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Sample records for strict infection control

  1. Synchronizing strict-feedback and general strict-feedback chaotic systems via a single controller

    International Nuclear Information System (INIS)

    Chen Shihua; Wang Feng; Wang Changping

    2004-01-01

    We present a systematic design procedure to synchronize a class of chaotic systems in a so-called strict-feedback form based on back-stepping procedure. This approach needs only a single controller to realize synchronization no matter how many dimensions the chaotic system contains. Furthermore, we point out that the method does not work for general strict-feedback chaotic systems, for instance, Lorenz system. Therefore, we propose three kinds of synchronization schemes for Lorenz system using the Lyapunov function method. All the three schemes avoid including divergence factor as in Ref. [Chaos, Solitons and Fractals 16 (2003) 37]. Especially in the last two schemes, we need only one state variable in controller, which has important significance in chaos synchronization used for communication purposes. Finally numerical simulations are provided to show the effectiveness and feasibility of the developed methods

  2. Strict integrity control of biomedical images

    Science.gov (United States)

    Coatrieux, Gouenou; Maitre, Henri; Sankur, Bulent

    2001-08-01

    The control of the integrity and authentication of medical images is becoming ever more important within the Medical Information Systems (MIS). The intra- and interhospital exchange of images, such as in the PACS (Picture Archiving and Communication Systems), and the ease of copying, manipulation and distribution of images have brought forth the security aspects. In this paper we focus on the role of watermarking for MIS security and address the problem of integrity control of medical images. We discuss alternative schemes to extract verification signatures and compare their tamper detection performance.

  3. General aspects concerning strictly meat and fish transmitted parasitic infections

    Directory of Open Access Journals (Sweden)

    Daniele Crotti

    2012-03-01

    Full Text Available All helminths parasitosis transmitted to humans trough ingestion of infested fleshes, where man is definitive host too, are represented by four groups of helminths: the cestodes Dyphyllobothrium spp and Spirometra spp. (Sparganum proliferum is the name of the immature plerocercoid larva, the trematodes Opisthorchis Clonorchis “group” (many could be the genera and species involved, and the nematode Capillaria philippinensis. So, for fishes humans foods (fresh or salted water the control and prevention in veterinary health must be directed to investigation regarding intermediate stages of these parasites in fishes for human alimentation; if present, they must be eliminated. The helminths parasitosis transmitted to humans trough ingestion of infected mammals meats, are represented by taeniasis (Taenia saginata, T. solium and T. saginata asiatica, where man id definitive host and the infection is caused by ingestion of bovine or swine meat, containing larvae of these cestodes, and by trichinellosis, where humans represent a intermediate stage, and the eventual pathology is caused as by adult (acute infection as by larvae (chronic infection of this nematode: usually the meats responsible are infected pork, wild pork or horse (Trichinella spp. Is inside the meats of these animals. So the veterinary control and prophylaxis are necessary to avoid this disease and preventing the infection that could be severe.

  4. Strategy and Aspects of Monitoring / Control Strictly in Coordinated Subsystems

    Directory of Open Access Journals (Sweden)

    William José Borges

    2012-06-01

    Full Text Available This paper aims to discuss the approach structures of the strictly coordinated theoretical framework developed by Zylbersztajn and Farina (1999 as an expanded perspective of the firm, taking into account the food supply chains as an extension of the nexus of contracts proposed by Coase (1937 and taken up by Williamson (1985. The structures stand out as strictly coordinated. Zylbersztajn and Farina (1999 turn to identifying points of common interests that encourage firms to promote contracts between themselves in a strictly coordinated way, considering the degree of asset specificity involved in the transaction and the competitive forces that determine the search for strategic positioning organizations to achieve sustainable superior results.

  5. Synchronization control of cross-strict feedback hyperchaotic system based on cross active backstepping design

    International Nuclear Information System (INIS)

    Wang Jing; Gao Jinfeng; Ma Xikui

    2007-01-01

    This Letter presents a novel cross active backstepping design method for synchronization control of cross-strict feedback hyperchaotic system, in which the ordinary backstepping design is unavailable. The proposed control method, combining backstepping design and active control approach, extends the application of backstepping technique in chaos control. Based on this method, different combinations of controllers can be designed to meet the needs of different applications. The proposed method is applied to achieve chaos synchronization of two identical cross-strict feedback hyperchaotic systems. Also it is used to implement synchronization between cross-strict feedback hyperchaotic system and Roessler hyperchaotic system. Numerical examples illustrate the validity of the control method

  6. Rate Control Efficacy in Permanent Atrial Fibrillation : Successful and Failed Strict Rate Control Against a Background of Lenient Rate Control

    NARCIS (Netherlands)

    Groenveld, Hessel F.; Tijssen, Jan G. P.; Crijns, Harry J. G. M.; Van den Berg, Maarten P.; Hillege, Hans L.; Alings, Marco; Van Veldhuisen, Dirk J.; Van Gelder, Isabelle C.

    2013-01-01

    Objectives This study sought to investigate differences in outcome between patients treated with successful strict, failed strict, and lenient rate control. Background The RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation) study showed no difference in outcome between lenient and

  7. Morfofunctional indices of peripheric blood for persons working within the strict radiation control area

    International Nuclear Information System (INIS)

    Nyagu, A.I.; Yukhimuk, L.N.; Egorova, D.M.; Pogontseva, I.M.

    1992-01-01

    The blood of 118 people permanently working within the area of strict radiation control has been investigated. Erythrocyte morphofunctional value has been estimated taking into consideration the erythrocyte morphological index as well as mechanical and osmotic resistivity of erythrocytes. For people permanently working within the area of strict radiation control intensity of signals of EPR for blood paramagnetic centres essentially changes. It proves profound changes in functioning of blood plasma antioxidant system for people working in the area of strict radiation control. For the people permanently working within the area of strict radiation control in peripheric blood growth of echynocytes and spherocytes as well as lowering of mechanical resistivity of erythrocytes is observed. 4 refs.; 1 fig.; 1 tab

  8. ASHP therapeutic position statement on strict glycemic control in patients with diabetes.

    Science.gov (United States)

    2003-11-15

    The deleterious effects of hyperglycemia have been documented from the biochemical to the pathophysiologic level. Given the research findings and the guidelines for glycemic control established by ADA and ACE, ASHP supports and encourages strict glycemic control in all appropriate patients with diabetes mellitus to reduce the progression of chronic complications.

  9. The Preventive Effect of Strict Gun Control Laws on Suicide and Homicide.

    Science.gov (United States)

    Lester, David; Murrell, Mary E.

    1982-01-01

    Examined state gun control laws and used a multidimensional scaling technique to study the relationship of strictness and death rates. Results showed states with stricter laws had lower suicide rates by firearms but higher rates by other means. No effect on homicide was found. (JAC)

  10. The conditions for attaining the greatest degree of system stability with strict generator excitation control

    Energy Technology Data Exchange (ETDEWEB)

    Gruzdev, I.A.; Ekimova, M.M.; Truspekova, G.A.

    1982-01-01

    Expressions are derived for an idealized model of a complex electric power system; these expressions define the greatest level of stability of an electric power system and the optimum combination of stabilization factors with automatic excitation control in a single power system. The possibility of increasing the level of stability of an electric power system with simultaneous strict automatic excitation control of the synychronous generators in several power systems is analyzed.

  11. Frequency effect on p-nitrophenol degradation under conditions of strict acoustic and electric control

    Directory of Open Access Journals (Sweden)

    Chang-ping Zhu

    2011-03-01

    Full Text Available The process of decomposing p-nitrophenol (PNP with power ultrasound requires strict control of acoustic and electric conditions. In this study, the conditions, including acoustic power and acoustic intensity, but not ultrasonic frequency, were controlled strictly at constant levels. The absorbency and the COD concentrations of the samples were measured in order to show the variation of the sample concentration. The results show significant differences in the trend of the solution degradation rate as acoustic power increases after the PNP solution (with a concentration of 114 mg/L and a pH value of 5.4 is irradiated for 60 min with ultrasonic frequencies of 530.8 kHz, 610.6 kHz, 855.0 kHz, and 1 130.0 kHz. The degradation rate of the solution increases with time and acoustic power (acoustic intensity. On the other hand, the degradation rate of the solution is distinctly dependent on frequency when the acoustic power and intensity are strictly controlled and maintained at constant levels. The degradation rate of the PNP solution declines with ultrasonic frequencies of 530.8 kHz, 610.6 kHz, 855.0 kHz, and 1 130.0 kHz; the COD concentration, on the contrary, increase.

  12. Optimal control of nonlinear continuous-time systems in strict-feedback form.

    Science.gov (United States)

    Zargarzadeh, Hassan; Dierks, Travis; Jagannathan, Sarangapani

    2015-10-01

    This paper proposes a novel optimal tracking control scheme for nonlinear continuous-time systems in strict-feedback form with uncertain dynamics. The optimal tracking problem is transformed into an equivalent optimal regulation problem through a feedforward adaptive control input that is generated by modifying the standard backstepping technique. Subsequently, a neural network-based optimal control scheme is introduced to estimate the cost, or value function, over an infinite horizon for the resulting nonlinear continuous-time systems in affine form when the internal dynamics are unknown. The estimated cost function is then used to obtain the optimal feedback control input; therefore, the overall optimal control input for the nonlinear continuous-time system in strict-feedback form includes the feedforward plus the optimal feedback terms. It is shown that the estimated cost function minimizes the Hamilton-Jacobi-Bellman estimation error in a forward-in-time manner without using any value or policy iterations. Finally, optimal output feedback control is introduced through the design of a suitable observer. Lyapunov theory is utilized to show the overall stability of the proposed schemes without requiring an initial admissible controller. Simulation examples are provided to validate the theoretical results.

  13. Control of Petri nets subject to strict temporal constraints using Max-Plus algebra

    Science.gov (United States)

    Tebani, K.; Amari, S.; Kara, R.

    2018-04-01

    In this paper, we treat the control problem of timed discrete event systems under temporal constraints. This type of constraint is very frequent in production systems, transportation network and in networked automation systems. Precisely, we are interested in the validation of strict temporal constraints imposed on the paths in a timed event graph (TEG) by using Max-Plus algebra. Not all the transitions of the considered TEG model are controllable, i.e. only the input transitions are controllable. An analytical approach for computing state feedback controllers is developed. Sufficient condition is given for the existence of causal control laws satisfying the temporal constraints. In the first, a TEG with observable transitions is considered. Then, the proposed approach is extended to the partially observable TEG. The synthesised feedback can be interpreted by places of control connected to the TEG to guarantee the respect of the time constraints. The proposed method is illustrated in the assembly system example.

