death.

Cost Attributable to Nosocomial Bacteremia. Analysis According to Microorganism and Antimicrobial Sensitivity in a University Hospital in Barcelona.

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Marta Riu

Full Text Available To calculate the incremental cost of nosocomial bacteremia caused by the most common organisms, classified by their antimicrobial susceptibility.We selected patients who developed nosocomial bacteremia caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Pseudomonas aeruginosa. These microorganisms were analyzed because of their high prevalence and they frequently present multidrug resistance. A control group consisted of patients classified within the same all-patient refined-diagnosis related group without bacteremia. Our hospital has an established cost accounting system (full-costing that uses activity-based criteria to analyze cost distribution. A logistic regression model was fitted to estimate the probability of developing bacteremia for each admission (propensity score and was used for propensity score matching adjustment. Subsequently, the propensity score was included in an econometric model to adjust the incremental cost of patients who developed bacteremia, as well as differences in this cost, depending on whether the microorganism was multidrug-resistant or multidrug-sensitive.A total of 571 admissions with bacteremia matched the inclusion criteria and 82,022 were included in the control group. The mean cost was € 25,891 for admissions with bacteremia and € 6,750 for those without bacteremia. The mean incremental cost was estimated at € 15,151 (CI, € 11,570 to € 18,733. Multidrug-resistant P. aeruginosa bacteremia had the highest mean incremental cost, € 44,709 (CI, € 34,559 to € 54,859. Antimicrobial-susceptible E. coli nosocomial bacteremia had the lowest mean incremental cost, € 10,481 (CI, € 8,752 to € 12,210. Despite their lower cost, episodes of antimicrobial-susceptible E. coli nosocomial bacteremia had a major impact due to their high frequency.Adjustment of hospital cost according to the organism causing bacteremia and antibiotic sensitivity could improve prevention strategies

CONTROL OF NOSOCOMIAL SPREAD OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA

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Viktorija Tomič

2003-12-01

Full Text Available Background. This prospective cohort study presents the effectiveness and feasibility of a comprehensive control strategy to reduce nosocomial transmission of methicillinresistant Staphylococcus aureus (MRSA in a highly endemic setting.Methods. All patients with MRSA carriage admitted to the University Clinic of Respiratory and Allergic Diseases over a period of 5 years (January 1998 through December 2002 were included and categorized into imported or hospitalacquired cases. In January 1999, an aggressive infection control program was implemented. It was focused on promoting alcohol hand rub, obtaining active surveillance cultures for MRSA, implementing strict barrier precautions and decolonizing MRSA carriers.Results. MRSA was recovered from 223 hospitalized patients; 142 cases were imported and 81 were acquired at our institution. After the introduction of an active surveillance program, the annual incidence of detected MRSA carriage per 1000 admissions first increased from 4.5 in 1998 to 8.0 in 1999 (p = 0.019, but remained stable thereafter. The proportion of patients detected through active surveillance cultures progressively increased from 23% in 1999 to 78% in 2002. Since 1999, the proportion of acquired MRSA cases in our institution has steadily decreased from 50% in 1999 to 6% in 2002 (p < 0.001, whereas the proportion of patients who acquired MRSA in other hospitals (p < 0.001 and nursing homes (p = 0.025 has increased.Conclusions. With a comprehensive infection control program it is possible to substantially reduce nosocomial transmission of MRSA in a highly endemic area. With good hand hygiene, early detection, isolation and decolonization strategy, containment of MRSA is achievable despite a high rate of transferred patients colonized or infected with MRSA from other healthcare facilities.

Epidemiological characterization of a nosocomial outbreak of extended spectrum β-lactamase Escherichia coli ST-131 confirms the clinical value of core genome multilocus sequence typing.

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Woksepp, Hanna; Ryberg, Anna; Berglind, Linda; Schön, Thomas; Söderman, Jan

2017-12-01

Enhanced precision of epidemiological typing in clinically suspected nosocomial outbreaks is crucial. Our aim was to investigate whether single nucleotide polymorphism (SNP) analysis and core genome (cg) multilocus sequence typing (MLST) of whole genome sequencing (WGS) data would more reliably identify a nosocomial outbreak, compared to earlier molecular typing methods. Sixteen isolates from a nosocomial outbreak of ESBL E. coli ST-131 in southeastern Sweden and three control strains were subjected to WGS. Sequences were explored by SNP analysis and cgMLST. cgMLST clearly differentiated between the outbreak isolates and the control isolates (>1400 differences). All clinically identified outbreak isolates showed close clustering (≥2 allele differences), except for two isolates (>50 allele differences). These data confirmed that the isolates with >50 differing genes did not belong to the nosocomial outbreak. The number of SNPs within the outbreak was ≤7, whereas the two discrepant isolates had >700 SNPs. Two of the ESBL E. coli ST-131 isolates did not belong to the clinically identified outbreak. Our results illustrate the power of WGS in terms of resolution, which may avoid overestimation of patients belonging to outbreaks as judged from epidemiological data and previously employed molecular methods with lower discriminatory ability. © 2017 APMIS. Published by John Wiley & Sons Ltd.

Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection.

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Kaier, Klaus; Hagist, Christian; Frank, Uwe; Conrad, Andreas; Meyer, Elisabeth

2009-04-01

To determine the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection and Clostridium difficile infection (CDI). Two multivariate time-series analyses were performed that used as dependent variables the monthly incidences of nosocomial MRSA infection and CDI at the Freiburg University Medical Center during the period January 2003 through October 2007. The volume of alcohol-based hand rub solution used per month was quantified in liters per 1,000 patient-days. Antibiotic consumption was calculated in terms of the number of defined daily doses per 1,000 patient-days per month. The use of alcohol-based hand rub was found to have a significant impact on the incidence of nosocomial MRSA infection (Phand rub was associated with a lower incidence of nosocomial MRSA infection. Conversely, a higher level of consumption of selected antimicrobial agents was associated with a higher incidence of nosocomial MRSA infection. This analysis showed this relationship was the same for the use of second-generation cephalosporins (P= .023), third-generation cephalosporins (P= .05), fluoroquinolones (P= .01), and lincosamides (P= .05). The multivariate analysis (R2=0.55) showed that a higher level of consumption of third-generation cephalosporins (P= .008), fluoroquinolones (P= .084), and/or macrolides (P= .007) was associated with a higher incidence of CDI. A correlation with use of alcohol-based hand rub was not detected. In 2 multivariate time-series analyses, we were able to show the impact of hand hygiene and antibiotic use on the incidence of nosocomial MRSA infection, but we found no association between hand hygiene and incidence of CDI.

Factores de riesgo de neumonía nosocomial en terapia intensiva. Hospital “Dr. Ernesto Guevara”

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Yadira Santiesteban Escalona

2015-11-01

Full Text Available Se realizó un estudio analítico, de tipo caso control pareados 1:2, para determinar los factores de riesgo de neumonía nosocomial en pacientes ingresados en terapia intensiva del Hospital “Dr. Ernesto Guevara de la Serna” de Las Tunas, en el período de enero de 2010 a diciembre de 2011. El universo fue de 1035 pacientes ingresados en terapia intensiva (UCI, en dicho período, de ellos constituyeron la muestra, denominada “casos”, 56 pacientes que desarrollaron Neumonía Nosocomial durante su estadía en UCI. Para el “control” de los factores de confusión, por cada caso, se parearon dos pacientes sin diagnóstico de neumonía. La información se obtuvo de fuentes secundarias (historias clínicas. A los casos y a los controles se les llenó una planilla de vaciamiento de datos con las variables analizadas. Los datos se procesaron utilizando el paquete de programas estadísticos Epinfo, versión 6. Para el estudio de los factores de riesgo se realizaron análisis univariados, evaluándose: ODDS RATIO, intervalo de confianza y probabilidad. Resultaron ser factores de riesgo para presentar neumonía nosocomial: la intubación endotraqueal, los trastornos de conciencia, el aislamiento de bacilos no fermentadores, citrobacter diversus y/o klebsiella ssp., haber requerido neurocirugía, el uso de tratamiento antibiótico previo, antiácidos anti H2, nutrición parenteral y la estadía en UCI mayor de siete días.

Concentrations of cadmium, Cobalt, Lead, Nickel, and Zinc in Blood and Fillets of Northern Hog Sucker (Hypentelium nigricans) from streams contaminated by lead-Zinc mining: Implications for monitoring

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Schmitt, C.J.; Brumbaugh, W.G.; May, T.W.

2009-01-01

Lead (Pb) and other metals can accumulate in northern hog sucker (Hypentelium nigricans) and other suckers (Catostomidae), which are harvested in large numbers from Ozark streams by recreational fishers. Suckers are also important in the diets of piscivorous wildlife and fishes. Suckers from streams contaminated by historic Pb-zinc (Zn) mining in southeastern Missouri are presently identified in a consumption advisory because of Pb concentrations. We evaluated blood sampling as a potentially nonlethal alternative to fillet sampling for Pb and other metals in northern hog sucker. Scaled, skin-on, bone-in "fillet" and blood samples were obtained from northern hog suckers (n = 75) collected at nine sites representing a wide range of conditions relative to Pb-Zn mining in southeastern Missouri. All samples were analyzed for cadmium (Cd), cobalt (Co), Pb, nickel (Ni), and Zn. Fillets were also analyzed for calcium as an indicator of the amount of bone, skin, and mucus included in the samples. Pb, Cd, Co, and Ni concentrations were typically higher in blood than in fillets, but Zn concentrations were similar in both sample types. Concentrations of all metals except Zn were typically higher at sites located downstream from active and historic Pb-Zn mines and related facilities than at nonmining sites. Blood concentrations of Pb, Cd, and Co were highly correlated with corresponding fillet concentrations; log-log linear regressions between concentrations in the two sample types explained 94% of the variation for Pb, 73-83% of the variation for Co, and 61% of the variation for Cd. In contrast, relations for Ni and Zn explained Fillet Pb and calcium concentrations were correlated (r = 0.83), but only in the 12 fish from the most contaminated site; concentrations were not significantly correlated across all sites. Conversely, fillet Cd and calcium were correlated across the range of sites (r = 0.78), and the inclusion of calcium in the fillet-to-blood relation explained an

Olfactory responses to natal stream water in sockeye salmon by BOLD fMRI.

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Hiroshi Bandoh

Full Text Available Many studies have shown that juvenile salmon imprint olfactory memory of natal stream odors during downstream migration, and adults recall this stream-specific odor information to discriminate their natal stream during upstream migration for spawning. The odor information processing of the natal stream in the salmon brain, however, has not been clarified. We applied blood oxygenation level-dependent (BOLD functional magnetic resonance imaging to investigate the odor information processing of the natal stream in the olfactory bulb and telencephalon of lacustrine sockeye salmon (Oncorhynchus nerka. The strong responses to the natal stream water were mainly observed in the lateral area of dorsal telencephalon (Dl, which are homologous to the medial pallium (hippocampus in terrestrial vertebrates. Although the concentration of L-serine (1 mM in the control water was 20,000-times higher than that of total amino acid in the natal stream water (47.5 nM, the BOLD signals resulting from the natal stream water were stronger than those by L-serine in the Dl. We concluded that sockeye salmon could process the odor information of the natal stream by integrating information in the Dl area of the telencephalon.

[Legal aspects of the health care institution liability for nosocomial infections].

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Garus-Pakowska, Anna; Szatko, Franciszek; Pakowski, Maciej

2009-01-01

In this paper, the basic concepts concerning the liability of health care institution for nosocomial infections are presented. The principles of ex contracto and ex delicto liabilities, as well as the concept of so-called anonymous guilt are discussed. The range of duties for both the health care institution and the employed medical personnel is indicated, the duties and the consequences of their non-fulfillment are systematized, and the obligatory jurisdiction concerning the functioning of prima facie evidence is considered. The author aimed at explaining the principles governing the civil liability of health care institutions and their employees.

Selective particle and cell capture in a continuous flow using micro-vortex acoustic streaming.

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Collins, David J; Khoo, Bee Luan; Ma, Zhichao; Winkler, Andreas; Weser, Robert; Schmidt, Hagen; Han, Jongyoon; Ai, Ye

2017-05-16

Acoustic streaming has emerged as a promising technique for refined microscale manipulation, where strong rotational flow can give rise to particle and cell capture. In contrast to hydrodynamically generated vortices, acoustic streaming is rapidly tunable, highly scalable and requires no external pressure source. Though streaming is typically ignored or minimized in most acoustofluidic systems that utilize other acoustofluidic effects, we maximize the effect of acoustic streaming in a continuous flow using a high-frequency (381 MHz), narrow-beam focused surface acoustic wave. This results in rapid fluid streaming, with velocities orders of magnitude greater than that of the lateral flow, to generate fluid vortices that extend the entire width of a 400 μm wide microfluidic channel. We characterize the forces relevant for vortex formation in a combined streaming/lateral flow system, and use these acoustic streaming vortices to selectively capture 2 μm from a mixed suspension with 1 μm particles and human breast adenocarcinoma cells (MDA-231) from red blood cells.

Pattern of causative microorgansims in catheter related blood stream infections in dialysis patients: experience from Saudi Arabia

International Nuclear Information System (INIS)

Mohsin, B.

2017-01-01

Catheter related blood stream infections (CRBSI) are the leading cause of morbidity in HD patients. The majority of these infections relate to haemodialysis catheters. There is a paucity of local data on microbial agents responsible for CRBSI in our region. This prompted our study. Methods: This Prospective observatory survey was conducted in Department of Nephrology, King Fahd Hospital, Hofuf KSA from Nov 2014 to Jan 2017 (26 months). It was performed on dialysis patients with HD catheters who developed features of CRBSI. Blood cultures were taken from the patient and cultured microorganisms were observed and stratified according to type and prevalence in relation to age gender and comorbidities. Results: There were 210 distinct episodes of CRBSI. 61.5% (n=129) were due to gram negative microorganisms and 38.5% (n=81) were due to Gram positive microorganism. Fifty-three events were due to Coagulase Negative Staphylococcus aureus. Enterobacter cloachae accounted for 28 events. Pseudomonas 19 events, enterococcus faecalis 13, Klebsiella 11, Acinitobacter accounted for 8 events. CRBSI was observed more frequently in males (n=136), diabetics (n=113) and in age 40 years+-19 years(n=97). Conclusion: Gram negative microorganisms were more commonly responsible for CRBSI in our settings. Enterobacter cloachae was most common gram-negative microorganism responsible for CRBSI, a finding not observed in other studies. There was significant predisposition to diabetics, male gender and middle age group. We need further studies to observe antibiotics sensitivity of microorganisms so that we can standardize empirical antibiotics in cases of CRBSI. (author)

Ventilator-associated nosocomial pneumonia in intensive care units in Malaysia.

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Gopal Katherason, Supaletchimi; Naing, Lin; Jaalam, Kamarudin; Imran Musa, Kamarul; Nik Mohamad, Nik Abdullah; Aiyar, Subramaniar; Bhojani, Kavita; Harussani, Najah; Abdul Rahman, Aisai; Ismail, Asma

2009-10-22

The outcome indicator of nosocomial infection (NI) in the intensive care unit (ICU) is used to benchmark the quality of patient care in Malaysia. We conducted a three-year prospective study on the incidences of ventilator-associated pneumonia (VAP), risk factors, and patterns of the microorganisms isolated in three ICUs. A follow-up in prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a university hospital and two governmental hospitals in Malaysia from October 2003 to December 2006. VAP was detected using CDC criteria which included clinical manifestation and confirmed endotracheal secretion culture results. In total, 215 patients (2,306 patient-days) were enrolled into the study. The incidence of ICU-acquired device-related NI was 29.3 % (n = 63). The device-related VAP infection rate was 27.0 % (n = 58), with a mechanical ventilator utilization rate of 88.7%. The death rate due to all ICU-acquired NI including sepsis was 6.5%. The most common causative pathogen was Klebsiella pneumoniae (n = 27). Multivariate analysis using Cox regression showed that the risk factors identified were aspiration pneumonia (HR = 4.09; 95% CI = 1.24, 13.51; P = 0.021), cancer (HR = 2.51; 95% CI = 1.27, 4.97; P = 0.008), leucocytosis (HR=3.43; 95% CI= 1.60, 7.37; P=0.002) and duration of mechanical ventilation (HR=1.04; 95% CI = 1.00, 1.08; P = 0.030). Age, gender and race were not identified as risk factors in the multivariable analysis performed. The incidence of VAP was comparable to that found in the National Nosocomial Infection Surveillance (NNIS) System report of June 1998. The incidence of VAP was considered high for the three hospitals studied.

Compliance of hospital staff with guidelines for the active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and its impact on rates of nosocomial MRSA bacteremia.

Science.gov (United States)

Zoabi, Marwan; Keness, Yoram; Titler, Nava; Bisharat, Naiel

2011-12-01

The compliance of hospital staff with guidelines for the active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) in Israel has not been determined. To evaluate the compliance of hospital staff with guidelines for the active surveillance of MRSA and assess its impact on the incidence of nosocomial MRSA bacteremia. We assessed compliance with MRSA surveillance guidelines by assessing adherence to the screening protocol and reviewing medical and nursing charts of patients colonized with MRSA, and observed hand hygiene opportunities among health care workers and colonized patients. Rates of nosocomial MRSA bacteremia and of adherence with hand hygiene among overall hospital staff were obtained from archived data for the period 2001-2010. Only 32.4% of eligible patients were screened for MRSA carriage on admission, and 69.9% of MRSA carriers did not receive any eradication treatment. The mean rate of adherence to glove use among nurses and doctors was 69% and 31% respectively (Phand hygiene 59% and 41% respectively (Phand hygiene increased from 42.3% in 2005 to 68.1% in 2010. Rates of nosocomial MRSA bacteremia decreased by 79.2%, from 0.48 (in 2001) to 0.1 (in 2010) per 1000 admissions (Phand hygiene and concomitant decrease in nosocomial MRSA bacteremia is gratifying. The deficiencies in compliance with MRSA infection control policy warrant an adjusted strategy based on the hospital resources.

Long-term normalization of diabetes mellitus after xenotransplantation of fetal pancreatic islet cells into the blood stream without immunosuppresive therapy.

Science.gov (United States)

Prochorov, A V; Tretjak, S I; Roudenok, V V; Goranov, V A

2004-11-01

The article presents a new method of surgical treatment of experimental diabetes mellitus in a rabbit to dog model. Rabbit islet cells, which had been macroencapsulated into a microporous polyamide, were implanted into the dog aorta without immunosuppressive therapy. Euglycemia was reached at 4 to 5 days and persisted for 12 months. Morphological and immunohistochemical investigations showed long-term preservation of islet cell viability, absence of graft rejection, and formation of a biological artificial pancreas in the capsule at 6 months after transplantation. Up to 60% of transplanted cells were still viable 12 months later. The major factor contributing to preservation of islet cells is neo-angiogenesis, which develops during the first weeks after transplantation. Double immune isolation of islet cells by macroencapsulation with implantation into the blood stream allows the use of either xenotransplantation or allotransplantation.

Diarréia nosocomial em unidade de terapia intensiva: incidência e fatores de risco Nosocomial diarrhea in the intensive care unit: incidence and risk factors

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Sérvulo Luiz Borges

2008-06-01

Full Text Available RACIONAL: Diarréia nosocomial parece ser comum em unidades de terapia intensiva, embora sua epidemiologia seja pouco documentada em nosso meio. OBJETIVO: Determinar a incidência e fatores de risco de diarréia entre pacientes adultos internados em unidade de terapia intensiva. MÉTODOS: Foram incluídos prospectivamente 457 pacientes no período entre outubro de 2005 e outubro de 2006. Dados demográficos, clínicos e bioquímicos, bem como aspecto e número de evacuações eram registrados diariamente até a saída do paciente do setor. RESULTADOS: Diarréia ocorreu em 135 (29,5% pacientes, durando em média 5,4 dias. O tempo do seu início em relação à internação foi de 17,8 dias e casos similares de diarréia no mesmo período foram registrados em 113 (83,7% pacientes. A mortalidade hospitalar foi maior nos pacientes com diarréia do que naqueles sem esta intercorrência. Na análise multivariada através de modelo de regressão logística, apenas o número de antibióticos (OR 1,65; IC 95% = 1,39-1,95 e o número de dias de antibioticoterapia (OR 1,16; IC 95% = 1,12-1,20 associaram-se estatisticamente com a ocorrência de diarréia. Cada dia de acréscimo a mais da antibioticoterapia aumentou em 16% o risco de diarréia (IC 12% a 20%, enquanto a adição de um antibiótico a mais ao esquema antimicrobiano aumentou as chances de ocorrência de diarréia em 65% (IC 39% a 95%. CONCLUSÃO: A incidência de diarréia nosocomial na unidade de terapia intensiva é elevada (29,5%. Os principais fatores de risco para sua ocorrência foram número de antibióticos prescritos e duração da antibioticoterapia. Além das precauções entéricas, a prescrição judiciosa e limitada de antimicrobianos, provavelmente reduzirá a ocorrência de diarréia neste setor.BACKGROUND: Nosocomial diarrhea seems to be common at intensive care units, although its epidemiology be poorly documented in Brazil. AIM: To determine the incidence and risk factors of

The prevalence of visible and/or occult blood on anesthesia and monitoring equipment.

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Perry, S M; Monaghan, W P

2001-02-01

The Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control and Prevention (CDC) have attempted to stop the spread of blood-borne pathogens by issuing several recommendations and regulations. However, unless healthcare workers comply with these standards, they are not effective. In the anesthesia care environment, the anesthetist is responsible for ensuring that the equipment is clean, and disinfected, before use. We studied the prevalence of visible and occult blood on 6 types of anesthesia and monitoring equipment identified as ready for use in 28 operating suites, in 2 facilities. The sample consisted of 336 observations of the 6 types of equipment. The equipment was inspected for visible blood and then tested for occult blood using a 3-stage phenolphthalein test. Of the 336 observations, 110 (32.7%), were positive for occult blood with only 6 showing visible blood. The presence of blood on this equipment may be in direct violation of the OSHA Blood-borne Pathogen Standard and the infection control guidelines of the American Association of Nurse Anesthetists. Furthermore, the presence of blood on this equipment may increase the risk for nosocomial and occupational exposure to viral and bacterial pathogens. Recommendations were made to decrease the risks from this contamination by redesigning equipment, increasing the use of disposable equipment, and ensuring compliance with effective infection control practices.

Pulsed-field gel electrophoresis of chromosomal DNA of methicillin-resistant Staphylococcus aureus associated with nosocomial infections.

Science.gov (United States)

Hanifah, Y A; Hiramatsu, K

1994-12-01

Methicillin-resistant Staphylococcus aureus (MRSA) infection has been endemic in the University Hospital, Kuala Lumpur since the late 1970s. Fifty isolates of MRSA obtained from clinical specimens of patients with nosocomial infections associated with this organism have been studied by pulsed-field gel electrophoresis (PFGE) of its chromosomal DNA fragments to discrimate between strains and to identify the predominant strain. Twenty-one chromosomal patterns were observed which could be further grouped into nine types. The predominant strain was Type 9-b (40% of isolates) found mainly in the Orthopaedic and Surgical Units. Outbreak strains found in the Special Care Nursery were of Type 1, entirely different from those of the surgical ward S2, which were of Type 9-b. Type 8 strains were found mainly at one end of the hospital building where the maternity, paediatric and orthopaedic units were situated. Genomic DNA fingerprinting by PFGE is recommended as a useful and effective tool for the purpose of epidemiological studies of MSRA infections, particularly for nosocomial infections.

Comparison of Disk Diffusion and E-Test Methods for Doripenem Susceptibility of Nosocomial Acinetobacter Baumannii Strains

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Yesim Cekin

2014-03-01

Full Text Available Aim: Acinetobacter species are amoung the most common two cause of infections isolated from patients of intensive care unit in our hospital. Doripenem which acts by inhibiting cell wall synthesis is resently introduced for use in our country is broad spectrum antibiotic belonging to carbapenems. There are many studies investigating the susceptibility of doripenem of Acinetobacter baumannii which is isolated as a cause of ventilatory associated pneumonia in the literature. We aimed to compare e-test and disc diffusion methods for doripenem susceptibility of acinetobacter baumannii strains as nosocomial infections Acinetobacter baumanni isolates detected as nosocomial infection. Material and Method:. Between January to December, 2009 a total of 94 Acinetobacter baumanni strains isolated from different clinical specimens from intensive care units have been studied for doripenem susceptibility by disc diffusion and E-test methods. Minimal inhibitory consantrations (MIC were accepted as; sensitive %u22641 %u03BCg/ml, intermadiate 2-4 %u03BCg/ml, resistant >4 %u03BCg/ml and diameters of inhibition zone with 10 µg disc; sensitive

Molecular mechanisms associated with nosocomial carbapenem-resistant Acinetobacter baumannii in Mexico.

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Alcántar-Curiel, María Dolores; García-Torres, Luis Francisco; González-Chávez, María Inés; Morfín-Otero, Rayo; Gayosso-Vázquez, Catalina; Jarillo-Quijada, Ma Dolores; Fernández-Vázquez, José Luis; Giono-Cerezo, Silvia; Rodríguez-Noriega, Eduardo; Santos-Preciado, José Ignacio

2014-10-01

Acinetobacter baumannii is an emerging pathogen worldwide that is most commonly associated with nosocomial infections and multi-drug resistance. In the present study we determined the mechanisms of carbapenem resistance and clonal diversity of A. baumannii nosocomial isolates in Hospital Civil de Guadalajara, Mexico. A total of 303 clinical isolates of A. baumannii identified during a period expanding from 2004-2011 were analyzed for carbapenem resistance using several microbiological and molecular methods. Clonal relatedness of these isolates was determined using pulsed-field gel electrophoresis. Of the 303 isolates, 84% were resistant to meropenem, 71.3% to imipenem and 78.3% the resistant isolates were positive for metallo-β-lactamases as determined by the phenotypic assay. In addition, 49.6% of carbapenem-intermediate or -resistant isolates carried the blaOXA-72 gene and 1.2% carried the blaVIM-1 gene. Efflux pump phenotype was responsible for reduced susceptibility to meropenem in 14.5% and to imipenem in 31.6% of the resistant isolates, respectively in the presence of the efflux pump inhibitor, carbonyl cyanide 3-chlorophenylhydrazone. Strains representing different carbapenem-resistant patterns exhibited reduced expression of 22, 29, 33, and 43 kDa OMPs. Among the bacterial collection studied, 48 different clones were identified, two of which were predominant and persistently transmitted. Carbapenemase production in combination with efflux pump expression, reduction in OMPs expression and the cross-transmission of clones appear to be major contributors to the high frequency of carbapenem-resistance observed in A. baumannii. To our knowledge, this is the first study to define the molecular mechanisms associated with carbapenem-resistance in A. baumannii in Mexico. Copyright © 2014 IMSS. Published by Elsevier Inc. All rights reserved.

“Data characterizing microfabricated human blood vessels created via hydrodynamic focusing”

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Kyle A. DiVito

2017-10-01

Full Text Available This data article provides further detailed information related to our research article titled “Microfabricated Blood Vessels Undergo Neovascularization” (DiVito et al., 2017 [1], in which we report fabrication of human blood vessels using hydrodynamic focusing (HDF. Hydrodynamic focusing with advection inducing chevrons were used in concert to encase one fluid stream within another, shaping the inner core fluid into ‘bullseye-like” cross-sections that were preserved through click photochemistry producing streams of cellularized hollow 3-dimensional assemblies, such as human blood vessels (Daniele et al., 2015a, 2015b, 2014, 2016; Roberts et al., 2016 [2–6]. Applications for fabricated blood vessels span general tissue engineering to organ-on-chip technologies, with specific utility in in vitro drug delivery and pharmacodynamics studies. Here, we report data regarding the construction of blood vessels including cellular composition and cell positioning within the engineered vascular construct as well as functional aspects of the tissues.

The Stream-Catchment (StreamCat) and Lake-Catchment ...

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Background/Question/MethodsLake and stream conditions respond to both natural and human-related landscape features. Characterizing these features within contributing areas (i.e., delineated watersheds) of streams and lakes could improve our understanding of how biological conditions vary spatially and improve the use, management, and restoration of these aquatic resources. However, the specialized geospatial techniques required to define and characterize stream and lake watersheds has limited their widespread use in both scientific and management efforts at large spatial scales. We developed the StreamCat and LakeCat Datasets to model, predict, and map the probable biological conditions of streams and lakes across the conterminous US (CONUS). Both StreamCat and LakeCat contain watershed-level characterizations of several hundred natural (e.g., soils, geology, climate, and land cover) and anthropogenic (e.g., urbanization, agriculture, mining, and forest management) landscape features for ca. 2.6 million stream segments and 376,000 lakes across the CONUS, respectively. These datasets can be paired with field samples to provide independent variables for modeling and other analyses. We paired 1,380 stream and 1,073 lake samples from the USEPAs National Aquatic Resource Surveys with StreamCat and LakeCat and used random forest (RF) to model and then map an invertebrate condition index and chlorophyll a concentration, respectively. Results/ConclusionsThe invertebrate

Multilocus Sequence Typing for Interpreting Blood Isolates of Staphylococcus epidermidis

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Prannda Sharma

2014-01-01

Full Text Available Staphylococcus epidermidis is an important cause of nosocomial infection and bacteremia. It is also a common contaminant of blood cultures and, as a result, there is frequently uncertainty as to its diagnostic significance when recovered in the clinical laboratory. One molecular strategy that might be of value in clarifying the interpretation of S. epidermidis identified in blood culture is multilocus sequence typing. Here, we examined 100 isolates of this species (50 blood isolates representing true bacteremia, 25 likely contaminant isolates, and 25 skin isolates and the ability of sequence typing to differentiate them. Three machine learning algorithms (classification regression tree, support vector machine, and nearest neighbor were employed. Genetic variability was substantial between isolates, with 44 sequence types found in 100 isolates. Sequence types 2 and 5 were most commonly identified. However, among the classification algorithms we employed, none were effective, with CART and SVM both yielding only 73% diagnostic accuracy and nearest neighbor analysis yielding only 53% accuracy. Our data mirror previous studies examining the presence or absence of pathogenic genes in that the overlap between truly significant organisms and contaminants appears to prevent the use of MLST in the clarification of blood cultures recovering S. epidermidis.

Streaming Pool: reuse, combine and create reactive streams with pleasure

CERN Multimedia

CERN. Geneva

2017-01-01

When connecting together heterogeneous and complex systems, it is not easy to exchange data between components. Streams of data are successfully used in industry in order to overcome this problem, especially in the case of "live" data. Streams are a specialization of the Observer design pattern and they provide asynchronous and non-blocking data flow. The ongoing effort of the ReactiveX initiative is one example that demonstrates how demanding this technology is even for big companies. Bridging the discrepancies of different technologies with common interfaces is already done by the Reactive Streams initiative and, in the JVM world, via reactive-streams-jvm interfaces. Streaming Pool is a framework for providing and discovering reactive streams. Through the mechanism of dependency injection provided by the Spring Framework, Streaming Pool provides a so called Discovery Service. This object can discover and chain streams of data that are technologically agnostic, through the use of Stream IDs. The stream to ...

Interaction between stream temperature, streamflow, and groundwater exchanges in alpine streams

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Constantz, James E.

1998-01-01

Four alpine streams were monitored to continuously collect stream temperature and streamflow for periods ranging from a week to a year. In a small stream in the Colorado Rockies, diurnal variations in both stream temperature and streamflow were significantly greater in losing reaches than in gaining reaches, with minimum streamflow losses occurring early in the day and maximum losses occurring early in the evening. Using measured stream temperature changes, diurnal streambed infiltration rates were predicted to increase as much as 35% during the day (based on a heat and water transport groundwater model), while the measured increase in streamflow loss was 40%. For two large streams in the Sierra Nevada Mountains, annual stream temperature variations ranged from 0° to 25°C. In summer months, diurnal stream temperature variations were 30–40% of annual stream temperature variations, owing to reduced streamflows and increased atmospheric heating. Previous reports document that one Sierra stream site generally gains groundwater during low flows, while the second Sierra stream site may lose water during low flows. For August the diurnal streamflow variation was 11% at the gaining stream site and 30% at the losing stream site. On the basis of measured diurnal stream temperature variations, streambed infiltration rates were predicted to vary diurnally as much as 20% at the losing stream site. Analysis of results suggests that evapotranspiration losses determined diurnal streamflow variations in the gaining reaches, while in the losing reaches, evapotranspiration losses were compounded by diurnal variations in streambed infiltration. Diurnal variations in stream temperature were reduced in the gaining reaches as a result of discharging groundwater of relatively constant temperature. For the Sierra sites, comparison of results with those from a small tributary demonstrated that stream temperature patterns were useful in delineating discharges of bank storage following

The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban neonatal intensive care unit: an intervention study with before and after comparison.

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Helder, Onno K; Brug, Johannes; Looman, Caspar W N; van Goudoever, Johannes B; Kornelisse, René F

2010-10-01

Nosocomial bloodstream infections are a major cause of morbidity and mortality in neonatal intensive care units. Appropriate hand hygiene is singled out as the most important measure in preventing these infections. However, hand hygiene compliance among healthcare professionals remains low despite the well-known effect on infection reduction. We studied the effectiveness of a hand hygiene education program on the incidence of nosocomial bloodstream infections. Observational study with two pretests and two posttest measurements and interrupted time series analysis. A 27 bed level IIID neonatal intensive care unit in a teaching hospital in the Netherlands. Healthcare professionals who had physical contact with very low birth weight (VLBW) infants. The study was conducted during a period of 4 years. Medical and nursing staff followed a problem-based education program on hand hygiene. Hand hygiene practices before and after the education program were compared by guided observations. The incidence of nosocomial infections in VLBW infants was compared. In addition, numbers of nosocomial bloodstream infections per day-at-risk in very low birth weight infants were analyzed by a segmented loglinear regression analysis. During 1201 observations hand hygiene compliance before patient contact increased from 65% to 88% (pinfections and the infection rate per 1000 patient days (relative risk reduction) before and after the education program on hand hygiene intervention decreased from 44.5% to 36.1% (18.9%, p=0.03) and from 17.3% to 13.5% (22.0%, p=0.03), respectively. At the baseline the nosocomial bloodstream infections per day-at-risk decreased by +0.07% (95% CI -1.41 to +1.60) per month and decreased with -1.25% (95% CI -4.67 to +2.44) after the intervention (p=0.51). The level of instant change was -14.8% (p=0.48). The results are consistent with relevant improvement of hand hygiene practices among healthcare professionals due to an education program. Improved hand hygiene

A Culture-Proven Case of Community-Acquired Legionella Pneumonia Apparently Classified as Nosocomial: Diagnostic and Public Health Implications

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Annalisa Bargellini

2013-01-01

Full Text Available We report a case of Legionella pneumonia in a 78-year-old patient affected by cerebellar haemangioblastoma continuously hospitalised for 24 days prior to the onset of overt symptoms. According to the established case definition, this woman should have been definitely classified as a nosocomial case (patient spending all of the ten days in hospital before onset of symptoms. Water samples from the oncology ward were negative, notably the patient’s room and the oxygen bubbler, and the revision of the case history induced us to verify possible contamination in water samples collected at home. We found that the clinical strain had identical rep-PCR fingerprint of L. pneumophila serogroup 1 isolated at home. The description of this culture-proven case of Legionnaires’ disease has major clinical, legal, and public health consequences as the complexity of hospitalised patients poses limitations to the rule-of-thumb surveillance definition of nosocomial pneumonia based on 2–10-day incubation period.