  14. Learning-Based Adaptive Optimal Tracking Control of Strict-Feedback Nonlinear Systems.

    Science.gov (United States)

    Gao, Weinan; Jiang, Zhong-Ping; Weinan Gao; Zhong-Ping Jiang; Gao, Weinan; Jiang, Zhong-Ping

    2018-06-01

    This paper proposes a novel data-driven control approach to address the problem of adaptive optimal tracking for a class of nonlinear systems taking the strict-feedback form. Adaptive dynamic programming (ADP) and nonlinear output regulation theories are integrated for the first time to compute an adaptive near-optimal tracker without any a priori knowledge of the system dynamics. Fundamentally different from adaptive optimal stabilization problems, the solution to a Hamilton-Jacobi-Bellman (HJB) equation, not necessarily a positive definite function, cannot be approximated through the existing iterative methods. This paper proposes a novel policy iteration technique for solving positive semidefinite HJB equations with rigorous convergence analysis. A two-phase data-driven learning method is developed and implemented online by ADP. The efficacy of the proposed adaptive optimal tracking control methodology is demonstrated via a Van der Pol oscillator with time-varying exogenous signals.

  15. Global neural dynamic surface tracking control of strict-feedback systems with application to hypersonic flight vehicle.

    Science.gov (United States)

    Xu, Bin; Yang, Chenguang; Pan, Yongping

    2015-10-01

    This paper studies both indirect and direct global neural control of strict-feedback systems in the presence of unknown dynamics, using the dynamic surface control (DSC) technique in a novel manner. A new switching mechanism is designed to combine an adaptive neural controller in the neural approximation domain, together with the robust controller that pulls the transient states back into the neural approximation domain from the outside. In comparison with the conventional control techniques, which could only achieve semiglobally uniformly ultimately bounded stability, the proposed control scheme guarantees all the signals in the closed-loop system are globally uniformly ultimately bounded, such that the conventional constraints on initial conditions of the neural control system can be relaxed. The simulation studies of hypersonic flight vehicle (HFV) are performed to demonstrate the effectiveness of the proposed global neural DSC design.

  16. Adaptive terminal sliding mode control for hypersonic flight vehicles with strictly lower convex function based nonlinear disturbance observer.

    Science.gov (United States)

    Wu, Yun-Jie; Zuo, Jing-Xing; Sun, Liang-Hua

    2017-11-01

    In this paper, the altitude and velocity tracking control of a generic hypersonic flight vehicle (HFV) is considered. A novel adaptive terminal sliding mode controller (ATSMC) with strictly lower convex function based nonlinear disturbance observer (SDOB) is proposed for the longitudinal dynamics of HFV in presence of both parametric uncertainties and external disturbances. First, for the sake of enhancing the anti-interference capability, SDOB is presented to estimate and compensate the equivalent disturbances by introducing a strictly lower convex function. Next, the SDOB based ATSMC (SDOB-ATSMC) is proposed to guarantee the system outputs track the reference trajectory. Then, stability of the proposed control scheme is analyzed by the Lyapunov function method. Compared with other HFV control approaches, key novelties of SDOB-ATSMC are that a novel SDOB is proposed and drawn into the (virtual) control laws to compensate the disturbances and that several adaptive laws are used to deal with the differential explosion problem. Finally, it is illustrated by the simulation results that the new method exhibits an excellent robustness and a better disturbance rejection performance than the convention approach. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  17. Globally Stable Adaptive Backstepping Neural Network Control for Uncertain Strict-Feedback Systems With Tracking Accuracy Known a Priori.

    Science.gov (United States)

    Chen, Weisheng; Ge, Shuzhi Sam; Wu, Jian; Gong, Maoguo

    2015-09-01

    This paper addresses the problem of globally stable direct adaptive backstepping neural network (NN) tracking control design for a class of uncertain strict-feedback systems under the assumption that the accuracy of the ultimate tracking error is given a priori. In contrast to the classical adaptive backstepping NN control schemes, this paper analyzes the convergence of the tracking error using Barbalat's Lemma via some nonnegative functions rather than the positive-definite Lyapunov functions. Thus, the accuracy of the ultimate tracking error can be determined and adjusted accurately a priori, and the closed-loop system is guaranteed to be globally uniformly ultimately bounded. The main technical novelty is to construct three new n th-order continuously differentiable functions, which are used to design the control law, the virtual control variables, and the adaptive laws. Finally, two simulation examples are given to illustrate the effectiveness and advantages of the proposed control method.

  18. Online Recorded Data-Based Composite Neural Control of Strict-Feedback Systems With Application to Hypersonic Flight Dynamics.

    Science.gov (United States)

    Xu, Bin; Yang, Daipeng; Shi, Zhongke; Pan, Yongping; Chen, Badong; Sun, Fuchun

    2017-09-25

    This paper investigates the online recorded data-based composite neural control of uncertain strict-feedback systems using the backstepping framework. In each step of the virtual control design, neural network (NN) is employed for uncertainty approximation. In previous works, most designs are directly toward system stability ignoring the fact how the NN is working as an approximator. In this paper, to enhance the learning ability, a novel prediction error signal is constructed to provide additional correction information for NN weight update using online recorded data. In this way, the neural approximation precision is highly improved, and the convergence speed can be faster. Furthermore, the sliding mode differentiator is employed to approximate the derivative of the virtual control signal, and thus, the complex analysis of the backstepping design can be avoided. The closed-loop stability is rigorously established, and the boundedness of the tracking error can be guaranteed. Through simulation of hypersonic flight dynamics, the proposed approach exhibits better tracking performance.

  19. Composite Intelligent Learning Control of Strict-Feedback Systems With Disturbance.

    Science.gov (United States)

    Xu, Bin; Sun, Fuchun

    2018-02-01

    This paper addresses the dynamic surface control of uncertain nonlinear systems on the basis of composite intelligent learning and disturbance observer in presence of unknown system nonlinearity and time-varying disturbance. The serial-parallel estimation model with intelligent approximation and disturbance estimation is built to obtain the prediction error and in this way the composite law for weights updating is constructed. The nonlinear disturbance observer is developed using intelligent approximation information while the disturbance estimation is guaranteed to converge to a bounded compact set. The highlight is that different from previous work directly toward asymptotic stability, the transparency of the intelligent approximation and disturbance estimation is included in the control scheme. The uniformly ultimate boundedness stability is analyzed via Lyapunov method. Through simulation verification, the composite intelligent learning with disturbance observer can efficiently estimate the effect caused by system nonlinearity and disturbance while the proposed approach obtains better performance with higher accuracy.

  20. A set-theoretic model reference adaptive control architecture for disturbance rejection and uncertainty suppression with strict performance guarantees

    Science.gov (United States)

    Arabi, Ehsan; Gruenwald, Benjamin C.; Yucelen, Tansel; Nguyen, Nhan T.

    2018-05-01

    Research in adaptive control algorithms for safety-critical applications is primarily motivated by the fact that these algorithms have the capability to suppress the effects of adverse conditions resulting from exogenous disturbances, imperfect dynamical system modelling, degraded modes of operation, and changes in system dynamics. Although government and industry agree on the potential of these algorithms in providing safety and reducing vehicle development costs, a major issue is the inability to achieve a-priori, user-defined performance guarantees with adaptive control algorithms. In this paper, a new model reference adaptive control architecture for uncertain dynamical systems is presented to address disturbance rejection and uncertainty suppression. The proposed framework is predicated on a set-theoretic adaptive controller construction using generalised restricted potential functions.The key feature of this framework allows the system error bound between the state of an uncertain dynamical system and the state of a reference model, which captures a desired closed-loop system performance, to be less than a-priori, user-defined worst-case performance bound, and hence, it has the capability to enforce strict performance guarantees. Examples are provided to demonstrate the efficacy of the proposed set-theoretic model reference adaptive control architecture.

  1. Effect of strict metabolic control on regulation of subcutaneous blood flow in insulin-dependent diabetic patients

    DEFF Research Database (Denmark)

    Kastrup, J; Mathiesen, E R; Saurbrey, Nina

    1987-01-01

    washout technique. Mean arterial blood pressure was reduced by a maximum of 23 mmHg by elevating the limb above heart level and elevated to a maximum of 65 mmHg by head-up tilt; in the latter position venous pressure was kept constantly low by activation of the leg muscle vein pump (heel raising......The effect of 10 weeks of improved metabolic control on the impaired autoregulation of the subcutaneous blood flow was studied at the level of the lateral malleolus in eight long-term insulin-dependent diabetic patients with clinical microangiopathy. Blood flow was measured by the local 133-Xenon......). Improved metabolic control was achieved using either continuous subcutaneous insulin infusion or multiple insulin injections. The blood glucose concentration declined from (median) 12.7 to 6.8 mmol/l and the HbA1C level from 10.1 to 7.5% during strict metabolic control (p less than 0.01 and p less than 0...

  2. Lenient vs. strict rate control in patients with atrial fibrillation and heart failure: a post-hoc analysis of the RACE II study

    NARCIS (Netherlands)

    Mulder, Bart A.; van Veldhuisen, Dirk J.; Crijns, Harry J. G. M.; Tijssen, Jan G. P.; Hillege, Hans L.; Alings, Marco; Rienstra, Michiel; Groenveld, Hessel F.; van den Berg, Maarten P.; van Gelder, Isabelle C.

    2013-01-01

    It is unknown whether lenient rate control is an acceptable strategy in patients with AF and heart failure. We evaluated differences in outcome in patients with AF and heart failure treated with lenient or strict rate control. This post-hoc analysis of the RACE II trial included patients with an

  3. Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France.

    Science.gov (United States)

    Birgand, Gabriel; Leroy, Christophe; Nerome, Simone; Luong Nguyen, Liem Binh; Lolom, Isabelle; Armand-Lefevre, Laurence; Ciotti, Céline; Lecorre, Bertrand; Marcade, Géraldine; Fihman, Vincent; Nicolas-Chanoine, Marie-Hélène; Pelat, Camille; Perozziello, Anne; Fantin, Bruno; Yazdanpanah, Yazdan; Ricard, Jean-Damien; Lucet, Jean-Christophe

    2016-01-29

    To assess costs associated with implementation of a strict 'search and isolate' strategy for controlling highly drug-resistant organisms (HDRO). Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO. Three university hospitals located in northern Paris. Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management. Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean ± SD) associated with management of a single case identified within and/or 48 h after admission was €4443 ± 11,552 and €11,445 ± 15,743, respectively (pcost varied from €14,864 ± 17,734 for an episode with one secondary case (€7432 ± 8867 per case) to €136,525 ± 151,231 (€12,845 ± 5129 per case) when more than one secondary case occurred. In episodes of single cases, contact precautions and microbiological analyses represented 51% and 30% of overall cost, respectively. In outbreaks, cost related to interruption of new admissions represented 77-94% of total costs, and had the greatest financial impact (R(2)=0.98, pcostly measure in an outbreak situation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Strict confluent drawing

    NARCIS (Netherlands)

    Eppstein, D.; Holten, D.H.R.; Löffler, M.; Nöllenburg, M.; Speckmann, B.; Verbeek, K.A.B.