The Antibiotic Resistance Profiles of Bacterial Strains Isolated from Patients with Hospital-Acquired Bloodstream and Urinary Tract Infections

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Hamed Ghadiri

2012-01-01

Full Text Available Treatment of nosocomial infections is becoming difficult due to the increasing trend of antibiotics resistance. Current knowledge on antibiotic resistance pattern is essential for appropriate therapy. We aimed to evaluate antibiotic resistance profiles in nosocomial bloodstream and urinary tract pathogens. A total of 129 blood stream and 300 urinary tract positive samples were obtained from patients referring to Besat hospital over a two-year period (2009 and 2010. Antibiotic sensitivity was ascertained using the Kirby-Bauer disk diffusion technique according to CLSI guidelines. Patient's data such as gender and age were recorded. The ratio of gram-negative to gram-positive bacteria in BSIs was 1.6 : 1. The most prevalent BSI pathogen was Coagulase-Negative Staphylococci (CoNS. The highest resistance rate of CoNS was against penicillin (91.1% followed by ampicillin (75.6%, and the lowest rate was against vancomycin (4.4%. Escherichia coli was the most prevalent pathogen isolated from urinary tract infections (UTIs. Ratio of gram-negative to gram-positive bacteria was 3.2 : 1. The highest resistance rate of E. coli isolates was against nalidixic acid (57.7%. The present study showed that CoNS and E. coli are the most common causative agents of nosocomial BSIs and UTIs, and control of infection needs to be addressed in both antibiotic prescription and general hygiene.

Relation between Streaming Potential and Streaming Electrification Generated by Streaming of Water through a Sandwich-type Cell

OpenAIRE

Maruyama, Kazunori; Nikaido, Mitsuru; Hara, Yoshinori; Tanizaki, Yoshie

2012-01-01

Both streaming potential and accumulated charge of water flowed out were measured simultaneously using a sandwich-type cell. The voltages generated in divided sections along flow direction satisfied additivity. The sign of streaming potential agreed with that of streaming electrification. The relation between streaming potential and streaming electrification was explained from a viewpoint of electrical double layer in glass-water interface.

Epidemiology of Blood Stream Infection due to Candida Species in a Tertiary Care Hospital in Japan over 12 Years: Importance of Peripheral Line-Associated Candidemia.

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Masahiro Ishikane

Full Text Available Candidemia is an important cause of mortality in healthcare settings. Peripheral lines are a source of candidemia, yet few studies have reported on the clinico-epidemiological features of candidemia due to peripheral-line associated blood stream infection (PLABSI.We conducted a single-centre retrospective cohort study of all patients with candidemia between 2002 and 2013. PLABSI was defined as the presence of at least one of the following: the presence of phlebitis or the resolution of clinical symptoms after peripheral-line withdrawal, with careful exclusion of an alternative explanation for bacteraemia. We described the epidemiology of candidemia and assessed predictive factors of PLABSI due to Candida spp., peripheral line-associated candidemia (PLAC, compared with non-PLAC.A total of 301 episodes of candidemia, including 37 of PLAC, were diagnosed during the study period. Central-line associated blood stream infection, intra-abdominal infection, and infection of unknown source accounted for the remaining 233, 14, and 17 cases, respectively. The overall incidence rate of candidemia was 0.11/1000 patient-days. In multivariate analysis, cephalosporin exposure (odds ratio [OR] = 2.22, 95% CI 1.04-4.77, polymicrobial bacteraemia/fungaemia (OR = 2.87, 95% CI 1.02-8.10, and ID specialist consultation (OR = 2.40, 95% CI 1.13-5.13 were identified as independent predictors of PLAC. Although non-PLAC had a higher mortality, the length of hospital stay after candidemia was similar between the two groups and candidemia duration was longer in the PLAC group.PLACs are an important cause of candidemia in hospitalized patients. Appropriate identification and management of PLAC are crucial.

The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit.

Science.gov (United States)

Picheansathian, Wilawan; Pearson, Alan; Suchaxaya, Prakin

2008-08-01

This quasi-experimental study aimed to identify the impact of a promotion programme on hand hygiene practices and its effect on nosocomial infection rates in a neonatal intensive care unit of a university hospital in Thailand. The study populations were 26 nursing personnel. After implementing a hand hygiene promotion programme, compliance with hand hygiene among nursing personnel improved significantly from 6.3% before the programme to 81.2% 7 months after the programme. Compliance rate did not correlate with the intensity of patient care. Nosocomial infection rate did not decrease after the intervention, probably because of the multifactorial nature of infections. All participants agreed that promotion programme implemented in this project motivated them to practise better hand hygiene. This study indicated that multiple approaches and persistent encouragement are key factors leading to a sustained high level of appropriate hand hygiene practices among nursing personnel.

StreamMap: Smooth Dynamic Visualization of High-Density Streaming Points.

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Li, Chenhui; Baciu, George; Han, Yu

2018-03-01

Interactive visualization of streaming points for real-time scatterplots and linear blending of correlation patterns is increasingly becoming the dominant mode of visual analytics for both big data and streaming data from active sensors and broadcasting media. To better visualize and interact with inter-stream patterns, it is generally necessary to smooth out gaps or distortions in the streaming data. Previous approaches either animate the points directly or present a sampled static heat-map. We propose a new approach, called StreamMap, to smoothly blend high-density streaming points and create a visual flow that emphasizes the density pattern distributions. In essence, we present three new contributions for the visualization of high-density streaming points. The first contribution is a density-based method called super kernel density estimation that aggregates streaming points using an adaptive kernel to solve the overlapping problem. The second contribution is a robust density morphing algorithm that generates several smooth intermediate frames for a given pair of frames. The third contribution is a trend representation design that can help convey the flow directions of the streaming points. The experimental results on three datasets demonstrate the effectiveness of StreamMap when dynamic visualization and visual analysis of trend patterns on streaming points are required.

Analyzing indicators of stream health for Minnesota streams

Science.gov (United States)

Singh, U.; Kocian, M.; Wilson, B.; Bolton, A.; Nieber, J.; Vondracek, B.; Perry, J.; Magner, J.

2005-01-01

Recent research has emphasized the importance of using physical, chemical, and biological indicators of stream health for diagnosing impaired watersheds and their receiving water bodies. A multidisciplinary team at the University of Minnesota is carrying out research to develop a stream classification system for Total Maximum Daily Load (TMDL) assessment. Funding for this research is provided by the United States Environmental Protection Agency and the Minnesota Pollution Control Agency. One objective of the research study involves investigating the relationships between indicators of stream health and localized stream characteristics. Measured data from Minnesota streams collected by various government and non-government agencies and research institutions have been obtained for the research study. Innovative Geographic Information Systems tools developed by the Environmental Science Research Institute and the University of Texas are being utilized to combine and organize the data. Simple linear relationships between index of biological integrity (IBI) and channel slope, two-year stream flow, and drainage area are presented for the Redwood River and the Snake River Basins. Results suggest that more rigorous techniques are needed to successfully capture trends in IBI scores. Additional analyses will be done using multiple regression, principal component analysis, and clustering techniques. Uncovering key independent variables and understanding how they fit together to influence stream health are critical in the development of a stream classification for TMDL assessment.

Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005 – 2006

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Wareham David W

2008-06-01

Full Text Available Abstract Background Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI. Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods Antimicrobial susceptibility to ampicillin, amoxicillin/clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results Nitrofurantoin was the most active agent (94% susceptible, followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55% and trimethoprim (40%, often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum β-lactamase production, was observed in 5.7% of community and 21.6% of nosocomial isolates. Conclusion With the exception of nitrofurantoin, resistance to agents commonly used as empirical oral treatments for UTI was extremely high. Levels of resistance to trimethoprim and ampicillin render them unsuitable for empirical use. Continued surveillance and investigation of other oral agents for treatment of UTI in the community is required.

Nosocomial infections of ocular conjunctiva in newborns delivered by cesarian section.

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Bezirtzoglou, E; Romond, C

1991-01-01

Colonization of the ocular conjunctiva in newborns delivered by cesarian section occurs usually within the first day of life. We have studied the flora of the ocular conjunctiva at birth, from 19 newborns delivered by cesarian section, coming from two different maternity hospitals. Ocular conjunctiva cultures yielded the main predominant flora in both maternity hospitals considered. The most common genus of this flora are: Staphylococcus, Corynebacterium and Propionibacterium acnes. Peptostreptococcus productus, Neisseria, Eubacterium and Clostridium perfringens are isolated occasionally. In newborns delivered by cesarian section, this flora principally acquired may be the consequence of the presence of bacteria in the ambient air, as well as differences in care provided by the nosocomial personnel.

A Model of the Costs of Community and Nosocomial Pediatric Respiratory Syncytial Virus Infections in Canadian Hospitals

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Philip Jacobs

2013-01-01

Full Text Available BACKGROUND: Approximately one in 10 hospitalized patients will acquire a nosocomial infection (NI after admission to hospital, of which 71% are due to respiratory viruses, including the respiratory syncytial virus (RSV. NIs are concerning and lead to prolonged hospitalizations. The economics of NIs are typically described in generalized terms and specific cost data are lacking.

Pneumonia in patients on the background of blood cancer

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Pertseva T.A.

2014-03-01

Full Text Available Problematic issues of etiologic diagnosis and treatment of community-acquired and nosocomial pneumonia are being studied actively. At the same time specific features of pneumonia in patients with severe immune defects, against blood cancer including are studied insufficiently. By the result of microbiological examinations of 149 patients with pneumonia on the background of blood cancer, who have undergone treatment in hematological center of CE “Dnipropetrovsk local multi-field clinical hospital №4” in 2010-2012, bacterial causative agents were determined in 59,7% of accidents, among which gram-negative microorganisms made up 69,7%, gram-positive – 30,3%. In 63% of accidents the asso¬ciations of causative agents were determined: the combination of fungal flora made up 58, 4% bacterial associations – 25, 8%. Invasive methods of research have demonstrated a considerably bigger informativeness in determination of possible etiological diagnosis of pneumonia. In determination of causative agent in fluid of brochoalveolar lavage the part of positive results made up 77,4% against 30,3% in examination of sputum.

Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March-August 2017.

Science.gov (United States)

Amendola, Antonella; Bianchi, Silvia; Frati, Elena R; Ciceri, Giulia; Faccini, Marino; Senatore, Sabrina; Colzani, Daniela; Lamberti, Anna; Baggieri, Melissa; Cereda, Danilo; Gramegna, Maria; Nicoletti, Loredana; Magurano, Fabio; Tanzi, Elisabetta

2017-08-17

A large measles outbreak has been ongoing in Milan and surrounding areas. From 1 March to 30 June 2017, 203 measles cases were laboratory-confirmed (108 sporadic cases and 95 related to 47 clusters). Phylogenetic analysis revealed the co-circulation of two different genotypes, D8 and B3. Both genotypes caused nosocomial clusters in two hospitals. The rapid analysis of epidemiological and phylogenetic data allowed effective surveillance and tracking of transmission pathways. This article is copyright of The Authors, 2017.

Early Prediction and Outcome of Septic Encephalopathy in Acute Stroke Patients With Nosocomial Coma

OpenAIRE

Tong, Dao-Ming; Zhou, Ye-Ting; Wang, Guang-Sheng; Chen, Xiao-Dong; Yang, Tong-Hui

2015-01-01

Background Septic encephalopathy (SE) is the most common acute encephalopathy in ICU; however, little attention has been focused on risk of SE in the course of acute stroke. Our aim is to investigate the early prediction and outcome of SE in stroke patients with nosocomial coma (NC). Methods A retrospective cohort study was conducted in an ICU of the tertiary teaching hospital in China from January 2006 to December 2009. Ninety-four acute stroke patients with NC were grouped according to with...

STREAM2016: Streaming Requirements, Experience, Applications and Middleware Workshop

Energy Technology Data Exchange (ETDEWEB)

Fox, Geoffrey [Indiana Univ., Bloomington, IN (United States); Jha, Shantenu [Rutgers Univ., New Brunswick, NJ (United States); Ramakrishnan, Lavanya [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-10-01

The Department of Energy (DOE) Office of Science (SC) facilities including accelerators, light sources and neutron sources and sensors that study, the environment, and the atmosphere, are producing streaming data that needs to be analyzed for next-generation scientific discoveries. There has been an explosion of new research and technologies for stream analytics arising from the academic and private sectors. However, there has been no corresponding effort in either documenting the critical research opportunities or building a community that can create and foster productive collaborations. The two-part workshop series, STREAM: Streaming Requirements, Experience, Applications and Middleware Workshop (STREAM2015 and STREAM2016), were conducted to bring the community together and identify gaps and future efforts needed by both NSF and DOE. This report describes the discussions, outcomes and conclusions from STREAM2016: Streaming Requirements, Experience, Applications and Middleware Workshop, the second of these workshops held on March 22-23, 2016 in Tysons, VA. STREAM2016 focused on the Department of Energy (DOE) applications, computational and experimental facilities, as well software systems. Thus, the role of “streaming and steering” as a critical mode of connecting the experimental and computing facilities was pervasive through the workshop. Given the overlap in interests and challenges with industry, the workshop had significant presence from several innovative companies and major contributors. The requirements that drive the proposed research directions, identified in this report, show an important opportunity for building competitive research and development program around streaming data. These findings and recommendations are consistent with vision outlined in NRC Frontiers of Data and National Strategic Computing Initiative (NCSI) [1, 2]. The discussions from the workshop are captured as topic areas covered in this report's sections. The report

[Bacteriologic and clinical analysis of nosocomial infections in patients from the intensive care unit].

Science.gov (United States)

Nikodemski, T

1999-01-01

The aim of this study is to evaluate what pathogens are mainly responsible for infection among all hospitalised at our ITU patients, to define the influence of antibiotic use on the aetiology of nosocomial infection. The research was conducted on a six-bedded surgical ITU in a 700-bed teaching hospital from January 1995 till June 1996. In August 1995 we changed infection control protocols (more stress on: handwashing with antiseptic soaps and routine microbiological culture for early prediction of infection) and antibiotic guidelines on our ITU (third generation cephalosporins, fluoroquinolones and Vancomycin were used only as the last option and never in prevention). 1276 samples for microbiological culture were obtained in routine manner. From 60% positive cultures 1216 strains were isolated (Tab. 1) and resistance to antibiotics were defined (Tab. 3). Monthly antibiotic consumption was expressed in defined daily dose (DDD) for 1000 hospitalisation-days. DDD = (X/Y)/Z x x 1000, were: X-cumulative antibiotic consumption during analysed period (g), Y-standard daily dose (g/24 h), Z-number of hospitalisation-days during analysed period (Tab. 2). Values were expressed as the mean +/- standard error (SE). Relationships between variables were analysed using linear correlation. All data were categorised for the frequency table. Statistically significant differences were considered to exist when calculated p values were less than 0.05. There were no statistically significant differences in the number of treated patients, length of stay and mortality rate on our ITU in 18 months. 58% of isolated strains were Gram-negative bacteria especially Pseudomonas aeruginosa (22%) and Acinetobacter spp. (16%) and Proteus spp. (9%). The commonly isolated Gram-positive bacteria were Enterococcus faecalis (14%), Staphylococcus aureus (12%)--of which 90% were MRSA. In 8% of cases we have isolated Candida spp. Monthly antibiotic consumption was displayed in table 2. Trend analysis

Characterizing Soil Lead Contamination Near Streams in Oakland, California

Science.gov (United States)

Tanouye, D.

2017-12-01

Lead (Pb) contamination of soils, groundwater, and surface waters is a major concern because of the potential health risks related to accumulation of high levels of lead in blood. This is a pervasive issue in many low-income neighborhoods throughout the United States, and is documented to be particularly acute in West Oakland, California. The fate and transport of lead in the environment is largely dependent on how it will bind to various solids and compounds in solution. These adsorption mechanisms are a principal aspect of metal dissolution and chemical speciation. Stream channels are natural drainage areas for urban runoff, and may represent a hot spot for increased levels of lead. This study evaluates the environmental conditions at 15 sites near streams in West Oakland using in-situ soil sampling with the handheld X-Ray Fluorescence (XRF) analyzer to measure concentrations of lead in soil. Results from this study suggest that the levels of lead in soils near stream channels are generally lower than the regional regulatory screening level of 80 milligrams per kilogram (mg/kg), but the highest concentrations are found near stream banks. The spatial distribution can be explained by a contaminant transport process related to the presence of fluvial channels.

Changes in gene expression following trauma are related to the age of transfused packed red blood cells.

Science.gov (United States)

Torrance, Hew D T; Vivian, Mark E; Brohi, Karim; Prowle, John R; Pearse, Rupert M; Owen, Helen C; Hinds, Charles J; O'Dwyer, Michael J

2015-03-01

Transfusion of packed red blood cells (PRBCs) is associated with an increased incidence of nosocomial infections and an increased risk of death. The duration of storage before transfusion may influence these outcomes. Here, we explore the association between the age of transfused PRBCs and specific patterns of inflammatory gene expression in severely injured trauma patients. Severely injured trauma patients requiring intensive care unit treatment and receiving transfusion of PRBCs within 24 hours of the injury were recruited. Blood samples were obtained within 2 hours of the trauma, at 24 hours, and at 72 hours. Messenger RNA was extracted from whole blood, and gene expression was quantified using quantitative polymerase chain reaction. The median age of the units of PRBCs transfused to each patient was recorded. The primary outcome measure was the change in candidate gene expression over the initial 72 hours. Sixty-four patients were studied. Fifty-three patients (83%) were male, and the median age was 40.5 years (interquartile range [IQR], 31-59). Median Injury Severity Score (ISS) was 31.5 (IQR, 23-43), and 55 patients (86%) experienced a blunt injury. Forty-one patients (64%) developed a nosocomial infection, and 15 patients (23%) died before hospital discharge. Each patient received a median of 5 U of PRBCs (IQR, 4-9.8 U) during the first 24 hours of hospital admission. The median age of the units of PRBCs transfused in each patient was 20 days (IQR, 17-22 days). Older blood was associated with greater decreases in interleukin 12 (IL-12), IL-23, and RORγt (all p's < 0.05) gene expression over the initial 24 hours, greater decreases in IL-12 gene expression over 72 hours, and a rise in transforming growth factor β gene expression over the first 72 hours. A multivariate analysis confirmed the independence of these associations. Increasing the duration of storage of PRBCs before transfusion is associated with a pattern of gene expression consistent with more

Exploring 5-nitrofuran derivatives against nosocomial pathogens: synthesis, antimicrobial activity and chemometric analysis.

Science.gov (United States)

Zorzi, Rodrigo Rocha; Jorge, Salomão Dória; Palace-Berl, Fanny; Pasqualoto, Kerly Fernanda Mesquita; Bortolozzo, Leandro de Sá; de Castro Siqueira, André Murillo; Tavares, Leoberto Costa

2014-05-15

The burden of nosocomial or health care-associated infection (HCAI) is increasing worldwide. According to the World Health Organization (WHO), it is several fold higher in low- and middle-income countries. Considering the multidrug-resistant infections, the development of new and more effective drugs is crucial. Herein, two series (I and II) of 5-nitrofuran derivatives were designed, synthesized and assayed against microorganisms, including Gram-positive and -negative bacteria, and fungi. The pathogens screened was directly related to either the most currently relevant HCAI, or to multidrug-resistant infection caused by MRSA/VRSA strains, for instance. The sets I and II were composed by substituted-[N'-(5-nitrofuran-2-yl)methylene]benzhydrazide and 3-acetyl-5-(substituted-phenyl)-2-(5-nitro-furan-2-yl)-2,3-dihydro-1,3,4-oxadiazole compounds, respectively. The selection of the substituent groups was based upon physicochemical properties, such as hydrophobicity and electronic effect. The compounds have showed better activity against Staphylococcus aureus, Escherichia coli, and Enterococcus faecalis. The findings from S. aureus strain, which was more susceptible, were used to investigate the intersamples and intervariables relationships by applying chemometric methods. It is noteworthy that the compound 4-butyl-[N'-(5-nitrofuran-2-yl)methylene]benzhydrazide has showed similar MIC value to vancomycin, which is the reference drug for multidrug-resistant S. aureus infections. Taken the findings together, the 5-nitrofuran derivatives might be indeed considered as promising hits to develop novel antimicrobial drugs to fight against nosocomial infection. Copyright © 2014 Elsevier Ltd. All rights reserved.

A case of nosocomial Legionella pneumonia associated with a contaminated hospital cooling tower.

Science.gov (United States)

Osawa, Kayo; Shigemura, Katsumi; Abe, Yasuhisa; Jikimoto, Takumi; Yoshida, Hiroyuki; Fujisawa, Masato; Arakawa, Soichi

2014-01-01

We report the epidemiological investigation of a nosocomial pneumonia case due to Legionella pneumophila linked to a contaminated hospital cooling tower in an immune-compromised patient. A 73-year-old female patient was diagnosed with nosocomial Legionella pneumonia proven by a culture of L. pneumophila serogroup 1 from bronchoalveolar lavage fluid. Two strains isolated from the patient and two strains isolated from two cooling towers were found to be identical using repetitive-sequence-based-PCR with a 95% probability. This Legionella pneumonia case might be caused by aerosol from cooling towers on the roof of the hospital building which was contaminated by L. pneumophila. We increased up the temperature of hot water supply appropriately for prevention of Legionella breeding in an environment of patients' living. On the other hand, as the maintenance of cooling tower, we increased the frequency of Legionella culture tests from twice a year to three times a year. In addition, we introduced an automated disinfectants insertion machine and added one antiseptic reagent (BALSTER ST-40 N, Tohzai Chemical Industry Co., Ltd., Kawasaki, Japan) after this Legionella disease, and thereafter, we have no additional cases of Legionella disease or detection of Legionella spp. from the cooling tower or hot water supply. This case demonstrates the importance of detecting the infection source and carrying out environmental maintenance in cooperation with the infection control team. Copyright © 2013 Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Prediction of temperature and damage in an irradiated human eye-Utilization of a detailed computer model which includes a vectorial blood stream in the choroid.

Science.gov (United States)

Heussner, Nico; Holl, Lukas; Nowak, Timo; Beuth, Thorsten; Spitzer, Martin S; Stork, Wilhelm

2014-08-01

The work presented here describes the development and use of a three-dimensional thermo-dynamic model of the human eye for the prediction of temperatures and damage thresholds under irradiation. This model takes into account the blood flow by the implementation of a vectorial blood stream in the choroid and also uses the actual physiological extensions and tissue parameters of the eye. Furthermore it considers evaporation, radiation and convection at the cornea as well as the eye lid. The predicted temperatures were successfully validated against existing eye models in terms of corneal and global thermal behaviour. The model׳s predictions were additionally checked for consistency with in-vivo temperature measurements of the cornea, the irradiated retina and its damage thresholds. These thresholds were calculated from the retinal temperatures using the Arrhenius integral. Hence the model can be used to predict the temperature increase and irradiation hazard within the human eye as long as the absorption values and the Arrhenius coefficients are known and the damage mechanism is in the thermal regime. Copyright © 2014 Elsevier Ltd. All rights reserved.

A survey of veterinary hospitals in Nigeria for the presence of some bacterial organisms of nosocomial and zoonotic potential

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Mohammed Lawal

2009-06-01

Full Text Available This study was undertaken to determine the type and estimate the prevalence of bacterial organisms on contact surfaces of five close-to-patient facilities in three veterinary health care settings within the Sokoto metropolis of north-western Nigeria. A total of 30 samples (10 from each setting were collected and analysed using culture, microscopy and biochemical testing. Bacterial species isolated from samples in this study included the following: Bacillus sp. (27.3%, Staphylococcus aureus (15.9%, Listeria sp. (13.6%, Streptococcus sp. (11.4%, Salmonella sp. (6.8%, Escherichia coli (4.5%, Staphylococcus epidermidis (4.5%, Citrobacter sp. (2.3%, Klebsiella sp. (2.3%, Lactobacillus sp. (2.3%, Micrococcus sp. (2.3%, Pasteurella sp. (2.3%, Proteus sp. (2.3%, and Yersinia sp. (2.3%. A higher percentage (64.3% of the total bacterial isolates were zoonotic in nature and hence of public health significance. Some pathogens have the potential of nosocomial spread. In this study, we seek to establish the first evidence of bacterial presence in the major veterinary health care settings in the Sokoto region of north-western Nigeria. Of particular interest is the hypothesis, which has not previously been formally tested, that nosocomial infections are especially likely to be implicated in both animals and occupational diseases in Nigeria. It was suggested that some of these isolates were associated with the risk of nosocomial and zoonotic infections and hence draws attention to the need to rigorously employ standard veterinary precautions as part of the hospital’s infection control programme in an attempt to protect both patients and staff from infections.

Shifting stream planform state decreases stream productivity yet increases riparian animal production

Science.gov (United States)

Venarsky, Michael P.; Walters, David M.; Hall, Robert O.; Livers, Bridget; Wohl, Ellen

2018-01-01

In the Colorado Front Range (USA), disturbance history dictates stream planform. Undisturbed, old-growth streams have multiple channels and large amounts of wood and depositional habitat. Disturbed streams (wildfires and logging tested how these opposing stream states influenced organic matter, benthic macroinvertebrate secondary production, emerging aquatic insect flux, and riparian spider biomass. Organic matter and macroinvertebrate production did not differ among sites per unit area (m−2), but values were 2 ×–21 × higher in undisturbed reaches per unit of stream valley (m−1 valley) because total stream area was higher in undisturbed reaches. Insect emergence was similar among streams at the per unit area and per unit of stream valley. However, rescaling insect emergence to per meter of stream bank showed that the emerging insect biomass reaching the stream bank was lower in undisturbed sites because multi-channel reaches had 3 × more stream bank than single-channel reaches. Riparian spider biomass followed the same pattern as emerging aquatic insects, and we attribute this to bottom-up limitation caused by the multi-channeled undisturbed sites diluting prey quantity (emerging insects) reaching the stream bank (riparian spider habitat). These results show that historic landscape disturbances continue to influence stream and riparian communities in the Colorado Front Range. However, these legacy effects are only weakly influencing habitat-specific function and instead are primarily influencing stream–riparian community productivity by dictating both stream planform (total stream area, total stream bank length) and the proportional distribution of specific habitat types (pools vs riffles).

Shifting stream planform state decreases stream productivity yet increases riparian animal production

Science.gov (United States)

Venarsky, Michael P.; Walters, David M.; Hall, Robert O.; Livers, Bridget; Wohl, Ellen

2018-01-01

In the Colorado Front Range (USA), disturbance history dictates stream planform. Undisturbed, old-growth streams have multiple channels and large amounts of wood and depositional habitat. Disturbed streams (wildfires and logging production, emerging aquatic insect flux, and riparian spider biomass. Organic matter and macroinvertebrate production did not differ among sites per unit area (m−2), but values were 2 ×–21 × higher in undisturbed reaches per unit of stream valley (m−1 valley) because total stream area was higher in undisturbed reaches. Insect emergence was similar among streams at the per unit area and per unit of stream valley. However, rescaling insect emergence to per meter of stream bank showed that the emerging insect biomass reaching the stream bank was lower in undisturbed sites because multi-channel reaches had 3 × more stream bank than single-channel reaches. Riparian spider biomass followed the same pattern as emerging aquatic insects, and we attribute this to bottom-up limitation caused by the multi-channeled undisturbed sites diluting prey quantity (emerging insects) reaching the stream bank (riparian spider habitat). These results show that historic landscape disturbances continue to influence stream and riparian communities in the Colorado Front Range. However, these legacy effects are only weakly influencing habitat-specific function and instead are primarily influencing stream–riparian community productivity by dictating both stream planform (total stream area, total stream bank length) and the proportional distribution of specific habitat types (pools vs riffles).

ADAPTIVE STREAMING OVER HTTP (DASH UNTUK APLIKASI VIDEO STREAMING

Directory of Open Access Journals (Sweden)

I Made Oka Widyantara

2015-12-01

Full Text Available This paper aims to analyze Internet-based streaming video service in the communication media with variable bit rates. The proposed scheme on Dynamic Adaptive Streaming over HTTP (DASH using the internet network that adapts to the protocol Hyper Text Transfer Protocol (HTTP. DASH technology allows a video in the video segmentation into several packages that will distreamingkan. DASH initial stage is to compress the video source to lower the bit rate video codec uses H.26. Video compressed further in the segmentation using MP4Box generates streaming packets with the specified duration. These packages are assembled into packets in a streaming media format Presentation Description (MPD or known as MPEG-DASH. Streaming video format MPEG-DASH run on a platform with the player bitdash teritegrasi bitcoin. With this scheme, the video will have several variants of the bit rates that gave rise to the concept of scalability of streaming video services on the client side. The main target of the mechanism is smooth the MPEG-DASH streaming video display on the client. The simulation results show that the scheme based scalable video streaming MPEG-DASH able to improve the quality of image display on the client side, where the procedure bufering videos can be made constant and fine for the duration of video views

Nosocomial Mycobacterium bovis-bacille Calmette-Guérin infections due to contamination of chemotherapeutics: case finding and route of transmission

NARCIS (Netherlands)

Vos, Margreet C.; de Haas, Petra E. W.; Verbrugh, Henri A.; Renders, Nicole H. M.; Hartwig, Nico G.; de Man, Peter; Kolk, Arend H. J.; van Deutekom, Henk; Yntema, J. L.; Vulto, Arnold G.; Messemaker, Marja; van Soolingen, Dick

2003-01-01

We studied nosocomial infections due to Mycobacterium bovis bacille Calmette-Guérin (BCG) Onco-TICE bacteria, transmitted by contamination of medication prepared in BCG Onco-TICE-contaminated hoods in the pharmacy, in 5 immunocompromised patients at 3 hospitals. The BCG strains cultured from the

Handwashing: a simple, economical and effective method for preventing nosocomial infections in intensive care units.

Science.gov (United States)

Akyol, A; Ulusoy, H; Ozen, I

2006-04-01

As most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered to be the single most important intervention to prevent nosocomial infections. However, studies have shown that handwashing practices are poor, especially among medical personnel. This review gives an overview of handwashing in health care and in the community, including some aspects that have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of micro-organisms which cause infection, both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education, are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors that determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognized that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs.

Emergence of Stenotrophomonas maltophilia nosocomial isolates in a Saudi children's hospital. Risk factors and clinical characteristics.

Science.gov (United States)

Alqahtani, Jobran M

2017-05-01

  To describe the clinical characteristics of pediatric patients colonized or infected by Stenotrophomonas maltophilia (S. maltophilia) at a Saudi children's hospital, to identify risk factors associated with infection, and to investigate the antimicrobial resistance patterns of this emerging pathogen.  Methods: In this cross-sectional observational study, 64 non-duplicating S. maltophilia strains were isolated  in Najran Maternity and Children's Hospital, Najran,  Saudi Arabia between January 2015 to February 2016. Antimicrobial susceptibility testing was performed using the reference broth microdilution method.  Results: In this study, 48 (75%) isolates were identified in true infections and 16 (25%) isolates were considered colonization. The main types of S. maltophilia infection were pneumonia in 22 (45.8%) patients and bloodstream infection in 14 (29.2%) patients. The significant risk factors included exposure to invasive procedure (p=0.02), and presence of acute leukemia as an underlying disease (p=0.02). The most active antimicrobials were trimethoprim/sulfamethoxazole (100% sensitivity) and tigecycline (93.7% sensitivity). Conclusions: Stenotrophomonas maltophilia is an emerging nosocomial pathogen among pediatric patients. Accurate identification and susceptibility testing of this emerging pathogen are crucial for the management of infected patients and prevention of spread of this nosocomial pathogen.

The gene bap, involved in biofilm production, is present in Staphylococcus spp. strains from nosocomial infections.

Science.gov (United States)

Potter, Amina; Ceotto, Hilana; Giambiagi-Demarval, Marcia; dos Santos, Kátia Regina Netto; Nes, Ingolf F; Bastos, Maria do Carmo de Freire

2009-06-01

This study analyzed ten strains of coagulase-negative staphylococci (CNS) involved in nosocomial infections in three Brazilian hospitals. Their antibiotic susceptibility profile showed that most strains exhibited multiple antibiotic resistance and possessed the mecA gene. The ability of these strains to adhere to polystyrene microtiter plates was also tested and nine of them proved to be biofilm producers at least in one of the three conditions tested: growth in TSB, in TSB supplemented with NaCl, or in TSB supplemented with glucose. The presence of the bap gene, which codes for the biofilm-associated protein (Bap), was investigated in all ten strains by PCR. AU strains were bop-positive and DNA sequencing experiments confirmed that the fragments amplified were indeed part of a bap gene. The presence of the icaA gene, one of the genes involved in polysaccharide intercellular adhesin (PIA) formation, was also detected by PCR in eight of the ten strains tested. The two icaA-negative strains were either weak biofilm producer or no biofilm producer, although they were bop-positive. To our knowledge, this is the first report demonstrating the presence of the bap gene in nosocomial isolates of CNS, being also the first report on the presence of this gene in Staphylococcus haemolyticus and S. cohnii.

Akamai Streaming

OpenAIRE

ECT Team, Purdue

2007-01-01

Akamai offers world-class streaming media services that enable Internet content providers and enterprises to succeed in today's Web-centric marketplace. They deliver live event Webcasts (complete with video production, encoding, and signal acquisition services), streaming media on demand, 24/7 Webcasts and a variety of streaming application services based upon their EdgeAdvantage.

Rinossinusite nosocomial em unidade de terapia intensiva: estudo microbiológico Nosocomial sinusitis in an intensive care unit: a microbiological study

Directory of Open Access Journals (Sweden)

Leonardo Lopes Balsalobre Filho

2011-02-01

Full Text Available Rinossinusite Nosocomial é uma complicação frequente de pacientes tratados em UTI. É importante o diagnóstico e tratamento precoce para prevenir complicações graves como pneumonia, sepse, meningite e abscesso intracraniano. OBJETIVO: Identificar os agentes causadores de sinusite em UTI através do swab nasal e da punção de seio maxilar, correlacionando seus resultados. MÉTODO: Pacientes atendidos nas unidades de terapia intensiva com diagnóstico tomográfico de sinusopatia maxilar uni ou bilateral foram submetidos ao swab nasal e punção do seio acometido com material enviado para cultura e antibiograma. RESULTADOS: O presente estudo avaliou 22 pacientes. Houve concordância entre o agente microbiano isolado no swab e na punção em 14 dos 22 casos (63%. A flora aeróbia gram negativa foi a mais encontrada com predomínio da Pseudomonas aeruginosa (29% nas punções, seguido de Proteus mirabillis (26% e Acinetobacter baumanni (14%. Houve alto índice de resistência aos antibióticos usados. CONCLUSÃO: A punção direta do seio maxilar acometido em pacientes em UTI com sinusite parece ser o melhor método para identificar os agentes bacterianos e, através do seu antibiograma, direcionar a conduta terapêutica antimicrobiana. O swab mostrou ter pouco valor diagnóstico, com concordância de 63%, podendo ser reservado para casos onde a punção está contraindicada.Nosocomial sinusitis is a common complication of patients in ICUs. Its diagnosis is important, and early treatment is required to avoid serious complications such as pneumonia, sepsis, meningitis, and intracranial abscesses. AIM: To identify the germs causing sinusitis in ICUs by nasal swabs and maxillary sinus puncture, and to correlate these results. METHODS: ICU patients with a diagnosis (CT confirmed of maxillary sinusitis underwent nasal swab and puncture of the sinus to collect material for culture and antibiogram. RESULTS: This study evaluated 22 patients. The

The Midwest Stream Quality Assessment—Influences of human activities on streams

Science.gov (United States)

Van Metre, Peter C.; Mahler, Barbara J.; Carlisle, Daren M.; Coles, James F.

2018-04-16

Healthy streams and the fish and other organisms that live in them contribute to our quality of life. Extensive modification of the landscape in the Midwestern United States, however, has profoundly affected the condition of streams. Row crops and pavement have replaced grasslands and woodlands, streams have been straightened, and wetlands and fields have been drained. Runoff from agricultural and urban land brings sediment and chemicals to streams. What is the chemical, physical, and biological condition of Midwestern streams? Which physical and chemical stressors are adversely affecting biological communities, what are their origins, and how might we lessen or avoid their adverse effects?In 2013, the U.S. Geological Survey (USGS) conducted the Midwest Stream Quality Assessment to evaluate how human activities affect the biological condition of Midwestern streams. In collaboration with the U.S. Environmental Protection Agency National Rivers and Streams Assessment, the USGS sampled 100 streams, chosen to be representative of the different types of watersheds in the region. Biological condition was evaluated based on the number and diversity of fish, algae, and invertebrates in the streams. Changes to the physical habitat and chemical characteristics of the streams—“stressors”—were assessed, and their relation to landscape factors and biological condition was explored by using mathematical models. The data and models help us to better understand how the human activities on the landscape are affecting streams in the region.

Analysis of hydraulic characteristics for stream diversion in small stream

Energy Technology Data Exchange (ETDEWEB)

Ahn, Sang-Jin; Jun, Kye-Won [Chungbuk National University, Cheongju(Korea)

2001-10-31

This study is the analysis of hydraulic characteristics for stream diversion reach by numerical model test. Through it we can provide the basis data in flood, and in grasping stream flow characteristics. Analysis of hydraulic characteristics in Seoknam stream were implemented by using computer model HEC-RAS(one-dimensional model) and RMA2(two-dimensional finite element model). As a result we became to know that RMA2 to simulate left, main channel, right in stream is more effective method in analysing flow in channel bends, steep slope, complex bed form effect stream flow characteristics, than HEC-RAS. (author). 13 refs., 3 tabs., 5 figs.

The metaphors we stream by: Making sense of music streaming

OpenAIRE

Hagen, Anja Nylund

2016-01-01

In Norway music-streaming services have become mainstream in everyday music listening. This paper examines how 12 heavy streaming users make sense of their experiences with Spotify and WiMP Music (now Tidal). The analysis relies on a mixed-method qualitative study, combining music-diary self-reports, online observation of streaming accounts, Facebook and last.fm scrobble-logs, and in-depth interviews. By drawing on existing metaphors of Internet experiences we demonstrate that music-streaming...

Incremental cost of nosocomial bacteremia according to the focus of infection and antibiotic sensitivity of the causative microorganism in a university hospital.

Science.gov (United States)

Riu, Marta; Chiarello, Pietro; Terradas, Roser; Sala, Maria; Garcia-Alzorriz, Enric; Castells, Xavier; Grau, Santiago; Cots, Francesc

2017-04-01

To estimate the incremental cost of nosocomial bacteremia according to the causative focus and classified by the antibiotic sensitivity of the microorganism.Patients admitted to Hospital del Mar in Barcelona from 2005 to 2012 were included. We analyzed the total hospital costs of patients with nosocomial bacteremia caused by microorganisms with a high prevalence and, often, with multidrug-resistance. A control group was defined by selecting patients without bacteremia in the same diagnosis-related group.Our hospital has a cost accounting system (full-costing) that uses activity-based criteria to estimate per-patient costs. A logistic regression was fitted to estimate the probability of developing bacteremia (propensity score) and was used for propensity-score matching adjustment. This propensity score was included in an econometric model to adjust the incremental cost of patients with bacteremia with differentiation of the causative focus and antibiotic sensitivity.The mean incremental cost was estimated at &OV0556;15,526. The lowest incremental cost corresponded to bacteremia caused by multidrug-sensitive urinary infection (&OV0556;6786) and the highest to primary or unknown sources of bacteremia caused by multidrug-resistant microorganisms (&OV0556;29,186).This is one of the first analyses to include all episodes of bacteremia produced during hospital stays in a single study. The study included accurate information about the focus and antibiotic sensitivity of the causative organism and actual hospital costs. It provides information that could be useful to improve, establish, and prioritize prevention strategies for nosocomial infections.

Prevention of nosocomial infections in critically ill patients with lactoferrin (PREVAIL study): study protocol for a randomized controlled trial.

Science.gov (United States)

Muscedere, John; Maslove, David; Boyd, John Gordon; O'Callaghan, Nicole; Lamontagne, Francois; Reynolds, Steven; Albert, Martin; Hall, Rick; McGolrick, Danielle; Jiang, Xuran; Day, Andrew G

2016-09-29

Nosocomial infections remain an important source of morbidity, mortality, and increased health care costs in hospitalized patients. This is particularly problematic in intensive care units (ICUs) because of increased patient vulnerability due to the underlying severity of illness and increased susceptibility from utilization of invasive therapeutic and monitoring devices. Lactoferrin (LF) and the products of its breakdown have multiple biological effects, which make its utilization of interest for the prevention of nosocomial infections in the critically ill. This is a phase II randomized, multicenter, double-blinded trial to determine the effect of LF on antibiotic-free days in mechanically ventilated, critically ill, adult patients in the ICU. Eligible, consenting patients will be randomized to receive either LF or placebo. The treating clinician will remain blinded to allocation during the study; blinding will be maintained by using opaque syringes and containers. The primary outcome will be antibiotic-free days, defined as the number of days alive and free of antibiotics 28 days after randomization. Secondary outcomes will include: antibiotic utilization, adjudicated diagnosis of nosocomial infection (longer than 72 h of admission to ICU), hospital and ICU length of stay, change in organ function after randomization, hospital and 90-day mortality, incidence of tracheal colonization, changes in gastrointestinal permeability, and immune function. Outcomes to inform the conduct of a larger definitive trial will also be evaluated, including feasibility as determined by recruitment rates and protocol adherence. The results from this study are expected to provide insight into a potential novel therapeutic use for LF in critically ill adult patients. Further, analysis of study outcomes will inform a future, large-scale phase III randomized controlled trial powered on clinically important outcomes related to the use of LF. The trial was registered at www

Ultra-fast low concentration detection of Candida pathogens utilizing high resolution micropore chips.

Science.gov (United States)

Mulero, Rafael; Lee, Dong Heun; Kutzler, Michele A; Jacobson, Jeffrey M; Kim, Min Jun

2009-01-01

Although Candida species are the fourth most common cause of nosocomial blood stream infections in the United States, early diagnostic tools for invasive candidemia are lacking. Due to an increasing rate of candidemia, a new screening system is needed to detect the Candida species in a timely manner. Here we describe a novel method of detection using a solid-state micro-scale pore similar to the operational principles of a Coulter counter. With a steady electrolyte current flowing through the pore, measurements are taken of changes in the current corresponding to the shape of individual yeasts as they translocate or travel through the pore. The direct ultra-fast low concentration electrical addressing of C. albicans has established criteria for distinguishing individual yeast based on their structural properties, which may reduce the currently used methods' complexity for both identification and quantification capabilities in mixed blood samples.

Ultra-Fast Low Concentration Detection of Candida Pathogens Utilizing High Resolution Micropore Chips

Directory of Open Access Journals (Sweden)

2009-03-01

Full Text Available Although Candida species are the fourth most common cause of nosocomial blood stream infections in the United States, early diagnostic tools for invasive candidemia are lacking. Due to an increasing rate of candidemia, a new screening system is needed to detect the Candida species in a timely manner. Here we describe a novel method of detection using a solid-state micro-scale pore similar to the operational principles of a Coulter counter. With a steady electrolyte current flowing through the pore, measurements are taken of changes in the current corresponding to the shape of individual yeasts as they translocate or travel through the pore. The direct ultra-fast low concentration electrical addressing of C. albicans has established criteria for distinguishing individual yeast based on their structural properties, which may reduce the currently used methods’ complexity for both identification and quantification capabilities in mixed blood samples

[Epidemic of Staphylococcus aureus nosocomial infections resistant to methicillin in a maternity ward].

Science.gov (United States)

Le Coq, M; Simon, I; Sire, C; Tissot-Guerraz, F; Fournier, L; Aho, S; Noblot, G; Reverdy, M E; Françoise, M

2001-02-01

Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infections frequently occur in the hospital environment, but their incidence is less often observed in neonates. In the present investigation, seventeen cases were recorded over a nine-week period (two cases per week). Pulsed field gradient gel electrophoresis confirmed the clonal character of the strain. The hypothesis of manually-transmitted infection due to contamination from multiple sources was reinforced by the fact the epidemic persisted in spite of the elimination of the main human infectious source and an absence of risk factors determined by the case-control study. The role of environmental factors in the persistence of this outbreak of MRSA infection has been considered.

[Risk factors of development of nosocomial pyogenic and septic infections in maternity hospitals].

Science.gov (United States)

Zakharova, Iu A; Nikolaeva, A M; Fel'dblium, I V

2007-01-01

During prospective epidemiological surveillance cases of pyogenic and septic infections (PSI) in mothers and newborns in two maternity hospitals were studied using standard case definition and leading risk factors of their development were revealed. These factors differed in two hospitals and were connected mainly with high level of patients colonization, contamination of the environment by nosocomial strains of microorganisms, and degree of participation of mother's relatives in delivery. It was shown that permission to relatives for presence on delivery did not influence on the rate of PSI. Specificity of risk factors of PSI in mothers and newborns dictates necessity to determine them in each maternity hospital.

Mannose-binding lectin codon 54 gene polymorphism in relation to risk of nosocomial invasive fungal infection in preterm neonates in the neonatal intensive care unit.

Science.gov (United States)

Aydemir, Cumhur; Onay, Huseyin; Oguz, Serife Suna; Ozdemir, Taha Resid; Erdeve, Omer; Ozkinay, Ferda; Dilmen, Ugur

2011-09-01

Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Invasive fungal infections are associated with significant morbidity and mortality among preterm infants cared for in the neonatal intensive care unit (NICU). Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the presence of any association between MBL gene polymorphism and nosocomial invasive fungal infection in preterm neonates. Codon 54 (B allele) polymorphism in exon 1 of the MBL gene was investigated in 31 patients diagnosed as nosocomial invasive fungal infection and 30 control preterm neonates. AB genotype was determined in 26% and 30% of patient and control groups, respectively, and the difference was not statistically significant. AA genotype was determined in 74% of the patient group and in 67% of the control group, and the difference was not statistically significant. B allele frequency was not different significantly in the patient group (13%) compared to the control group (18%). In our study, no relationship was found between MBL codon 54 gene polymorphism and the risk of nosocomial invasive fungal infection in preterm neonates in NICU.

Methicillin-Resistant Staphylococcus aureus nosocomial infection trends in Hospital universiti sains Malasia during 2002-2007

International Nuclear Information System (INIS)

Al-Talib, Hasnain I.; Yean, Chan Y

2010-01-01

Methicillin-resistant staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide.The aim of the present study was to assess the burden of MRSA nosocomial infection,its association with factors of interest, and its antimicrobial susceptibility.This was a retrospective analysis of a database of all s aureus that were cultured from patients admitted to the defferent wards of hospital universiti sains malasia(HUSM) over a aperiod of 6 years.The MRSA infections rate was 10.0 Per 1000 hospital admissions.The incidence density rate of MRSA infections during the study period was 1.8 per 1000 patient-days,with annual rates ranging from 0.95 to 3.47 per 1000 patients-days.Duration of hospitalization,previous antibiotic use,and bedside invasive proceures of MRSa infections were found in orthopedic wards (25.3%) followed by surgical wards (18.2%) amd omtensive care units(ICU) (16.4%).All MRSA isolates were resistant to erythromycin (98.0%),co-trimoxazole (94.0%)and gentamicin (92.0%)clindamycin was the best antibiotic with only 6% resistance.All MRSA isolates were sensitive to vancomycin.The rate of the noscomial MRSA infection per 1000 admissions was higher than that in other studies.The three factors associated most signaficantly with acquired MRSA infections included duration of hospitalization,antibiotic use,and bedside invasive procedures.This study confirmed that vancomycin-resistant s aureus has not yet been established in HUSM (Author).

Antibacterial and antioxidant activities of Musa sp. leaf extracts against multidrug resistant clinical pathogens causing nosocomial infection.

Science.gov (United States)

Karuppiah, Ponmurugan; Mustaffa, Muhammed

2013-09-01

To investigate different Musa sp. leave extracts of hexane, ethyl acetate and methanol were evaluated for antibacterial activity against multi-drug resistant pathogens causing nosocomial infection by agar well diffusion method and also antioxidant activities. The four different Musa species leaves were extracted with hexane, ethyl acetate and methanol. Antibacterial susceptibility test, minimum inhibitory concentration and minimum inhibitory bacterial concentration were determined by agar well diffusion method. Total phenolic content and in vitro antioxidant activity was determined. All the Musa sp. extracts showed moderate antibacterial activities expect Musa paradisiaca with the inhibition zone ranging from 8.0 to 18.6 mm. Among four species ethyl acetate extracts of Musa paradisiaca showed highest activity against tested pathogens particularly E. coli, P. aeruginosa and Citrobacter sp. The minimum inhibitory concentrations were within the value of 15.63- 250 µg/mL and minimum bactericidal concentrations were ranging from 31.25- 250 µg/mL. Antioxidant activity of Musa acuminate exhibited maximum activity among other three Musa species. The present study concluded that among the different Musa species, Musa paradisiaca displayed efficient antibacterial activity followed by Musa acuminata against multi-drug resistant nosocomial infection causing pathogens. Further, an extensive study is needed to identify the bioactive compounds, mode of action and toxic effect in vivo of Musa sp.

Emergence of Stenotrophomonas maltophilia nosocomial isolates in a Saudi children’s hospital. Risk factors and clinical characteristics

Directory of Open Access Journals (Sweden)

Jobran M. Alqahtani

2017-05-01

Full Text Available Objectives: To describe the clinical characteristics of pediatric patients colonized or infected by Stenotrophomonas maltophilia (S. maltophilia at a Saudi children’s hospital, to identify risk factors associated with infection, and to investigate the antimicrobial resistance patterns of this emerging pathogen. Methods: In this cross-sectional observational study, 64 non-duplicating S. maltophilia strains were isolated in Najran Maternity and Children’s Hospital, Najran, Saudi Arabia between January 2015 to February 2016. Antimicrobial susceptibility testing was performed using the reference broth microdilution method. Results: In this study, 48 (75% isolates were identified in true infections and 16 (25% isolates were considered colonization. The main types of S. maltophilia infection were pneumonia in 22 (45.8% patients and bloodstream infection in 14 (29.2% patients. The significant risk factors included exposure to invasive procedure (p=0.02, and presence of acute leukemia as an underlying disease (p=0.02. The most active antimicrobials were trimethoprim/sulfamethoxazole (100% sensitivity and tigecycline (93.7% sensitivity. Conclusions: Stenotrophomonas maltophilia is an emerging nosocomial pathogen among pediatric patients. Accurate identification and susceptibility testing of this emerging pathogen are crucial for the management of infected patients and prevention of spread of this nosocomial pathogen.

[Preliminary result on the nosocomial infection of severe acute respiratory syndrome in one hospital of Beijing].

Science.gov (United States)

He, Yao; Jiang, Yong; Xing, Yu-bin; Zhong, Guang-lin; Wang, Lei; Sun, Zheng-ji; Jia, Hong; Chang, Qing; Wang, Yong; Ni, Bin; Chen, Shi-ping

2003-07-01

To study the transmission route of severe acute respiratory syndrome (SARS) nosocomial infection. Ten identified SARS patients were selected from a general hospital in March. Survey was carried out through a standardized questionnaire provided by Chinese Center for Disease Control and Prevention. Contents of the questionnaire would include: history of contact with SARS patient, route of infection, methods used for protection and so on. (1) Distribution os SARS patients were confined to 3 wards: 4, 5, and 6 on the 7, 8, 12, 13 and 14 floors in the west unit of the inpatient building. Most of the inpatients were elderly and having severe original diseases. (2) Index patients were the first generation source of transmission and they infected inpatients and medical staff, making them the second generation. People with latent infection who had close contact with SARS patients might also serve as the possible source of transmission. (3) The major transmission routes were: near distant droplet infection and close contact infection. There was also a clue to the probability of aerosol or droplet nuclei infection through air-conditioning and ventilation system. Nosocomial infection appeared to be the main characteristic of the SARS epidemic in the early stage of this hospital. Other than close contact and near space airborne transmission of SARS virus, the possibility of long-distance aerosol transmission called for further epidemiological and experimental studies in the future.

[Nosocomial Clostridium difficile diarrhea--adverse effect of antibiotic therapy].

Science.gov (United States)

Lemeni, Daniela

2010-01-01

C. difficile is recognised as the main cause for colitis in hospitalised patients which are treated with antibiotics, chemotherapics or other drugs that disturb intestinal microbiota. Thus, a rapid and correct diagnostic of Clostridium difficile infections is essential for preventing nosocomial infection spread. Empiric therapy, regardless of the laboratory investigation results, is inadequate, especially in epidemic situations, as not all the cases of diarrhoea are due to C. difficile infection. Other risk factors for CDAD (Clostridiumn difficile Associated Diseases might be: prolonged hospitalization or residency in an asylum, age, existence of a severe chronic disease in the background nasogastric intubation, anti-ulcer drugs, at less extent gastrointestinal surgery, other immunosuppresive compounds etc. In our country, C. difficile infection is rather frequent in adults, though it is not always reported by clinicians. The circulation of endemic rybotype 027 in Romania is not well documented, the rybotype being extremely virulent and spread in other European countries. Hence the importance of extending the diagnostic capacity of C. difficile infection in order to allow detection of this rybotype among the strains isolated in our country.

[Racism of "Blood" and colonial medicine - Blood group anthropology studies at Keijo Imperial University Department of Forensic Medicine].

Science.gov (United States)

Jung, Joon Young

2012-12-01

This paper attempts to explore implications of Colonial medicine's Blood Type Studies, concerning the characteristics and tasks of racism in the Japanese Colonial Empire. Especially, it focuses on the Blood Group Anthropology Studies at Keijo Imperial University Department of Forensic Medicine. In Colonial Korea, the main stream of Blood Type Studies were Blood Group Anthropology Studies, which place Korean people who was inferior to Japanese people in the geography of the race on the one hand, but on the other, put Koreans as a missing link between the Mongolian and the Japanese for fulfillment of the Japanese colonialism, that is, assimilationist ideology. Then, Compared to the Western medicine and Metropole medicine of Japan, How differentiated was this tendency of Colonial Medicine from them? In this paper, main issues of Blood Group Anthropology Studies and its colonial implications are examined. The Korean Society for the History of Medicine.

StreamCat

Data.gov (United States)

U.S. Environmental Protection Agency — The StreamCat Dataset provides summaries of natural and anthropogenic landscape features for ~2.65 million streams, and their associated catchments, within the...

Stream Crossings

Data.gov (United States)

Vermont Center for Geographic Information — Physical measurements and attributes of stream crossing structures and adjacent stream reaches which are used to provide a relative rating of aquatic organism...

Cross-stream distribution of red blood cells in sickle-cell disease

Science.gov (United States)

Zhang, Xiao; Lam, Wilbur; Graham, Michael

2017-11-01

Experiments revealed that in blood flow, red blood cells (RBCs) tend to migrate away from the vessel walls, leaving a cell-free layer near the walls, while leukocytes and platelets tend to marginate towards the vessel walls. This segregation behavior of different cellular components in blood flow can be driven by their differences in stiffness and shape. An alteration of this segregation behavior may explain endothelial dysfunction and pain crisis associated with sickle-cell disease (SCD). It is hypothesized that the sickle RBCs, which are considerably stiffer than the healthy RBCs, may marginate towards the vessel walls and exert repeated damage to the endothelial cells. Direct simulations are performed to study the flowing suspensions of deformable biconcave discoids and stiff sickles representing healthy and sickle cells, respectively. It is observed that the sickles exhibit a strong margination towards the walls. The biconcave discoids in flowing suspensions undergo a so-called tank-treading motion, while the sickles behave as rigid bodies and undergo a tumbling motion. The margination behavior and tumbling motion of the sickles may help substantiate the aforementioned hypothesis of the mechanism for the SCD complications and shed some light on the design of novel therapies.

Multidrug resistance in Pseudomonas aeruginosa isolated from nosocomial respiratory and urinary infections in Aleppo, Syria.

Science.gov (United States)

Mahfoud, Maysa; Al Najjar, Mona; Hamzeh, Abdul Rezzak

2015-02-19

Pseudomonas aeruginosa represents a serious clinical challenge due to its frequent involvement in nosocomial infections and its tendency towards multidrug resistance. This study uncovered antibiotic susceptibility patterns in 177 isolates from inpatients in three key hospitals in Aleppo, the largest city in Syria. Exceptionally low susceptibility to most routinely used antibiotics was uncovered; resistance to ciprofloxacin and gentamicin was 64.9% and 70.3%, respectively. Contrarily, susceptibility to colistin was the highest (89.1%). Multidrug resistance was rife, found at a rate of 53.67% among studied P. aeruginosa isolates.

Prioritized Contact Transport Stream

Science.gov (United States)

Hunt, Walter Lee, Jr. (Inventor)

2015-01-01

A detection process, contact recognition process, classification process, and identification process are applied to raw sensor data to produce an identified contact record set containing one or more identified contact records. A prioritization process is applied to the identified contact record set to assign a contact priority to each contact record in the identified contact record set. Data are removed from the contact records in the identified contact record set based on the contact priorities assigned to those contact records. A first contact stream is produced from the resulting contact records. The first contact stream is streamed in a contact transport stream. The contact transport stream may include and stream additional contact streams. The contact transport stream may be varied dynamically over time based on parameters such as available bandwidth, contact priority, presence/absence of contacts, system state, and configuration parameters.

Re-Meandering of Lowland Streams

DEFF Research Database (Denmark)

Pedersen, Morten Lauge; Kristensen, Klaus Kevin; Friberg, Nikolai

2014-01-01

We evaluated the restoration of physical habitats and its influence on macroinvertebrate community structure in 18 Danish lowland streams comprising six restored streams, six streams with little physical alteration and six channelized streams. We hypothesized that physical habitats...... and macroinvertebrate communities of restored streams would resemble those of natural streams, while those of the channelized streams would differ from both restored and near-natural streams. Physical habitats were surveyed for substrate composition, depth, width and current velocity. Macroinvertebrates were sampled...... along 100 m reaches in each stream, in edge habitats and in riffle/run habitats located in the center of the stream. Restoration significantly altered the physical conditions and affected the interactions between stream habitat heterogeneity and macroinvertebrate diversity. The substrate in the restored...

StreamExplorer: A Multi-Stage System for Visually Exploring Events in Social Streams.

Science.gov (United States)

Wu, Yingcai; Chen, Zhutian; Sun, Guodao; Xie, Xiao; Cao, Nan; Liu, Shixia; Cui, Weiwei

2017-10-18

Analyzing social streams is important for many applications, such as crisis management. However, the considerable diversity, increasing volume, and high dynamics of social streams of large events continue to be significant challenges that must be overcome to ensure effective exploration. We propose a novel framework by which to handle complex social streams on a budget PC. This framework features two components: 1) an online method to detect important time periods (i.e., subevents), and 2) a tailored GPU-assisted Self-Organizing Map (SOM) method, which clusters the tweets of subevents stably and efficiently. Based on the framework, we present StreamExplorer to facilitate the visual analysis, tracking, and comparison of a social stream at three levels. At a macroscopic level, StreamExplorer uses a new glyph-based timeline visualization, which presents a quick multi-faceted overview of the ebb and flow of a social stream. At a mesoscopic level, a map visualization is employed to visually summarize the social stream from either a topical or geographical aspect. At a microscopic level, users can employ interactive lenses to visually examine and explore the social stream from different perspectives. Two case studies and a task-based evaluation are used to demonstrate the effectiveness and usefulness of StreamExplorer.Analyzing social streams is important for many applications, such as crisis management. However, the considerable diversity, increasing volume, and high dynamics of social streams of large events continue to be significant challenges that must be overcome to ensure effective exploration. We propose a novel framework by which to handle complex social streams on a budget PC. This framework features two components: 1) an online method to detect important time periods (i.e., subevents), and 2) a tailored GPU-assisted Self-Organizing Map (SOM) method, which clusters the tweets of subevents stably and efficiently. Based on the framework, we present Stream

Nosocomial Transmission of C. difficile in English Hospitals from Patients with Symptomatic Infection

Science.gov (United States)

van Kleef, Esther; Gasparrini, Antonio; Guy, Rebecca; Cookson, Barry; Hope, Russell; Jit, Mark; Robotham, Julie V.; Deeny, Sarah R.; Edmunds, W. John

2014-01-01

Background Recent evidence suggests that less than one-quarter of patients with symptomatic nosocomial Clostridium difficile infections (CDI) are linked to other in-patients. However, this evidence was limited to one geographic area. We aimed to investigate the level of symptomatic CDI transmission in hospitals located across England from 2008 to 2012. Methods A generalized additive mixed-effects Poisson model was fitted to English hospital-surveillance data. After adjusting for seasonal fluctuations and between-hospital variation in reported CDI over time, possible clustering (transmission between symptomatic in-patients) of CDI cases was identified. We hypothesised that a temporal proximity would be reflected in the degree of correlation between in-hospital CDI cases per week. This correlation was modelled through a latent autoregressive structure of order 1 (AR(1)). Findings Forty-six hospitals (33 general, seven specialist, and six teaching hospitals) located in all English regions met our criteria. In total, 12,717 CDI cases were identified; seventy-five per cent of these occurred >48 hours after admission. There were slight increases in reports during winter months. We found a low, but statistically significant, correlation between successive weekly CDI case incidences (phi = 0.029, 95%CI: 0.009–0.049). This correlation was five times stronger in a subgroup analysis restricted to teaching hospitals (phi = 0.104, 95%CI: 0.048–0.159). Conclusions The results suggest that symptomatic patient-to-patient transmission has been a source of CDI-acquisition in English hospitals in recent years, and that this might be a more important transmission route in teaching hospitals. Nonetheless, the weak correlation indicates that, in line with recent evidence, symptomatic cases might not be the primary source of nosocomial CDI in England. PMID:24932484

High Variability in Nosocomial Clostridium difficile Infection Rates Across Hospitals After Colorectal Resection.

Science.gov (United States)

Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Hensley, Bradley J; Iannuzzi, James C; Noyes, Katia; Monson, John R T; Fleming, Fergal J

2016-04-01

Hospital-acquired Clostridium difficile infection is associated with adverse patient outcomes and high medical costs. The incidence and severity of C. difficile has been rising in both medical and surgical patients. Our aim was to assess risk factors and variation associated with the development of nosocomial C. difficile colitis among patients undergoing colorectal resection. This was a retrospective cohort study. The study included segmental colectomy and proctectomy cases in New York State from 2005 to 2013. The study cohort included 150,878 colorectal resections. Patients with a documented previous history of C. difficile infection or residence outside of New York State were excluded. A diagnosis of C. difficile colitis either during the index hospital stay or on readmission within 30 days was the main measure. C. difficile colitis occurred in 3323 patients (2.2%). Unadjusted C. difficile colitis rates ranged from 0% to 11.3% among surgeons and 0% to 6.8% among hospitals. After controlling for patient, surgeon, and hospital characteristics using mixed-effects multivariable analysis, significant unexplained variation in C. difficile rates remained present across hospitals but not surgeons. Patient factors explained only 24% of the total hospital-level variation, and known surgeon and hospital-level characteristics explained an additional 8% of the total hospital-level variation. Therefore, ≈70% of the hospital variation in C. difficile infection rates remained unexplained by captured patient, surgeon, and hospital factors. Furthermore, there was an ≈5-fold difference in adjusted C. difficile rates across hospitals. A limited set of hospital and surgeon characteristics was available. Colorectal surgery patients appear to be at high risk for C. difficile infection, and alarming variation in nosocomial C. difficile infection rates currently exists among hospitals after colorectal resection. Given the high morbidity and cost associated with C. difficile colitis

Pilot-Streaming: Design Considerations for a Stream Processing Framework for High-Performance Computing

OpenAIRE

Andre Luckow; Peter Kasson; Shantenu Jha

2016-01-01

This White Paper (submitted to STREAM 2016) identifies an approach to integrate streaming data with HPC resources. The paper outlines the design of Pilot-Streaming, which extends the concept of Pilot-abstraction to streaming real-time data.

La infección nosocomial. Un reto en las unidades de cuidados intensivos

Directory of Open Access Journals (Sweden)

Edwin Javier Gordon Zamora

2018-01-01

Full Text Available El estudio de la infección nosocomial en las unidades de cuidados intensivos deviene eje central de la asistencia médica y, un pilar del control de su calidad. Estas unidades asumen un elevado número de pacientes críticamente enfermos con comorbilidad, compromiso inmunológico y en contacto con dispositivos invasivos, factores estos que condicionan la diseminación de bacterias multirresistentes, por lo cual se requiere vigilancia e implementación eficiente de las medidas de prevención y control. En este trabajo se intenta abrir el debate en torno a un reto en las unidades de cuidados intensivos: las infecciones nosocomiales.

Diagnosis of Acute Respiratory Distress Syndrome in Nosocomial Pneumonia

Directory of Open Access Journals (Sweden)

A. N. Kuzovlev

2009-01-01

Full Text Available Objective: to define the informative value of the parameters of gas exchange, lung volumetry, and central hemodynamics in the diagnosis of acute respiratory distress syndrome (ARDS in nosocomial pneumonia (NP. Subjects and methods. The study included 38 patients with cancer and severe injury who were divided into 3 groups in accordance with the diagnostic criteria of ARDS and NP: 1 patients with ARDS + NP; 2 those with NP; 3 those with non-ARDS, non-PN. ARDS was diagnosed in 2 steps. At Step 1, the investigators took into account risk factors for ARDS and used the lung injury scale developed by J. Murray et al. and the ARDS diagnostic criteria defined by the American-European Consensus Conference on ARDS. At Step 2, after obtaining the data of lung volume-try (1—2 hours after Step 1, they assessed the compliance of the above criteria for ARDS with those developed by the V. A. Negovsky Research Institute of General Reanimatology, Russian Academy of Medical Sciences, and redistributed the patients between the groups. The stage of ARDS was determined in accordance with the classification of the above Institute. All the patients underwent a comprehensive examination the key element of which was to estimate gas exchange parameters and to monitor lung volumetry and central hemodynamics by the transpulmonary thermodilution methods, by using a Pulsion PiCCO Plus monitor (Pulsion Medical Systems, Germany. The findings were statistically analyzed using a Statistica 7.0 package (arithmetic mean, error of the mean, _ Student’s test, Newman-Keuls test, correlation analysis. The difference was considered to be significant if p-value was Results. The patients with ARDS + NP were observed to have a significantly lower oxygenation index (10 ml/kg and Murray scale scores (>2 than those in patients with NP without ARDS. The reference values of the pulmonary vascular permeability index due to its inadequate informative value call for further investigation. The

Introduction to stream: An Extensible Framework for Data Stream Clustering Research with R

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Michael Hahsler

2017-02-01

Full Text Available In recent years, data streams have become an increasingly important area of research for the computer science, database and statistics communities. Data streams are ordered and potentially unbounded sequences of data points created by a typically non-stationary data generating process. Common data mining tasks associated with data streams include clustering, classification and frequent pattern mining. New algorithms for these types of data are proposed regularly and it is important to evaluate them thoroughly under standardized conditions. In this paper we introduce stream, a research tool that includes modeling and simulating data streams as well as an extensible framework for implementing, interfacing and experimenting with algorithms for various data stream mining tasks. The main advantage of stream is that it seamlessly integrates with the large existing infrastructure provided by R. In addition to data handling, plotting and easy scripting capabilities, R also provides many existing algorithms and enables users to interface code written in many programming languages popular among data mining researchers (e.g., C/C++, Java and Python. In this paper we describe the architecture of stream and focus on its use for data stream clustering research. stream was implemented with extensibility in mind and will be extended in the future to cover additional data stream mining tasks like classification and frequent pattern mining.

Knowledge, Attitude and Practice on Blood Donation among Health Science Students in a University campus, South India

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Sabu Karakkamandapam

2011-07-01

Full Text Available Background: The major part of demand for blood in India has been meeting through voluntary blood donations. The healthy, active and receptive huge student population is potential blood donors to meet safe blood requirements. However, there is a paucity of studies on awareness and attitude among health science students on voluntary blood donation. Objective: The objective of this study was to determine the knowledge and attitude about blood donation among health science students. Methods: A cross-sectional study was conducted among 410 health sciences students from different streams in a University campus of South India through a structured survey questionnaire in the year 2009. Results: The overall knowledge on blood donation was good, but majority (62% of students never donated blood. Knowledge level was found highest among allied health science (53.1% and lowest among pharmacy students (20.7%. ‘Feeling of medically unfit’ and ‘never thought of blood donation’ were the major reasons for not donating blood. A significant association was observed between different streams of students and levels of knowledge and attitude about blood donation. Conclusion: This study elicits the importance of adopting effective measures in our campuses to motivate about voluntary blood donation among students.

Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

OpenAIRE

Vajihe Karbasizade; Leila Heidari; Reyhaneh Jafari

2016-01-01

"> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nos...

Incidenza della meticillino-resistenza in Staphylococcus aureus e stafilococchi coagulasi-negativi isolati da emocolture

Directory of Open Access Journals (Sweden)

Alessandra Siddi

2007-12-01

Full Text Available Background: Staphylococci are major cause of nosocomial blood stream infections.This local surveillance study was carry out to monitor frequency of occurrence of Staphylococcus aureus and coagulase-negative staphylococci (CoNS in blood stream infections and the incidence of methicillin-resistant (MET-R strains. Materials and methods: During the period January – December 2006, 9840 blood specimens were analyzed and microrganisms from positive samples were collected. Bacterial identifications were performed according to the standard methods (Murray, 2003.We evaluated, in particular, the antibiotic-resistance phenotype of staphylococci employing disk diffusion test as suggested by the CLSI (2006. The following antimicrobial agents were tested: oxacillin, penicillin, amoxiciclin-clavulanate, cefalotin, cefamandole, imipenem, teicoplanin, linezolid, ciprofloxacin, erythromycin, clindamicin, rifampicin, trimethoprim-sulfamethoxazole, gentamicin, doxiciclin, fosfomycin. Results: The microrganisms isolated were 551: 370 Gram-positives (67%, 131 Gram-negatives (24%, 11 anaerobes (2% and 39 mycetes (7%. In particular, 121 S. epidermidis, 75 S. aureus, 42 S. haemolyticus and other 39 CoNS were analyzed: methicillin-resistance occurred in more than 80% of S.aureus strains collected from Intensive Care Units (ICU and in about 50 % of those isolated from other divisions. In CoNS the incidence of MET-R ranged from 30 to 80 %, the higher values were registered among S. epidermidis and S. haemolyticus. MET-R strains were characterized by high resistance rates even to ciprofloxacin (from 47 to 100%, erythromycin (from 70 to 100%, and in same cases to gentamicin (from 23 to 86% also. Conclusions: Staphylococci are the prevalent cause of blood stream infections.The distinctive feature of MET-R strains is their resistance not only to all b-lactam antibiotics, but also to a wide range of other antimicrobial agents. However, the glycopeptide teicoplanin remains 100

Benthic invertebrate fauna, small streams

Science.gov (United States)

J. Bruce Wallace; S.L. Eggert

2009-01-01

Small streams (first- through third-order streams) make up >98% of the total number of stream segments and >86% of stream length in many drainage networks. Small streams occur over a wide array of climates, geology, and biomes, which influence temperature, hydrologic regimes, water chemistry, light, substrate, stream permanence, a basin's terrestrial plant...