    2013-01-01

    We define strict confluent drawing, a form of confluent drawing in which the existence of an edge is indicated by the presence of a smooth path through a system of arcs and junctions (without crossings), and in which such a path, if it exists, must be unique. We prove that it is NP-complete to

  5. Strict confluent drawing

    NARCIS (Netherlands)

    Eppstein, D.; Holten, D.; Löffler, M.; Nöllenburg, M.; Speckmann, B.; Verbeek, K.A.B.

    2016-01-01

    We define strict confluent drawing, a form of confluent drawing in which the existence of an edge is indicated by the presence of a smooth path through a system of arcs and junctions (without crossings), and in which such a path, if it exists, must be unique. We prove that it is NP-complete to

  6. Quine's "Strictly Vegetarian" Analyticity

    NARCIS (Netherlands)

    Decock, L.B.

    2017-01-01

    I analyze Quine’s later writings on analyticity from a linguistic point of view. In Word and Object Quine made room for a “strictly vegetarian” notion of analyticity. In later years, he developed this notion into two more precise notions, which I have coined “stimulus analyticity” and “behaviorist

  7. Synthesis of nanoparticles in a flame aerosol reactor with independent and strict control of their size, crystal phase and morphology

    International Nuclear Information System (INIS)

    Jiang Jingkun; Chen, D-R; Biswas, Pratim

    2007-01-01

    A flame aerosol reactor (FLAR) was developed to synthesize nanoparticles with desired properties (crystal phase and size) that could be independently controlled. The methodology was demonstrated for TiO 2 nanoparticles, and this is the first time that large sets of samples with the same size but different crystal phases (six different ratios of anatase to rutile in this work) were synthesized. The degree of TiO 2 nanoparticle agglomeration was determined by comparing the primary particle size distribution measured by scanning electron microscopy (SEM) to the mobility-based particle size distribution measured by online scanning mobility particle spectrometry (SMPS). By controlling the flame aerosol reactor conditions, both spherical unagglomerated particles and highly agglomerated particles were produced. To produce monodisperse nanoparticles, a high throughput multi-stage differential mobility analyser (MDMA) was used in series with the flame aerosol reactor. Nearly monodisperse nanoparticles (geometric standard deviation less than 1.05) could be collected in sufficient mass quantities (of the order of 10 mg) in reasonable time (1 h) that could be used in other studies such as determination of functionality or biological effects as a function of size

  8. Synthesis of nanoparticles in a flame aerosol reactor with independent and strict control of their size, crystal phase and morphology

    Energy Technology Data Exchange (ETDEWEB)

    Jiang Jingkun; Chen, D-R; Biswas, Pratim [Aerosol and Air Quality Research Laboratory, Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, Campus Box 1180, St Louis, MO 63130 (United States)

    2007-07-18

    A flame aerosol reactor (FLAR) was developed to synthesize nanoparticles with desired properties (crystal phase and size) that could be independently controlled. The methodology was demonstrated for TiO{sub 2} nanoparticles, and this is the first time that large sets of samples with the same size but different crystal phases (six different ratios of anatase to rutile in this work) were synthesized. The degree of TiO{sub 2} nanoparticle agglomeration was determined by comparing the primary particle size distribution measured by scanning electron microscopy (SEM) to the mobility-based particle size distribution measured by online scanning mobility particle spectrometry (SMPS). By controlling the flame aerosol reactor conditions, both spherical unagglomerated particles and highly agglomerated particles were produced. To produce monodisperse nanoparticles, a high throughput multi-stage differential mobility analyser (MDMA) was used in series with the flame aerosol reactor. Nearly monodisperse nanoparticles (geometric standard deviation less than 1.05) could be collected in sufficient mass quantities (of the order of 10 mg) in reasonable time (1 h) that could be used in other studies such as determination of functionality or biological effects as a function of size.

  9. Infection control in Indonesian Hospitals

    OpenAIRE

    Duerink, Daphne Offra

    2009-01-01

    The studies in this thesis were performed as part of the AMRIN (Antimicrobial Resistance in Indonesia) study that addressed antimicrobial resistance, antibiotic usage and infection control in Indonesia. They are the first studies that give insight into the incidence of healthcare-associated infections, determinants for carriage of resistant bacteria in Indonesian individuals and the implementation of measures for the prevention of the spread of bacteria and nosocomial infections in Indonesian...

  10. "Open mesh" or "strictly selected population" recruitment? The experience of the randomized controlled MeMeMe trial

    Directory of Open Access Journals (Sweden)

    Cortellini M

    2017-07-01

    Full Text Available Mauro Cortellini, Franco Berrino, Patrizia Pasanisi Department of Preventive & Predictive Medicine, Foundation IRCCS National Cancer Institute of Milan, Milan, Italy Abstract: Among randomized controlled trials (RCTs, trials for primary prevention require large samples and long follow-up to obtain a high-quality outcome; therefore the recruitment process and the drop-out rates largely dictate the adequacy of the results. We are conducting a Phase III trial on persons with metabolic syndrome to test the hypothesis that comprehensive lifestyle changes and/or metformin treatment prevents age-related chronic diseases (the MeMeMe trial, EudraCT number: 2012-005427-32, also registered on ClinicalTrials.gov [NCT02960711]. Here, we briefly analyze and discuss the reasons which may lead to participants dropping out from trials. In our experience, participants may back out of a trial for different reasons. Drug-induced side effects are certainly the most compelling reason. But what are the other reasons, relating to the participants’ perception of the progress of the trial which led them to withdraw after randomization? What about the time-dependent drop-out rate in primary prevention trials? The primary outcome of this analysis is the point of drop-out from trial, defined as the time from the randomization date to the withdrawal date. Survival functions were non-parametrically estimated using the product-limit estimator. The curves were statistically compared using the log-rank test (P=0.64, not significant. Researchers involved in primary prevention RCTs seem to have to deal with the paradox of the proverbial “short blanket syndrome”. Recruiting only highly motivated candidates might be useful for the smooth progress of the trial but it may lead to a very low enrollment rate. On the other hand, what about enrolling all the eligible subjects without considering their motivation? This might boost the enrollment rate, but it can lead to biased

  11. "Open mesh" or "strictly selected population" recruitment? The experience of the randomized controlled MeMeMe trial.

    Science.gov (United States)

    Cortellini, Mauro; Berrino, Franco; Pasanisi, Patrizia

    2017-01-01

    Among randomized controlled trials (RCTs), trials for primary prevention require large samples and long follow-up to obtain a high-quality outcome; therefore the recruitment process and the drop-out rates largely dictate the adequacy of the results. We are conducting a Phase III trial on persons with metabolic syndrome to test the hypothesis that comprehensive lifestyle changes and/or metformin treatment prevents age-related chronic diseases (the MeMeMe trial, EudraCT number: 2012-005427-32, also registered on ClinicalTrials.gov [NCT02960711]). Here, we briefly analyze and discuss the reasons which may lead to participants dropping out from trials. In our experience, participants may back out of a trial for different reasons. Drug-induced side effects are certainly the most compelling reason. But what are the other reasons, relating to the participants' perception of the progress of the trial which led them to withdraw after randomization? What about the time-dependent drop-out rate in primary prevention trials? The primary outcome of this analysis is the point of drop-out from trial, defined as the time from the randomization date to the withdrawal date. Survival functions were non-parametrically estimated using the product-limit estimator. The curves were statistically compared using the log-rank test ( P =0.64, not significant). Researchers involved in primary prevention RCTs seem to have to deal with the paradox of the proverbial "short blanket syndrome". Recruiting only highly motivated candidates might be useful for the smooth progress of the trial but it may lead to a very low enrollment rate. On the other hand, what about enrolling all the eligible subjects without considering their motivation? This might boost the enrollment rate, but it can lead to biased results on account of large proportions of drop-outs. Our experience suggests that participants do not change their mind depending on the allocation group (intervention or control). There is no single

  12. Infection Control: MedlinePlus Health Topic

    Science.gov (United States)

    ... Staph infections - hospital (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Infection Control updates ... infections when visiting Staph infections - hospital Related Health Topics Hepatitis HIV/AIDS MRSA National Institutes of Health ...

  13. Distributed cooperative H∞ optimal tracking control of MIMO nonlinear multi-agent systems in strict-feedback form via adaptive dynamic programming

    Science.gov (United States)

    Luy, N. T.

    2018-04-01

    The design of distributed cooperative H∞ optimal controllers for multi-agent systems is a major challenge when the agents' models are uncertain multi-input and multi-output nonlinear systems in strict-feedback form in the presence of external disturbances. In this paper, first, the distributed cooperative H∞ optimal tracking problem is transformed into controlling the cooperative tracking error dynamics in affine form. Second, control schemes and online algorithms are proposed via adaptive dynamic programming (ADP) and the theory of zero-sum differential graphical games. The schemes use only one neural network (NN) for each agent instead of three from ADP to reduce computational complexity as well as avoid choosing initial NN weights for stabilising controllers. It is shown that despite not using knowledge of cooperative internal dynamics, the proposed algorithms not only approximate values to Nash equilibrium but also guarantee all signals, such as the NN weight approximation errors and the cooperative tracking errors in the closed-loop system, to be uniformly ultimately bounded. Finally, the effectiveness of the proposed method is shown by simulation results of an application to wheeled mobile multi-robot systems.

  14. Health benefit from decreasing exposure to heavy metals and metalloid after strict pollution control measures near a typical river basin area in China.

    Science.gov (United States)

    Cao, Suzhen; Duan, Xiaoli; Ma, Yingqun; Zhao, Xiuge; Qin, Yanwen; Liu, Yan; Li, Sai; Zheng, Binghui; Wei, Fusheng

    2017-10-01

    The metal(loid) pollution still is a great concern due to the effects from urbanization and industrialization. While, the health risks from the toxic metal(loid)s could decrease if strict pollution control measures were adopted. However, few studies to date investigate the health risks of heavy metal(loid)s in a systematic river basin for the dependent residents, after taking pollution control measures. Thus, the contents of metal(loid)s (Cu, Pb, Zn, Cd, Mn, As) in surface water along a typical river basin were investigated in this study, and the potential non-carcinogenic and carcinogenic health risks posed to the residents were assessed. Although the soluble contents of Cu, Pb, Zn and Cd exceeded the respective thresholds in two sites located downstream the mine area, they were greatly decreased in comparison with previous contamination levels, and the soluble concentrations of all the metal(loid)s were within the relevant thresholds in the sites far away from the mining area. Moreover, the closer to the mining area, the higher the pollution levels of metal(loid)s. The total hazard index for non-carcinogenic risks of metal(loid)s were basically lower than the threshold (1) for the local population. Whereas, although the content of metal(loid)s were low (such as As), they could pose relative higher non-carcinogenic health risks. The result illustrated that pollution levels, toxicity of the contaminants and exposure behavior patterns all could contribute to the potential detrimental health risks. Additionally, the non-carcinogenic and carcinogenic risks from ingestion exposure were ∼2-∼4 orders of magnitude higher than those from dermal contact. The total carcinogenic risks were basically lower than the maximum tolerable levels (1.0 × 10 -4 ), indicating carcinogenic risks from most areas of the river could also be accepted. Among different population groups, heavy metal(loid)s posed relative higher non-carcinogenic and carcinogenic risks to the children in

  15. Infection control in developing countries.

    Science.gov (United States)

    Meers, P D

    1988-02-01

    The level of socio-political and economic development achieved by a country determines the quality and quantity of the health care its citizens receive. These factors also govern the amount of attention given to hospital-acquired infection. The problems of infection control in 'developing' countries include, first, the international problems that arise from clashes of personality and viewpoint among those responsible for it, exacerbated in some places by ethnic or religious traditions. Second are problems imposed by factors that affect the spectrum of infectious disease, and third is a variable deficiency of human and financial resources. In the search for solutions, an analysis suggests that nurses are particularly suited to take the lead in the prevention of infection, so that a special initiative directed towards their education in the rapidly developing science of hospital infection and its control is likely to be the most cost effective and appropriate initial approach. This needs to be accompanied by parallel improvements in the education of medical undergraduates. Anything else should be applied in response to measured need, and then only as money and manpower permit. Careful thought is required to avoid squandering scarce resources by applying inappropriate infection control technology.