Cutting-edge analysis of extracellular microparticles using ImageStream(X) imaging flow cytometry.

Science.gov (United States)

Headland, Sarah E; Jones, Hefin R; D'Sa, Adelina S V; Perretti, Mauro; Norling, Lucy V

2014-06-10

Interest in extracellular vesicle biology has exploded in the past decade, since these microstructures seem endowed with multiple roles, from blood coagulation to inter-cellular communication in pathophysiology. In order for microparticle research to evolve as a preclinical and clinical tool, accurate quantification of microparticle levels is a fundamental requirement, but their size and the complexity of sample fluids present major technical challenges. Flow cytometry is commonly used, but suffers from low sensitivity and accuracy. Use of Amnis ImageStream(X) Mk II imaging flow cytometer afforded accurate analysis of calibration beads ranging from 1 μm to 20 nm; and microparticles, which could be observed and quantified in whole blood, platelet-rich and platelet-free plasma and in leukocyte supernatants. Another advantage was the minimal sample preparation and volume required. Use of this high throughput analyzer allowed simultaneous phenotypic definition of the parent cells and offspring microparticles along with real time microparticle generation kinetics. With the current paucity of reliable techniques for the analysis of microparticles, we propose that the ImageStream(X) could be used effectively to advance this scientific field.

Inventory of miscellaneous streams

International Nuclear Information System (INIS)

Lueck, K.J.

1995-09-01

On December 23, 1991, the US Department of Energy, Richland Operations Office (RL) and the Washington State Department of Ecology (Ecology) agreed to adhere to the provisions of the Department of Ecology Consent Order. The Consent Order lists the regulatory milestones for liquid effluent streams at the Hanford Site to comply with the permitting requirements of Washington Administrative Code. The RL provided the US Congress a Plan and Schedule to discontinue disposal of contaminated liquid effluent into the soil column on the Hanford Site. The plan and schedule document contained a strategy for the implementation of alternative treatment and disposal systems. This strategy included prioritizing the streams into two phases. The Phase 1 streams were considered to be higher priority than the Phase 2 streams. The actions recommended for the Phase 1 and 2 streams in the two reports were incorporated in the Hanford Federal Facility Agreement and Consent Order. Miscellaneous Streams are those liquid effluents streams identified within the Consent Order that are discharged to the ground but are not categorized as Phase 1 or Phase 2 Streams. This document consists of an inventory of the liquid effluent streams being discharged into the Hanford soil column

Time-Based Data Streams: Fundamental Concepts for a Data Resource for Streams

Energy Technology Data Exchange (ETDEWEB)

Beth A. Plale

2009-10-10

Real time data, which we call data streams, are readings from instruments, environmental, bodily or building sensors that are generated at regular intervals and often, due to their volume, need to be processed in real time. Often a single pass is all that can be made on the data, and a decision to discard or keep the instance is made on the spot. Too, the stream is for all practical purposes indefinite, so decisions must be made on incomplete knowledge. This notion of data streams has a different set of issues from a file, for instance, that is byte streamed to a reader. The file is finite, so the byte stream is becomes a processing convenience more than a fundamentally different kind of data. Through the duration of the project we examined three aspects of streaming data: the first, techniques to handle streaming data in a distributed system organized as a collection of web services, the second, the notion of the dashboard and real time controllable analysis constructs in the context of the Fermi Tevatron Beam Position Monitor, and third and finally, we examined provenance collection of stream processing such as might occur as raw observational data flows from the source and undergoes correction, cleaning, and quality control. The impact of this work is severalfold. We were one of the first to advocate that streams had little value unless aggregated, and that notion is now gaining general acceptance. We were one of the first groups to grapple with the notion of provenance of stream data also.

Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection.

Science.gov (United States)

Johnson, Paul D R; Martin, Rhea; Burrell, Laurelle J; Grabsch, Elizabeth A; Kirsa, Susan W; O'Keeffe, Jason; Mayall, Barrie C; Edmonds, Deidre; Barr, Wendy; Bolger, Christopher; Naidoo, Humsha; Grayson, M Lindsay

2005-11-21

To assess the effect of a multifaceted hand hygiene culture-change program on health care worker behaviour, and to reduce the burden of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections. Timetabled introduction of interventions (alcohol/chlorhexidine hand hygiene solution [ACHRS], improved cleaning of shared ward equipment, targeted patient decolonisation, comprehensive "culture change" package) to five clinical areas of a large university teaching hospital that had high levels of MRSA. Health care worker hand hygiene compliance; volume of ACHRS used; prevalence of patient and health care worker MRSA colonisation; environmental MRSA contamination; rates of clinical MRSA infection; and rates of laboratory detection of ESBL-producing Escherichia coli and Klebsiella spp. In study wards, health care worker hand hygiene compliance improved from a pre-intervention mean of 21% (95% CI, 20.3%-22.9%) to 42% (95% CI, 40.2%-43.8%) 12 months post-intervention (P hand hygiene compliance and reducing nosocomial MRSA infections, despite high-level MRSA endemicity.

Asteroid/meteorite streams

Science.gov (United States)

Drummond, J.

The independent discovery of the same three streams (named alpha, beta, and gamma) among 139 Earth approaching asteroids and among 89 meteorite producing fireballs presents the possibility of matching specific meteorites to specific asteroids, or at least to asteroids in the same stream and, therefore, presumably of the same composition. Although perhaps of limited practical value, the three meteorites with known orbits are all ordinary chondrites. To identify, in general, the taxonomic type of the parent asteroid, however, would be of great scientific interest since these most abundant meteorite types cannot be unambiguously spectrally matched to an asteroid type. The H5 Pribram meteorite and asteroid 4486 (unclassified) are not part of a stream, but travel in fairly similar orbits. The LL5 Innisfree meteorite is orbitally similar to asteroid 1989DA (unclassified), and both are members of a fourth stream (delta) defined by five meteorite-dropping fireballs and this one asteroid. The H5 Lost City meteorite is orbitally similar to 1980AA (S type), which is a member of stream gamma defined by four asteroids and four fireballs. Another asteroid in this stream is classified as an S type, another is QU, and the fourth is unclassified. This stream suggests that ordinary chondrites should be associated with S (and/or Q) asteroids. Two of the known four V type asteroids belong to another stream, beta, defined by five asteroids and four meteorite-dropping (but unrecovered) fireballs, making it the most probable source of the eucrites. The final stream, alpha, defined by five asteroids and three fireballs is of unknown composition since no meteorites have been recovered and only one asteroid has an ambiguous classification of QRS. If this stream, or any other as yet undiscovered ones, were found to be composed of a more practical material (e.g., water or metalrich), then recovery of the associated meteorites would provide an opportunity for in-hand analysis of a potential

Aeroacoustics of Three-Stream Jets

Science.gov (United States)

Henderson, Brenda S.

2012-01-01

Results from acoustic measurements of noise radiated from a heated, three-stream, co-annular exhaust system operated at subsonic conditions are presented. The experiments were conducted for a range of core, bypass, and tertiary stream temperatures and pressures. The nozzle system had a fan-to-core area ratio of 2.92 and a tertiary-to-core area ratio of 0.96. The impact of introducing a third stream on the radiated noise for third-stream velocities below that of the bypass stream was to reduce high frequency noise levels at broadside and peak jet-noise angles. Mid-frequency noise radiation at aft observation angles was impacted by the conditions of the third stream. The core velocity had the greatest impact on peak noise levels and the bypass-to-core mass flow ratio had a slight impact on levels in the peak jet-noise direction. The third-stream jet conditions had no impact on peak noise levels. Introduction of a third jet stream in the presence of a simulated forward-flight stream limits the impact of the third stream on radiated noise. For equivalent ideal thrust conditions, two-stream and three-stream jets can produce similar acoustic spectra although high-frequency noise levels tend to be lower for the three-stream jet.

Academic Self-Concepts in Ability Streams: Considering Domain Specificity and Same-Stream Peers

Science.gov (United States)

Liem, Gregory Arief D.; McInerney, Dennis M.; Yeung, Alexander S.

2015-01-01

The study examined the relations between academic achievement and self-concepts in a sample of 1,067 seventh-grade students from 3 core ability streams in Singapore secondary education. Although between-stream differences in achievement were large, between-stream differences in academic self-concepts were negligible. Within each stream, levels of…

Solar wind stream interfaces

International Nuclear Information System (INIS)

Gosling, J.T.; Asbridge, J.R.; Bame, S.J.; Feldman, W.C.

1978-01-01

Measurements aboard Imp 6, 7, and 8 reveal that approximately one third of all high-speed solar wind streams observed at 1 AU contain a sharp boundary (of thickness less than approx.4 x 10 4 km) near their leading edge, called a stream interface, which separates plasma of distinctly different properties and origins. Identified as discontinuities across which the density drops abruptly, the proton temperature increases abruptly, and the speed rises, stream interfaces are remarkably similar in character from one stream to the next. A superposed epoch analysis of plasma data has been performed for 23 discontinuous stream interfaces observed during the interval March 1971 through August 1974. Among the results of this analysis are the following: (1) a stream interface separates what was originally thick (i.e., dense) slow gas from what was originally thin (i.e., rare) fast gas; (2) the interface is the site of a discontinuous shear in the solar wind flow in a frame of reference corotating with the sun; (3) stream interfaces occur at speeds less than 450 km s - 1 and close to or at the maximum of the pressure ridge at the leading edges of high-speed streams; (4) a discontinuous rise by approx.40% in electron temperature occurs at the interface; and (5) discontinuous changes (usually rises) in alpha particle abundance and flow speed relative to the protons occur at the interface. Stream interfaces do not generally recur on successive solar rotations, even though the streams in which they are embedded often do. At distances beyond several astronomical units, stream interfaces should be bounded by forward-reverse shock pairs; three of four reverse shocks observed at 1 AU during 1971--1974 were preceded within approx.1 day by stream interfaces. Our observations suggest that many streams close to the sun are bounded on all sides by large radial velocity shears separating rapidly expanding plasma from more slowly expanding plasma

Stream systems.

Science.gov (United States)

Jack E. Williams; Gordon H. Reeves

2006-01-01

Restored, high-quality streams provide innumerable benefits to society. In the Pacific Northwest, high-quality stream habitat often is associated with an abundance of salmonid fishes such as chinook salmon (Oncorhynchus tshawytscha), coho salmon (O. kisutch), and steelhead (O. mykiss). Many other native...

Rapid and high-resolution distinction of community-acquired and nosocomial Staphylococcus aureus isolates with identical pulsed-field gel electrophoresis patterns and spa types

NARCIS (Netherlands)

Glasner, Corinna; Sabat, Artur J.; Dreisbach, Annette; Larsen, Anders R.; Friedrich, Alexander W.; Skov, Robert L.; van Dijl, Jan Maarten

Methicillin-resistant Staphylococcus aureus (MRSA) represent a serious threat for public health worldwide. Of particular concern is the emergence of community-acquired MRSA, which is often difficult to distinguish from nosocomial MRSA due to a lack of suitable typing methods for early detection. For

Rational approaches to the therapy of nosocomial infections caused by gram-positive microorganisms in cancer p

Directory of Open Access Journals (Sweden)

V. V. Aginova

2017-01-01

Full Text Available Nosocomial infections caused by gram-positive organisms, including Staphylococcus aureus and enterococci (Enterococcus faecium and Enterococcus faecalis are steadily increasing in almost all clinics around the world. Cancer patients have a higher risk of hospital-acquired infections than non-cancer patients. Cancer patients are immunosuppressed due to increased use of broad-spectrum antibiotics and chemotherapy drugs, radiation therapy, surgery and use of steroids. This paper presents an analysis of resistance of gram-positive bacterial pathogens to antimicrobial agents to determine treatment strategy for cancer patients.

Risk factors for nosocomial infections after cardiac surgery in newborns with congenital heart disease.

Science.gov (United States)

García, Heladia; Cervantes-Luna, Beatriz; González-Cabello, Héctor; Miranda-Novales, Guadalupe

2017-11-23

Congenital heart diseases are among the most common congenital malformations. Approximately 50% of the patients with congenital heart disease undergo cardiac surgery. Nosocomial infections (NIs) are the main complications and an important cause of increased morbidity and mortality associated with congenital heart diseases. This study's objective was to identify the risk factors associated with the development of NIs after cardiac surgery in newborns with congenital heart disease. This was a nested case-control study that included 112 newborns, including 56 cases (with NI) and 56 controls (without NI). Variables analyzed included perinatal history, associated congenital malformations, Risk-Adjusted Congenital Heart Surgery (RACHS-1) score, perioperative and postoperative factors, transfusions, length of central venous catheter, nutritional support, and mechanical ventilation. Differences were calculated with the Mann-Whitney-U test, Pearson X 2 , or Fisher's exact test. A multivariate logistic regression was used to determine the independent risk factors. Sepsis was the most common NI (37.5%), and the main causative microorganisms were gram-positive cocci. The independent risk factors associated with NI were non-cardiac congenital malformations (OR 6.1, CI 95% 1.3-29.4), central venous catheter indwelling time > 14 days (OR 3.7, CI 95% 1.3-11.0), duration of mechanical ventilation > 7 days (OR 6.6, CI 95% 2.1-20.1), and ≥5 transfusions of blood products (OR 3.1, CI 95% 1.3-8.5). Mortality attributed to NI was 17.8%. Newborns with non-cardiac congenital malformations and with >7 days of mechanical ventilation were at higher risk for a postoperative NI. Efforts must focus on preventable infections, especially in bloodstream catheter-related infections, which account for 20.5% of all NIs. Copyright © 2017. Published by Elsevier B.V.

Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries: international Nosocomial Infection Control Consortium findings.

Science.gov (United States)

Rosenthal, Victor D; Jarvis, William R; Jamulitrat, Silom; Silva, Cristiane Pavanello Rodrigues; Ramachandran, Bala; Dueñas, Lourdes; Gurskis, Vaidotas; Ersoz, Gulden; Novales, María Guadalupe Miranda; Khader, Ilham Abu; Ammar, Khaldi; Guzmán, Nayide Barahona; Navoa-Ng, Josephine Anne; Seliem, Zeinab Salah; Espinoza, Teodora Atencio; Meng, Cheong Yuet; Jayatilleke, Kushlani

2012-07-01

We report the results of the International Nosocomial Infection Control Consortium prospective surveillance study from January 2004 to December 2009 in 33 pediatric intensive care units of 16 countries and the impact of being in a private vs. public hospital and the income country level on device-associated health care-associated infection rates. Additionally, we aim to compare these findings with the results of the Centers for Disease Control and Prevention National Healthcare Safety Network annual report to show the differences between developed and developing countries regarding device-associated health care-associated infection rates. A prospective cohort, active device-associated health care-associated infection surveillance study was conducted on 23,700 patients in International Nosocomial Infection Control Consortium pediatric intensive care units. The protocol and methodology implemented were developed by International Nosocomial Infection Control Consortium. Data collection was performed in the participating intensive care units. Data uploading and analyses were conducted at International Nosocomial Infection Control Consortium headquarters on proprietary software. Device-associated health care-associated infection rates were recorded by applying Centers for Disease Control and Prevention National Healthcare Safety Network device-associated infection definitions, and the impact of being in a private vs. public hospital and the income country level on device-associated infection risk was evaluated. None. Central line-associated bloodstream infection rates were similar in private, public, or academic hospitals (7.3 vs. 8.4 central line-associated bloodstream infection per 1,000 catheter-days [p infection rates in lower middle-income countries were higher than low-income countries or upper middle-income countries (12.2 vs. 5.5 central line-associated bloodstream infections per 1,000 catheter-days [p infection rates were similar in academic, public and private

PROXY-BASED PATCHING STREAM TRANSMISSION STRATEGY IN MOBILE STREAMING MEDIA SYSTEM

Institute of Scientific and Technical Information of China (English)

Liao Jianxin; Lei Zhengxiong; Ma Xutao; Zhu Xiaomin

2006-01-01

A mobile transmission strategy, PMPatching (Proxy-based Mobile Patching) transmission strategy is proposed, it applies to the proxy-based mobile streaming media system in Wideband Code Division Multiple Access (WCDMA) network. Performance of the whole system can be improved by using patching stream to transmit anterior part of the suffix that had been played back, and by batching all the demands for the suffix arrived in prefix period and patching stream transmission threshold period. Experimental results show that this strategy can efficiently reduce average network transmission cost and number of channels consumed in central streaming media server.

Improving hand hygiene compliance for the reduction of nosocomial infections: recommendations for behaviour change in a health care setting

OpenAIRE

Reason, Florence Paige

2008-01-01

Nosocomial infection rates are highly dependent on hand hygiene compliance within health care facilities. This paper examines the literature concerning elements of effective hand hygiene interventions and relevant behaviour change theory, in addition to current practice surrounding hand hygiene interventions in leading institutions, in order to inform and propose recommendations for the improvement and success of the University Health Network’s current hand hygiene initiative. The results of ...

Evaluation of the streaming-matrix method for discrete-ordinates duct-streaming calculations

International Nuclear Information System (INIS)

Clark, B.A.; Urban, W.T.; Dudziak, D.J.

1983-01-01

A new deterministic streaming technique called the Streaming Matrix Hybrid Method (SMHM) is applied to two realistic duct-shielding problems. The results are compared to standard discrete-ordinates and Monte Carlo calculations. The SMHM shows promise as an alternative deterministic streaming method to standard discrete-ordinates

CuO nanoparticles and their antimicrobial activity against nosocomial strains

Directory of Open Access Journals (Sweden)

Mónica Marcela Gómez León

2017-09-01

Full Text Available Using a prototype reactor, CuO nanoparticles (NPs were synthetized through the precipitation method, starting from CuSO2·5H2O and Cu(CH3COO2·H2O. The obtained NPs were characterized by XDR, FT-IR, SEM, and TEM. The antimicrobial activity of the NPs was determined by the plate diffusion method, placing 20 mg of NPs onto four nosocomial strains obtained from north Lima national hospital Intensive-Care Unit (Staphylococcus epidermidis, Aerococcus viridans, Ochrobactrum anthropic, and Micrococcus lylae. NPs characterization revealed that those synthetized from acetate (CuO–Acet shown pure CuO phase, while those synthetized from sulphate CuO–Sulf shown two phases where CuO was the predominant one, having more than 84%. The crystal domains for CuO–Acet and CuO–Sulf were 15 and 19 nm, respectively. The inhibition halos for the studied strains were larger for CuO–Sulf NPs than CuO–Acet NPs, only Ochrobactrum anthropi displayed similar inhibition halos for both types of NPs.

[Nosocomial sinusitis in an intensive care unit: a microbiological study].

Science.gov (United States)

Balsalobre Filho, Leonardo Lopes; Vieira, Fernando Mirage Jardim; Stefanini, Renato; Cavalcante, Ricardo; Santos, Rodrigo de Paula; Gregório, Luis Carlos

2011-01-01

Nosocomial sinusitis is a common complication of patients in ICUs. Its diagnosis is important, and early treatment is required to avoid serious complications such as pneumonia, sepsis, meningitis, and intracranial abscesses. To identify the germs causing sinusitis in ICUs by nasal swabs and maxillary sinus puncture, and to correlate these results. ICU patients with a diagnosis (CT confirmed) of maxillary sinusitis underwent nasal swab and puncture of the sinus to collect material for culture and antibiogram. This study evaluated 22 patients. The microbial agent isolated in the swab correlated with the agent in the puncture in 14 of 22 cases (63%). Gram-negative bacteria were the most frequent, as follows: Pseudomonas aeruginosa (29% of punctures), following by Proteus mirabillis (26%) and Acinetobacter baumanni (14%). The resistance index in the antibiogram was high to antibiotics. Maxillary sinus puncture of ICU patients with sinusitis appears to be the best method for identifying bacteria; antibiograms demonstrate resistance to therapy. The swab has little diagnostic value; the correlation was 63%. It may be used when sinus puncture is contraindicated.

[Risk of nosocomial infection in Intertropical Africa. Part 4: prevention].

Science.gov (United States)

Rebaudet, S; De Pina, J J; Rapp, C; Kraemer, P; Savini, H; Demortiere, E; Simon, F

2008-02-01

Nosocomial infections have long been neglected in Sub-Saharan Africa, even though their prevalence is higher than in developed countries. Recently, however, this major public health problem has been the focus of a growing number of recommendations not only from the World Health Organization but also from some national health ministries. Because of the numerous limitations especially in financial resources in these regions, priority must be given to the implementation of simple and cost-effective measures. Accordingly the greatest efforts must be devoted to educating healthcare workers and patients about the importance of handwashing, eliminating unnecessary injections and transfusions, performing the latter acts in aseptic conditions, isolating patients with communicable diseases, handling waste products safely, and using antimicrobials properly. Amid the daunting health issues facing Sub-Saharan Africa, implementing these inexpensive measures that could save the lives of thousands of patients and healthcare workers appears easy. However it will require a cultural revolution. The keys to success will be changing the organizational culture, developing a commitment to prevention and evaluating performance regularly.

Consequences of variation in stream-landscape connections for stream nitrate retention and export

Science.gov (United States)

Handler, A. M.; Helton, A. M.; Grimm, N. B.

2017-12-01

Hydrologic and material connections among streams, the surrounding terrestrial landscape, and groundwater systems fluctuate between extremes in dryland watersheds, yet the consequences of this variation for stream nutrient retention and export remain uncertain. We explored how seasonal variation in hydrologic connection among streams, landscapes, and groundwater affect nitrate and ammonium concentrations across a dryland stream network and how this variation mediates in-stream nitrate uptake and watershed export. We conducted spatial surveys of stream nitrate and ammonium concentration across the 1200 km2 Oak Creek watershed in central Arizona (USA). In addition, we conducted pulse releases of a solution containing biologically reactive sodium nitrate, with sodium chloride as a conservative hydrologic tracer, to estimate nitrate uptake rates in the mainstem (Q>1000 L/s) and two tributaries. Nitrate and ammonium concentrations generally increased from headwaters to mouth in the mainstem. Locally elevated concentrations occurred in spring-fed tributaries draining fish hatcheries and larger irrigation ditches, but did not have a substantial effect on the mainstem nitrogen load. Ambient nitrate concentration (as N) ranged from below the analytical detection limit of 0.005 mg/L to 0.43 mg/L across all uptake experiments. Uptake length—average stream distance traveled for a nutrient atom from the point of release to its uptake—at ambient concentration ranged from 250 to 704 m and increased significantly with higher discharge, both across streams and within the same stream on different experiment dates. Vertical uptake velocity and aerial uptake rate ranged from 6.6-10.6 mm min-1 and 0.03 to 1.4 mg N m-2 min-1, respectively. Preliminary analyses indicate potentially elevated nitrogen loading to the lower portion of the watershed during seasonal precipitation events, but overall, the capacity for nitrate uptake is high in the mainstem and tributaries. Ongoing work

Implementation of link management to improve control of nosocomial infections in outpatient transfusion room%实施环节管理提高门诊输液室医院感染管理质量

Institute of Scientific and Technical Information of China (English)

卢桂存; 卢宝珍; 孟瑞芳

2013-01-01

目的 加强门诊输液室医院感染管理,以降低门诊输液室医院感染的发生.方法 以门诊输液室的工作流程为基点,对布局、环境消毒、培训监督、优化工作流程、正确处置医疗废物、保洁员的消毒隔离环节实行干预措施,对各环节进行管理.结果 门诊输液室的医院感染管理质量大大提高,有效降低医院感染的发生.结论 实行环节管理,严格消毒隔离措施是降低医院感染的有效方法.%OBJECTIVE To strengthen the control of nosocomial infections in the outpatient transfusion room, so sa to reduce the incidence of nosocomial infections in the transfusion room of outpatient department. METHODS The work flow of the transfusion room was set as the base point, the interventions were implanted to the layout, environmental disinfection, training supervision, optimization of the work flow, disposal of the medical waster, and the disinfection and isolation of the cleaning staff. RESULTS The quality of control of nosocomial infections in the transfusion room has been significantly improved, and the incidence of nosocomial infections has been effectively reduced. CONCLUSION The implementation of link management and strict disinfection and isolation measures are the effective measures to reduce the incidence of nosocomial infections.

Streaming tearing mode

Science.gov (United States)

Shigeta, M.; Sato, T.; Dasgupta, B.

1985-01-01

The magnetohydrodynamic stability of streaming tearing mode is investigated numerically. A bulk plasma flow parallel to the antiparallel magnetic field lines and localized in the neutral sheet excites a streaming tearing mode more strongly than the usual tearing mode, particularly for the wavelength of the order of the neutral sheet width (or smaller), which is stable for the usual tearing mode. Interestingly, examination of the eigenfunctions of the velocity perturbation and the magnetic field perturbation indicates that the streaming tearing mode carries more energy in terms of the kinetic energy rather than the magnetic energy. This suggests that the streaming tearing mode instability can be a more feasible mechanism of plasma acceleration than the usual tearing mode instability.

The distribution of copper in stream sediments in an anomalous stream near Steinkopf, Namaqualand

International Nuclear Information System (INIS)

De Bruin, D.

1987-01-01

Anomalous copper concentrations detected by the regional stream-sediment programme of the Geological Survey was investigated in a stream near Steinkopf, Namaqualand. A follow-up disclosed the presence of malachite mineralization. However, additional stream-sediment samples collected from the 'anomalous' stream revealed an erratic distribution of copper and also that the malachite mineralization had no direct effect on the copper distribution in the stream sediments. Low partial-extraction yields, together with X-ray diffraction analyses, indicated that dispersion is mainly mechanical and that the copper occurs as cations in the lattice of the biotite fraction of the stream sediments. (author). 8 refs., 5 figs., 1 tab

The distribution of copper in stream sediments in an anomalous stream near Steinkopf, Namaqualand

Energy Technology Data Exchange (ETDEWEB)

De Bruin, D

1987-01-01

Anomalous copper concentrations detected by the regional stream-sediment programme of the Geological Survey was investigated in a stream near Steinkopf, Namaqualand. A follow-up disclosed the presence of malachite mineralization. However, additional stream-sediment samples collected from the 'anomalous' stream revealed an erratic distribution of copper and also that the malachite mineralization had no direct effect on the copper distribution in the stream sediments. Low partial-extraction yields, together with X-ray diffraction analyses, indicated that dispersion is mainly mechanical and that the copper occurs as cations in the lattice of the biotite fraction of the stream sediments. (author). 8 refs., 5 figs., 1 tab.

Proactive infection control measures to prevent nosocomial transmission of vancomycin-resistant enterococci in Hong Kong.

Science.gov (United States)

Cheng, Vincent Chi-Chung; Tai, Josepha Wai-Ming; Chen, Jonathan Hon-Kwan; So, Simon Yung-Chun; Ng, Wing-Chun; Hung, Ivan Fan-Ngan; Leung, Sally Sau-Man; Wong, Sally Cheuk-Ying; Chan, Tuen-Ching; Chan, Felix Hon-Wai; Ho, Pak-Leung; Yuen, Kwok-Yung

2014-10-01

The study describes a proactive infection control approach to prevent nosocomial transmission of vancomycin-resistant enterococci (VRE) and tests if this approach is effective for controlling multiple-drug resistant organisms in a nonendemic setting. In response to the increasing prevalence of VRE in Hong Kong since 2011, we adopted a multifaceted assertive approach in our health care network. This included active surveillance culture, extensive contact tracing, directly observed hand hygiene in conscious patients before they received meals and medications, stringent hand hygiene and environmental cleanliness, and an immediate feedback antimicrobial stewardship program. We report the occurrence of VRE outbreaks in our hospital after institution of these measures and compared with the concurrent occurrence in other public hospitals in Hong Kong. Between July 1, 2011 and November 13, 2013, VRE was identified in 0.32% (50/15,851) of admission episodes by active surveillance culture. The risk of VRE carriage was three times higher in patients with a history of hospitalization outside our hospital networks in the past 3 months (0.56% vs. 0.17%; p = 0.001) compared with those who were not. Extensive contact tracing involving 3277 patient episodes was performed in the investigation for the 25 VRE index patients upon whom implementation of contact precautions was delayed (more than 48 hours of hospitalization). One episode of VRE outbreak was identified in our hospital network, compared with the 77 VRE outbreaks reported in the other hospital networks (controls) without these proactive infection control measures. Our multifaceted assertive proactive infection control approach can minimize the nosocomial transmission and outbreak of VRE in a nonendemic area. Copyright © 2014. Published by Elsevier B.V.

A morphological comparison of narrow, low-gradient streams traversing wetland environments to alluvial streams.

Science.gov (United States)

Jurmu, Michael C

2002-12-01

Twelve morphological features from research on alluvial streams are compared in four narrow, low-gradient wetland streams located in different geographic regions (Connecticut, Indiana, and Wisconsin, USA). All four reaches differed in morphological characteristics in five of the features compared (consistent bend width, bend cross-sectional shape, riffle width compared to pool width, greatest width directly downstream of riffles, and thalweg location), while three reaches differed in two comparisons (mean radius of curvature to width ratio and axial wavelength to width ratio). The remaining five features compared had at least one reach where different characteristics existed. This indicates the possibility of varying morphology for streams traversing wetland areas further supporting the concept that the unique qualities of wetland environments might also influence the controls on fluvial dynamics and the development of streams. If certain morphological features found in streams traversing wetland areas differ from current fluvial principles, then these varying features should be incorporated into future wetland stream design and creation projects. The results warrant further research on other streams traversing wetlands to determine if streams in these environments contain unique morphology and further investigation of the impact of low-energy fluvial processes on morphological development. Possible explanations for the morphology deviations in the study streams and some suggestions for stream design in wetland areas based upon the results and field observations are also presented.

InSTREAM: the individual-based stream trout research and environmental assessment model

Science.gov (United States)

Steven F. Railsback; Bret C. Harvey; Stephen K. Jackson; Roland H. Lamberson

2009-01-01

This report documents Version 4.2 of InSTREAM, including its formulation, software, and application to research and management problems. InSTREAM is a simulation model designed to understand how stream and river salmonid populations respond to habitat alteration, including altered flow, temperature, and turbidity regimes and changes in channel morphology. The model...

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

Directory of Open Access Journals (Sweden)

Wenzel Richard P

2005-10-01

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

Re-Meandering of Lowland Streams

DEFF Research Database (Denmark)

Pedersen, Morten Lauge; Kristensen, Klaus Kevin; Friberg, Nikolai

2014-01-01

We evaluated the restoration of physical habitats and its influence on macroinvertebrate community structure in 18 Danish lowland streams comprising six restored streams, six streams with little physical alteration and six channelized streams. We hypothesized that physical habitats and macroinver...

[Nosocomial infection/colonization of the respiratory tract caused by Acinetobacter baumannii in an Internal Medicine ward].

Science.gov (United States)

Salas Coronas, J; Cabezas Fernández, T; Alvarez-Ossorio García de Soria, R; Rogado González, M C; Delgado Fernández, M; Díez García, F

2002-10-01

To present the epidemiology of the outbreak and the description of patients with infection or colonization of the respiratory tract caused by A. baumannii in an Internal Medicine ward. 20 consecutively patients hospitalized in the Internal Medicine ward were studied during 18 months with isolation of multiresistant A. baumanni in respiratory tract specimens with or without clinical signs of infection. Starting on an index case, that was a patient coming from other hospital with diagnosis of nosocomial Acinetobacter pneumonia, we detected 20 patients. The age of the patients ranged from 48 to 95 years, with a mean of 71.4 years. Eighty percent were males. The clinical features were similar: advanced age, with chronic diseases (35 percent diabetics, 45 percent with chronic lung diseases), and use of broad-spectrum antibiotics agents, fundamentally third generation cephalosporin (70 percent), clarithromycin (55 percent) and quinolones (30 percent). 75 percent of patients were in the same ward. Eight (40 percent) of the patients with chronic lung diseases were subjects with COPD, two with asthma and chronic glucocorticoids treatment, and one with a sleep apnea. In four cases the isolation was considered a colonization. The mean stay was 26.15 days, and the mortality 40 percent. The nosocomial infection caused by Acinetobacter baumannii is responsible of a high morbi-mortality between the patients hospitalized in an Internal Medicine ward, and produce an increase in length of stay. It is necessary a combination of control measures to prevent the transmission in the hospital and the outbreak of new multiresistant strains.

Experimental investigation of acoustic streaming in a cylindrical wave guide up to high streaming Reynolds numbers.

Science.gov (United States)

Reyt, Ida; Bailliet, Hélène; Valière, Jean-Christophe

2014-01-01

Measurements of streaming velocity are performed by means of Laser Doppler Velocimetry and Particle Image Velociimetry in an experimental apparatus consisting of a cylindrical waveguide having one loudspeaker at each end for high intensity sound levels. The case of high nonlinear Reynolds number ReNL is particularly investigated. The variation of axial streaming velocity with respect to the axial and to the transverse coordinates are compared to available Rayleigh streaming theory. As expected, the measured streaming velocity agrees well with the Rayleigh streaming theory for small ReNL but deviates significantly from such predictions for high ReNL. When the nonlinear Reynolds number is increased, the outer centerline axial streaming velocity gets distorted towards the acoustic velocity nodes until counter-rotating additional vortices are generated near the acoustic velocity antinodes. This kind of behavior is followed by outer streaming cells only and measurements in the near wall region show that inner streaming vortices are less affected by this substantial evolution of fast streaming pattern. Measurements of the transient evolution of streaming velocity provide an additional insight into the evolution of fast streaming.

A Statistical Method to Predict Flow Permanence in Dryland Streams from Time Series of Stream Temperature

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Ivan Arismendi

2017-12-01

Full Text Available Intermittent and ephemeral streams represent more than half of the length of the global river network. Dryland freshwater ecosystems are especially vulnerable to changes in human-related water uses as well as shifts in terrestrial climates. Yet, the description and quantification of patterns of flow permanence in these systems is challenging mostly due to difficulties in instrumentation. Here, we took advantage of existing stream temperature datasets in dryland streams in the northwest Great Basin desert, USA, to extract critical information on climate-sensitive patterns of flow permanence. We used a signal detection technique, Hidden Markov Models (HMMs, to extract information from daily time series of stream temperature to diagnose patterns of stream drying. Specifically, we applied HMMs to time series of daily standard deviation (SD of stream temperature (i.e., dry stream channels typically display highly variable daily temperature records compared to wet stream channels between April and August (2015–2016. We used information from paired stream and air temperature data loggers as well as co-located stream temperature data loggers with electrical resistors as confirmatory sources of the timing of stream drying. We expanded our approach to an entire stream network to illustrate the utility of the method to detect patterns of flow permanence over a broader spatial extent. We successfully identified and separated signals characteristic of wet and dry stream conditions and their shifts over time. Most of our study sites within the entire stream network exhibited a single state over the entire season (80%, but a portion of them showed one or more shifts among states (17%. We provide recommendations to use this approach based on a series of simple steps. Our findings illustrate a successful method that can be used to rigorously quantify flow permanence regimes in streams using existing records of stream temperature.

A statistical method to predict flow permanence in dryland streams from time series of stream temperature

Science.gov (United States)

Arismendi, Ivan; Dunham, Jason B.; Heck, Michael; Schultz, Luke; Hockman-Wert, David

2017-01-01

Intermittent and ephemeral streams represent more than half of the length of the global river network. Dryland freshwater ecosystems are especially vulnerable to changes in human-related water uses as well as shifts in terrestrial climates. Yet, the description and quantification of patterns of flow permanence in these systems is challenging mostly due to difficulties in instrumentation. Here, we took advantage of existing stream temperature datasets in dryland streams in the northwest Great Basin desert, USA, to extract critical information on climate-sensitive patterns of flow permanence. We used a signal detection technique, Hidden Markov Models (HMMs), to extract information from daily time series of stream temperature to diagnose patterns of stream drying. Specifically, we applied HMMs to time series of daily standard deviation (SD) of stream temperature (i.e., dry stream channels typically display highly variable daily temperature records compared to wet stream channels) between April and August (2015–2016). We used information from paired stream and air temperature data loggers as well as co-located stream temperature data loggers with electrical resistors as confirmatory sources of the timing of stream drying. We expanded our approach to an entire stream network to illustrate the utility of the method to detect patterns of flow permanence over a broader spatial extent. We successfully identified and separated signals characteristic of wet and dry stream conditions and their shifts over time. Most of our study sites within the entire stream network exhibited a single state over the entire season (80%), but a portion of them showed one or more shifts among states (17%). We provide recommendations to use this approach based on a series of simple steps. Our findings illustrate a successful method that can be used to rigorously quantify flow permanence regimes in streams using existing records of stream temperature.

Persistent blood stream infection in patients supported with a continuous-flow left ventricular assist device is associated with an increased risk of cerebrovascular accidents.

Science.gov (United States)

Trachtenberg, Barry H; Cordero-Reyes, Andrea M; Aldeiri, Molham; Alvarez, Paulino; Bhimaraj, Arvind; Ashrith, Guha; Elias, Barbara; Suarez, Erik E; Bruckner, Brian; Loebe, Matthias; Harris, Richard L; Zhang, J Yi; Torre-Amione, Guillermo; Estep, Jerry D

2015-02-01

Common adverse events in patients supported with Continuous-flow left ventricular assist devices (CF-LVAD) include infections and cerebrovascular accidents (CVA). Some studies have suggested a possible association between blood stream infection (BSI) and CVA. Medical records of patients who received Heartmate II (HMII) CF-LVADs in 2008-2012 at a single center were reviewed. CVA was categorized as either hemorrhagic (HCVA) or ischemic (ICVA). BSI was divided into persistent (pBSI) and nonpersistent (non-pBSI). pBSI was defined as BSI with the same organism on repeated blood culture >72 hours from initial blood culture despite antibiotics. Univariate and multivariate analyses were performed to determine predictors. A total of 149 patients had HMII implanted; 76% were male, and the overall mean age was 55.4 ± 13 years. There were a total of 19 (13%) patients who had CVA (7 HCVA and 12 ICVA) at a median of 295 days (range 5-1,096 days) after implantation. There were a total of 28 (19%) patients with pBSI and 17 (11%) patients with non-pBSI. Patients with pBSI had a trend toward greater BMI (31 kg/m(2) vs 27 kg/m(2); P = .09), and longer duration of support (1,019 d vs 371 d; P < .001) compared with those with non-pBSI. Persistent BSI was associated with an increased risk of mortality and with all-cause CVA on multivariate analysis (odds ratio [OR] 5.97; P = .003) as well as persistent Pseudomonas aeruginosa infection (OR 4.54; P = .048). Persistent BSI is not uncommon in patients supported by CF-LVAD and is highly associated with all-cause CVA and increased all-cause mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

Rhodotorula fungemia: two cases and a brief review.

Science.gov (United States)

Duggal, Shalini; Jain, Hemant; Tyagi, Amit; Sharma, Anuradha; Chugh, T D

2011-11-01

Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We present two cases of Rhodotorula mucilaginosa fungemia diagnosed over a period of 3 months at our hospital. The first case was of a pre-term neonate in the neonatal ICU who presented with respiratory failure and sepsis. The second involved an adult female who had been injured in a road traffic accident requiring an operation for a hematoma and was later shifted to the medical ICU. For a new hospital like ours, finding two cases of Rhodotorula fungemia within a span of 3 months prompted us to describe them in this report. These cases emphasize the emerging importance of Rhodotorula mucilaginosa as a pathogen and the importance of identification and MIC testing for all fungal isolates recovered from the blood stream.

Neonatal nosocomial sepsis in a level-III NICU: evaluation of the causative agents and antimicrobial susceptibilities.

Science.gov (United States)

Yalaz, Mehmet; Cetin, Hasan; Akisu, Mete; Aydemir, Söhret; Tunger, Alper; Kültürsay, Nilgün

2006-01-01

Despite advances in supportive care and use of antibiotics, sepsis preserves its importance due to its high mortality and morbidity for neonates. Identifying the causative agents and antibiotic resistance yearly in a neonatal intensive care unit (NICU) helps the physician to choose the most appropriate empirical therapy. In this study we aimed to evaluate positive blood cultures and antibiotic susceptibilities of newborns with proven sepsis during the years 2000-2002 in our NICU. The charts of babies with sepsis were evaluated for clinical characteristics, positive cultures and antimicrobial susceptibilities, retrospectively. Although most of the admitted patients were premature (76.5%), the frequency of proven sepsis was quite low, at 9.1% among 909 newborns. Mortality rate in sepsis was 16%. The most commonly isolated micro-organisms were coagulase-negative staphylococci (CoNS) (31.3%), fungi (19.2%), Staphylococcus aureus (13%) and Klebsiella pneumoniae (10.5%). Methicillin resistance for CoNS was 92.3% and for S. aureus was 72.7%. In the last year, a significant increase in the frequency of Klebsiella pneumoniae (8.3 vs 14.2%), CoNS (27.1 vs 37.1%), Pseudomonas aeruginosa (2.1 vs 8.6%) and fungal infections (18.8 vs 20%) was observed compared to the previous years. An initial empirical antibiotic therapy for late-onset sepsis was designed with teicoplanin + piperacillin-tazobactam/meropenem + antifungal (fluconazole or amphotericin B) as the best combination to cover this spectrum until the culture results arrive. However, this combination is only compatible with our results and may not be applied in all units. Every unit must follow the bacterial spectrum and antibacterial resistance patterns to choose their specific empirical treatment strategy for nosocomial infections.

StreamQRE: Modular Specification and Efficient Evaluation of Quantitative Queries over Streaming Data.

Science.gov (United States)

Mamouras, Konstantinos; Raghothaman, Mukund; Alur, Rajeev; Ives, Zachary G; Khanna, Sanjeev

2017-06-01

Real-time decision making in emerging IoT applications typically relies on computing quantitative summaries of large data streams in an efficient and incremental manner. To simplify the task of programming the desired logic, we propose StreamQRE, which provides natural and high-level constructs for processing streaming data. Our language has a novel integration of linguistic constructs from two distinct programming paradigms: streaming extensions of relational query languages and quantitative extensions of regular expressions. The former allows the programmer to employ relational constructs to partition the input data by keys and to integrate data streams from different sources, while the latter can be used to exploit the logical hierarchy in the input stream for modular specifications. We first present the core language with a small set of combinators, formal semantics, and a decidable type system. We then show how to express a number of common patterns with illustrative examples. Our compilation algorithm translates the high-level query into a streaming algorithm with precise complexity bounds on per-item processing time and total memory footprint. We also show how to integrate approximation algorithms into our framework. We report on an implementation in Java, and evaluate it with respect to existing high-performance engines for processing streaming data. Our experimental evaluation shows that (1) StreamQRE allows more natural and succinct specification of queries compared to existing frameworks, (2) the throughput of our implementation is higher than comparable systems (for example, two-to-four times greater than RxJava), and (3) the approximation algorithms supported by our implementation can lead to substantial memory savings.

Risk factors associated with multi-drug-resistant Acinetobacter baumannii nosocomial infections at a tertiary care hospital in Makkah, Saudi Arabia - a matched case–control study

Science.gov (United States)

Al-Gethamy, Manal M; Faidah, Hani S; Adetunji, Hamed Ademola; Ashgar, Sami S; Mohanned, Tayeb K; Mohammed, Al-Haj; Khurram, Muhammad; Hassali, Mohamed A

2017-01-01

Objective To determine risk factors for multi-drug-resistant Acinetobacter baumannii (MDR-AB) nosocomial infections in intensive care units in a tertiary care hospital, Makkah, Saudi Arabia. Methods We performed a hospital-based, matched case–control study in patients who were admitted to Al Noor Specialist Hospital between 1 January 2012 and 31 August 2012. The study included cases of A. baumannii nosocomial infection and controls without infection. Controls were matched to cases by age and ward of admission. Results The most frequent site of infection was the respiratory tract (77.3%). Susceptibility to antimicrobial MDR-AB was 92.0% for ceftazidime and ciprofloxacin, while it was 83.3% for imipenem, 83.0% for trimethoprim, 79.0% for amikacin, and 72.7% for gentamicin. Multiple logistic regression of risk factors showed that immunosuppression (OR = 2.9; 95% CI 1.5–5.6; p = 0.002), clinical outcome (OR = 0.4; 95% CI 0.3–0.9; p = 0.01), invasive procedures (OR = 7.9; 95% CI 1.8–34.2; p = 0.002), a central venous catheter (OR = 2.9; 95% CI 1.5–5.6; p = 0.000), and an endotracheal tube (OR = 3.4; 95% CI 1.6–7.3; p = 0.001) were associated with MDR-AB. Conclusions Acinetobacter nosocomial infections are associated with admission to the ICU (Intensive care unit) and exposure to invasive procedures. PMID:28480813

Productivity of Stream Definitions

NARCIS (Netherlands)

Endrullis, Jörg; Grabmayer, Clemens; Hendriks, Dimitri; Isihara, Ariya; Klop, Jan

2007-01-01

We give an algorithm for deciding productivity of a large and natural class of recursive stream definitions. A stream definition is called ‘productive’ if it can be evaluated continuously in such a way that a uniquely determined stream is obtained as the limit. Whereas productivity is undecidable

Productivity of stream definitions

NARCIS (Netherlands)

Endrullis, J.; Grabmayer, C.A.; Hendriks, D.; Isihara, A.; Klop, J.W.

2008-01-01

We give an algorithm for deciding productivity of a large and natural class of recursive stream definitions. A stream definition is called ‘productive’ if it can be evaluated continually in such a way that a uniquely determined stream in constructor normal form is obtained as the limit. Whereas

Frequency and antibiotic resistance patterns of isolated bacteria from positive blood culture of hospitalized patients

Directory of Open Access Journals (Sweden)

Azadeh Vahedi

2018-03-01

Conclusion: The most prevalent bacterial isolate among the blood cultures of patients was Pseudomonas. The patients more than 50 years were more susceptible to blood stream infections. The most bacteria were isolated from the internal medicine department of hospital. The antibiotic resistance was also increasing especially in Acinetobacter, Staphylococcus coagulase negative, Escherichia coil and Klebsiella

Correlation of compliance with central line associated blood stream infection guidelines and outcomes: a review of the evidence

Directory of Open Access Journals (Sweden)

Gerkin R

2012-05-01

Full Text Available Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 8 Institute of Health Care (IHI guidelines for prevention of central line associated blood stream infection (CLABSI. Quality of evidence was assessed by the American Thoracic Society (ATS levels of evidence (levels I through III. We also examined data from our intensive care units (ICUs for evidence of a correlation between guideline compliance and the development of VAP.Results None of the guidelines was graded at level I. Two of the guidelines were graded at level II and the remaining 6 at level III. Despite the lack of evidence, 2 of the guidelines (hand hygiene, sterile gloves were given a strong recommendation. Chlorhexidine and use of nonfemoral sites were given a moderate recommendation. In our ICUs compliance with the use of chlorhexidine correlated with a reduction in CLABSI (p<0.02 but the remainder did not.Conclusions The IHI CLABSI guidelines are based on level II or III evidence. Data from our ICUs supported the use of chlorhexidine in reducing CLABSI. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current IHI guidelines to direct patient care decisions or as an assessment of the quality of care.

Streams and their future inhabitants

DEFF Research Database (Denmark)

Sand-Jensen, K.; Friberg, Nikolai

2006-01-01

In this fi nal chapter we look ahead and address four questions: How do we improve stream management? What are the likely developments in the biological quality of streams? In which areas is knowledge on stream ecology insuffi cient? What can streams offer children of today and adults of tomorrow?...

Salamander occupancy in headwater stream networks

Science.gov (United States)

Grant, E.H.C.; Green, L.E.; Lowe, W.H.

2009-01-01

1. Stream ecosystems exhibit a highly consistent dendritic geometry in which linear habitat units intersect to create a hierarchical network of connected branches. 2. Ecological and life history traits of species living in streams, such as the potential for overland movement, may interact with this architecture to shape patterns of occupancy and response to disturbance. Specifically, large-scale habitat alteration that fragments stream networks and reduces connectivity may reduce the probability a stream is occupied by sensitive species, such as stream salamanders. 3. We collected habitat occupancy data on four species of stream salamanders in first-order (i.e. headwater) streams in undeveloped and urbanised regions of the eastern U.S.A. We then used an information-theoretic approach to test alternative models of salamander occupancy based on a priori predictions of the effects of network configuration, region and salamander life history. 4. Across all four species, we found that streams connected to other first-order streams had higher occupancy than those flowing directly into larger streams and rivers. For three of the four species, occupancy was lower in the urbanised region than in the undeveloped region. 5. These results demonstrate that the spatial configuration of stream networks within protected areas affects the occurrences of stream salamander species. We strongly encourage preservation of network connections between first-order streams in conservation planning and management decisions that may affect stream species.

Clinical significance of detection of serum markers of several viral infections in hospitalized patients before blood exposure

International Nuclear Information System (INIS)

Hong Kai; Chen Linxing; Chen Yichang; Ding Yingshu

2005-01-01

Objective: To explore the desirability of setting a routine of test for detection of the serum markers of several viral infections hospitalized patients before anticipated blood exposure. Methods: Serum levels of five HBV markers, anti-HCV, anti-HIV (with ELISA) and ALT were determined in 214 hospitalized patients before forthcoming blood exposure as well as in 2468 controls. Results: The positive rate of each of the above-mentioned markers in the patients was: HBsAg 15.2% (397/2614), HBcAb- IgG 72.5% (1895/2614), anti-HCV 3.91% (102/2614), anti- HIV 0.08% (2/2614) and ALT level was above 40 u in 8.7% of the patients (227/2614). Each of the positive rate was significantly higher than that in the controls. Conclusion: There is a substantial portion of subjects harboring viral infections in the hospitalized patients. It is imperative to have these patients identified before blood exposure so that proper cautions can be taken and preventive measures implemented to minimize possible nosocomial as well as patients-to-staff infections. Moreover, any potential legal problems can also be appropriately dealt with. (authors)

Intravascular streaming and variable delivery to brain following carotid artery infusions in the Sprague-Dawley rat

International Nuclear Information System (INIS)

Saris, S.C.; Wright, D.C.; Oldfield, E.H.; Blasberg, R.G.

1988-01-01

Intracarotid artery infusions in animals are commonly performed in studies of the blood-brain barrier and in chemotherapy trials. Implicit in the analysis of these experiments is that the infusate will be distributed to the territory of the internal carotid artery in a manner that is proportional to blood flow. Fifteen Sprague-Dawley rats were studied to determine if poor infusate mixing with blood due to intravascular streaming occurred during intracarotid artery drug infusions and if it could be eliminated with fast retrograde infusion. In three experimental groups, a radiolabeled flow tracer-- 14 C-iodoantipyrine (IAP)--was infused retrograde through the external carotid artery into the common carotid artery at slow, medium, and fast rates (0.45, 1.5, and 5.0 ml/min). In a control group, IAP was injected intravenously (i.v.). Local isotope concentrations in the brain were determined by quantitative autoradiography, and the variability of isotope delivery was assessed in the frontoparietal cortex, temporal cortex, and caudate putamen of all animals. Streaming phenomena were manifest in all selected anatomic areas after the slow and medium rates of intraarterial infusion. After fast intracarotid infusion or i.v. injection, there was uniform distribution of isotope in the same brain regions

Investigating category- and shape-selective neural processing in ventral and dorsal visual stream under interocular suppression.

Science.gov (United States)

Ludwig, Karin; Kathmann, Norbert; Sterzer, Philipp; Hesselmann, Guido

2015-01-01

Recent behavioral and neuroimaging studies using continuous flash suppression (CFS) have suggested that action-related processing in the dorsal visual stream might be independent of perceptual awareness, in line with the "vision-for-perception" versus "vision-for-action" distinction of the influential dual-stream theory. It remains controversial if evidence suggesting exclusive dorsal stream processing of tool stimuli under CFS can be explained by their elongated shape alone or by action-relevant category representations in dorsal visual cortex. To approach this question, we investigated category- and shape-selective functional magnetic resonance imaging-blood-oxygen level-dependent responses in both visual streams using images of faces and tools. Multivariate pattern analysis showed enhanced decoding of elongated relative to non-elongated tools, both in the ventral and dorsal visual stream. The second aim of our study was to investigate whether the depth of interocular suppression might differentially affect processing in dorsal and ventral areas. However, parametric modulation of suppression depth by varying the CFS mask contrast did not yield any evidence for differential modulation of category-selective activity. Together, our data provide evidence for shape-selective processing under CFS in both dorsal and ventral stream areas and, therefore, do not support the notion that dorsal "vision-for-action" processing is exclusively preserved under interocular suppression. © 2014 Wiley Periodicals, Inc.

Stream hydraulics and temperature determine the metabolism of geothermal Icelandic streams

Directory of Open Access Journals (Sweden)

Demars B. O.L.

2011-07-01

Full Text Available Stream ecosystem metabolism plays a critical role in planetary biogeochemical cycling. Stream benthic habitat complexity and the available surface area for microbes relative to the free-flowing water volume are thought to be important determinants of ecosystem metabolism. Unfortunately, the engineered deepening and straightening of streams for drainage purposes could compromise stream natural services. Stream channel complexity may be quantitatively expressed with hydraulic parameters such as water transient storage, storage residence time, and water spiralling length. The temperature dependence of whole stream ecosystem respiration (ER, gross primary productivity (GPP and net ecosystem production (NEP = GPP − ER has recently been evaluated with a “natural experiment” in Icelandic geothermal streams along a 5–25 °C temperature gradient. There remained, however, a substantial amount of unexplained variability in the statistical models, which may be explained by hydraulic parameters found to be unrelated to temperature. We also specifically tested the additional and predicted synergistic effects of water transient storage and temperature on ER, using novel, more accurate, methods. Both ER and GPP were highly related to water transient storage (or water spiralling length but not to the storage residence time. While there was an additional effect of water transient storage and temperature on ER (r2 = 0.57; P = 0.015, GPP was more related to water transient storage than temperature. The predicted synergistic effect could not be confirmed, most likely due to data limitation. Our interpretation, based on causal statistical modelling, is that the metabolic balance of streams (NEP was primarily determined by the temperature dependence of respiration. Further field and experimental work is required to test the predicted synergistic effect on ER. Meanwhile, since higher metabolic activities allow for higher pollutant degradation or uptake

The changing pattern of antimicrobial resistance within 42,033 Escherichia coli isolates from nosocomial, community and urology patient-specific urinary tract infections, Dublin, 1999-2009.

LENUS (Irish Health Repository)

Cullen, Ivor M

2012-04-01

To investigate the changing pattern of antimicrobial resistance in Escherichia coli urinary tract infection over an eleven year period, and to determine whether E. coli antibiotic resistance rates vary depending on whether the UTI represents a nosocomial, community acquired or urology patient specific infection.

Nitrogen saturation in stream ecosystems.

Science.gov (United States)

Earl, Stevan R; Valett, H Maurice; Webster, Jackson R

2006-12-01

The concept of nitrogen (N) saturation has organized the assessment of N loading in terrestrial ecosystems. Here we extend the concept to lotic ecosystems by coupling Michaelis-Menten kinetics and nutrient spiraling. We propose a series of saturation response types, which may be used to characterize the proximity of streams to N saturation. We conducted a series of short-term N releases using a tracer (15NO3-N) to measure uptake. Experiments were conducted in streams spanning a gradient of background N concentration. Uptake increased in four of six streams as NO3-N was incrementally elevated, indicating that these streams were not saturated. Uptake generally corresponded to Michaelis-Menten kinetics but deviated from the model in two streams where some other growth-critical factor may have been limiting. Proximity to saturation was correlated to background N concentration but was better predicted by the ratio of dissolved inorganic N (DIN) to soluble reactive phosphorus (SRP), suggesting phosphorus limitation in several high-N streams. Uptake velocity, a reflection of uptake efficiency, declined nonlinearly with increasing N amendment in all streams. At the same time, uptake velocity was highest in the low-N streams. Our conceptual model of N transport, uptake, and uptake efficiency suggests that, while streams may be active sites of N uptake on the landscape, N saturation contributes to nonlinear changes in stream N dynamics that correspond to decreased uptake efficiency.

Percent Forest Adjacent to Streams

Data.gov (United States)

U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

Percent Agriculture Adjacent to Streams

Data.gov (United States)

U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

Nutritional status and nosocomial infections among adult elective surgery patients in a Mexican tertiary care hospital.

Directory of Open Access Journals (Sweden)

Judith Rodríguez-García

Full Text Available Controversy exists as to whether obesity constitutes a risk-factor or a protective-factor for the development of nosocomial Infection (NI. According to the obesity-paradox, there is evidence that moderate obesity is a protective-factor. In Mexico few studies have focused on the nutritional status (NS distribution in the hospital setting.The aim of this study was to estimate the distribution of NS and the prevalence of nosocomial infection NI among adult elective surgery (ES patients and to compare the clinical and anthropometric characteristics and length of stays (LOS between obese and non-obese patients and between patients with and without NI.We conducted a cross-sectional study with a sample (n = 82 adult ES patients (21-59 years old who were recruited from a tertiary-care hospital. The prevalences of each NS category and NI were estimated, the assessments were compared between groups (Mann-Whitney, Chi-squared or the Fisher's-exact-test, and the association between preoperative risk-factors and NI was evaluated using odds ratios.The distribution of subjects by NS category was: underweight (3.66%, normal-weight (28.05%, overweight (35.36%, and obese (32.93%. The prevalence of NI was 14.63%. The LOS was longer (p<0.001 for the patients who developed NI. The percentages of NI were: 33.3% in underweight, 18.52% in obese, 17.39% in normal-weight, and 6.90% in overweight patients.The prevalence of overweight and obesity in adult ES patients is high. The highest prevalence of NI occurred in the underweight and obese patients. The presence of NI considerably increased the LOS, resulting in higher medical care costs.

Organizational culture, team climate, and quality management in an important patient safety issue: nosocomial pressure ulcers.

Science.gov (United States)

Bosch, Marije; Halfens, Ruud J G; van der Weijden, Trudy; Wensing, Michel; Akkermans, Reinier; Grol, Richard

2011-03-01

Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score ≤ 18) and preventive quality management at ward level. No associations were found between organizational culture, team climate, or preventive quality management at the ward level and the prevalence of nosocomial pressure ulcers. Institutional quality management was positively correlated with preventive quality management at ward level (adj. β 0.32; p organizational culture, team climate, or preventive quality management at the ward level. These results would therefore not subscribe the widely suggested importance of these factors in improving health care. However, different designs and research methods (that go beyond the cross-sectional design) may be more informative in studying relations between such complex factors and outcomes in a more meaningful way. Copyright ©2010 Sigma Theta Tau International.

Nosocomial infections in hospitalized patients in the burn unit of Hospital Universitario San José, Popayán - Colombia

Directory of Open Access Journals (Sweden)

Yeni Arroyave

2014-08-01

Full Text Available Objective. To determine the prevalence and microbiological behavior of the infections in hospitalized patients in the burn unit of the University Hospital San José ( HUSJ at Popayan, Colombia, 2010-2011. Methods: A retrospective cross-sectional study was conducted in patients admitted to the burn unit of HUSJ between the years 2010–2011. Patients were characterized sociodemographic and clinically. The prevalence of nosocomial infections was estimated. Frequency and antibiotic resistance of microorganisms isolated was described. Data were analyzed using SPSS version 15. Results. 113 patients was enrolled, the average age was 17.7 years and male gender predominated (55.8%. Hot liquids (64.6% were the principal cause, the average of body surface area burned was 11.3% and the average hospital stay was 19.8 days. 13.3% of the patients had some nosocomial infection. The most frequently diagnosed infections were sepsis (24%, urinary tract infection (20% and pneumonia (20%. Staphylococcus aureus was the most frequent bacteria (41.7% followed by Staphylococcus epidermidis, mostly meticilino-resistant. The mean length of hospital stay and burned surface area (BSA in patients with diagnosis of infection was 36.6 days and 17.3% respectively. Conclusions. The prevalence of infection is similar to that reported in Colombia. The resistance of the isolates was high. The meticilinoresistance of Staphylococcus was associated with clindamicina resistance.

Assessing the nosocomial infections' rate and the antibiotic resistance pattern among the patient hospitalized in beheshti hospital during 2013

Directory of Open Access Journals (Sweden)

Manijeh Kadkhodaei

2018-01-01

Full Text Available Aims: Nosocomial infection is associated with increased mortality, morbidity, and length of stay. Detection of infection, identify the etiology of bacterial antibiotic resistance pattern, is necessary given the widespread use of antibiotics and antibiotic-resistant organisms. Materials and Methods: This cross-sectional study was done on 288 patients admitted to the Beheshti Hospitals in Kashan based on NNIS definitions according to the state of Health and Medical education. In this study infections and antibiotic resistance symptoms were found. Data analyses were performed with Chi-square test. Results: Among the 288 patients studied, with mean out of hospital infection was 0.80%. Most cases of infection associated were pneumonia. The highest rates of infection were in the Intensive Care Unit (ICU with 51.7%. Nosocomial infection in ICU wards was associated with increased mortality and morbidity. The most common types were ventilator-associated pneumonia. Among the microorganisms, negative Gram was seen more. The common pathogens were including Acinetobacter, Escherichia coli, and Klebsiella. Antimicrobial resistance was generally increasing and had emerged from selective pressure from antibiotic use and transmission through health staff. Conclusion: This study showed a correlation between antibiotic use and resistance of microorganisms is significant. Hence, it seems that reducing aggressive acts and conduct hygiene education and monitoring act of antibiotics is necessary to prevent antibiotic resistance.

Morphology of a Wetland Stream

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Jurmu; Andrle

1997-11-01

/ Little attention has been paid to wetland stream morphology in the geomorphological and environmental literature, and in the recently expanding wetland reconstruction field, stream design has been based primarily on stream morphologies typical of nonwetland alluvial environments. Field investigation of a wetland reach of Roaring Brook, Stafford, Connecticut, USA, revealed several significant differences between the morphology of this stream and the typical morphology of nonwetland alluvial streams. Six morphological features of the study reach were examined: bankfull flow, meanders, pools and riffles, thalweg location, straight reaches, and cross-sectional shape. It was found that bankfull flow definitions originating from streams in nonwetland environments did not apply. Unusual features observed in the wetland reach include tight bends and a large axial wavelength to width ratio. A lengthy straight reach exists that exceeds what is typically found in nonwetland alluvial streams. The lack of convex bank point bars in the bends, a greater channel width at riffle locations, an unusual thalweg location, and small form ratios (a deep and narrow channel) were also differences identified. Further study is needed on wetland streams of various regions to determine if differences in morphology between alluvial and wetland environments can be applied in order to improve future designs of wetland channels.KEY WORDS: Stream morphology; Wetland restoration; Wetland creation; Bankfull; Pools and riffles; Meanders; Thalweg

Dynamical modeling of tidal streams

International Nuclear Information System (INIS)

Bovy, Jo

2014-01-01

I present a new framework for modeling the dynamics of tidal streams. The framework consists of simple models for the initial action-angle distribution of tidal debris, which can be straightforwardly evolved forward in time. Taking advantage of the essentially one-dimensional nature of tidal streams, the transformation to position-velocity coordinates can be linearized and interpolated near a small number of points along the stream, thus allowing for efficient computations of a stream's properties in observable quantities. I illustrate how to calculate the stream's average location (its 'track') in different coordinate systems, how to quickly estimate the dispersion around its track, and how to draw mock stream data. As a generative model, this framework allows one to compute the full probability distribution function and marginalize over or condition it on certain phase-space dimensions as well as convolve it with observational uncertainties. This will be instrumental in proper data analysis of stream data. In addition to providing a computationally efficient practical tool for modeling the dynamics of tidal streams, the action-angle nature of the framework helps elucidate how the observed width of the stream relates to the velocity dispersion or mass of the progenitor, and how the progenitors of 'orphan' streams could be located. The practical usefulness of the proposed framework crucially depends on the ability to calculate action-angle variables for any orbit in any gravitational potential. A novel method for calculating actions, frequencies, and angles in any static potential using a single orbit integration is described in the Appendix.

Human impacts to mountain streams

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Wohl, Ellen

2006-09-01

Mountain streams are here defined as channel networks within mountainous regions of the world. This definition encompasses tremendous diversity of physical and biological conditions, as well as history of land use. Human effects on mountain streams may result from activities undertaken within the stream channel that directly alter channel geometry, the dynamics of water and sediment movement, contaminants in the stream, or aquatic and riparian communities. Examples include channelization, construction of grade-control structures or check dams, removal of beavers, and placer mining. Human effects can also result from activities within the watershed that indirectly affect streams by altering the movement of water, sediment, and contaminants into the channel. Deforestation, cropping, grazing, land drainage, and urbanization are among the land uses that indirectly alter stream processes. An overview of the relative intensity of human impacts to mountain streams is provided by a table summarizing human effects on each of the major mountainous regions with respect to five categories: flow regulation, biotic integrity, water pollution, channel alteration, and land use. This table indicates that very few mountains have streams not at least moderately affected by land use. The least affected mountainous regions are those at very high or very low latitudes, although our scientific ignorance of conditions in low-latitude mountains in particular means that streams in these mountains might be more altered than is widely recognized. Four case studies from northern Sweden (arctic region), Colorado Front Range (semiarid temperate region), Swiss Alps (humid temperate region), and Papua New Guinea (humid tropics) are also used to explore in detail the history and effects on rivers of human activities in mountainous regions. The overview and case studies indicate that mountain streams must be managed with particular attention to upstream/downstream connections, hillslope

Decontamination Efficacy of Ultraviolet Radiation against Biofilms of Common Nosocomial Bacteria.

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Tingpej, Pholawat; Tiengtip, Rattana; Kondo, Sumalee

2015-06-01

Ultraviolet radiation (UV) is commonly used to destroy microorganisms in the health-care environment. However, the efficacy of UV radiation against bacteria growing within biofilms has never been studied. To measure the sterilization effectiveness of UV radiation against common healthcare associated pathogens growing within biofilms. Staphylococcus aureus, Methicillin-resistant S. aureus (MRSA), Streptococcus epidermidis, Escherichia coli, ESBL-producing E. coli, Pseudomonas aeruginosa and Acinetobacter baumannii were cultivated in the Calgary Biofilm Device. Their biofilms were placed 50 cm from the UV lamp within the Biosafety Cabinet. Viability test, crystal violet assay and a scanning electron microscope were used to evaluate the germicidal efficacy. Within 5 minutes, UV radiation could kill S. aureus, MRSA, S. epidermidis, A. baumannii and ESBL-producing E. coli completely while it required 20 minutes and 30 minutes respectively to kill E. coli and P. aeruginosa. However, the amounts of biomass and the ultrastructure between UV-exposed biofilms and controls were not significantly different. UV radiation is effective in inactivating nosocomial pathogens grown within biofilms, but not removing biofilms and EPS. The biofilm of P. aeruginosa was the most durable.

How and Why Does Stream Water Temperature Vary at Small Spatial Scales in a Headwater Stream?

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Morgan, J. C.; Gannon, J. P.; Kelleher, C.

2017-12-01

The temperature of stream water is controlled by climatic variables, runoff/baseflow generation, and hyporheic exchange. Hydrologic conditions such as gaining/losing reaches and sources of inflow can vary dramatically along a stream on a small spatial scale. In this work, we attempt to discern the extent that the factors of air temperature, groundwater inflow, and precipitation influence stream temperature at small spatial scales along the length of a stream. To address this question, we measured stream temperature along the perennial stream network in a 43 ha catchment with a complex land use history in Cullowhee, NC. Two water temperature sensors were placed along the stream network on opposite sides of the stream at 100-meter intervals and at several locations of interest (i.e. stream junctions). The forty total sensors recorded the temperature every 10 minutes for one month in the spring and one month in the summer. A subset of sampling locations where stream temperature was consistent or varied from one side of the stream to the other were explored with a thermal imaging camera to obtain a more detailed representation of the spatial variation in temperature at those sites. These thermal surveys were compared with descriptions of the contributing area at the sample sites in an effort to discern specific causes of differing flow paths. Preliminary results suggest that on some branches of the stream stormflow has less influence than regular hyporheic exchange, while other tributaries can change dramatically with stormflow conditions. We anticipate this work will lead to a better understanding of temperature patterns in stream water networks. A better understanding of the importance of small-scale differences in flow paths to water temperature may be able to inform watershed management decisions in the future.

Stream Deniable-Encryption Algorithms

Directory of Open Access Journals (Sweden)

N.A. Moldovyan

2016-04-01

Full Text Available A method for stream deniable encryption of secret message is proposed, which is computationally indistinguishable from the probabilistic encryption of some fake message. The method uses generation of two key streams with some secure block cipher. One of the key streams is generated depending on the secret key and the other one is generated depending on the fake key. The key streams are mixed with the secret and fake data streams so that the output ciphertext looks like the ciphertext produced by some probabilistic encryption algorithm applied to the fake message, while using the fake key. When the receiver or/and sender of the ciphertext are coerced to open the encryption key and the source message, they open the fake key and the fake message. To disclose their lie the coercer should demonstrate possibility of the alternative decryption of the ciphertext, however this is a computationally hard problem.

CAMS: OLAPing Multidimensional Data Streams Efficiently

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Cuzzocrea, Alfredo

In the context of data stream research, taming the multidimensionality of real-life data streams in order to efficiently support OLAP analysis/mining tasks is a critical challenge. Inspired by this fundamental motivation, in this paper we introduce CAMS (C ube-based A cquisition model for M ultidimensional S treams), a model for efficiently OLAPing multidimensional data streams. CAMS combines a set of data stream processing methodologies, namely (i) the OLAP dimension flattening process, which allows us to obtain dimensionality reduction of multidimensional data streams, and (ii) the OLAP stream aggregation scheme, which aggregates data stream readings according to an OLAP-hierarchy-based membership approach. We complete our analytical contribution by means of experimental assessment and analysis of both the efficiency and the scalability of OLAPing capabilities of CAMS on synthetic multidimensional data streams. Both analytical and experimental results clearly connote CAMS as an enabling component for next-generation Data Stream Management Systems.