  16. Infection control in Indonesian Hospitals

    NARCIS (Netherlands)

    Duerink, Daphne Offra

    2009-01-01

    The studies in this thesis were performed as part of the AMRIN (Antimicrobial Resistance in Indonesia) study that addressed antimicrobial resistance, antibiotic usage and infection control in Indonesia. They are the first studies that give insight into the incidence of healthcare-associated

  17. Manual of infection prevention and control

    National Research Council Canada - National Science Library

    Damani, N. N

    2012-01-01

    .... Unlike other books on infection control, the main strength of this book is to provide clear, up-to-date and practical guidance in infection control in an easy to read format which can act as a quick...

  18. 42 CFR 483.65 - Infection control.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Infection control. 483.65 Section 483.65 Public... Care Facilities § 483.65 Infection control. The facility must establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the...

  19. 38 CFR 52.190 - Infection control.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Infection control. 52.190... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.190 Infection control. The program management must establish and maintain an infection control program designed to prevent the development and...

  20. 38 CFR 51.190 - Infection control.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Infection control. 51.190... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must establish and maintain an infection control program designed to provide a safe, sanitary, and...

  1. 42 CFR 460.74 - Infection control.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Infection control. 460.74 Section 460.74 Public...) PACE Administrative Requirements § 460.74 Infection control. (a) Standard procedures. The PACE organization must follow accepted policies and standard procedures with respect to infection control, including...

  2. Species Protection in the European Union : How Strict is Strict?

    NARCIS (Netherlands)

    Schoukens, Hendrik; Bastmeijer, Kees; Born et al., Charles-Hubert

    2015-01-01

    European Union law to protect wild species of plants and animals is generally considered as ‘strict’. Opponents of nature conservation law often pick the species protection components of the EU Bird Directive and Habitat Directive as a prime example of an unnecessary strict regulatory scheme that

  3. Efficient Strictness Analysis of Haskell

    DEFF Research Database (Denmark)

    Jensen, Kristian Damm; Hjæresen, Peter; Rosendahl, Mads

    1994-01-01

    Strictness analysis has been a living field of investigation since Mycroft's original work in 1980, and is getting increasingly significant with the still wider use of lazy functional programming languages. This paper focuses on an actual implementation of a strictness analyser for Haskell....... The analyser uses abstract interpretation with chaotic fixpoint iteration. The demand-driven nature of this iteration technique allows us to use large domains including function domains in the style of Burn et al. 1986 and Wadler 87 and retain reasonable efficiency. The implementation, furthermore, allows us...

  4. Flexible or Strict Taxonomic Organization?

    DEFF Research Database (Denmark)

    Glückstad, Fumiko Kano; Mørup, Morten

    2012-01-01

    This work compares methods for constructing feature-based ontologies that are supposed to be used for culturally-specific knowledge transfer. The methods to be compared are the Terminological Ontology (TO) [1], a method of constructing ontology based on strict principles and rules, and the Infinite...

  5. Dynamic Enforcement of the Strict Integrity Policy

    Institute of Scientific and Technical Information of China (English)

    ZHANGXiangfeng; LIANGHongliang; SUNYufang

    2005-01-01

    The Strict integrity policy (SIP) in Biba's integrity model is widely used in protecting information integrity, but the static integrity labels of both subjects and objects increase compatibility cost of applications and might prevent some operations that are indeed harmless.In order to improve compatibility, Dynamic enforcement of the Strict integrity policy (DESIP) is put forward. The current integrity label attribute of a subject in SIP is replaced with two attributes in DESIP, which are used to confine dynamically the range of objects a subject could be allowed to access. The new rules of access control in DESIP are given for each kind of access mode (observe,modify and invoke) together with the proofs of their valid-ity. Comparison between SIP and DESIP shows that after a sequence of operations, a subject controlled by DESIP tends to behave in a similar way as it is controlled by SIP and DESIP is more compatible than SIP.

  6. Strictness Analysis for Attribute Grammars

    DEFF Research Database (Denmark)

    Rosendahl, Mads

    1992-01-01

    interpretation of attribute grammars. The framework is used to construct a strictness analysis for attribute grammars. Results of the analysis enable us to transform an attribute grammar such that attributes are evaluated during parsing, if possible. The analysis is proved correct by relating it to a fixpoint...... semantics for attribute grammars. An implementation of the analysis is discussed and some extensions to the analysis are mentioned....

  7. The trend to get strict

    International Nuclear Information System (INIS)

    Clarke, Chris.

    1997-01-01

    Most policy makers in the USA and Europe are committed to strict environmental liability. The polluter pays principle is seen as popular with voters and easy to defend. For the energy sector, encompassing everything from disused gas works and coal mines to refineries, tank farms and filling stations, the cost of cleaning up old sites can be huge. Within the policy commitment to strict liability there are some issues up for negotiation, however. These include such things as: available defences; the burden of proof; mechanisms for sharing liability at multi-party sites; funding of orphan shares; the protection afforded to lenders. Most governments have shown some flexibility on these issues and some examples from the USA are given. Nevertheless, in Europe the momentum towards comprehensive strict liability regimes seems unrelenting. In the Member states of the European Union, liability laws are either already in place or new laws are in preparation. The European Commission is working on proposals for an EU-wide environmental liability regime but there are formidable obstacles to overcome if it is to become EU law. In the meanwhile, the process of trying to reach agreement at an EU level is likely to strengthen the legislative drive at national level. (UK)

  8. Abstract: Implementing Infection Control Measures in Neonatology ...

    African Journals Online (AJOL)

    Abstract. Background Neonatal infection is a primary cause of morbidity and mortality globally. Objective The project's objective is to facilitate quality improvement by reduction of hospital-acquired infection (HAI) in hospitalized neonates. Methods Current infection control practices were surveyed and three main areas were ...

  9. Infection control in design and construction work.

    Science.gov (United States)

    Collinge, William H

    2015-01-01

    To clarify how infection control requirements are represented, communicated, and understood in work interactions through the medical facility construction project life cycle. To assist project participants with effective infection control management by highlighting the nature of such requirements and presenting recommendations to aid practice. A 4-year study regarding client requirement representation and use on National Health Service construction projects in the United Kingdom provided empirical evidence of infection control requirement communication and understanding through design and construction work interactions. An analysis of construction project resources (e.g., infection control regulations and room data sheets) was combined with semi-structured interviews with hospital client employees and design and construction professionals to provide valuable insights into the management of infection control issues. Infection control requirements are representationally indistinct but also omnipresent through all phases of the construction project life cycle: Failure to recognize their nature, relevance, and significance can result in delays, stoppages, and redesign work. Construction project resources (e.g., regulatory guidance and room data sheets) can mask or obscure the meaning of infection control issues. A preemptive identification of issues combined with knowledge sharing activities among project stakeholders can enable infection control requirements to be properly understood and addressed. Such initiatives should also reference existing infection control regulatory guidance and advice. © The Author(s) 2015.

  10. Enterobiasis (Pinworm Infection): Prevention and Control

    Science.gov (United States)

    ... General Information Pinworm Infection FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Get Email Updates ...

  11. Nosocomial infections and their control strategies

    Directory of Open Access Journals (Sweden)

    Hassan Ahmed Khan

    2015-07-01

    Full Text Available Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel's skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

  12. Journal of the Nigerian Infection Control Association

    African Journals Online (AJOL)

    The Journal of the Nigerian Infection Control Association publishes articles which deal with clinical medicine, basic medical science, dental sciences, pharmaceutical, veterinary sciences, nursing services and medical education and other related disciplines which are pertinent to infection control. Language of Publication: ...

  13. Infection control in the intensive care unit.

    Science.gov (United States)

    Osman, Mohamed F; Askari, Reza

    2014-12-01

    It is critical for health care personnel to recognize and appreciate the detrimental impact of intensive care unit (ICU)-acquired infections. The economic, clinical, and social expenses to patients and hospitals are overwhelming. To limit the incidence of ICU-acquired infections, aggressive infection control measures must be implemented and enforced. Researchers and national committees have developed and continue to develop evidence-based guidelines to control ICU infections. A multifaceted approach, including infection prevention committees, antimicrobial stewardship programs, daily reassessments-intervention bundles, identifying and minimizing risk factors, and continuing staff education programs, is essential. Infection control in the ICU is an evolving area of critical care research. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. 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.

  15. 75 FR 22816 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-04-30

    ... Infectious Diseases (NCEZID), regarding the practice of hospital infection control and strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections... policy statements regarding prevention of healthcare- associated infections and healthcare-related...

  16. 75 FR 50770 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-08-17

    ... Infectious Diseases (NCEZID), regarding: (1) The practice of hospital infection control; strategies for surveillance, prevention, and control of infections (e.g., nosocomial infections), antimicrobial resistance... and other policy statements regarding prevention of healthcare- associated infections and healthcare...

  17. Infection control during filoviral hemorrhagic fever outbreaks

    Directory of Open Access Journals (Sweden)

    N Raabe Vanessa

    2012-01-01

    Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

  18. Mixed Infections and their Control

    Science.gov (United States)

    1983-04-29

    of cultures are available. Anaerobes predominate in abscesses in ’.he vulvo- vaginal , buttocks, perirectal, finger, and head areas, but aerobes are 7...trauma-induced infections is that most of them are polymicrobial, including multiple aerobic and anaerobic organisms. Furthermore, due to the depletion...species of Gram-negative aerobic • . bacteria and at least one obligate anaerobe such as Bacteroides, Peptostrepto- coccus, or Peptococcus. Cutaneous

  19. 75 FR 63844 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-10-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare...), regarding the practice of healthcare infection control and strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections), antimicrobial resistance, and...

  20. Investigation of Color Constancy in 4.5-Month-Old Infants under a Strict Control of Luminance Contrast for Individual Participants

    Science.gov (United States)

    Yang, Jiale; Kanazawa, So; Yamaguchi, Masami K.; Kuriki, Ichiro

    2013-01-01

    The current study examined color constancy in infants using a familiarization paradigm. We first obtained isoluminance in each infant as defined by the minimum motion paradigm and used these data to control the luminance of stimuli in the main experiments. In the familiarization phase of the main experiment, two identical smiling face patterns…

  1. Discourse of 'transformational leadership' in infection control.

    Science.gov (United States)

    Koteyko, Nelya; Carter, Ronald

    2008-10-01

    The article explores the impact of the ;transformational leadership' style in the role of modern matron with regards to infection control practices. Policy and guidance on the modern matron role suggest that it is distinctive in its combination of management and clinical components, and in its reliance on transformational leadership. Senior nurses are therefore expected to motivate staff by creating high expectations, modelling appropriate behaviour, and providing personal attention to followers by giving respect and responsibility. In this article, we draw on policy documents and interview data to explore the potential impact of this new management style on infection control practices. Combining the techniques of discourse analysis and corpus linguistics, we identify examples where matrons appear to disassociate themselves from the role of ;an empowered manager' who has control over human and financial resources to resolve problems in infection control efficiently.

  2. Peri-operative glycaemic control regimens for preventing surgical site infections in adults.

    Science.gov (United States)

    Kao, Lillian S; Meeks, Derek; Moyer, Virginia A; Lally, Kevin P

    2009-07-08

    Surgical site infections (SSIs) are associated with significant morbidity, mortality, and resource utilization and are potentially preventable. Peri-operative hyperglycaemia has been associated with increased SSIs and previous recommendations have been to treat glucose levels above 200 mg/dL. However, recent studies have questioned the optimal glycaemic control regimen to prevent SSIs. Whether the benefits of strict or intensive glycaemic control with insulin infusion as compared to conventional management outweigh the risks remains controversial. To summarise the evidence for the impact of glycaemic control in the peri-operative period on the incidence of surgical site infections, hypoglycaemia, level of glycaemic control, all-cause and infection-related mortality, and hospital length of stay and to investigate for differences of effect between different levels of glycaemic control. A search strategy was developed to search the following databases: Cochrane Wounds Group Specialised Register (searched 25 March 2009), The Cochrane Central Register of Controlled Trials, The Cochrane Library 2009, Issue 1; Ovid MEDLINE (1950 to March Week 2 2009); Ovid EMBASE (1980 to 2009 Week 12) and EBSCO CINAHL (1982 to March Week 3 2009). The search was not limited by language or publication status. Randomised controlled trials (RCTs) were eligible for inclusion if they evaluated two (or more) glycaemic control regimens in the peri-operative period (within one week pre-, intra-, and/or post-operative) and reported surgical site infections as an outcome. The standard method for conducting a systematic review in accordance with the Cochrane Wounds Group was used. Two review authors independently reviewed the results from the database searches and identified relevant studies. Two review authors extracted study data and outcomes from each study and reviewed each study for methodological quality. Any disagreement was resolved by discussion or by referral to a third review author. Five

  3. Lyme Neuroborreliosis: Preliminary Results from an Urban Referral Center Employing Strict CDC Criteria for Case Selection

    Directory of Open Access Journals (Sweden)

    David S. Younger

    2010-01-01

    Full Text Available Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of 23 patients submitted to strict criteria for case selection of the Centers for Disease Control and Prevention employing a two-tier test to detect antibodies to Borrelia burgdorferi at a single institution. One patient had symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of early infection; and another had symptomatic small fiber sensory neuropathy, distal polyneuropathy, dysautonomia, and serological evidence of late infection. In the remaining patients symptoms initially ascribed to Lyme disease were probably unrelated to B. burgdorferi infection. Our findings suggest early susceptibility and protracted involvement of the nervous system most likely due to the immunological effects of B. burgdorferi infection, although the exact mechanisms remain uncertain.

  4. [Confidentiality in HIV-infection/AIDS--a comment on the Communicable Disease Control Act].

    Science.gov (United States)

    Frich, J C

    1995-05-10

    The new Communicable Diseases Control Act has come into force in Norway. It makes it compulsory for a physician to warn a third party if it is obvious that a HIV-positive patient, with a high degree of certainty, puts the third party at risk of being infected with HIV. Some philosophers characterize medical confidentiality as an intransigent and absolute obligation, others as a prima facie duty. This article supports the latter view, but the author still argues that strict conditions have to be fulfilled before a physician should consider breaking medical confidentiality: The doctor must try repeatedly to gain the consent or co-operation of the patient involved. Possible negative long-term consequences for the preventive HIV-work support strict medical confidentiality.

  5. Focus on Infection Control in Child Care.

    Science.gov (United States)

    Biblio Alert! New Resources for Child Care Health and Safety, 1994

    1994-01-01

    The first in a series intended to provide child caregivers, parents, schools, health departments, and regulatory agencies with recent resources on child health and safety, this bibliography cites sources on the topic of controlling infections in child care settings. The list of annotated references contains background information and resource…

  6. Finite Metric Spaces of Strictly Negative Type

    DEFF Research Database (Denmark)

    Hjorth, Poul; Lisonek, P.; Markvorsen, Steen

    1998-01-01

    of Euclidean spaces. We prove that, if the distance matrix is both hypermetric and regular, then it is of strictly negative type. We show that the strictly negative type finite subspaces of spheres are precisely those which do not contain two pairs of antipodal points. In connection with an open problem raised...

  7. Extremely strict ideals in Banach spaces

    Indian Academy of Sciences (India)

    Abstract. Motivated by the notion of an ideal introduced by Godefroy et al. (Stu- dia Math. 104 (1993) 13–59), in this article, we introduce and study the notion of an extremely strict ideal. For a Poulsen simplex K, we show that the space of affine contin- uous functions on K is an extremely strict ideal in the space of continuous ...

  8. Creutzfeldt-Jakob Disease and Infection Control

    Directory of Open Access Journals (Sweden)

    Lynn Johnston

    2001-01-01

    Full Text Available Over the past year, several situations have occurred in Canada in which patients who had recently undergone a surgical procedure were subsequently diagnosed with confirmed or suspected Creutzfeldt-Jakob disease (CJD. This raised concerns over contamination of surgical instruments: which instruments might have been contaminated from direct exposure to tissues; can instruments become cross-contaminated by exposure to other contaminated instruments; what assessment is necessary to determine cross-contamination; and what should be done with instruments that have been contaminated. Additionally, should there be a patient traceback in the face of potential but unproven exposure? Unfortunately, there are no easy answers to most of the above questions. Australia, the United Kingdom and the World Health Organization have developed guidelines for the infection control management of patients with CJD, as well as instruments and devices that come into contact with them and their tissues (1-3. Health Canada's draft CJD infection control guidelines, withdrawn from the Health Canada Web site until safety concerns regarding sodium hydroxide can be addressed, closely mirrored recommendations made in those documents. The Centers for Disease Control and Prevention guidelines for CJD are under revision. However, a recent American publication made recommendations on what procedures should be used for reprocessing items that have been in contact with the prion protein (PrP (4. These recommendations differ substantially from the draft Canadian guidelines. This article reviews current knowledge about CJD, and highlights some of the infection control concerns and controversies.

  9. Hospital design for better infection control

    Directory of Open Access Journals (Sweden)

    Lateef Fatimah

    2009-01-01

    Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges

  10. Organization of infection control in European hospitals.

    Science.gov (United States)

    Hansen, S; Zingg, W; Ahmad, R; Kyratsis, Y; Behnke, M; Schwab, F; Pittet, D; Gastmeier, P

    2015-12-01

    The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) survey was initiated to investigate the status of healthcare-associated infection (HCAI) prevention across Europe. This paper presents the methodology of the quantitative PROHIBIT survey and outlines the findings on infection control (IC) structure and organization including management's support at the hospital level. Hospitals in 34 countries were invited to participate between September 2011 and March 2012. Respondents included IC personnel and hospital management. Data from 309 hospitals in 24 countries were analysed. Hospitals had a median (interquartile range) of four IC nurses (2-6) and one IC doctor (0-2) per 1000 beds. Almost all hospitals (96%) had defined IC objectives, which mainly addressed hand hygiene (87%), healthcare-associated infection reduction (84%), and antibiotic stewardship (66%). Senior management provided leadership walk rounds in about half of hospitals, most often in Eastern and Northern Europe, 65% and 64%, respectively. In the majority of hospitals (71%), sanctions were not employed for repeated violations of IC practices. Use of sanctions varied significantly by region (P hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.

  11. Hyperbolic spaces are of strictly negative type

    DEFF Research Database (Denmark)

    Hjorth, Poul G.; Kokkendorff, Simon L.; Markvorsen, Steen

    2002-01-01

    We study finite metric spaces with elements picked from, and distances consistent with, ambient Riemannian manifolds. The concepts of negative type and strictly negative type are reviewed, and the conjecture that hyperbolic spaces are of strictly negative type is settled, in the affirmative....... The technique of the proof is subsequently applied to show that every compact manifold of negative type must have trivial fundamental group, and to obtain a necessary criterion for product manifolds to be of negative type....

  12. Strictly diagonal holomorphic functions on Banach spaces

    Directory of Open Access Journals (Sweden)

    O. I. Fedak

    2016-01-01

    Full Text Available In this paper we investigate the boundedness of holomorphic functionals on a Banach space with a normalized basis $\\{e_n\\}$ which have a very special form $f(x=f(0+\\sum_{n=1}^\\infty c_nx_n^n$ and which we call strictly diagonal. We consider under which conditions strictly diagonal functions are entire and uniformly continuous on every ball of a fixed radius.

  13. Nosocomial infections and staff hygiene.

    Science.gov (United States)

    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.

  14. Controlling endemic multidrug-resistant Acinetobacter baumannii in Intensive Care Units using antimicrobial stewardship and infection control.

    Science.gov (United States)

    Cheon, Shinhye; Kim, Mi-Ja; Yun, Seon-Jin; Moon, Jae Young; Kim, Yeon-Sook

    2016-03-01

    Nosocomial infections caused by multidrug-resistant (MDR) Acinetobacter baumannii have become public-health problem. However, few studies have evaluated the control of endemic MDR A. baumannii in Intensive Care Units (ICUs). Therefore, we investigated the effectiveness of antimicrobial stewardship and comprehensive intensified infection control measures for controlling endemic MDR A. baumannii in ICUs at a tertiary care center. Carbapenem use was strictly restricted through antimicrobial stewardship. Environmental cleaning and disinfection was performed at least 3 times per day in addition to basic infection control measures. Isolation using plastic curtains and contact precautions were applied to patients who were colonized or infected with MDR A. baumannii. The outcome was measured as the incidence density rate of hospital-onset MDR A. baumannii among patients in the ICUs. The incidence density rate of hospital-onset MDR A. baumannii decreased from 22.82 cases per 1,000 patient-days to 2.68 cases per 1,000 patient-days after the interventions were implemented (odds ratio, 0.12; 95% confidence interval, 0.03 to 0.4; p baumannii in our ICUs within 1 year.