Three-dimensional model of corotating streams in the solar wind 3. Magnetohydrodynamic streams

International Nuclear Information System (INIS)

Pizzo, V.J.

1982-01-01

The focus of this paper is two-fold: (1) to examine how the presence of the spiral magnetic field affects the evolution of interplanetary corotating solar wind streams, and (2) to ascertain the nature of secondary large-scale phenomena likely to be associated with streams having a pronounced three-dimensional (3-D) structure. The dynamics are presumed to be governed by the nonlinear polytropic, single-fluid, 3-D MHD equations. Solutions are obtained with an explicit, Eulerian, finite differences technique that makes use of a simple form of artificial diffusion for handling shocks. For smooth axisymmetric flows, the picture of magnetically induced meridional motions previously established by linear models requires only minor correction. In the case of broad 3-D streams input near the sun, inclusion of the magnetic field is found to retard the kinematic steepening at the stream front substantially but to produce little deviation from planar flow. For the more realistic case of initially sharply bounded streams, however, it becomes essential to account for magnetic effects in the formulation. Whether a full 3-D treatment is required depends upon the latitudinal geometry of the stream

Cytoplasmic Streaming in the Drosophila Oocyte.

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Quinlan, Margot E

2016-10-06

Objects are commonly moved within the cell by either passive diffusion or active directed transport. A third possibility is advection, in which objects within the cytoplasm are moved with the flow of the cytoplasm. Bulk movement of the cytoplasm, or streaming, as required for advection, is more common in large cells than in small cells. For example, streaming is observed in elongated plant cells and the oocytes of several species. In the Drosophila oocyte, two stages of streaming are observed: relatively slow streaming during mid-oogenesis and streaming that is approximately ten times faster during late oogenesis. These flows are implicated in two processes: polarity establishment and mixing. In this review, I discuss the underlying mechanism of streaming, how slow and fast streaming are differentiated, and what we know about the physiological roles of the two types of streaming.

The role of patient isolation and compliance with isolation practices in the control of nosocomial MRSA in acute care.

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Halcomb, Elizabeth J; Griffiths, Rhonda; Fernandez, Ritin

2008-06-01

Background  Nosocomial infection remains the most common complication of hospitalisation. Despite infection control efforts, nosocomial methicillin resistant Staphylococcus aureus (MRSA) transmission continues to rise. Various isolation practices are used to minimise MRSA transmission in acute care. However, the effectiveness of these practices has seldom been evaluated. Objectives  This review sought to evaluate the efficacy of isolation practices in minimising MRSA transmission in the acute hospital setting and explore staff, visitor and patient compliance with isolation practices. This review updates a review published in 2002. Search strategy  A systematic search for relevant published or unpublished English language literature was undertaken using electronic databases, the reference lists of retrieved papers and the Internet. This extended the search published in the original review. Databases searched included: Medline, CINAHL, EMBASE, Cochrane Library and Joanna Briggs Institute Evidence Library. Selection criteria  All English language research reports published between 1990 and August 2005 that focused on the role of isolation practices on the nosocomial transmission of MRSA in adult, paediatric or neonatal acute care settings were eligible for inclusion in the review. Studies that evaluated multiple infection control strategies or control of MRSA outbreaks were excluded. The main outcome of interest was the incidence of new cases of MRSA. The secondary outcome was staff, visitor and patient compliance with the isolation practices. Data collection and analysis  Two reviewers assessed each paper against the inclusion criteria and a validated quality scale. Data extraction was undertaken using a tool designed specifically for this review. Statistical comparisons of findings were not possible, so findings are presented in a narrative form. Results  Seven studies met the inclusion criteria. Given the small number of included studies and variable

In-stream Physical Heterogeneity, Rainfall Aided Flushing, and Discharge on Stream Water Quality.

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Gomes, Pattiyage I A; Wai, Onyx W H

2015-08-01

Implications of instream physical heterogeneity, rainfall-aided flushing, and stream discharge on water quality control have been investigated in a headwater stream of a climatic region that has contrasting dry and wet seasons. Dry (low flow) season's physical heterogeneity showed a positive correlation with good water quality. However, in the wet season, physical heterogeneity showed minor or no significance on water quality variations. Furthermore, physical heterogeneity appeared to be more complementary with good water quality subsequent to rainfall events. In many cases stream discharge was a reason for poor water quality. For the dry season, graywater inputs to the stream could be held responsible. In the wet season, it was probably the result of catchment level disturbances (e.g., regulation of ephemeral freshwater paths). Overall, this study revealed the importance of catchment-based approaches on water quality improvement in tandem with in-stream approaches framed on a temporal scale.

Stream II-V5: Revision Of Stream II-V4 To Account For The Effects Of Rainfall Events

International Nuclear Information System (INIS)

Chen, K.

2010-01-01

STREAM II-V4 is the aqueous transport module currently used by the Savannah River Site emergency response Weather Information Display (WIND) system. The transport model of the Water Quality Analysis Simulation Program (WASP) was used by STREAM II to perform contaminant transport calculations. WASP5 is a US Environmental Protection Agency (EPA) water quality analysis program that simulates contaminant transport and fate through surface water. STREAM II-V4 predicts peak concentration and peak concentration arrival time at downstream locations for releases from the SRS facilities to the Savannah River. The input flows for STREAM II-V4 are derived from the historical flow records measured by the United States Geological Survey (USGS). The stream flow for STREAM II-V4 is fixed and the flow only varies with the month in which the releases are taking place. Therefore, the effects of flow surge due to a severe storm are not accounted for by STREAM II-V4. STREAM II-V4 has been revised to account for the effects of a storm event. The steps used in this method are: (1) generate rainfall hyetographs as a function of total rainfall in inches (or millimeters) and rainfall duration in hours; (2) generate watershed runoff flow based on the rainfall hyetographs from step 1; (3) calculate the variation of stream segment volume (cross section) as a function of flow from step 2; (4) implement the results from steps 2 and 3 into the STREAM II model. The revised model (STREAM II-V5) will find the proper stream inlet flow based on the total rainfall and rainfall duration as input by the user. STREAM II-V5 adjusts the stream segment volumes (cross sections) based on the stream inlet flow. The rainfall based stream flow and the adjusted stream segment volumes are then used for contaminant transport calculations.

Stream Clustering of Growing Objects

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Siddiqui, Zaigham Faraz; Spiliopoulou, Myra

We study incremental clustering of objects that grow and accumulate over time. The objects come from a multi-table stream e.g. streams of Customer and Transaction. As the Transactions stream accumulates, the Customers’ profiles grow. First, we use an incremental propositionalisation to convert the multi-table stream into a single-table stream upon which we apply clustering. For this purpose, we develop an online version of K-Means algorithm that can handle these swelling objects and any new objects that arrive. The algorithm also monitors the quality of the model and performs re-clustering when it deteriorates. We evaluate our method on the PKDD Challenge 1999 dataset.

LHCb trigger streams optimization

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Derkach, D.; Kazeev, N.; Neychev, R.; Panin, A.; Trofimov, I.; Ustyuzhanin, A.; Vesterinen, M.

2017-10-01

The LHCb experiment stores around 1011 collision events per year. A typical physics analysis deals with a final sample of up to 107 events. Event preselection algorithms (lines) are used for data reduction. Since the data are stored in a format that requires sequential access, the lines are grouped into several output file streams, in order to increase the efficiency of user analysis jobs that read these data. The scheme efficiency heavily depends on the stream composition. By putting similar lines together and balancing the stream sizes it is possible to reduce the overhead. We present a method for finding an optimal stream composition. The method is applied to a part of the LHCb data (Turbo stream) on the stage where it is prepared for user physics analysis. This results in an expected improvement of 15% in the speed of user analysis jobs, and will be applied on data to be recorded in 2017.

Trapping of Embolic Particles in a Vessel Phantom by Cavitation-Enhanced Acoustic Streaming

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Maxwell, Adam D.; Park, Simone; Vaughan, Benjamin L.; Cain, Charles A.; Grotberg, James B.; Xu, Zhen

2014-01-01

Cavitation clouds generated by short, high-amplitude, focused ultrasound pulses were previously observed to attract, trap, and erode thrombus fragments in a vessel phantom. This phenomenon may offer a noninvasive method to capture and eliminate embolic fragments flowing through the bloodstream during a cardiovascular intervention. In this article, the mechanism of embolus trapping was explored by particle image velocimetry (PIV). PIV was used to examine the fluid streaming patterns generated by ultrasound in a vessel phantom with and without crossflow of blood-mimicking fluid. Cavitation enhanced streaming, which generated fluid vortices adjacent to the focus. The focal streaming velocity, uf, was as high as 120 cm/s, while mean crossflow velocities, uc, were imposed up to 14 cm/s. When a solid particle 3-4 mm diameter was introduced into crossflow, it was trapped near the focus. Increasing uf promoted particle trapping while increasing uc promoted particle escape. The maximum crossflow Reynolds number at which particles could be trapped, Rec, was approximately linear with focal streaming number, Ref, i.e. Rec = 0.25Ref + 67.44 (R2=0.76) corresponding to dimensional velocities uc=0.084uf + 3.122 for 20 < uf < 120 cm/s. The fluidic pressure map was estimated from PIV and indicated a negative pressure gradient towards the focus, trapping the embolus near this location. PMID:25109407

The ventral stream offers more affordance and the dorsal stream more memory than believed

NARCIS (Netherlands)

Postma, Albert; van der Lubbe, Robert Henricus Johannes; Zuidhoek, Sander

2002-01-01

Opposed to Norman's proposal, processing of affordance is likely to occur not solely in the dorsal stream but also in the ventral stream. Moreover, the dorsal stream might do more than just serve an important role in motor actions. It supports egocentric location coding as well. As such, it would

The role of remediation, natural alkalinity sources and physical stream parameters in stream recovery.

Science.gov (United States)

Kruse, Natalie A; DeRose, Lisa; Korenowsky, Rebekah; Bowman, Jennifer R; Lopez, Dina; Johnson, Kelly; Rankin, Edward

2013-10-15

Acid mine drainage (AMD) negatively impacts not only stream chemistry, but also aquatic biology. The ultimate goal of AMD treatment is restoration of the biological community, but that goal is rarely explicit in treatment system design. Hewett Fork in Raccoon Creek Watershed, Ohio, has been impacted by historic coal mining and has been treated with a calcium oxide doser in the headwaters of the watershed since 2004. All of the acidic inputs are isolated to a 1.5 km stretch of stream in the headwaters of the Hewett Fork watershed. The macroinvertebrate and fish communities have begun to recover and it is possible to distinguish three zones downstream of the doser: an impaired zone, a transition zone and a recovered zone. Alkalinity from both the doser and natural sources and physical stream parameters play a role in stream restoration. In Hewett Fork, natural alkaline additions downstream are higher than those from the doser. Both, alkaline additions and stream velocity drive sediment and metal deposition. Metal deposition occurs in several patterns; aluminum tends to deposit in regions of low stream velocity, while iron tends to deposit once sufficient alkalinity is added to the system downstream of mining inputs. The majority of metal deposition occurs upstream of the recovered zone. Both the physical stream parameters and natural alkalinity sources influence biological recovery in treated AMD streams and should be considered in remediation plans. Copyright © 2013 Elsevier Ltd. All rights reserved.

The long term response of stream flow to climatic warming in headwater streams of interior Alaska

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Jeremy B. Jones; Amanda J. Rinehart

2010-01-01

Warming in the boreal forest of interior Alaska will have fundamental impacts on stream ecosystems through changes in stream hydrology resulting from upslope loss of permafrost, alteration of availability of soil moisture, and the distribution of vegetation. We examined stream flow in three headwater streams of the Caribou-Poker Creeks Research Watershed (CPCRW) in...

Evaluation of antibacterial efficacy of phyto fabricated silver nanoparticles using Mukia scabrella (Musumusukkai) against drug resistance nosocomial gram negative bacterial pathogens.

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Prabakar, Kandasamy; Sivalingam, Periyasamy; Mohamed Rabeek, Siyed Ibrahim; Muthuselvam, Manickam; Devarajan, Naresh; Arjunan, Annavi; Karthick, Rajamanickam; Suresh, Micky Maray; Wembonyama, John Pote

2013-04-01

Given the fact in the limitation of the therapeutic options for emerging multidrug resistance gram-negative bacteria (MDR-GNB) of respiratory tract infections, the present study was focused on green synthesis of antimicrobial silver nanoparticles (AgNPs) using leaf extract of Mukia scabrella. An obvious color change to brown color and surface plasmon resonance by UV-visible spectroscopy (UV-vis) indicated a well observable peak at 440 nm confirming the synthesis of AgNPs. Fourier transform infra-red spectroscopy (FTIR) analysis indicates protein as possible capping agents. Energy dispersive X-ray (EDAX) spectroscopy results showed major signal for elemental silver. X-ray diffraction (XRD) analysis indicates the formation of metallic silver nanomaterials. Transmission electron microscopic (TEM) study showed the nanoparticles in the size range of 18-21 nm with spherical shape. Zeta potential analysis showed -21.7 mV characteristic for stable AgNPs. The biosynthesized AgNPs exhibited significant antimicrobial activity against MDR-GNB nosocomial pathogens of Acinetobacter sp., Klebsiella pneumoniae and Pseudomonas aeruginosa. Results from the current study suggested that M. scabrella material could be exploited for the fabrication of AgNPs with potential therapeutic applications in nanomedicine especially for nosocomial bacterial infections. Copyright © 2012 Elsevier B.V. All rights reserved.

Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: An interrupted time series over a 10-year period

NARCIS (Netherlands)

Helder, O.K.; Brug, J.; van Goudoever, J.B.; Looman, C.W.N.; Reiss, I.K.M.; Kornelisse, R.F.

2014-01-01

Background Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. Methods An observational study with an interrupted

Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: an interrupted time series over a 10-year period

NARCIS (Netherlands)

Helder, Onno K.; Brug, Johannes; van Goudoever, Johannes B.; Looman, Caspar W. N.; Reiss, Irwin K. M.; Kornelisse, René F.

2014-01-01

Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. An observational study with an interrupted time series

The Stream-Catchment (StreamCat) Dataset: A database of watershed metrics for the conterminous USA

Science.gov (United States)

We developed an extensive database of landscape metrics for ~2.65 million streams, and their associated catchments, within the conterminous USA: The Stream-Catchment (StreamCat) Dataset. These data are publically available and greatly reduce the specialized geospatial expertise n...

Stream processing health card application.

Science.gov (United States)

Polat, Seda; Gündem, Taflan Imre

2012-10-01

In this paper, we propose a data stream management system embedded to a smart card for handling and storing user specific summaries of streaming data coming from medical sensor measurements and/or other medical measurements. The data stream management system that we propose for a health card can handle the stream data rates of commonly known medical devices and sensors. It incorporates a type of context awareness feature that acts according to user specific information. The proposed system is cheap and provides security for private data by enhancing the capabilities of smart health cards. The stream data management system is tested on a real smart card using both synthetic and real data.

Leaf litter processing in West Virginia mountain streams: effects of temperature and stream chemistry

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Jacquelyn M. Rowe; William B. Perry; Sue A. Perry

1996-01-01

Climate change has the potential to alter detrital processing in headwater streams, which receive the majority of their nutrient input as terrestrial leaf litter. Early placement of experimental leaf packs in streams, one month prior to most abscission, was used as an experimental manipulation to increase stream temperature during leaf pack breakdown. We studied leaf...

Recognition and Prevention of Nosocomial Malnutrition: A Review and A Call to Action!

Science.gov (United States)

Kirkland, Lisa L; Shaughnessy, Erin

2017-12-01

Nosocomial malnutrition in hospitalized adults is a morbid, costly, and potentially preventable and treatable problem. Although recognized as contributing to many serious complications of hospitalization, malnutrition is often missed when present on admission and rarely diagnosed if it occurs during hospital stay. Many routine clinical practices such as holding nutrition for testing or failing to address poor intake, when added to acute inflammatory disease states, cause rapid deterioration in nutritional status in up to 70% of inpatients. Malnutrition during hospitalization is associated with increased mortality for years after discharge. In addition, unrecognized (and under-coded) malnutrition is associated with potential lost revenues for hospital systems. Low-cost interventions of recognizing at-risk patients and providing adequate nutrition have the potential to improve patient outcomes and reduce health care costs. Physicians must champion implementation of these interventions, using guidance from national organizations. Copyright © 2017 Elsevier Inc. All rights reserved.

Stream invertebrate productivity linked to forest subsidies: 37 stream-years of reference and experimental data.

Science.gov (United States)

Wallace, J Bruce; Eggert, Susan L; Meyer, Judy L; Webster, Jackson R

2015-05-01

Riparian habitats provide detrital subsidies of varying quantities and qualities to recipient ecosystems. We used long-term data from three reference streams (covering 24 stream-years) and 13-year whole-stream organic matter manipulations to investigate the influence of terrestrial detrital quantity and quality on benthic invertebrate community structure, abundance, biomass, and secondary production in rockface (RF) and mixed substrates (MS) of forested headwater streams. Using a mesh canopy covering the entire treatment stream, we examined effects of litter ex'clusion, small- and large-wood removal, and addition of artificial wood (PVC) and leaves of varying quality on organic matter standing crops and invertebrate community structure and function. We assessed differences in functional feeding group distribution between substrate types as influenced by organic matter manipulations and long-term patterns of predator and prey production in manipulated vs. reference years. Particulate organic matter standing crops in MS of the treatment stream declined drastically with each successive year of litter exclusion, approaching zero after three years. Monthly invertebrate biomass and annual secondary production was positively related to benthic organic matter in the MS habitats. Rockface habitats exhibited fewer changes than MS habitats across all organic matter manipulations. With leaf addition, the patterns of functional group distribution among MS and RF habitats returned to patterns seen in reference streams. Secondary production per unit organic matter standing crop was greatest for the leaf addition period, followed by the reference streams, and significantly less for the litter exclusion and wood removal periods. These data indicate that the limited organic matter remaining in the stream following litter exclusion and wood removal was more refractory than that in the reference streams, whereas the added leaf material was more labile and readily converted into

Fast acoustic streaming in standing waves: generation of an additional outer streaming cell.

Science.gov (United States)

Reyt, Ida; Daru, Virginie; Bailliet, Hélène; Moreau, Solène; Valière, Jean-Christophe; Baltean-Carlès, Diana; Weisman, Catherine

2013-09-01

Rayleigh streaming in a cylindrical acoustic standing waveguide is studied both experimentally and numerically for nonlinear Reynolds numbers from 1 to 30 [Re(NL)=(U0/c0)(2)(R/δν)(2), with U0 the acoustic velocity amplitude at the velocity antinode, c0 the speed of sound, R the tube radius, and δν the acoustic boundary layer thickness]. Streaming velocity is measured by means of laser Doppler velocimetry in a cylindrical resonator filled with air at atmospheric pressure at high intensity sound levels. The compressible Navier-Stokes equations are solved numerically with high resolution finite difference schemes. The resonator is excited by shaking it along the axis at imposed frequency. Results of measurements and of numerical calculation are compared with results given in the literature and with each other. As expected, the axial streaming velocity measured and calculated agrees reasonably well with the slow streaming theory for small ReNL but deviates significantly from such predictions for fast streaming (ReNL>1). Both experimental and numerical results show that when ReNL is increased, the center of the outer streaming cells are pushed toward the acoustic velocity nodes until counter-rotating additional vortices are generated near the acoustic velocity antinodes.

Dimethyl Sulfoxide Enhances Effectiveness of Skin Antiseptics and Reduces Contamination Rates of Blood Cultures

Science.gov (United States)

LaSala, Paul R.; Han, Xiang-Yang; Rolston, Kenneth V.; Kontoyiannis, Dimitrios P.

2012-01-01

Effective skin antisepsis is of central importance in the prevention of wound infections, colonization of medical devices, and nosocomial transmission of microorganisms. Current antiseptics have a suboptimal efficacy resulting in substantial infectious morbidity, mortality, and increased health care costs. Here, we introduce an in vitro method for antiseptic testing and a novel alcohol-based antiseptic containing 4 to 5% of the polar aprotic solvent dimethyl sulfoxide (DMSO). The DMSO-containing antiseptic resulted in a 1- to 2-log enhanced killing of Staphylococcus epidermidis and other microbes in vitro compared to the same antiseptic without DMSO. In a prospective clinical validation, blood culture contamination rates were reduced from 3.04% for 70% isopropanol–1% iodine (control antiseptic) to 1.04% for 70% isopropanol–1% iodine–5% DMSO (P antiseptics containing strongly polarized but nonionizing (polar aprotic) solvents. PMID:22378911

[Analysis of the factors influencing the internal reporting of nosocomial infections. A review of 108 notifications].

Science.gov (United States)

Penel, N; Fournier, C; Roussel-Delvallez, M; Deberles, M-F; Buisset, E; Cazin, J-L; Leclercq, B

2003-11-29

Since July 26, 2001, the external reporting to the regional office of health and social affairs (Direction départementale des affaires sanitaires et sociales--Ddass) and the coordination centre (Comité de lutte contre les infections nosocomiales--Cclin) for the fight against nosocomial infections (NI) is mandatory. However, the modalities of internal reporting to the Clin are unknown. We performed a retrospective analysis of 108 cases of NI reported over 23 months in 4 medical-surgical departments (MSD) with 14 to 35 NI reported/MSD. The distribution of the bacteria responsible was compared with that of the local epidemiological state (chi2 test). A correlation analysis was performed between the number of NI reported in each MSD and the structural characteristics and activity index of these MSD (Spearmann's correlation test). The NI were predominantly infections related to a catheter (43), lower respiratory tract (25) and infection of the site of surgery (19). Ninety were documented biologically, among which 10 implied multi-resistant bacteria. Ninety-four NI were associated with the prescription of an antibiotic. Compared with the local epidemiological state, the NI reported generally implied multi-resistant bacteria (p=0.009). The other microbiological data had little implication. In each of the MSD, the number of cases reported was independent of: the global activity, the number of interventions, the mean duration of hospitalisation, the number of beds, the number of clinicians, the number of new patients managed and the chemotherapy outpatient activity. Conversely, there was a strong correlation between the global consumption of antibiotics (r=0.78), and the number of the Clin members in each MSD DMC (r=0.82). In each MSD, the internal reporting of NI relies on the discovery of multi-resistant bacteria, but above all on the implication of those involved in the fight against nosocomial infections.

Prevention of nosocomial infection in the ICU setting.

Science.gov (United States)

Corona, A; Raimondi, F

2004-05-01

The aim of this review is to focus the epidemiology and preventing measures of nosocomial infections that affect the critically ill patients. Most of them (over 80%) are related to the device utilization needed for patient life support but responsible for such complications as ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSI), surgical site infections (SSI) and urinary tract infections (UTI). General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. The routine changing of central catheters is not necessary and increases costs; it is necessary to decrease the handling of administration sets, to use a more careful insertion technique and less frequent set replacement. Specific measures for VAP prevention are: 1). use of multi-use, closed-system suction catheters; 2). no routine change of the breathing circuit; 3). lubrication of the the endotracheal tube cuff with a water-soluble gel; 4). maintenance of patient in semi-recumbent position to improve chest physiotherapy. Specific measures for UTI prevention include: 1). use of a catheter-valve instead of a standard drainage system; 2). use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. By implementing effective preventive measures and maintaining strict surveillance of ICU infections, we hope to affect the associated morbidity, mortality, and cost that our patients and society bare. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

Pattern Of Polymicrobial Isolates And Antimicrobial Susceptibility From Blood

International Nuclear Information System (INIS)

Shabbir, S.; Jamil, S.; Hafiz, S.

2016-01-01

Objective: To determine the pattern of polymicrobial isolates in blood cultures and antimicrobial susceptibility in a tertiary care hospital of Karachi. Study Design: Cross-sectional study. Place and Duration of Study: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan, from September to November 2014. Methodology: Blood culture samples were received from patients, which were processed by BACTEC 9240 system (Becton Dickinson). All positive blood samples were further analyzed. Susceptibility to antimicrobial agents was determined according to the Clinical and Laboratory Standards Institute (CLSI) criteria of the year. Identification of growth was based on Gram staining, colony morphology and appropriate biochemical tests. Antibiotic susceptibility was done as per Clinical and Laboratory Standards Institute (CLSI) recommendations. Results: Out of the 7251 samples submitted, 2931 (40.42 percent) were positive for growth, 2389 (81.5 percent) samples were monomicrobial, whereas 542 (18.5 percent) samples were polymicrobial. Among the polymicrobial isolates, 468 (86.34 percent) blood culture samples yielded two, 66 (12.17 percent) yielded three, and 8 (1.47 percent) yielded four organisms. Gram positive isolates were 281 (51.84 percent) and Gram negative were 261 (48.15 percent). The most frequent isolates in polymicrobial blood stream infection were Acinetobacterspp. (51/542, 9.4 percent) and Coagulase negative Staphylococcus(84/542, 15.5 percent), respectively. Staphylococcus aureus isolates, which were resistant to Methicillin, accounted for 24.65 percent. Third generation Cephalosporins resistance in Klebsiella spp. and Eschericia (E.) coli was found to be 63.6 percent and 58 percent, respectively. Carbapenem resistance was seen in 5.9 percent of Pseudomonas aeruginosa and 17.6 percent Acinetobacter spp. Conclusion: Gram positive bacteria were more commonly involved in polymicrobial blood stream infections with Coagulase negative Staphylococcus

MEKANISME SEGMENTASI LAJU BIT PADA DYNAMIC ADAPTIVE STREAMING OVER HTTP (DASH UNTUK APLIKASI VIDEO STREAMING

Directory of Open Access Journals (Sweden)

Muhammad Audy Bazly

2015-12-01

Full Text Available This paper aims to analyze Internet-based streaming video service in the communication media with variable bit rates. The proposed scheme on Dynamic Adaptive Streaming over HTTP (DASH using the internet network that adapts to the protocol Hyper Text Transfer Protocol (HTTP. DASH technology allows a video in the video segmentation into several packages that will distreamingkan. DASH initial stage is to compress the video source to lower the bit rate video codec uses H.26. Video compressed further in the segmentation using MP4Box generates streaming packets with the specified duration. These packages are assembled into packets in a streaming media format Presentation Description (MPD or known as MPEG-DASH. Streaming video format MPEG-DASH run on a platform with the player bitdash teritegrasi bitcoin. With this scheme, the video will have several variants of the bit rates that gave rise to the concept of scalability of streaming video services on the client side. The main target of the mechanism is smooth the MPEG-DASH streaming video display on the client. The simulation results show that the scheme based scalable video streaming MPEG- DASH able to improve the quality of image display on the client side, where the procedure bufering videos can be made constant and fine for the duration of video views

Estudio clínico y epidemiológico de un brote nosocomial producido por klebsiella oxytoca productora de IMP-8

OpenAIRE

Vergara López, Salvador

2015-01-01

Falta resumen Klebsiella oxytoca, al igual que K. pneumoniae, son dos patógenos humanos asociados a múltiples cuadros clínicos, pero fundamentalmente importantes como patógenos oportunistas. El progresivo aumento de las enfermedades crónicas, la inmunodepresión y los procedimientos agresivos, la capacidad de este género de bacterias para adaptarse al ambiente nosocomial, adquirir determinantes de resistencia frente a distintos antimicrobianos y diseminarse explican esta situación. Específi...

Nosocomial tuberculosis prevention in Portuguese hospitals: a cross-sectional evaluation.

Science.gov (United States)

Sousa, M; Gomes, M; Gaio, A R; Duarte, R

2017-08-01

Measures to control tuberculous infection are crucial to prevent nosocomial transmission and protect health care workers (HCWs). In Portugal, the extent of implementation of tuberculosis (TB) control measures in hospitals is not known. To determine the current implementation of preventive measures for tuberculous infection at administrative, environmental and personal levels in Portuguese hospitals. A cross-sectional evaluation was performed using two anonymous questionnaires: one sent to all the hospital infection control (IC) committees and the other sent to all pulmonologists and physicians specialising in infectious disease. Fourteen IC committees and 72 physicians responded. According to the IC committees, 92% of hospitals had a written TB control plan, but only 37% of the physicians said there was always/almost always a fast track for diagnosing suspected pulmonary TB cases. The majority of the hospitals had an isolation policy (85%) and these patients were always/almost always admitted in separate rooms, according to 70% of physicians. Both HCWs and TB patients used respiratory protection equipment (92%). These findings indicate that the most basic TB IC measures had been undertaken, but some TB IC measures were not fully implemented at all hospitals. An institutional effort should be made to solve this problem and strengthen TB prevention activities.

POLA RASIO KEUANGAN PADA SAAT UP STREAM DAN DOWN STREAM DI INDUSTRI REALESTAT YANG GO PUBLIC

Directory of Open Access Journals (Sweden)

David Sukardi Kodrat

2006-01-01

Full Text Available This research has purpose to explain differences on indicator financial ratio in up and down stream condition. This research uses real estate industries listed on Jakarta Stock Exchange as a sample. Sample selection is performed based on purposive sampling method with object to gain sample according to the research aim. Based on those criteria, there are 18 companies, which have fulfilling the conditions needed, starting from 1994 until 2002. The classification of business cycle on up and down stream conditions to used stock pricing indexes of property and real estate which calculated by arithmatic mean method. Based on those criteria, the classifications from 1994 until 1997 are represented by up stream condition and from 1998 until 2002 are represented by down stream condition. The result shows indicators: profitability ratios, gross margin ratios, capital turnover ratios, asset to equity ratios, growth ratios, liquidity ratios, leverage ratios, and cash flow ratios are different in up and down stream conditions, both simultaneously and partially. Simultaneously, there is a significant difference between up and down stream condition with wilks lambda of 0,346 and p value of 0,000. This research shows financial ratio indicator has differences on business cycle. Abstract in Bahasa Indonesia : Penelitan ini mempunyai tujuan untuk mengetahui perbedaan indikator rasio keuangan pada kondisi up stream dan down stream. Penelitian ini menggunakan sampel pada industri di sektor properti yang terdaftar di Bursa Efek Jakarta. Pemilihan sampel dalam penelitian ini menggunakan Purposive Sampling yaitu sampel diambil berdasarkan kriteria-kriteria tertentu yang sesuai dengan tujuan penelitian ini. Berdasarkan kriteria tersebut, terdapat 18 perusahaan yang dapat dijadikan sampel mulai tahun 1994 sampai dengan 2002. Untuk menentukan perubahan business cycle pada kondisi up stream dan down stream dilakukan dengan menggunakan indeks harga saham di sektor properti

Etiología bacteriana de la neumonía nosocomial y resistencia a los antimicrobianos en pacientes con y sin tratamiento antimicrobiano previo Bacterial etiology of nosocomial pneumonia and antimicrobial resistance in patients with and without antimicrobial treatment

Directory of Open Access Journals (Sweden)

Beatriz Weyland

2011-03-01

Full Text Available La neumonía nosocomial (NN se asocia a una elevada morbimortalidad y es la segunda causa de infección intrahospitalaria después de la infección urinaria. El objetivo de este trabajo fue conocer la etiología de la NN en adultos y evaluar el perfil de resistencia a los antimicrobianos de los microorganismos aislados teniendo en cuenta si los pacientes recibieron o no tratamiento antimicrobiano previo. Desde el año 2000 hasta el 2005 se analizaron 430 lavados broncoalveolares provenientes de 430 pacientes adultos con diagnóstico de neumonía internados en la unidad de cuidados intensivos del Hospital de Clínicas "José de San Martín". El 74% (199/ 269 de los pacientes con tratamiento previo tuvieron cultivos positivos, mientras que en el grupo sin tratamiento previo esta proporción fue del 83% (134/161 (p = 0,03. Los microorganismos prevalentes fueron Acinetobacter spp., Staphylococcus aureus y Pseudomonas aeruginosa (37,9% ; 21,3% y 20,9% vs. 36,1%; 26,6% y 17,7% en los pacientes con tratamiento previo o sin él, respectivamente; p > 0,05. La resistencia a los antimicrobianos de los citados microorganismos cuando los aislamientos provinieron de pacientes que recibieron antes tratamiento antibiótico fue superior a la encontrada en el grupo de pacientes que no recibió tratamiento previo (p Nosocomial pneumonia (NP is associated with high morbimortality, representing the second cause of nosocomial infection after urinary tract infection. The objective of this work was to become acquainted with the etiology of NP and to evaluate the antimicrobial resistance profile of the isolated microorganisms from adult patients with and without previous antimicrobial treatment admitted in the intensive care unit (ICU. From 2000 to 2005, 430 bronchoalveolar lavages from 430 adult patients diagnosed with pneumonia admitted in the ICU were analyzed. Seventy-four percent (199/ 269 of the patients with previous treatment had positive cultures, whereas in

HUNTING THE PARENT OF THE ORPHAN STREAM: IDENTIFYING STREAM MEMBERS FROM LOW-RESOLUTION SPECTROSCOPY

International Nuclear Information System (INIS)

Casey, Andrew R.; Da Costa, Gary; Keller, Stefan C.; Maunder, Elizabeth

2013-01-01

We present candidate K-giant members in the Orphan Stream that have been identified from low-resolution data taken with the AAOmega spectrograph on the Anglo-Australian Telescope. From modest signal-to-noise spectra and independent cuts in photometry, kinematics, gravity, and metallicity we yield self-consistent, highly probable stream members. We find a revised stream distance of 22.5 ± 2.0 kpc near the celestial equator and our kinematic signature peaks at V GSR = 82.1 ± 1.4 km s –1 . The observed velocity dispersion of our most probable members is consistent with arising from the velocity uncertainties alone. This indicates that at least along this line of sight, the Orphan Stream is kinematically cold. Our data indicate an overall stream metallicity of [Fe/H] = –1.63 ± 0.19 dex which is more metal-rich than previously found and unbiased by spectral type. Furthermore, the significant metallicity dispersion displayed by our most probable members, σ([Fe/H]) = 0.56 dex, suggests that the unidentified Orphan Stream parent is a dSph satellite. We highlight likely members for high-resolution spectroscopic follow-up.

THE STUDY OF ANTIBIOTIC- AND FAGOSENSITIVITY OF NOSOCOMIAL STRAINS BACTERIA ISOLATED FROM TRANSPLANTED PATIENTS

Directory of Open Access Journals (Sweden)

N. I. Gabrielan

2011-01-01

Full Text Available Antibiotic and fagosensitivity most etiologically important nosocomial strains of bacteria – Pseudomonas aeru- ginosa, Klebsiella pneumoniae, E. coli, Proteus spp., Staphylococcus spp. were studied. Multiple drug-resistant bacteria as gram-positive and gram-negative, isolated from 8 substrates, had been demonstrated. With regard to the sensitivity of Pseudomonas aeruginosa >40% was observed in 40–50% of the strains to aminoglycosides – aztreonam, amikacin, netilmicin, and only 23–25% of the strains – to gentamicin and levofloxacin (an average of antibiotic susceptibility was 27%. All strains of ESBL Klebsiella drew up and were sensitive only to imipenem, meropenem and aminoglycosides. Specific phages lysed 43–48% of the strains Pseudomonas aeruginosa and Klebsiella pneumoniae, E. coli, Pro- teus spp., multidrug resistant strains of Staphylococcus spp. It is proposed to introduce the use of phages in clinical practice. 

In-stream nutrient uptake kinetics along stream size and development gradients in a rapidly developing mountain resort watershed

Science.gov (United States)

Covino, T.; McGlynn, B.; McNamarra, R.; Gardner, K.

2012-04-01

Land use / land cover (LULC) change including mountain resort development often lead to increased nutrient loading to streams, however the potential influence on stream ecosystem nutrient uptake kinetics and transport remain poorly understood. Given the deleterious impacts elevated nutrient loading can have on aquatic ecosystems, it is imperative to improve understanding of nutrient retention capacities across stream scales and watershed development intensities. We performed seventeen nutrient addition experiments on six streams across the West Fork Gallatin Watershed, Montana, USA, to quantify nitrogen (N) uptake kinetics and retention dynamics across stream sizes (1st to 4th order) and along a mountain resort development gradient. We observed that stream N uptake kinetics and spiraling parameters varied across streams of different development intensity and scale. In more developed watersheds we observed a fertilization affect, however, none of the streams exhibited saturation with respect to N. Additionally, we observed that elevated loading led to increased biomass and retentive capacities in developed streams that helped maintain export at low levels during baseflow. Our results indicate that LULC can enhance in-stream uptake of limiting nutrients and highlight the value of characterizing uptake kinetic curves from ambient to saturation.

Delivery of Biologics Across the Blood-Brain Barrier Through Nanoencapsulation

DEFF Research Database (Denmark)

Bruun, Jonas

is a polymeric micelle made from an anionic triblock copolymer and was intended for delivery of drugs to the central nervous system (CNS), which is protected by the largely impermeable blood-brain barrier (BBB). In order to target the nanocarrier to the brain endothelial cells and obtain receptor...... of the reporter protein. One of the great challenges for drug delivery by nanocarriers is the dilemma of designing a particle that is highly stable whit no cellular interaction while in the blood stream but has a high uptake and efficient drug release in the diseased cells. As a solution to this dilemma...

Stream invertebrate productivity linked to forest subsidies: 37 stream-years of reference and experimental data

Science.gov (United States)

J. Bruce Wallace; Susan L Eggert; Judy L. Meyer; Jackson R. Webster

2015-01-01

Riparian habitats provide detrital subsidies of varying quantities and qualities to recipient ecosystems. We used long-term data from three reference streams (covering 24 stream-years) and 13-year whole-stream organic matter manipulations to investigate the influence of terrestrial detrital quantity and quality on benthic invertebrate community structure, abundance,...

How wide is a stream? Spatial extent of the potential "stream signature" in terrestrial food webs using meta-analysis.

Science.gov (United States)

Muehlbauer, Jeffrey D; Collins, Scott F; Doyle, Martin W; Tockner, Klement

2014-01-01

The magnitude of cross-ecosystem resource subsidies is increasingly well recognized; however, less is known about the distance these subsidies travel into the recipient landscape. In streams and rivers, this distance can delimit the "biological stream width," complementary to hydro-geomorphic measures (e.g., channel banks) that have typically defined stream ecosystem boundaries. In this study we used meta-analysis to define a "stream signature" on land that relates the stream-to-land subsidy to distance. The 50% stream signature, for example, identifies the point on the landscape where subsidy resources are still at half of their maximum (in- or near-stream) level. The decay curve for these data was best fit by a negative power function in which the 50% stream signature was concentrated near stream banks (1.5 m), but a non-trivial (10%) portion of the maximum subsidy level was still found > 0.5 km from the water's edge. The meta-analysis also identified explanatory variables that affect the stream signature. This improves our understanding of ecosystem conditions that permit spatially extensive subsidy transmission, such as in highly productive, middle-order streams and rivers. Resultant multivariate models from this analysis may be useful to managers implementing buffer rules and conservation strategies for stream and riparian function, as they facilitate prediction of the extent of subsidies. Our results stress that much of the subsidy remains near the stream, but also that subsidies (and aquatic organisms) are capable of long-distance dispersal into adjacent environments, and that the effective "biological stream width" of stream and river ecosystems is often much larger than has been defined by hydro-geomorphic metrics alone. Limited data available from marine and lake sources overlap well with the stream signature data, indicating that the "signature" approach may also be applicable to subsidy spatial dynamics across other ecosystems.

The Northeast Stream Quality Assessment

Science.gov (United States)

Van Metre, Peter C.; Riva-Murray, Karen; Coles, James F.

2016-04-22

In 2016, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) is assessing stream quality in the northeastern United States. The goal of the Northeast Stream Quality Assessment (NESQA) is to assess the quality of streams in the region by characterizing multiple water-quality factors that are stressors to aquatic life and evaluating the relation between these stressors and biological communities. The focus of NESQA in 2016 will be on the effects of urbanization and agriculture on stream quality in all or parts of eight states: Connecticut, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.Findings will provide the public and policymakers with information about the most critical factors affecting stream quality, thus providing insights about possible approaches to protect the health of streams in the region. The NESQA study will be the fourth regional study conducted as part of NAWQA and will be of similar design and scope to the first three, in the Midwest in 2013, the Southeast in 2014, and the Pacific Northwest in 2015 (http://txpub.usgs.gov/RSQA/).

What Can Hierarchies Do for Data Streams?

DEFF Research Database (Denmark)

Yin, Xuepeng; Pedersen, Torben Bach

Much effort has been put into building data streams management systems for querying data streams. Here, data streams have been viewed as a flow of low-level data items, e.g., sensor readings or IP packet data. Stream query languages have mostly been SQL-based, with the STREAM and TelegraphCQ lang...

StreamSqueeze: a dynamic stream visualization for monitoring of event data

Science.gov (United States)

Mansmann, Florian; Krstajic, Milos; Fischer, Fabian; Bertini, Enrico

2012-01-01

While in clear-cut situations automated analytical solution for data streams are already in place, only few visual approaches have been proposed in the literature for exploratory analysis tasks on dynamic information. However, due to the competitive or security-related advantages that real-time information gives in domains such as finance, business or networking, we are convinced that there is a need for exploratory visualization tools for data streams. Under the conditions that new events have higher relevance and that smooth transitions enable traceability of items, we propose a novel dynamic stream visualization called StreamSqueeze. In this technique the degree of interest of recent items is expressed through an increase in size and thus recent events can be shown with more details. The technique has two main benefits: First, the layout algorithm arranges items in several lists of various sizes and optimizes the positions within each list so that the transition of an item from one list to the other triggers least visual changes. Second, the animation scheme ensures that for 50 percent of the time an item has a static screen position where reading is most effective and then continuously shrinks and moves to the its next static position in the subsequent list. To demonstrate the capability of our technique, we apply it to large and high-frequency news and syslog streams and show how it maintains optimal stability of the layout under the conditions given above.

Stream temperature responses to timber harvest and best management practices—findings from the ODF RipStream project

Science.gov (United States)

Jeremy D. Groom

2013-01-01

Studies over the past 40 years have established that riparian buff er retention along streams protects against stream temperature increase. Th is protection is neither universal nor complete; some buff ered streams still warm, while other streams’ temperatures remain stable. Oregon Department of Forestry developed riparian rules in the Forest Practices Act (FPA) to...

Percent Forest Adjacent to Streams (Future)

Data.gov (United States)

U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

Percent Agriculture Adjacent to Streams (Future)

Data.gov (United States)

U.S. Environmental Protection Agency — The type of vegetation along a stream influences the water quality in the stream. Intact buffer strips of natural vegetation along streams tend to intercept...

Ecological health in the Nation's streams

Science.gov (United States)

Carlisle, Daren M.; Woodside, Michael D.

2013-01-01

Aquatic biological communities, which are collections of organisms, are a direct measure of stream health because they indicate the ability of a stream to support life. This fact sheet highlights selected findings of a national assessment of stream health by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The assessment was unique in that it integrated the condition of three biological communities—algae, macroinvertebrates, and fish—as well as measures of streamflow modification, pesticides, nutrients, and other factors. At least one biological community was altered at 83 percent of assessed streams, and the occurrence of altered communities was highest in urban streams. Streamflows were modified at 86 percent of assessed streams, and increasing severity of streamflow modification was associated with increased occurrence of altered biological communities. Agricultural and urban land use in watersheds may contribute pesticides and nutrients to stream waters, and increasing concentrations of these chemicals were associated with increased occurrence of altered biological communities.

Trapping of embolic particles in a vessel phantom by cavitation-enhanced acoustic streaming

International Nuclear Information System (INIS)

Maxwell, Adam D; Park, Simone; Cain, Charles A; Grotberg, James B; Xu, Zhen; Vaughan, Benjamin L

2014-01-01

Cavitation clouds generated by short, high-amplitude, focused ultrasound pulses were previously observed to attract, trap, and erode thrombus fragments in a vessel phantom. This phenomenon may offer a noninvasive method to capture and eliminate embolic fragments flowing through the bloodstream during a cardiovascular intervention. In this article, the mechanism of embolus trapping was explored by particle image velocimetry (PIV). PIV was used to examine the fluid streaming patterns generated by ultrasound in a vessel phantom with and without crossflow of blood-mimicking fluid. Cavitation enhanced streaming, which generated fluid vortices adjacent to the focus. The focal streaming velocity, u f , was as high as 120 cm/s, while mean crossflow velocities, u c , were imposed up to 14 cm/s. When a solid particle 3–4 mm diameter was introduced into crossflow, it was trapped near the focus. Increasing u f promoted particle trapping while increasing u c promoted particle escape. The maximum crossflow Reynolds number at which particles could be trapped, Re c , was approximately linear with focal streaming number, Re f , i.e. Re c = 0.25Re f + 67.44 (R 2 = 0.76) corresponding to dimensional velocities u c = 0.084u f + 3.122 for 20 < u f  < 120 cm/s. The fluidic pressure map was estimated from PIV and indicated a negative pressure gradient towards the focus, trapping the embolus near this location. (paper)

ORIGINAL ARTICLES

African Journals Online (AJOL)

2000-01-02

Jan 2, 2000 ... Nosocomial viral hepatitis and infections transmitted by blood and blood ... absence of liver disease contributes to changes in renal function and renal ... sodium excretion with a reduction in water excretion, while the PAH and ...

The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban neonatal intensive care unit: an intervention study with before and after comparison

NARCIS (Netherlands)

Helder, Onno K.; Brug, Johannes; Looman, Caspar W. N.; van Goudoever, Johannes B.; Kornelisse, René F.

2010-01-01

Nosocomial bloodstream infections are a major cause of morbidity and mortality in neonatal intensive care units. Appropriate hand hygiene is singled out as the most important measure in preventing these infections. However, hand hygiene compliance among healthcare professionals remains low despite

Comparison of active and passive stream restoration

DEFF Research Database (Denmark)

Kristensen, Esben Astrup; Thodsen, Hans; Dehli, Bjarke

2013-01-01

Modification and channelization of streams and rivers have been conducted extensively throughout the world during the past century. Subsequently, much effort has been directed at re-creating the lost habitats and thereby improving living conditions for aquatic organisms. However, as restoration...... methods are plentiful, it is difficult to determine which one to use to get the anticipated result. The aim of this study was to compare two commonly used methods in small Danish streams to improve the physical condition: re-meandering and passive restoration through cease of maintenance. Our...... investigation included measurement of the physical conditions in 29 stream reaches covering four different groups: (1) re-meandered streams, (2) LDC streams (the least disturbed streams available), (3) passively restored streams (>10 years stop of aintenance) and (4) channelized and non-restored streams. The in...

The Pacific northwest stream quality assessment

Science.gov (United States)

Van Metre, Peter C.; Morace, Jennifer L.; Sheibley, Rich W.

2015-01-01

In 2015, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) program is assessing stream quality in the Pacific Northwest. The goals of the Pacific Northwest Stream Quality Assessment (Pacific Northwest study) are to assess the quality of streams in the region by characterizing multiple water-quality factors that are stressors to aquatic life and to evaluate the relation between these stressors and biological communities. The effects of urbanization and agriculture on stream quality for the Puget Lowlands and Willamette Valley are the focus of this regional study. Findings will provide the public and policymakers with information regarding which human and environmental factors are the most critical in affecting stream quality and, thus, provide insights about possible approaches to protect or improve the health of streams in the region.

Studies on incidence and prevention of nosocomial infection of urinary tract endoscopies by different antimicrobial agents

International Nuclear Information System (INIS)

Hasanien, Y.A.M.

2010-01-01

Nosocomial infections occur world wide and affect both developed and resource-poor countries. Infections acquired in health care settings are among the major causes of death and increased morbidity among hospitalized patients. They are a significant burden both for the patient and for public health. A prevalence survey conducted under the auspices of WHO in 55 hospitals of 14 countries representing 4 WHO Regions (Europe, Eastern Mediterranean, South-East Asia and Western Pacific) showed an average of 8.7% of hospital patients had nosocomial infections. At any time, over 1.4 million people worldwide suffer from infectious complications acquired in hospital (Tikhomirov , 1987 ) . In medical practice, an object should be disinfected or sterilized depending on its intended use. Items that come in direct contact with mucous membranes, such as endoscopes, require a high level of disinfection (Ayliffe et al., 2000) . The major problems leading to inadequate decontamination are inappropriate or incomplete decontamination methods, for example, choice of disinfectant and duration of contact, as well as use of water or other fluids of poor microbiological quality for decontamination (Fallis , 1994 ). Endoscopes had been used widely for the diagnosis and therapy of medical disorders and were used increasingly for performing laparoscopic surgery. Currently, greater than 10,000,000 gastrointestinal endoscopic procedures were performed each year. Endoscopes were contaminated routinely by microorganisms during clinical use. Failure to employ appropriate cleaning, disinfection, or sterilization of endoscopes have been responsible for multiple nosocomial outbreaks and serious, sometimes life-threatening infections (Spach et al ., 1993 ). Because the endoscope comes into intimate contact with mucous membranes, high-level disinfection was the current reprocessing standard after each patient use. High level disinfection refered to the use of a chemical sterilant at shorter exposure

An ecohydrological stream type cassification of intermittent and ephemeral streams in the Southwestern United States 2397

Science.gov (United States)

Ephemeral and intermittent streams are the predominant fluvial forms in arid and semi-arid environments. Various studies have shown biological and habitat diversity in these lands to be considerably higher along stream corridors in comparison to adjacent uplands, yet knowledge of how these streams f...

Streaming Media Seminar--Effective Development and Distribution of Streaming Multimedia in Education

Science.gov (United States)

Mainhart, Robert; Gerraughty, James; Anderson, Kristine M.

2004-01-01

Concisely defined, "streaming media" is moving video and/or audio transmitted over the Internet for immediate viewing/listening by an end user. However, at Saint Francis University's Center of Excellence for Remote and Medically Under-Served Areas (CERMUSA), streaming media is approached from a broader perspective. The working definition includes…

Process for humidifying a gaseous fuel stream

International Nuclear Information System (INIS)

Sederquist, R. A.

1985-01-01

A fuel gas stream for a fuel cell is humidified by a recirculating hot liquid water stream using the heat of condensation from the humidified stream as the heat to vaporize the liquid water. Humidification is accomplished by directly contacting the liquid water with the dry gas stream in a saturator to evaporate a small portion of water. The recirculating liquid water is reheated by direct contact with the humidified gas stream in a condenser, wherein water is condensed into the liquid stream. Between the steps of humidifying and condensing water from the gas stream it passes through the fuel cell and additional water, in the form of steam, is added thereto

Stochastic ice stream dynamics.

Science.gov (United States)

Mantelli, Elisa; Bertagni, Matteo Bernard; Ridolfi, Luca

2016-08-09

Ice streams are narrow corridors of fast-flowing ice that constitute the arterial drainage network of ice sheets. Therefore, changes in ice stream flow are key to understanding paleoclimate, sea level changes, and rapid disintegration of ice sheets during deglaciation. The dynamics of ice flow are tightly coupled to the climate system through atmospheric temperature and snow recharge, which are known exhibit stochastic variability. Here we focus on the interplay between stochastic climate forcing and ice stream temporal dynamics. Our work demonstrates that realistic climate fluctuations are able to (i) induce the coexistence of dynamic behaviors that would be incompatible in a purely deterministic system and (ii) drive ice stream flow away from the regime expected in a steady climate. We conclude that environmental noise appears to be crucial to interpreting the past behavior of ice sheets, as well as to predicting their future evolution.

Stream Tracker: Crowd sourcing and remote sensing to monitor stream flow intermittence

Science.gov (United States)

Puntenney, K.; Kampf, S. K.; Newman, G.; Lefsky, M. A.; Weber, R.; Gerlich, J.

2017-12-01

Streams that do not flow continuously in time and space support diverse aquatic life and can be critical contributors to downstream water supply. However, these intermittent streams are rarely monitored and poorly mapped. Stream Tracker is a community powered stream monitoring project that pairs citizen contributed observations of streamflow presence or absence with a network of streamflow sensors and remotely sensed data from satellites to track when and where water is flowing in intermittent stream channels. Citizens can visit sites on roads and trails to track flow and contribute their observations to the project site hosted by CitSci.org. Data can be entered using either a mobile application with offline capabilities or an online data entry portal. The sensor network provides a consistent record of streamflow and flow presence/absence across a range of elevations and drainage areas. Capacitance, resistance, and laser sensors have been deployed to determine the most reliable, low cost sensor that could be mass distributed to track streamflow intermittence over a larger number of sites. Streamflow presence or absence observations from the citizen and sensor networks are then compared to satellite imagery to improve flow detection algorithms using remotely sensed data from Landsat. In the first two months of this project, 1,287 observations have been made at 241 sites by 24 project members across northern and western Colorado.

Structured multi-stream command language

International Nuclear Information System (INIS)

Glad, A.S.

1982-12-01

A multi-stream command language was implemented to provide the sequential and decision-making operations necessary to run the neutral-beam ion sources connected to the Doublet III tokamak fusion device. A multi-stream command language was implemented in Pascal on a Classic 7870 running under MAX IV. The purpose of this paper is threefold. First, to provide a brief description of the programs comprising the command language including the operating system interaction. Second, to give a description of the language syntax and commands necessary to develop a procedure stream. Third, to provide a description of the normal operating procedures for executing either the sequential or interactive streams

Acoustic streaming of a sharp edge.

Science.gov (United States)

Ovchinnikov, Mikhail; Zhou, Jianbo; Yalamanchili, Satish

2014-07-01

Anomalous acoustic streaming is observed emanating from sharp edges of solid bodies that are vibrating in fluids. The streaming velocities can be orders of magnitude higher than expected from the Rayleigh streaming at similar amplitudes of vibration. Acoustic velocity of fluid relative to a solid body diverges at a sharp edge, giving rise to a localized time-independent body force acting on the fluid. This force results in a formation of a localized jet. Two-dimensional numerical simulations are performed to predict acoustic streaming for low amplitude vibration using two methods: (1) Steady-state solution utilizing perturbation theory and (2) direct transient solution of the Navier-Stokes equations. Both analyses agree with each other and correctly predict the streaming of a sharp-edged vibrating blade measured experimentally. The origin of the streaming can be attributed to the centrifugal force of the acoustic fluid flow around a sharp edge. The dependence of this acoustic streaming on frequency and velocity is examined using dimensional analysis. The dependence law is devised and confirmed by numerical simulations.

Global perspectives on the urban stream syndrome

Science.gov (United States)

Roy, Allison; Booth, Derek B.; Capps, Krista A.; Smith, Benjamin

2016-01-01

Urban streams commonly express degraded physical, chemical, and biological conditions that have been collectively termed the “urban stream syndrome”. The description of the syndrome highlights the broad similarities among these streams relative to their less-impaired counterparts. Awareness of these commonalities has fostered rapid improvements in the management of urban stormwater for the protection of downstream watercourses, but the focus on the similarities among urban streams has obscured meaningful differences among them. Key drivers of stream responses to urbanization can vary greatly among climatological and physiographic regions of the globe, and the differences can be manifested in individual stream channels even through the homogenizing veneer of urban development. We provide examples of differences in natural hydrologic and geologic settings (within similar regions) that can result in different mechanisms of stream ecosystem response to urbanization and, as such, should lead to different management approaches. The idea that all urban streams can be cured using the same treatment is simplistic, but overemphasizing the tremendous differences among natural (or human-altered) systems also can paralyze management. Thoughtful integration of work that recognizes the commonalities of the urban stream syndrome across the globe has benefitted urban stream management. Now we call for a more nuanced understanding of the regional, subregional, and local attributes of any given urban stream and its watershed to advance the physical, chemical, and ecological recovery of these systems.

Organic carbon spiralling in stream ecosystems

Energy Technology Data Exchange (ETDEWEB)

Newbold, J D; Mulholland, P J; Elwood, J W; O' Neill, R V

1982-01-01

The term spiralling has been used to describe the combined processes of cycling and longitudinal transport in streams. As a measure or organic carbon spiralling, we introduced organic carbon turnover length, S, defined as the average or expected downstream distance travelled by a carbon atom between its entry or fixation in the stream and its oxidation. Using a simple model for organic carbon dynamics in a stream, we show that S is closely related to fisher and Likens' ecosystem efficiency. Unlike efficiency, however, S is independent of the length of the study reach, and values of S determined in streams of differing lengths can be compared. Using data from three different streams, we found the relationship between S and efficiency to agree closely with the model prediction. Hypotheses of stream functioning are discussed in the context of organic carbeon spiralling theory.

ESTIMATION OF THE TEMPERATURE RISE OF A MCU ACID STREAM PIPE IN NEAR PROXIMITY TO A SLUDGE STREAM PIPE

International Nuclear Information System (INIS)

Fondeur, F; Michael Poirier, M; Samuel Fink, S

2007-01-01

Effluent streams from the Modular Caustic-Side Solvent Extraction Unit (MCU) will transfer to the tank farms and to the Defense Waste Processing Facility (DWPF). These streams will contain entrained solvent. A significant portion of the Strip Effluent (SE) pipeline (i.e., acid stream containing Isopar(reg s ign) L residues) length is within one inch of a sludge stream. Personnel envisioned the sludge stream temperature may reach 100 C during operation. The nearby SE stream may receive heat from the sludge stream and reach temperatures that may lead to flammability issues once the contents of the SE stream discharge into a larger reservoir. To this end, personnel used correlations from the literature to estimate the maximum temperature rise the SE stream may experience if the nearby sludge stream reaches boiling temperature. Several calculation methods were used to determine the temperature rise of the SE stream. One method considered a heat balance equation under steady state that employed correlation functions to estimate heat transfer rate. This method showed the maximum temperature of the acid stream (SE) may exceed 45 C when the nearby sludge stream is 80 C or higher. A second method used an effectiveness calculation used to predict the heat transfer rate in single pass heat exchanger. By envisioning the acid and sludge pipes as a parallel flow pipe-to-pipe heat exchanger, this method provides a conservative estimation of the maximum temperature rise. Assuming the contact area (i.e., the area over which the heat transfer occurs) is the whole pipe area, the results found by this method nearly matched the results found with the previous calculation method. It is recommended that the sludge stream be maintained below 80 C to minimize a flammable vapor hazard from occurring

MALDI-TOF MS typing of a nosocomial methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit.

Science.gov (United States)

Steensels, Deborah; Deplano, Ariane; Denis, Olivier; Simon, Anne; Verroken, Alexia

2017-08-01

The early detection of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak is decisive to control its spread and rapidly initiate adequate infection control measures. Therefore, prompt determination of epidemiologic relatedness of clinical MRSA isolates is essential. Genetic typing methods have a high discriminatory power but their availability remains restricted. In this study, we aimed to challenge matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) as a typing tool of a nosocomial MRSA outbreak in a neonatal intensive care unit. Over a 2-year period, 15 MRSA isolates were recovered from patients (n = 14) and health care workers (n = 1) at the neonatal intensive care unit. Five reference strains were included for comparison. Identification was performed by MALDI-TOF MS and susceptibility profiles determined by automated broth microdilution. Typing analysis by MALDI-TOF MS included mean spectrum profiles and subsequent dendrogram creation using BioNumerics software. Results were compared with spa typing and pulsed-field gel electrophoresis (PFGE). Our study showed good concordance (93%) between PFGE, spa typing, and MALDI-TOF MS for the outbreak-related MRSA strains. MALDI-TOF MS typing showed excellent typeability and discriminatory power but showed poor reproducibility. This study is one of the first to document the potential usefulness of MALDI-TOF MS with standardized data analysis as a typing tool for investigating a nosocomial MRSA outbreak. A concordance of 93% compared to reference typing techniques was observed. However, because of poor reproducibility, long-term follow-up of prospective isolated strains is not practical for routine use. Further studies are needed to confirm our observations.

On-stream chemical element monitor

International Nuclear Information System (INIS)

Averitt, O.R.; Dorsch, R.R.

1979-01-01

An apparatus and method for on-stream chemical element monitoring are described wherein a multiplicity of sample streams are flowed continuously through individual analytical cells and fluorescence analyses are performed on the sample streams in sequence, together with a method of controlling the time duration of each analysis as a function of the concomitant radiation exposure of a preselected perforate reference material interposed in the sample-radiation source path

Reconfigurable Multicore Architectures for Streaming Applications

NARCIS (Netherlands)

Smit, Gerardus Johannes Maria; Kokkeler, Andre B.J.; Rauwerda, G.K.; Jacobs, J.W.M.; Nicolescu, G.; Mosterman, P.J.

2009-01-01

This chapter addresses reconfigurable heterogenous and homogeneous multicore system-on-chip (SoC) platforms for streaming digital signal processing applications, also called DSP applications. In streaming DSP applications, computations can be specified as a data flow graph with streams of data items

Stretch-minimising stream surfaces

KAUST Repository

Barton, Michael; Kosinka, Jin; Calo, Victor M.

2015-01-01

We study the problem of finding stretch-minimising stream surfaces in a divergence-free vector field. These surfaces are generated by motions of seed curves that propagate through the field in a stretch minimising manner, i.e., they move without stretching or shrinking, preserving the length of their arbitrary arc. In general fields, such curves may not exist. How-ever, the divergence-free constraint gives rise to these 'stretch-free' curves that are locally arc-length preserving when infinitesimally propagated. Several families of stretch-free curves are identified and used as initial guesses for stream surface generation. These surfaces are subsequently globally optimised to obtain the best stretch-minimising stream surfaces in a given divergence-free vector field. Our algorithm was tested on benchmark datasets, proving its applicability to incompressible fluid flow simulations, where our stretch-minimising stream surfaces realistically reflect the flow of a flexible univariate object. © 2015 Elsevier Inc. All rights reserved.

Stretch-minimising stream surfaces

KAUST Repository

Barton, Michael

2015-05-01

We study the problem of finding stretch-minimising stream surfaces in a divergence-free vector field. These surfaces are generated by motions of seed curves that propagate through the field in a stretch minimising manner, i.e., they move without stretching or shrinking, preserving the length of their arbitrary arc. In general fields, such curves may not exist. How-ever, the divergence-free constraint gives rise to these \\'stretch-free\\' curves that are locally arc-length preserving when infinitesimally propagated. Several families of stretch-free curves are identified and used as initial guesses for stream surface generation. These surfaces are subsequently globally optimised to obtain the best stretch-minimising stream surfaces in a given divergence-free vector field. Our algorithm was tested on benchmark datasets, proving its applicability to incompressible fluid flow simulations, where our stretch-minimising stream surfaces realistically reflect the flow of a flexible univariate object. © 2015 Elsevier Inc. All rights reserved.

Self-focusing relativistic electron streams in plasmas

International Nuclear Information System (INIS)

Cox, J.L. Jr.

1975-01-01

A relativistic electron stream propagating through a dense plasma induces current and charge densities which determine how the stream can self-focus. Magnetic self-focusing is possible because stream-current neutralization, although extensive, is not complete. Electric self-focusing can occur because the stream charge becomes overneutralized when the net current is smaller than a critical value. Under some circumstances, the latter process can cause the stream to focus into a series of electron bunches

BLOSTREAM: A HIGH SPEED STREAM CIPHER

Directory of Open Access Journals (Sweden)

ALI H. KASHMAR

2017-04-01

Full Text Available Although stream ciphers are widely utilized to encrypt sensitive data at fast speeds, security concerns have led to a shift from stream to block ciphers, judging that the current technology in stream cipher is inferior to the technology of block ciphers. This paper presents the design of an improved efficient and secure stream cipher called Blostream, which is more secure than conventional stream ciphers that use XOR for mixing. The proposed cipher comprises two major components: the Pseudo Random Number Generator (PRNG using the Rabbit algorithm and a nonlinear invertible round function (combiner for encryption and decryption. We evaluate its performance in terms of implementation and security, presenting advantages and disadvantages, comparison of the proposed cipher with similar systems and a statistical test for randomness. The analysis shows that the proposed cipher is more efficient, high speed, and secure than current conventional stream ciphers.

Removal of sulfur from process streams

International Nuclear Information System (INIS)

Brignac, D.G.

1984-01-01

A process wherein water is added to a non-reactive gas stream, preferably a hydrogen or hydrogen-containing gas stream, sufficient to raise the water level thereof to from about 0.2 percent to about 50 percent, based on the total volume of the process gas stream, and the said moist gas stream is contacted, at elevated temperature, with a particulate mass of a sulfur-bearing metal alumina spinel characterized by the formula MAl 2 O 4 , wherein M is chromium, iron, cobalt, nickel, copper, cadmium, mercury, or zinc to desorb sulfur thereon. In the sulfur sorption cycle, due to the simultaneous adsorption of water and sulfur, the useful life of the metal alumina spinel for sulfur adsorption can be extended, and the sorbent made more easily regenerable after contact with a sulfur-bearing gas stream, notably sulfur-bearing wet hydrogen or wet hydrogen-rich gas streams

StreamStats in Oklahoma - Drainage-Basin Characteristics and Peak-Flow Frequency Statistics for Ungaged Streams

Science.gov (United States)

Smith, S. Jerrod; Esralew, Rachel A.

2010-01-01

The USGS Streamflow Statistics (StreamStats) Program was created to make geographic information systems-based estimation of streamflow statistics easier, faster, and more consistent than previously used manual techniques. The StreamStats user interface is a map-based internet application that allows users to easily obtain streamflow statistics, basin characteristics, and other information for user-selected U.S. Geological Survey data-collection stations and ungaged sites of interest. The application relies on the data collected at U.S. Geological Survey streamflow-gaging stations, computer aided computations of drainage-basin characteristics, and published regression equations for several geographic regions comprising the United States. The StreamStats application interface allows the user to (1) obtain information on features in selected map layers, (2) delineate drainage basins for ungaged sites, (3) download drainage-basin polygons to a shapefile, (4) compute selected basin characteristics for delineated drainage basins, (5) estimate selected streamflow statistics for ungaged points on a stream, (6) print map views, (7) retrieve information for U.S. Geological Survey streamflow-gaging stations, and (8) get help on using StreamStats. StreamStats was designed for national application, with each state, territory, or group of states responsible for creating unique geospatial datasets and regression equations to compute selected streamflow statistics. With the cooperation of the Oklahoma Department of Transportation, StreamStats has been implemented for Oklahoma and is available at http://water.usgs.gov/osw/streamstats/. The Oklahoma StreamStats application covers 69 processed hydrologic units and most of the state of Oklahoma. Basin characteristics available for computation include contributing drainage area, contributing drainage area that is unregulated by Natural Resources Conservation Service floodwater retarding structures, mean-annual precipitation at the

Collaborative Media Streaming

OpenAIRE

Kahmann, Verena

2008-01-01

Mit Hilfe der IP-Technologie erbrachte Multimedia-Dienste wie IPTV oder Video-on-Demand sind zur Zeit ein gefragtes Thema. Technisch werden solche Dienste unter dem Begriff "Streaming" eingeordnet. Ein Server sendet Mediendaten kontinuierlich an Empfänger, welche die Daten sofort weiterverarbeiten und anzeigen. Über einen Rückkanal hat der Kunde die Möglichkeit der Einflussnahme auf die Wiedergabe. Eine Weiterentwicklung dieser Streaming-Dienste ist die Möglichkeit, gemeinsam mit anderen dens...

Motion of shocks through interplanetary streams

International Nuclear Information System (INIS)

Burlaga, L.F.; Scudder, J.D.

1975-01-01

A model for the motion of flare-generated shocks through interplanetary streams is presented, illustrating the effects of a stream-shock interaction on the shock strength and geometry. It is a gas dynamic calculation based on Whitham's method and on an empirical approximation for the relevant characteristics of streams. The results show that the Mach number of a shock can decrease appreciably to near unity in the interaction region ahead of streams and that the interaction of a spherically symmetric shock with a spiral-shaped corotating stream can cause significant distortions of the initial shock front geometry. The geometry of the February 15--16, 1967, shock discussed by Lepping and Chao (1972) is qualitatively explained by this model

Stream chemistry in the eastern United States. 2. Current sources of acidity in acidic and low acid-neutralizing-capacity streams

International Nuclear Information System (INIS)

Herlihy, A.T.; Kaufmann, P.R.; Mitch, M.E.

1991-01-01

The authors examined anion composition in National Stream Survey (NSS) data in order to evaluate the most probable sources of current acidity in acidic and low acid neutralizing capacity (ANC) streams in the eastern United States. Acidic streams that had almost no organic influence (less than 10% of total anions) and sulfate and nitrate concentrations indicative of evaporative concentration of atmospheric deposition were classified as acidic due to acidic deposition. These acidic streams were located in small forested watersheds in the Mid-Atlantic Highlands (an estimated 1950 km of stream length) and in the Mid-Atlantic Coastal Plain (1250 km). Acidic streams affected primarily by acidic deposition but also influenced by naturally occurring organic anions accounted for another 1180 km of acidic stream length and were located in the New Jersey Pine Barrens, plateau tops in the Mid-Atlantic and Southeast Highlands, and the Florida Panhandle. The total length of streams acidic due to acid mine drainage in the NSS (4590 km) was about the same as the total length of acidic streams likely affected by acidic deposition (4380 km). Acidic streams whose acid anion composition was dominated by organics were located in Florida and the Mid-Atlantic Coastal Plain. In Florida, most of the acidic streams were organic dominated, whereas about half of the streams in the Mid-Atlantic Coastal Plain were organic dominated. Organic-dominated acidic streams were not observed in the Mid-Atlantic and Southeast Highlands

A multiplex nested PCR for the detection and identification of Candida species in blood samples of critically ill paediatric patients.

Science.gov (United States)

Taira, Cleison Ledesma; Okay, Thelma Suely; Delgado, Artur Figueiredo; Ceccon, Maria Esther Jurfest Rivero; de Almeida, Margarete Teresa Gottardo; Del Negro, Gilda Maria Barbaro

2014-07-21

Nosocomial candidaemia is associated with high mortality rates in critically ill paediatric patients; thus, the early detection and identification of the infectious agent is crucial for successful medical intervention. The PCR-based techniques have significantly increased the detection of Candida species in bloodstream infections. In this study, a multiplex nested PCR approach was developed for candidaemia detection in neonatal and paediatric intensive care patients. DNA samples from the blood of 54 neonates and children hospitalised in intensive care units with suspected candidaemia were evaluated by multiplex nested PCR with specific primers designed to identify seven Candida species, and the results were compared with those obtained from blood cultures. The multiplex nested PCR had a detection limit of four Candida genomes/mL of blood for all Candida species. Blood cultures were positive in 14.8% of patients, whereas the multiplex nested PCR was positive in 24.0% of patients, including all culture-positive patients. The results obtained with the molecular technique were available within 24 hours, and the assay was able to identify Candida species with 100% of concordance with blood cultures. Additionally, the multiplex nested PCR detected dual candidaemia in three patients. Our proposed PCR method may represent an effective tool for the detection and identification of Candida species in the context of candidaemia diagnosis in children, showing highly sensitive detection and the ability to identify the major species involved in this infection.