  15. Influence of staff infection control training on infection-related quality measures in US nursing homes.

    Science.gov (United States)

    Kaur, Jasjit; Stone, Patricia W; Travers, Jasmine L; Cohen, Catherine C; Herzig, Carolyn T A

    2017-09-01

    Health care-associated infections are a leading cause of morbidity and mortality in US nursing home residents. Ongoing training of nursing home staff is vital to the implementation of infection prevention and control processes. Our aim was to describe associations between methods, frequency, and timing of staff infection prevention and control training and infection-related quality measures. In this national survey of nursing homes, timing of staff infection prevention and control training was associated with reduced indwelling urinary catheter use. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. 75 FR 3912 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-01-25

    ..., Detection, and Control of Infectious Diseases (NCPDCID), regarding: (1) The practice of hospital infection control; (2) strategies for surveillance, prevention, and control of infections (e.g., nosocomial... healthcare-associated infections Recovery Act efforts; discussion on the draft guideline for prevention of...

  17. 42 CFR 482.42 - Condition of participation: Infection control.

    Science.gov (United States)

    2010-10-01

    ... Hospital Functions § 482.42 Condition of participation: Infection control. The hospital must provide a... be an active program for the prevention, control, and investigation of infections and communicable... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Infection control. 482...

  18. Photodynamic antimicrobial polymers for infection control.

    Directory of Open Access Journals (Sweden)

    Colin P McCoy

    Full Text Available Hospital-acquired infections pose both a major risk to patient wellbeing and an economic burden on global healthcare systems, with the problem compounded by the emergence of multidrug resistant and biocide tolerant bacterial pathogens. Many inanimate surfaces can act as a reservoir for infection, and adequate disinfection is difficult to achieve and requires direct intervention. In this study we demonstrate the preparation and performance of materials with inherent photodynamic, surface-active, persistent antimicrobial properties through the incorporation of photosensitizers into high density poly(ethylene (HDPE using hot-melt extrusion, which require no external intervention except a source of visible light. Our aim is to prevent bacterial adherence to these surfaces and eliminate them as reservoirs of nosocomial pathogens, thus presenting a valuable advance in infection control. A two-layer system with one layer comprising photosensitizer-incorporated HDPE, and one layer comprising HDPE alone is also described to demonstrate the versatility of our approach. The photosensitizer-incorporated materials are capable of reducing the adherence of viable bacteria by up to 3.62 Log colony forming units (CFU per square centimeter of material surface for methicillin resistant Staphylococcus aureus (MRSA, and by up to 1.51 Log CFU/cm(2 for Escherichia coli. Potential applications for the technology are in antimicrobial coatings for, or materials comprising objects, such as tubing, collection bags, handrails, finger-plates on hospital doors, or medical equipment found in the healthcare setting.

  19. Status of hospital infection control measures at seven major tertiary care hospitals of northern Punjab

    International Nuclear Information System (INIS)

    Ikram, A.; Shah, S.I.H.; Naseem, S.; Absar, S.A.; Safi-Ullah; Ambreen, T.

    2010-01-01

    To determine the availability and implementation of various hospital infection control measures at tertiary care hospitals. Study Design: Survey. Place and Duration of Study: National Institute of Science and Technology, Islamabad, from June through August 2008. Methodology: Seven tertiary care very busy hospitals were selected; one from Islamabad, 5 from Rawalpindi, and one from Lahore. A detailed proforma was designed addressing all the issues pertaining to hospital infection control measures. Air sampling was done and growth yielded was identified by standard methods. Results: Analyses revealed that all of the hospitals had an Infection Control Committee. Microbiological diagnostic facilities were adequate at all the hospitals and overall microorganism yield was very high. Antibiotic policy was claimed by most, not available on ground. Majority of the operation theatres were without proper air flow system and autoclaves were not being regularly monitored. There was no proper disposal for sharps and needles. Incineration was not the usual mode for infectious waste. Conclusion: The results of the present study imply availability of proper hospital infection control policies with need of strict implementation of such measures. (author)

  20. Electronuclear Park, Privatization and Civil Strict Liability

    International Nuclear Information System (INIS)

    Mondello, Gerard Camille

    2008-01-01

    The civil strict liability regime of the electronuclear industry is a fundamental variable for preventing risk. Because prices of other energies as oil or gas are becoming higher and unpredictable, nuclear power becomes cost-effective and may favour the partial privatization of nuclear parks. By considering theoretical traditional liability models, we study the conditions that ensure the most efficient safety level when comparing natural monopoly situation and Bertrand duopoly. Our results are that natural monopoly is safer than duopoly only when strict liability is fully applied. We define conditions that neutralize risk for applying some privatization plan to nuclear park

  1. Infection control practice in countries with limited resources.

    NARCIS (Netherlands)

    Alp, E.; Leblebicioglu, H.; Doganay, M.; Voss, A.

    2011-01-01

    Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control

  2. Is an increase of MRSA in Oslo, Norway, associated with changed infection control policy?

    Science.gov (United States)

    Andersen, Bjørg Marit; Rasch, Mette; Syversen, Gaute

    2007-12-01

    The objective was to describe the prevalence of MRSA in Oslo, Norway, before and after introduction of a new National MRSA Control Guideline. From 1993 to 2006, we prospectively collected clinical and microbiological data on all MRSA cases in Oslo, Norway. Two MRSA guidelines; a strict Ullevål Standard MRSA Guideline and a less strict National MRSA Control Guideline were compared. During 1993-2006, 358 MRSA cases were registered in Oslo; 43.9% detected in Ullevål University Hospital, 21.2% in nursing homes, and 18.7% in primary healthcare. One out of three (30.4%) were import-associated, and one out of ten (11.2%) were healthcare personnel. From 2004 on, a new National MRSA Control Guideline was introduced in primary healthcare, served by the community infection control. From 2004 on, there was a 4-6-fold increase of MRSA in primary healthcare (p = 0.038) and nursing homes (p = 0.005). Increase of MRSA cases at Ullevål (p Norway may be associated with the 4-6-fold increase of MRSA cases in the community after 2003.

  3. Finite Metric Spaces of Strictly negative Type

    DEFF Research Database (Denmark)

    Hjorth, Poul G.

    If a finite metric space is of strictly negative type then its transfinite diameter is uniquely realized by an infinite extent (“load vector''). Finite metric spaces that have this property include all trees, and all finite subspaces of Euclidean and Hyperbolic spaces. We prove that if the distance...

  4. 76 FR 29756 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2011-05-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Director, Division of Healthcare Quality Promotion regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  5. 76 FR 63622 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Science.gov (United States)

    2011-10-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Director, Division of Healthcare Quality Promotion regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  6. 75 FR 29772 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Science.gov (United States)

    2010-05-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Emerging and Zoonotic Infectious Diseases (NCEZID) regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  7. Pathology Laboratories and Infection Prevention and Control

    Directory of Open Access Journals (Sweden)

    R Baral

    2014-11-01

    Full Text Available Laboratory health care workers are vulnerable to infection with the Hospital Acquired Infections (HAIs while receiving, handling and disposing biological samples. Ideally the infrastructure of the lab should be according to the best practices like good ventilation, room pressure differential, lighting, space adequacy, hand hygiene facilities, personal protective equipments, biological safety cabinets etc. Disinfection of the environment, and specific precautions with sharps and microbial cultures should follow the protocols and policies of the Infection Prevention and Control Practices (IPAC. If Mycobacterium tuberculosis or Legionella pneumophila are expected, diagnostic tests should be performed in a bio-safety level 3 facilities (for agents which may cause serious or potentially lethal disease in healthy adults after inhalation. Laboratory access should be limited only to people working in it.Along with the advent of new technologies and advanced treatment we are now facing problems with the dreadful HAIs with Antimicrobial Resistant Organisms (AROs which is taking a pandemic form. According to WHO, hundreds of millions of patients develop HAI every year worldwide and as many as 1.4 million occur each day in hospitals alone. The principal goals for hospital IPAC programs are to protect the patient, protect the health care worker (HCW, visitors, and other persons in the health environment, and to accomplish the previous goals in a cost-effective manner like hand hygiene, surveillance, training of the HCWs, initiating awareness programs and making Best Practices and Guidelines to be followed by everyone in the hospital.The initiation for the best practices in the Pathology Laboratories can be either Sporadic or Organizational. Sporadic initiation is when the laboratories make their own IPAC policies. It has been seen that in few centres these policies have been conceptualized but not materialized. Organizational initiation is much more

  8. Hand hygiene: Back to the basics of infection control

    Science.gov (United States)

    Mathur, Purva

    2011-01-01

    Health care associated infections are drawing increasing attention from patients, insurers, governments and regulatory bodies. This is not only because of the magnitude of the problem in terms of the associated morbidity, mortality and cost of treatment, but also due to the growing recognition that most of these are preventable. The medical community is witnessing in tandem unprecedented advancements in the understanding of pathophysiology of infectious diseases and the global spread of multi-drug resistant infections in health care set-ups. These factors, compounded by the paucity of availability of new antimicrobials have necessitated a re-look into the role of basic practices of infection prevention in modern day health care. There is now undisputed evidence that strict adherence to hand hygiene reduces the risk of cross-transmission of infections. With “Clean Care is Safer Care” as a prime agenda of the global initiative of WHO on patient safety programmes, it is time for developing countries to formulate the much-needed policies for implementation of basic infection prevention practices in health care set-ups. This review focuses on one of the simplest, low cost but least accepted from infection prevention: hand hygiene. PMID:22199099

  9. Cannulae and infection control in theatre.

    Science.gov (United States)

    Aziz, Ann-Marie

    Healthcare-associated infections (HAIs) are those that are not present or incubating when an individual enters hospital, but are acquired while in hospital. At any one time, 8% of patients have an infection acquired in hospital (Department of Health (DH), 2008). On average, an infection adds 3-10 days to the length of a patient's stay in hospital. It can cost pound4000- pound10 000 more to treat a patient with an infection than one without an infection (DH, 2008). It is not surprising, then, that attention has been focused on tackling HAIs and, in particular, in-dwelling devices such as cannulae that have a potential for causing infections.

  10. Ventilator associated pneumonia and infection control

    Directory of Open Access Journals (Sweden)

    Alp Emine

    2006-04-01

    Full Text Available Abstract Ventilator associated pneumonia (VAP is the leading cause of morbidity and mortality in intensive care units. The incidence of VAP varies from 7% to 70% in different studies and the mortality rates are 20–75% according to the study population. Aspiration of colonized pathogenic microorganisms on the oropharynx and gastrointestinal tract is the main route for the development of VAP. On the other hand, the major risk factor for VAP is intubation and the duration of mechanical ventilation. Diagnosis remains difficult, and studies showed the importance of early initiation of appropriate antibiotic for prognosis. VAP causes extra length of stay in hospital and intensive care units and increases hospital cost. Consequently, infection control policies are more rational and will save money.

  11. [Inspection by infection control team of the University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University].