Evaluation of Stream Mining Classifiers for Real-Time Clinical Decision Support System: A Case Study of Blood Glucose Prediction in Diabetes Therapy

Directory of Open Access Journals (Sweden)

Simon Fong

2013-01-01

Full Text Available Earlier on, a conceptual design on the real-time clinical decision support system (rt-CDSS with data stream mining was proposed and published. The new system is introduced that can analyze medical data streams and can make real-time prediction. This system is based on a stream mining algorithm called VFDT. The VFDT is extended with the capability of using pointers to allow the decision tree to remember the mapping relationship between leaf nodes and the history records. In this paper, which is a sequel to the rt-CDSS design, several popular machine learning algorithms are investigated for their suitability to be a candidate in the implementation of classifier at the rt-CDSS. A classifier essentially needs to accurately map the events inputted to the system into one of the several predefined classes of assessments, such that the rt-CDSS can follow up with the prescribed remedies being recommended to the clinicians. For a real-time system like rt-CDSS, the major technological challenges lie in the capability of the classifier to process, analyze and classify the dynamic input data, quickly and upmost reliably. An experimental comparison is conducted. This paper contributes to the insight of choosing and embedding a stream mining classifier into rt-CDSS with a case study of diabetes therapy.

The effect of in-stream activities on the Njoro River, Kenya. Part I: Stream flow and chemical water quality

Science.gov (United States)

Yillia, Paul T.; Kreuzinger, Norbert; Mathooko, Jude M.

For shallow streams in sub-Saharan Africa, in-stream activities could be described as the actions by people and livestock, which take place within or besides stream channels. This study examined the nature of in-stream activities along a rural stream in Kenya and established the inequality in water allocation for various livelihood needs, as well as the negative impact they have on dry weather stream flow and chemical water quality. Seven locations along the stream were studied in wet and dry weather of 2006. Enumeration consisted of making head counts of people and livestock and tallying visitors at hourly intervals from 6 a.m. to 7 p.m. To estimate water abstraction, filled containers of known volume were counted and the stream was sampled to examine the impact on water quality. Water samples were obtained upstream and downstream of in-stream activities before (6 a.m.) and during (11 a.m., 6 p.m.) activities. Samples were analyzed for suspended solids, turbidity, BOD 5, total nitrogen and total phosphorus. The daily total abstraction at the middle reaches during dry weather was 120-150 m 3 day -1. More than 60% of abstraction was done by water vendors. Vended water from the stream was sold at US 3.5-7.5 per m 3 and vendors earned between US 3-6 a day. Abstracted water contributed approximately 40-60% of the total daily consumptive water use in the riparian area during dry weather but >30% of the morning stream flow was abstracted thereby upsetting stream flow in the lower reaches. The daily total water abstraction correlated positively ( R2, 0.98) and significantly ( p < 0.05) with the daily total human visit, which was diurnally periodic with two peaks, occurring between 9 a.m. and 10 a.m. and from 4 p.m. to 5 p.m. This diurnal pattern of visits and the corresponding in-stream activities affected water quality. In particular, suspended solids, turbidity and BOD 5 levels increased significantly ( p < 0.05) downstream during in-stream activities. It was concluded

Stream Intermittency Sensors Monitor the Onset and Duration of Stream Flow Along a Channel Network During Storms

Science.gov (United States)

Jensen, C.; McGuire, K. J.

2017-12-01

Headwater streams are spatially extensive, accounting for a majority of global stream length, and supply downstream water bodies with water, sediment, organic matter, and pollutants. Much of this transmission occurs episodically during storms when stream flow and connectivity are high. Many headwaters are temporary streams that expand and contract in length in response to storms and seasonality. Understanding where and when streams carry flow is critical for conserving headwaters and protecting downstream water quality, but storm events are difficult to study in small catchments. The rise and fall of stream flow occurs rapidly in headwaters, making observation of the entire stream network difficult. Stream intermittency sensors that detect the presence or absence of water can reveal wetting and drying patterns over short time scales. We installed 50 intermittency sensors along the channel network of a small catchment (35 ha) in the Valley and Ridge of southwest Virginia. Previous work shows stream length is highly variable in this shale catchment, as the drainage density spans two orders of magnitude. The sensors record data every 15 minutes for one year to capture different seasons, antecedent moisture conditions, and precipitation rates. We seek to determine whether hysteresis between stream flow and network length occurs on the rising and falling limbs of events and if reach-scale characteristics such as valley width explain spatial patterns of flow duration. Our results indicate reaches with a wide, sediment-filled valley floor carry water for shorter periods of time than confined channel segments with steep valley side slopes. During earlier field mapping surveys, we only observed flow in a few of the tributaries for the wettest conditions mapped. The sensors now show that these tributaries flow more frequently during much smaller storms, but only for brief periods of time (hour). The high temporal sampling resolution of the sensors permits a more realistic

Energy from streaming current and potential

NARCIS (Netherlands)

Olthuis, Wouter; Schippers, Bob; Eijkel, Jan C.T.; van den Berg, Albert

2005-01-01

It is investigated how much energy can be delivered by a streaming current source. A streaming current and subsequent streaming potential originate when double layer charge is transported by hydrodynamic flow. Theory and a network model of such a source is presented and initial experimental results

Wadeable Streams Assessment Data

Science.gov (United States)

The Wadeable Streams Assessment (WSA) is a first-ever statistically-valid survey of the biological condition of small streams throughout the U.S. The U.S. Environmental Protection Agency (EPA) worked with the states to conduct the assessment in 2004-2005. Data for each parameter sampled in the Wadeable Streams Assessment (WSA) are available for downloading in a series of files as comma separated values (*.csv). Each *.csv data file has a companion text file (*.txt) that lists a dataset label and individual descriptions for each variable. Users should view the *.txt files first to help guide their understanding and use of the data.

Industrial-Strength Streaming Video.

Science.gov (United States)

Avgerakis, George; Waring, Becky

1997-01-01

Corporate training, financial services, entertainment, and education are among the top applications for streaming video servers, which send video to the desktop without downloading the whole file to the hard disk, saving time and eliminating copyrights questions. Examines streaming video technology, lists ten tips for better net video, and ranks…

STREAMS - Technology Programme. Yearbook 2003

International Nuclear Information System (INIS)

2003-01-01

The STREAMS Technology Programme addresses municipal waste. Municipal waste is composed of waste from households and small businesses. The programme focuses on five areas Waste prevention, Collection, transportation, and management of waste streams, Waste treatment technologies, Waste recycling into raw materials and new products, Landfill technologies. The development projects of the STREAMS Programme utilize a number of different technologies, such as biotechnology, information technology, materials technology, measurement and analysis, and automation technology. Finnish expertise in materials recycling technologies and related electronics and information technology is extremely high on a worldwide scale even though the companies represent SMEs. Started in 2001, the STREAMS programme has a total volume of 27 million euros, half of which is funded by Tekes. The programme runs through the end of 2004. (author)

Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

Directory of Open Access Journals (Sweden)

Mamta Dhaneria

2018-01-01

Full Text Available Very little is known about laboratory-confirmed blood stream infections (LCBIs in neonatal intensive care units (NICUs in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm were included in the study. The overall incidence of LCBIs was 31%. The independent risk factors for LCBIs were: preterm neonates (relative risk (RR 2.23, duration of NICU stay more than 14 days (RR 1.75, chorioamnionitis in the mother (RR 3.18, premature rupture of membrane in mothers (RR 2.32, neonate born through meconium-stained amniotic fluid (RR 2.32, malpresentation (RR 3.05, endotracheal intubation (RR 3.41, umbilical catheterization (RR 4.18, and ventilator-associated pneumonia (RR 3.17. The initiation of minimal enteral nutrition was protective from LCBIs (RR 0.22. The predominant causative organisms were gram-negative pathogens (58%. The results of the present study can be used to design and implement antibiotic stewardship policy and introduce interventions to reduce LCBIs in resource-limited settings.

Nutrient spiraling in streams and river networks

Science.gov (United States)

Ensign, Scott H.; Doyle, Martin W.

2006-12-01

Over the past 3 decades, nutrient spiraling has become a unifying paradigm for stream biogeochemical research. This paper presents (1) a quantitative synthesis of the nutrient spiraling literature and (2) application of these data to elucidate trends in nutrient spiraling within stream networks. Results are based on 404 individual experiments on ammonium (NH4), nitrate (NO3), and phosphate (PO4) from 52 published studies. Sixty-nine percent of the experiments were performed in first- and second-order streams, and 31% were performed in third- to fifth-order streams. Uptake lengths, Sw, of NH4 (median = 86 m) and PO4 (median = 96 m) were significantly different (α = 0.05) than NO3 (median = 236 m). Areal uptake rates of NH4 (median = 28 μg m-2 min-1) were significantly different than NO3 and PO4 (median = 15 and 14 μg m-2 min-1, respectively). There were significant differences among NH4, NO3, and PO4 uptake velocity (median = 5, 1, and 2 mm min-1, respectively). Correlation analysis results were equivocal on the effect of transient storage on nutrient spiraling. Application of these data to a stream network model showed that recycling (defined here as stream length ÷ Sw) of NH4 and NO3 generally increased with stream order, while PO4 recycling remained constant along a first- to fifth-order stream gradient. Within this hypothetical stream network, cumulative NH4 uptake decreased slightly with stream order, while cumulative NO3 and PO4 uptake increased with stream order. These data suggest the importance of larger rivers to nutrient spiraling and the need to consider how stream networks affect nutrient flux between terrestrial and marine ecosystems.

Stream Lifetimes Against Planetary Encounters

Science.gov (United States)

Valsecchi, G. B.; Lega, E.; Froeschle, Cl.

2011-01-01

We study, both analytically and numerically, the perturbation induced by an encounter with a planet on a meteoroid stream. Our analytical tool is the extension of pik s theory of close encounters, that we apply to streams described by geocentric variables. The resulting formulae are used to compute the rate at which a stream is dispersed by planetary encounters into the sporadic background. We have verified the accuracy of the analytical model using a numerical test.

Air bubbles and hemolysis of blood samples during transport by pneumatic tube systems.

Science.gov (United States)

Mullins, Garrett R; Bruns, David E

2017-10-01

Transport of blood samples through pneumatic tube systems (PTSs) generates air bubbles in transported blood samples and, with increasing duration of transport, the appearance of hemolysis. We investigated the role of air-bubble formation in PTS-induced hemolysis. Air was introduced into blood samples for 0, 1, 3 or 5min to form air bubbles. Hemolysis in the blood was assessed by (H)-index, lactate dehydrogenase (LD) and potassium in plasma. In an effort to prevent PTS-induced hemolysis, blood sample tubes were completely filled, to prevent air bubble formation, and compared with partially filled samples after PTS transport. We also compared hemolysis in anticoagulated vs clotted blood subjected to PTS transport. As with transport through PTSs, the duration of air bubble formation in blood by a gentle stream of air predicted the extent of hemolysis as measured by H-index (pair space in a blood sample prevented bubble formation and fully protected the blood from PTS-induced hemolysis (ptransport and was partially protected from hemolysis vs anticoagulated blood as indicated by lower LD (ptransport. Prevention of air bubble formation in blood samples during PTS transport protects samples from hemolysis. Copyright © 2017 Elsevier B.V. All rights reserved.

Sulfhydryl variable-5 extended spectrum β-lactamase in nosocomial enteric bacteria causing sepsis in mexican children

Directory of Open Access Journals (Sweden)

Angélica Flores-Pérez

2015-10-01

Full Text Available Introduction: Enteric bacteria causing nosocomial infections are often resistant to third-generation cephalosporins due to the production of extended-spectrum β-lactamases (ESBLs. Objective: To describe and characterize the ESBLs pattern present in Klebsiella pneumoniae and Serratia marcescens strains, isolated as causative of nosocomial sepsis in pediatric patients at Instituto Nacional de Pediatría (National Institute of Pediatrics. Material and methods: We analyzed 94 strains of K. pneumoniae and 7 of S. marcescens isolated from clinical specimens from 2002-2005, causative of sepsis in a children’s hospital. We evaluated antibiotic susceptibility and detection of ESBL phenotypes by disk diffusion methods; ceftazidime-resistant isolates were further characterized by pulsed field gel electrophoresis (PFGE; and ESBLs were phenotypically and genotypically characterized by isoelectric focusing, polymerase chain reaction (PCR and sequencing. We also assed for presence of conjugative plasmids bearing the ESBL gene. Results: 51/94 (54% of K. pneumoniae isolates, and 5/7 (71% of S. marcescens isolates were resistant to ceftazidime; all carried a blaSHV-5 gene. All K. pneumoniae isolates had a distinct PFGE profile, yet all carried a ~48-Kb plasmid, that was conjugatively transferable to an Escherichia coli receptor, which expressed the resistance phenotype. On the other hand, all S. marcescens isolates had a similar PFGE profile, were unable to transfer the ceftazidime-resistance phenotype, and were isolated from the same ward in a short time-span suggesting an outbreak. Conclusions: The overall prevalence of ESBL-producing enteric bacteria in this hospital is high but similar to other Latin American reports. The sulfhydryl variable-5 (SHV-5 ESBL gene appears to reside in a highly mobile plasmid, capable of spreading among different K. pneumoniae clones and perhaps even to S. marcescens.

THE PAL 5 STAR STREAM GAPS

International Nuclear Information System (INIS)

Carlberg, R. G.; Hetherington, Nathan; Grillmair, C. J.

2012-01-01

Pal 5 is a low-mass, low-velocity-dispersion, globular cluster with spectacular tidal tails. We use the Sloan Digital Sky Survey Data Release 8 data to extend the density measurements of the trailing star stream to 23 deg distance from the cluster, at which point the stream runs off the edge of the available sky coverage. The size and the number of gaps in the stream are measured using a filter which approximates the structure of the gaps found in stream simulations. We find 5 gaps that are at least 99% confidence detections with about a dozen gaps at 90% confidence. The statistical significance of a gap is estimated using bootstrap resampling of the control regions on either side of the stream. The density minimum closest to the cluster is likely the result of the epicyclic orbits of the tidal outflow and has been discounted. To create the number of 99% confidence gaps per unit length at the mean age of the stream requires a halo population of nearly a thousand dark matter sub-halos with peak circular velocities above 1 km s –1 within 30 kpc of the galactic center. These numbers are a factor of about three below cold stream simulation at this sub-halo mass or velocity but, given the uncertainties in both measurement and more realistic warm stream modeling, are in substantial agreement with the LCDM prediction.

Fish populations in Plynlimon streams

Directory of Open Access Journals (Sweden)

D. T. Crisp

1997-01-01

Full Text Available In Plynlimon streams, brown trout (Salmo trutta L. are widespread in the upper Wye at population densities of 0.03 to 0.32 fish m-2 and show evidence of successful recruitment in most years. In the upper Severn, brown trout are found only in an area of c. 1670 -2 downstream of Blaenhafren Falls at densities of 0.03 to 0.24 fish -2 and the evidence suggests very variable year to year success in recruitment (Crisp & Beaumont, 1996. Analyses of the data show that temperature differences between afforested and unafforested streams may affect the rates of trout incubation and growth but are not likely to influence species survival. Simple analyses of stream discharge data suggest, but do not prove, that good years for recruitment in the Hafren population were years of low stream discharge. This may be linked to groundwater inputs detected in other studies in this stream. More research is needed to explain the survival of the apparently isolated trout population in the Hafren.

Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings

Energy Technology Data Exchange (ETDEWEB)

Volpato, Richard [Cassiano Antonio de Moraes University Hospital, Department of Diagnostic Radiology, Vitoria, ES (Brazil); Campi de Castro, Claudio [University of Sao Paulo Medical School, Department of Radiology, Cerqueira Cesar, Sao Paulo (Brazil); Hadad, David Jamil [Cassiano Antonio de Moraes University Hospital, Nucleo de Doencas Infecciosas, Department of Internal Medicine, Vitoria, ES (Brazil); Silva Souza Ribeiro, Flavya da [Laboratorio de Patologia PAT, Department of Diagnostic Radiology, Unit 1473, Vitoria, ES (Brazil); Filho, Ezequiel Leal [UNIMED Diagnostico, Department of Diagnostic Radiology, Unit 1473, Vitoria, ES (Brazil); Marcal, Leonardo P. [The University of Texas M D Anderson Cancer Center, Department of Diagnostic Radiology, Unit 1473, Houston, TX (United States)

2015-09-15

To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery. A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules. Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5 %), small nodules (61.5 %), small pseudocavitated nodules (23.1 %), nodules (38.5 %), pseudocavitated nodules (15.4 %), and collections (26.9 %). The findings in the abdominal wall were: densification (61.5 %), pseudocavitated nodules (3.8 %), and collections (15.4 %). The intraperitoneal findings were: densification (46.1 %), small nodules (42.3 %), nodules (15.4 %), and collections (11.5 %). Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections. (orig.)

Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings

International Nuclear Information System (INIS)

Volpato, Richard; Campi de Castro, Claudio; Hadad, David Jamil; Silva Souza Ribeiro, Flavya da; Filho, Ezequiel Leal; Marcal, Leonardo P.

2015-01-01

To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery. A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules. Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5 %), small nodules (61.5 %), small pseudocavitated nodules (23.1 %), nodules (38.5 %), pseudocavitated nodules (15.4 %), and collections (26.9 %). The findings in the abdominal wall were: densification (61.5 %), pseudocavitated nodules (3.8 %), and collections (15.4 %). The intraperitoneal findings were: densification (46.1 %), small nodules (42.3 %), nodules (15.4 %), and collections (11.5 %). Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections. (orig.)

Stream Response to an Extreme Defoliation Event

Science.gov (United States)

Gold, A.; Loffredo, J.; Addy, K.; Bernhardt, E. S.; Berdanier, A. B.; Schroth, A. W.; Inamdar, S. P.; Bowden, W. B.

2017-12-01

Extreme climatic events are known to profoundly impact stream flow and stream fluxes. These events can also exert controls on insect outbreaks, which may create marked changes in stream characteristics. The invasive Gypsy Moth (Lymantria dispar dispar) experiences episodic infestations based on extreme climatic conditions within the northeastern U.S. In most years, gypsy moth populations are kept in check by diseases. In 2016 - after successive years of unusually warm, dry spring and summer weather -gypsy moth caterpillars defoliated over half of Rhode Island's 160,000 forested ha. No defoliation of this magnitude had occurred for more than 30 years. We examined one RI headwater stream's response to the defoliation event in 2016 compared with comparable data in 2014 and 2015. Stream temperature and flow was gauged continuously by USGS and dissolved oxygen (DO) was measured with a YSI EXO2 sonde every 30 minutes during a series of deployments in the spring, summer and fall from 2014-2016. We used the single station, open channel method to estimate stream metabolism metrics. We also assessed local climate and stream temperature data from 2009-2016. We observed changes in stream responses during the defoliation event that suggest changes in ET, solar radiation and heat flux. Although the summer of 2016 had more drought stress (PDSI) than previous years, stream flow occurred throughout the summer, in contrast to several years with lower drought stress when stream flow ceased. Air temperature in 2016 was similar to prior years, but stream temperature was substantially higher than the prior seven years, likely due to the loss of canopy shading. DO declined dramatically in 2016 compared to prior years - more than the rising stream temperatures would indicate. Gross Primary Productivity was significantly higher during the year of the defoliation, indicating more total fixation of inorganic carbon from photo-autotrophs. In 2016, Ecosystem Respiration was also higher and Net

Hospital ownership: a risk factor for nosocomial infection rates?

Science.gov (United States)

Schröder, C; Behnke, M; Geffers, C; Gastmeier, P

2018-03-26

In some countries, a relationship between hospital ownership and the occurrence of healthcare-associated infection (HCAI) rates has been described. To investigate the association between hospital ownership and occurrence of HCAI in Germany. Five different components of the German national nosocomial infection surveillance system were analysed with regard to the influence of hospital ownership in the period 2014-2016. Endpoints included ventilator-associated pneumonia, central-venous-catheter-associated bloodstream infections, urinary-catheter-associated urinary tract infections, surgical site infections (SSI) following hip prosthesis and colon surgery, meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile infections (CDI) and hand rub consumption per 1000 patient-days. Three hospital ownership types (public, non-profit and private) were analysed using univariate and multi-variate methods. The distribution of hospitals according to the three ownership types was similar in all components. In total, 661 intensive care units (ICUs), 149 departments performing colon procedures, and 349 departments performing hip prosthesis were included. In addition, 568 hospitals provided their MRSA rates and 236 provided their CDI rates, and 1833 ICUs and 12,934 non-ICUs provided their hand rub consumption data. In general, the differences between the hospital types were rather small and not significant for the ICUs. In the multi-variate analysis, public hospitals had a lower SSI rate following hip prosthesis (odds ratio 0.80, 95% confidence interval 0.65-0.99). Hospital ownership was not found to have a major influence on the incidence of HCAI in Germany. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Mobile phones: Reservoirs for the transmission of nosocomial pathogens.

Science.gov (United States)

Pal, Shekhar; Juyal, Deepak; Adekhandi, Shamanth; Sharma, Munesh; Prakash, Rajat; Sharma, Neelam; Rana, Amit; Parihar, Ashwin

2015-01-01

Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients. Mobile phones are indispensible part of communication among doctors and other health care workers (HCWs) in hospitals. Hands of HCWs play an important role in transmission of HAI and mobile phones which are seldom cleaned and often touched during or after the examination of patients without hand washing can act as a reservoir for transmission of potent pathogens. This study aimed to investigate the rate of bacterial contamination of mobile phones among HCWs in our tertiary care hospital and to compare it with personal mobile phones of non-HCWs (control group). The mobile phones and dominant hands of 386 participants were sampled from four different groups, hospital doctors and staff (132), college faculty and staff (54), medical students (100) and control group (100). Informed consent and questionnaire was duly signed by all the participants. Samples were processed according to standard guidelines. 316 mobile phones (81.8%) and 309 hand swab samples (80%) showed growth of bacterial pathogens. The most predominant isolates were Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Enterococcus species. Hundred percent contamination was found in mobile phones and hands of HCWs indicating mobile phones can be the potential source of nosocomial pathogens. Our study results suggest that use of mobile phones in health care setup should be restricted only for emergency calls. Strict adherence to infection control policies such as proper hand hygiene practices should be followed.

Evaluation of the efficacy of akacid plus® fogging in eradicating causative microorganism in nosocomial infections.

Science.gov (United States)

Unal, Nevzat; Yanik, Keramettin; Karadag, Adil; Odabaşı, Hakan; Esen, Saban; Günaydin, Murat

2014-01-01

The novel polymeric guanidine Akacid Plus® is a member of the cationic family of disinfectants. The aim of the present study was to evaluate the activity of Akacid Plus® against bacteria which cause nosocomial infections and remain viable after contaminating the environment and determine the effects of organic materials to the activity. Closed room and control room were created for experimental disinfection. Bacterial suspensions of 0.5 McFarland were prepared from methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter baumannii and vancomycine-resistant Enterococcus faecium (VRE) strains. A 0.1 mL of each suspension was applied on the chipboard (25 cm(2)) and tile (25 cm(2)) test surfaces without albumin and with 2% albumin to simulate organic dirt, and the test surfaces were placed in the test and control rooms after drying. Before testing, cotton swab premoistened with serum physiologic was used to obtain samples from various surfaces in the environment and the samples were transferred onto 5% sheep blood agar for incubation at 37°C. Akacid Plus® solution at a concentration of 0.5% was nebulized with an aerosol applicator (Prowi-06, Germany) for 45 minutes. After a 2-hour waiting period, 1 mL neutralizing broth (Dey-Engley Neutralizing Broth, Fluka) was transferred on the test surfaces, and samples were collected with a swab from the test surfaces and various surfaces in the testing room and inoculated on 5% sheep blood agar for incubation at 37oC for 24 hours. At the end of the incubation period, number of colonies were evaluated on the control and test plates. Although coagulase-negative staphylococci, Bacillus spp., and fungi were grown in cultured samples obtained from the environment of experimental laboratory, no growth was observed in the test plates after room disinfection with Akacid Plus®. After room disinfection, MRSA and A. baumannii were not detectable in the cultured media prepared from the test surfaces with or without albumin. The

Resource synergy in stream periphyton communities

Energy Technology Data Exchange (ETDEWEB)

Hill, Walter [University of Illinois, Urbana-Champaign; Fanta, S.E. [University of Illinois; Roberts, Brian J [ORNL; Francoeur, Steven N. [Eastern Michigan University, Ypsilanti, MI

2011-03-01

1. Light and nutrients play pivotal roles in determining the growth of autotrophs, yet the potential for synergistic interactions between the two resources in algal communities is poorly understood, especially in stream ecosystems. In this study, light and phosphorus were manipulated in large experimental streams to examine resource colimitation and synergy in stream periphyton. 2. Whole-stream metabolism was simultaneously limited by light and phosphorus. Increasing the supply of either light or phosphorus resulted in significant increases in primary production and the transformation of the streams from heterotrophy to autotrophy. 3. Resource-driven changes in periphyton community structure occurred in concert with changes in production. Algal assemblages in highly shaded streams were composed primarily of small diatoms such as Achnanthidium minutissima, whereas larger diatoms such as Melosira varians predominated at higher irradiances. Phosphorus enrichment had relatively little effect on assemblage structure, but it did substantially diminish the abundance of Meridion circulare, a diatom whose mucilaginous colonies were conspicuously abundant in phosphorus-poor, high-light streams. Bacterial biomass declined relative to algal biomass with increases in primary productivity, regardless of whether the increases were caused by light or phosphorus. 4. Synergistic effects on primary production appeared to occur because the availability of one resource facilitated the utilization of the other. Light increased the abundance of large diatoms, which are known to convert high concentrations of nutrients into primary production more effectively than smaller taxa. Phosphorus enrichment led to the replacement of Meridion circulare by non-mucilaginous taxa in phosphorus-enriched streams, and we hypothesize that this change enabled more efficient use of light in photosynthesis. Higher ratios of chlorophyll a : biomass in phosphorus-enriched streams may have also led to more

Hydraulic Properties related to Stream Reaeration

Energy Technology Data Exchange (ETDEWEB)

Tsivoglou, E. C.; Wallace, J. R. [School of Civil Engineering, Georgia Institute of Technology, Atlanta, GA (United States)

1970-09-15

The paper reports the results of recent and current field tracer experiments designed to investigate the relationships between the reaeration capacity of a flowing stream and the stream's hydraulic properties. The purpose of the studies is to develop models for the accurate prediction of stream reaeration capacity on the basis of observation of the associated hydraulic properties. The ability of a flowing stream to absorb oxygen from the overlying atmosphere is the principal process by which the stream is able to recover its dissolved oxygen resources once they have been depleted by bacterial degradation of organic wastes. Accurate knowledge of stream reaeration capacity is therefore a necessity in determining the required degree of waste treatment, and the associated costs, in any specific case. Oxygen absorption can only occur at the air-water interface, hence reaeration is a direct function of the rate of surface water replacement due to turbulent mixing. The latter is not directly observable, and so reaeration capacity has not been observable before the quite recent development of a gaseous radiotracer technique for field measurement of reaeration. This procedure involves the simultaneous use of three tracers, namely a fluorescent dye for time of flow, tritiated water for accurate dispersion measurement, and dissolved krypton-85 for measurement of gas transfer. Field results obtained by this technique are highly reproducible. Field tracer studies of the reaeration capacities of three medium-sized streams have been conducted over a total of about fifty river miles. Associated hydraulic properties such as stream flow, cross-sectional area, depth, velocity, hydraulic gradient and dispersion have also been measured. Features such as waterfalls, rapids and pools are included, and more than eighty observations of the reaeration capacities of individual stream reaches have been made. The paper reports the observed relationships between stream reaeration capacity and

Hydraulic properties related to stream reaeration

Energy Technology Data Exchange (ETDEWEB)

Tsivoglou, E C; Wallace, J R [School of Civil Engineering, Georgia Institute of Technology, Atlanta, GA (United States)

1970-09-15

The paper reports the results of recent and current field tracer experiments designed to investigate the relationships between the reaeration capacity of a flowing stream and the stream's hydraulic properties. The purpose of the studies is to develop models for the accurate prediction of stream reaeration capacity on the basis of observation of the associated hydraulic properties. The ability of a flowing stream to absorb oxygen from the overlying atmosphere is the principal process by which the stream is able to recover its dissolved oxygen resources once they have been depleted by bacterial degradation of organic wastes. Accurate knowledge of stream reaeration capacity is therefore a necessity in determining the required degree of waste treatment, and the associated costs, in any specific case. Oxygen absorption can only occur at the air-water interface, hence reaeration is a direct function of the rate of surface water replacement due to turbulent mixing. The latter is not directly observable, and so reaeration capacity has not been observable before the quite recent development of a gaseous radiotracer technique for field measurement of reaeration. This procedure involves the simultaneous use of three tracers, namely a fluorescent dye for time of flow, tritiated water for accurate dispersion measurement, and dissolved krypton-85 for measurement of gas transfer. Field results obtained by this technique are highly reproducible. Field tracer studies of the reaeration capacities of three medium-sized streams have been conducted over a total of about fifty river miles. Associated hydraulic properties such as stream flow, cross-sectional area, depth, velocity, hydraulic gradient and dispersion have also been measured. Features such as waterfalls, rapids and pools are included, and more than eighty observations of the reaeration capacities of individual stream reaches have been made. The paper reports the observed relationships between stream reaeration capacity and

Discharge modulates stream metabolism dependence on fine particulate organic carbon in a Mediterranean WWTP-influenced stream

Science.gov (United States)

Drummond, J. D.; Bernal, S.; Meredith, W.; Schumer, R.; Martí Roca, E.

2017-12-01

Waste water treatment plant (WWTP) effluents constitute point source inputs of fine sediment, nutrients, carbon, and microbes to stream ecosystems. A range of responses to these inputs may be observed in recipient streams, including increases in respiration rates, which augment CO2 emissions to the atmosphere. Yet, little is known about which fractions of organic carbon (OC) contribute the most to stream metabolism in WWTP-influenced streams. Fine particulate OC (POC) represents ca. 40% of the total mass of OC in river networks, and is generally more labile than dissolved OC. Therefore, POC inputs from WWTPs could contribute disproportionately to higher rates of heterotrophic metabolism by stream microbial communities. The aim of this study was to investigate the influence of POC inputs from a WWTP effluent on the metabolism of a Mediterranean stream over a wide range of hydrologic conditions. We hypothesized that POC inputs would have a positive effect on respiration rates, and that the response to POC availability would be larger during low flows when the dilution capacity of the recipient stream is negligible. We focused on the easily resuspended fine sediment near the sediment-water interface (top 3 cm), as this region is a known hot spot for biogeochemical processes. For one year, samples of resuspended sediment were collected bimonthly at 7 sites from 0 to 800 m downstream of the WWTP point source. We measured total POC, organic matter (OM) content (%), and the associated metabolic activity of the resuspended sediment using the resazurin-resorufin smart tracer system as a proxy for aerobic ecosystem respiration. Resuspended sediment showed no difference in total POC over the year, while the OM content increased with decreasing discharge. This result together with the decreasing trend of total POC observed downstream of the point source during autumn after a long dry period, suggests that the WWTP effluent was the main contributor to stream POC. Furthermore

Fast algorithm for automatically computing Strahler stream order

Science.gov (United States)

Lanfear, Kenneth J.

1990-01-01

An efficient algorithm was developed to determine Strahler stream order for segments of stream networks represented in a Geographic Information System (GIS). The algorithm correctly assigns Strahler stream order in topologically complex situations such as braided streams and multiple drainage outlets. Execution time varies nearly linearly with the number of stream segments in the network. This technique is expected to be particularly useful for studying the topology of dense stream networks derived from digital elevation model data.

Waste streams from reprocessing operations

International Nuclear Information System (INIS)

Andersson, B.; Ericsson, A.-M.

1978-03-01

The three main products from reprocessing operations are uranium, plutonium and vitrified high-level-waste. The purpose of this report is to identify and quantify additional waste streams containing radioactive isotops. Special emphasis is laid on Sr, Cs and the actinides. The main part, more than 99 % of both the fission-products and the transuranic elements are contained in the HLW-stream. Small quantities sometimes contaminate the U- and Pu-streams and the rest is found in the medium-level-waste

Human parvovirus B19 nosocomial outbreak in healthcare personnel in a paediatric ward at a national tertiary referral centre in Thailand.

Science.gov (United States)

Sungkate, S; Phongsamart, W; Rungmaitree, S; Lapphra, K; Wittawatmongkol, O; Pumsuwan, V; Wiruchkul, N; Assanasen, S; Rongrungruang, Y; Onlamoon, N; Horthongkham, N; Lermankul, W; Kongstan, N; Chokephaibulkit, K

2017-06-01

Nosocomial outbreaks of parvovirus B19 (pB19) have been reported, but they rarely occur among healthcare personnel (HCP). Susceptibility among pregnant HCP was the major concern. An outbreak of pB19 among HCP is described in a paediatric ward with a cross-sectional serologic study in all HCP and patients exposed to the outbreak. Acute infection was diagnosed by polymerase chain reaction or positive anti-parvovirus B19 IgM. Among 48 HCP (three pregnant) and 22 patients included in the outbreak serologic study, 11 (23%) HCP and two (9%) patients had acute infection. Of these, six HCP and no patients were symptomatic. Clinical manifestations included itchy rash (100%) and joint pain following resolution of rash (67%), with median rash duration of four days. Forty percent of HCP and 50% of patients had positive anti-parvovirus IgG, indicating previously immune status. HCP with acute infection and HCP who were susceptible without infection were younger than HCP with previous immunity (mean age 32.2 vs 40.5 years, respectively; P = 0.003). The attack rate was 38% among HCP and 18% among patients who were susceptible, respectively. The outbreak ended within two weeks following strict droplet precaution and segregation of symptomatic HCP. Parvovirus B19 infection may cause nosocomial outbreak with high attack rate among HCP. Outbreak control with droplet precaution was highly effective. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Potential stream density in Mid-Atlantic US watersheds.

Science.gov (United States)

Elmore, Andrew J; Julian, Jason P; Guinn, Steven M; Fitzpatrick, Matthew C

2013-01-01

Stream network density exerts a strong influence on ecohydrologic processes in watersheds, yet existing stream maps fail to capture most headwater streams and therefore underestimate stream density. Furthermore, discrepancies between mapped and actual stream length vary between watersheds, confounding efforts to understand the impacts of land use on stream ecosystems. Here we report on research that predicts stream presence from coupled field observations of headwater stream channels and terrain variables that were calculated both locally and as an average across the watershed upstream of any location on the landscape. Our approach used maximum entropy modeling (MaxEnt), a robust method commonly implemented to model species distributions that requires information only on the presence of the entity of interest. In validation, the method correctly predicts the presence of 86% of all 10-m stream segments and errors are low (stream density and compare our results with the National Hydrography Dataset (NHD). We find that NHD underestimates stream density by up to 250%, with errors being greatest in the densely urbanized cities of Washington, DC and Baltimore, MD and in regions where the NHD has never been updated from its original, coarse-grain mapping. This work is the most ambitious attempt yet to map stream networks over a large region and will have lasting implications for modeling and conservation efforts.