    Science.gov (United States)

    Sunakawa, Mitsuhiro; Matsumoto, Hiroyuki; Harasawa, Hideki; Tsukikawa, Wakana; Takagi, Yuzo; Suda, Hideaki

    2006-06-01

    Factors affecting infection are the existence of infectious microorganisms, sensitivity of hosts, number of microorganisms, and infectious routes. Efforts to prevent infection focus on not allowing these factors to reach the threshold level. Inspection by an infection control team (ICT) of a hospital is one countermeasure for preventing nosocomial infection. We summarize here the problems for complete prevention of nosocomial infection based on the results of inspection by our ICT, so that staff working in the hospital can recognize the importance of preventing nosocomial infection. The following were commonly observed problems in our clinics found by the ICT : (1) incomplete practice of standard precautions and/or isolation precautions, (2) noncompliance with guidelines for the prevention of cross-infection, and (3) inappropriate management of medical rejectamenta. Infection control can be accomplished by strictly observing the standard precautions and isolation precautions. The ICT inspection round in the hospital could be an effective metaff working in the hod to clarify and overcome the problems involved in infection.

  12. Infection control in neonatal intensive care unit : from a certified nurse in infection control's point of view

    OpenAIRE

    坂木, 晴世

    2007-01-01

    Neonates, especially those in neonatal intensive care units (NICU), are at high risk for infection. And nosocomial infections are responsible for almost 50% of the deaths that occur beyond 2 weeks of age. Advances in neonatal intensive care have resulted in survival of more low birth weight and sick infants. On the other hand, infection control measures in NICU are hard to say that we established. Therefore it is often that infection control measure in NICU of our country is taken in original...

  13. 78 FR 62636 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-10-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

  14. 78 FR 28221 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-05-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

  15. A strictly hyperbolic equilibrium phase transition model

    International Nuclear Information System (INIS)

    Allaire, G; Faccanoni, G; Kokh, S.

    2007-01-01

    This Note is concerned with the strict hyperbolicity of the compressible Euler equations equipped with an equation of state that describes the thermodynamical equilibrium between the liquid phase and the vapor phase of a fluid. The proof is valid for a very wide class of fluids. The argument only relies on smoothness assumptions and on the classical thermodynamical stability assumptions, that requires a definite negative Hessian matrix for each phase entropy as a function of the specific volume and internal energy. (authors)

  16. On Fixed Points of Strictly Causal Functions

    Science.gov (United States)

    2013-04-08

    were defined to be the functions that are strictly contracting with respect to the Cantor metric (also called the Baire distance) on signals over non...in Computer Science, pages 447–484. Springer Berlin / Heidelberg, 1992. [36] George Markowsky. Chain-complete posets and directed sets with...Journal of Logic Programming, 42(2):59–70, 2000. [53] George M. Reed and A. William Roscoe. A timed model for communicating sequential processes. In

  17. 42 CFR 494.30 - Condition: Infection control.

    Science.gov (United States)

    2010-10-01

    ... of potentially infectious waste; and (ii) Cleaning and disinfection of contaminated surfaces, medical... adjacent hospital or other public areas. (a) Standard: Procedures for infection control. The facility must...

  18. [Infection control and hand hygiene in nursing homes in Oslo].

    Science.gov (United States)

    Sie, Ingrid; Thorstad, Margrete; Andersen, Bjørg Marit

    2008-06-26

    Nosocomial infections and transmission can be substantially reduced by good infection control. The laws and regulations for infection control in heath care institutions emphasize establishment of infection control programs and improved hand hygiene. Our study reviews some factors that are important for practicing adequate hand hygiene (knowledge about infection control and hand-washing facilities). Health care workers (HCW) in nursing homes in Oslo participated in this study in 2006-2007. A questionnaire was made and SPSS was used to analyse the data . 70.7% of 324 HCW (in 42 nursing homes) answered the questionnaires. Nearly all of the respondents (95.6%) knew about the written procedures for hygiene and infection control; 88.5% knew that an infection control program was in place and about 50% had received information through internal education. Three of four had read the National guidelines for hand hygiene, 77.5% thought that hand disinfection was more effective than hand washing, and 97% reported hand hygiene after contact with a patient having an infection. Dispensers for hand disinfection were situated at central work places. At the same time, 17.9% informed that they worked in more than one place at the same time. This study confirms that most nursing homes in Oslo have an infection control program and training that improves the knowledge and awareness of hand hygiene among HCWs. However, the fact that nursing homes in Oslo have the resources, knowledge and education, is not the same as compliance.

  19. Infection control practice in countries with limited resources

    Directory of Open Access Journals (Sweden)

    Alp Emine

    2011-10-01

    Full Text Available Abstract Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control challenges between Turkey, a country with "limited" resources, and the Netherlands, a country with "reasonable" resources. Infrastructure of hospitals, low compliance of hand hygiene, understaffing, overcrowding, heavy workload, misuse of personal protective equipments, late establishment of infection control programme are major problems in limited-resources countries. These problems cause high infection rates and spread of multi-drug resistant pathogens. To improve the control and prevention of infections in countries with limited resources, a multi-facet approach is needed.

  20. 7 CFR 28.441 - Strict Middling Yellow Stained Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Middling Yellow Stained Color. 28.441 Section... Strict Middling Yellow Stained Color. Strict Middling Yellow Stained Color is color which is deeper than that of Strict Middling Tinged Color. [57 FR 34498, Aug. 5, 1992] ...

  1. 7 CFR 28.412 - Strict Middling Light Spotted Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Middling Light Spotted Color. 28.412 Section 28... Light Spotted Color. Strict Middling Light Spotted Color is color which in spot or color, or both, is between Strict Middling Color and Strict Middling Spotted Color. ...

  2. 77 FR 58397 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2012-09-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare...) strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections) antimicrobial resistance and related events in settings where healthcare is provided, including...

  3. High infection control rate and function after routine one-stage exchange for chronically infected TKA.

    Science.gov (United States)

    Jenny, Jean-Yves; Barbe, Bruno; Gaudias, Jeannot; Boeri, Cyril; Argenson, Jean-Noël

    2013-01-01

    Many surgeons consider two-stage exchange the gold standard for treating chronic infection after TKA. One-stage exchange is an alternative for infection control and might provide better knee function, but the rates of infection control and levels of function are unclear. We asked whether a one-stage exchange protocol would lead to infection control rates and knee function similar to those after two-stage exchange. We followed all 47 patients with chronically infected TKAs treated with one-stage exchange between July 2004 and February 2007. We monitored for recurrence of infection and obtained Knee Society Scores. We followed patients a minimum of 3 years or until death or infection recurrence. Three of the 47 patients (6%) experienced a persistence or recurrence of the index infection with the same pathogen isolated. Three patients (6%) had control of the index infection but between 6 and 17 months experienced an infection with another pathogen. The 3-year survival rates were 87% for being free of any infection and 91% for being healed of the index infection. Twenty-five of the 45 patients (56%) had a Knee Society Score of more than 150 points. While routine one-stage exchange was not associated with a higher rate of infection recurrence failure, knee function was not improved compared to that of historical patients having two-stage exchange. One stage-exchange may be a reasonable alternative in chronically infected TKA as a more convenient approach for patients without the risks of two operations and hospitalizations and for reducing costs. The ideal one stage-exchange candidate should be identified in future studies.

  4. Organizational culture and its implications on infection prevention and control

    Directory of Open Access Journals (Sweden)

    R Baral

    2015-09-01

    Full Text Available The hospital acquired infections are becoming common in our hospitals lately. These infections are difficult to treat and maybe life threatening. Hospital acquired infection  can be minimized or eradicated by good Infection Prevention and Control guidelines and good hand hygiene practices. The success of Infection Prevention and Control guidelines program in any hospital is largely impacted by the organizational culture.  In any health care setting the management is challenged by the organizational culture to change of any kind. Where implementation of Infection Prevention and Control guidelines program is easily implemented in some hospitals it is very difficult in others. Moreover, hand hygiene is not only biomedical practice but also has more behavioral factors. 

  5. “Save Antibiotics, Save lives”: an Indian success story of infection control through persuasive diplomacy

    Directory of Open Access Journals (Sweden)

    Ghafur A

    2012-08-01

    Full Text Available Abstract Background Carbapenem resistant Enterobacteriaceae is a worldwide threat, with increasing prevalence in many countries. Restricted usage of higher end antibiotics, especially carbapenem is of great importance in tackling these super bugs. Purpose of this retrospective study was to analyse the impact of antibiotic stewardship activities on the prevalence of carbapenem resistant Enterobacteriaceae in our hospital. Findings In the first Quarter of 2009, average usage of carbapenem group of antibiotics was 955 vials a month while in 2010, the usage dropped to 745 vials per month. Carbapenem resistant E.coli rate dropped from 3.7% in 2009 to 1.6% in 2010 and Klebsiella rate reduced from 6% in 2009 to 3.6% in 2010. Conclusions Strict antibiotic stewardship strategies in conjunction with good infection control practices are useful in restricting higher end antibiotic usage and reducing the prevalence of carbapenem resistant Enterobacteriaceae.

  6. How to Manage and Control Healthcare Associated Infections

    Science.gov (United States)

    Wijaya, L.

    2018-03-01

    Healthcare associated infections (HAI) are the major complications of modern medical therapy. The most important HAIs are related to invasive devices including central line- associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and surgical-site infections (SSI). Excessive use of antibiotics has also led to the emergence and the global dissemination of antibiotic resistant bacteria over the last few decades. Reducing HAIs will involve a multi-modal approach to infection control practices as well as antibiotic stewardship program.

  7. Clinical Characteristics of Nosocomial Rotavirus Infection in Children in Taiwan

    Directory of Open Access Journals (Sweden)

    Jian-Te Lee

    2008-10-01

    Conclusion: NRI may cause significant morbidity in hospitalized children, especially young infants and those with underlying diseases. Infection control with hospital surveillance, strict isolation and cohort care should be adopted to prevent the spread of rotavirus among special care units.

  8. Identity tags: A vector for cross-infection?

    African Journals Online (AJOL)

    infection-control measures such as strict hand hygiene, specific dress ... [7] With modern security systems in place in most hospitals, it has ... differences between variables such as ward or area of work, nature of patient contact, time since.

  9. Infection prevention and control in deployed military medical treatment facilities.

    Science.gov (United States)

    Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

    2011-08-01

    Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

  10. Current standards for infection control: audit assures compliance.

    Science.gov (United States)

    Flanagan, Pauline

    Having robust policies and procedures in place for infection control is fundamentally important. However, each organization has to go a step beyond this; evidence has to be provided that these policies and procedures are followed. As of 1 April 2009, with the introduction of the Care Quality Commission and The Health and Social Care Act 2008 Code of Practice for the NHS on the Prevention and Control of Healthcare-Associated Infections and Related Guidance, the assurance of robust infection control measures within any UK provider of health care became an even higher priority. Also, the commissioning of any service by the NHS must provide evidence that the provider has in place robust procedures for infection control. This article demonstrates how the clinical audit team at the Douglas Macmillan Hospice in North Staffordshire, UK, have used audit to assure high rates of compliance with the current national standards for infection control. Prior to the audit, hospice staff had assumed that the rates of compliance for infection control approached 100%. This article shows that a good quality audit tool can be used to identify areas of shortfall in infection control and the effectiveness of putting in place an action plan followed by re-audit.

  11. Lactobacillus paracasei feeding improves the control of secondary experimental meningococcal infection in flu-infected mice.

    Science.gov (United States)

    Belkacem, Nouria; Bourdet-Sicard, Raphaëlle; Taha, Muhamed-Kkeir

    2018-04-10

    The use of probiotics to improve anti-microbial defence, such as for influenza infections, is increasingly recommended. However, no data are available on the effect of probiotics on flu-associated secondary bacterial infections. There is strong evidence of a spatiotemporal association between influenza virus infection and invasive Neisseria meningitidis. We thus investigated the effect of feeding mice Lactobacillus paracasei CNCM I-1518 in a mouse model of sequential influenza-meningococcal infection. We intranasally infected BALB/c mice with a strain of influenza A virus (IAV) H3N2 that was first adapted to mice. Seven days later, a secondary bacterial infection was induced by intranasal administration of bioluminescent N. meningitidis. During the experiment, mice orally received either L. paracasei CNCM I-1518 or PBS as a control. The effect of L. paracasei administration on secondary bacterial infection by N. meningitidis was evaluated. Oral consumption of L. paracasei CNCM I-1518 reduced the weight loss of infected mice and lowered the bioluminescent signal of infecting meningococci. This improvement was associated with higher recruitment of inflammatory myeloid cells, such as interstitial monocytes and dendritic cells, to the lungs. Our data highlight the role of the gut-lung axis. L. paracasei CNCM I-1518 may boost the defence against IAV infection and secondary bacterial infection, which should be further studied and validated in clinical trials.

  12. Infection control for SARS in a tertiary neonatal centre.

    Science.gov (United States)

    Ng, P C; So, K W; Leung, T F; Cheng, F W T; Lyon, D J; Wong, W; Cheung, K L; Fung, K S C; Lee, C H; Li, A M; Hon, K L E; Li, C K; Fok, T F

    2003-09-01

    The Severe Acute Respiratory Syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus, which can readily spread in the healthcare setting. A recent community outbreak in Hong Kong infected a significant number of pregnant women who subsequently required emergency caesarean section for deteriorating maternal condition and respiratory failure. As no neonatal clinician has any experience in looking after these high risk infants, stringent infection control measures for prevention of cross infection between patients and staff are important to safeguard the wellbeing of the work force and to avoid nosocomial spread of SARS within the neonatal unit. This article describes the infection control and patient triage policy of the neonatal unit at the Prince of Wales Hospital, Hong Kong. We hope this information is useful in helping other units to formulate their own infection control plans according to their own unit configuration and clinical needs.

  13. Where does infection control fit into a hospital management structure?

    Science.gov (United States)

    Brannigan, E T; Murray, E; Holmes, A

    2009-12-01

    To be effective, infection prevention and control must be integrated into the complex and multiple interlinking systems within a hospital's management structure. Each of the systems must consider how activity associated with it can be optimised to minimise infection risk to patients. The components of an organisational structure to achieve these quality assurance and patient safety aims are discussed. The use of performance management tools in relation to infection control metrics is reviewed, and the use of hospital-acquired infection as a proxy indicator for deficiencies of system management is considered. Infection prevention and control cannot be the role and responsibility of a single individual or a small dedicated team; rather it should be a priority at all levels and integrated within all management systems, including the research and educational agendas.

  14. HIV infection and treatment: beyond viral control

    NARCIS (Netherlands)

    Sprenger, Herman

    2017-01-01

    Since 1996, Infection caused by the human immunodeficiency virus(HIV) can be successfully treated with a combination therapy of 3 antiviral drugs from 2 different classes. Life expectancy has increased dramatically by this treatment. Especially in the early years these combination therapies had many

  15. Building new hospitals: a UK infection control perspective.

    Science.gov (United States)

    Stockley, J M; Constantine, C E; Orr, K E

    2006-03-01

    Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

  16. Exploring the context for effective clinical governance in infection control.

    Science.gov (United States)

    Halton, Kate; Hall, Lisa; Gardner, Anne; MacBeth, Deborough; Mitchell, Brett G

    2017-03-01

    Effective clinical governance is necessary to support improvements in infection control. Historically, the focus has been on ensuring that infection control practice and policy is based on evidence, and that there is use of surveillance and auditing for self-regulation and performance feedback. There has been less exploration of how contextual and organizational factors mediate an infection preventionists (IP's) ability to engage with evidence-based practice and enact good clinical governance. A cross sectional Web-based survey of IPs in Australia and New Zealand was undertaken. Questions focused on engagement in evidence-based practice and perceptions about the context, culture, and leadership within the infection control team and organization. Responses were mapped against dimensions of Scally and Donaldson's clinical governance framework. Three hundred surveys were returned. IPs appear well equipped at an individual level to undertake evidence-based practice. The most serious set of perceived challenges to good clinical governance related to a lack of leadership or active resistance to infection control within the organization. Additional challenges included lack of information technology solutions and poor access to specialist expertise and financial resources. Focusing on strengthening contextual factors at the organizational level that otherwise undermine capacity to implement evidence-based practice is key to sustaining current infection control successes and promoting further practice improvements. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  17. Mathematical modelling : a tool for hospital infection control

    NARCIS (Netherlands)

    Grundmann, H; Hellriegel, B

    Health-care-associated infections caused by antibiotic-resistant pathogens have become a menace in hospitals worldwide and infection control measures have lead to vastly different outcomes in different countries. During the past 6 years, a theoretical framework based on mathematical models has

  18. Mathematical modelling: a tool for hospital infection control

    NARCIS (Netherlands)

    Grundmann, Hajo; Hellriegel, B.

    2006-01-01

    Health-care-associated infections caused by antibiotic-resistant pathogens have become a menace in hospitals worldwide and infection control measures have lead to vastly different outcomes in different countries. During the past 6 years, a theoretical framework based on mathematical models has

  19. Mathematical modelling: a tool for hospital infection control.

    NARCIS (Netherlands)

    Grundmann, Hajo; Hellriegel, B

    2006-01-01

    Health-care-associated infections caused by antibiotic-resistant pathogens have become a menace in hospitals worldwide and infection control measures have lead to vastly different outcomes in different countries. During the past 6 years, a theoretical framework based on mathematical models has

  20. Knowledge, awareness and practice of infection control by health ...

    African Journals Online (AJOL)

    Training workshop on infection control should be organized for all ICU health care ... across the world are infected at any given time. ... er during the course of their stay in the hospital.4,5 The ... which permits unrestricted use, distribution, and reproduction in any medium, ..... Batuduwaarachchi VR, Balasubramanium M, Bal-.

  1. Education in infection control : A need for European certification

    NARCIS (Netherlands)

    Zingg, W.; Mutters, N. T.; Harbarth, S.; Friedrich, A. W.

    2015-01-01

    Healthcare-associated infections are common adverse events in acute-care medicine, causing significant morbidity and mortality. There has been a significant increase in the commitment to infection prevention and control (IPC) among European countries in recent years. However, there is still

  2. ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC).

    Science.gov (United States)

    Chandy, Sujith J; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O C; Bachhav, Sagar S; Kshirsagar, Nilima A

    2014-02-01

    Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance.

  3. Infection prevention and control practices in children's hospitals.

    Science.gov (United States)

    Bender, Jeffrey M; Virgallito, Mary; Newland, Jason G; Sammons, Julia S; Thorell, Emily A; Coffin, Susan E; Pavia, Andrew T; Sandora, Thomas J; Hersh, Adam L

    2015-05-01

    We surveyed hospital epidemiologists at 28 Children's Hospital Association member hospitals regarding their infection prevention and control programs. We found substantial variability between children's hospitals in both the structure and the practice of these programs. Research and the development of evidence-based guidelines addressing infection prevention in pediatrics are needed.

  4. [Critical role of clinical laboratories in hospital infection control].

    Science.gov (United States)

    Yagi, Tetsuya

    2010-11-01

    The hospital infection control and prevention is recognized to be more and more important according to the advances in modern medical treatment and care. Clinical microbiology laboratory play critical roles in the hospital infection control as a member of infection control team (ICT). They are the first in a hospital to identify outbreak of MRSA in NICU and molecular epidemiological analysis of the isolates lead proper intervention of ICT to the concerned ward. From a viewpoint of infectious disease specialist, rapid and precise microbiological information is essential for the appropriate diagnosis and treatment of infectious diseases. Each medical technologist need to make efforts to understand the characteristics of the examinations for infectious diseases and send out information useful for clinical practices. In our hospital, with the participation of all members of medical technologists, rapid reporting system was developed for blood culture examinations, which greatly contribute to the appropriate treatment of bloodstream infections. Collaborations of clinical microbiology laboratory with other members of ICT realize high quality hospital infection control. They also need to be aware of themselves as good practitioners of infection control measures to prevent hospital infections.

  5. STRICT STABILITY OF IMPULSIVE SET VALUED DIFFERENTIAL EQUATIONS

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    In this paper, we develop strict stability concepts of ODE to impulsive hybrid set valued differential equations. By Lyapunov’s original method, we get some basic strict stability criteria of impulsive hybrid set valued equations.

  6. [Infection control and hygiene management in equine hospitals].

    Science.gov (United States)

    Walther, Birgit; Janssen, Traute; Gehlen, Heidrun; Vincze, Szilvia; Borchers, Kerstin; Wieler, Lothar H; Barton, Ann Kristin; Lübke-Becker, Antina

    2014-01-01

    With the rising importance of nosocomial infections in equine hospitals, increased efforts with regard to biosecurity and infection control are necessary. This even more since nosocomial infections are often associated with multi-drug resistant pathogens. Consequently, the implementation of targeted prevention programs is essential. Since nosocomial infections are usually multifactorial events, realization of only a single measure is rarely effective to overcome nosocomial spread in clinical practice. Equine patients may be colonized at admission with multi-drug resistant pathogens such as methicillin resistant Staphylococcus aureus (MRSA) and/or extended spectrum beta lactamase-producing (ESBL-) Enterobacteriaceae. Regardless of their individual resistance properties, these bacteria are common and usually unnoticed colonizers of either the nasopharynx or the intestinal tract. Also viral diseases caused by equine herpesvirus 1 (EHV-1) and EHV-4 may reach a clinic by patients which are latently infected or in the incubation period. To prevent nosocomal outbreaks, achieve an interruption in the infection chain and to eradicate infectious agents from the hospital environment, a professional hospital management is necessary. This should be adapted to both the wide range of pathogens causing nosocomial infections and the individual needs of equine patients. Amongst others, this approach includes a risk classification of equine patients at admission and information/enlightenment of the animal owners at discharge. An efficient management of inpatients, a targeted hygiene management and clear responsibilities with respect to biosecurity together with a surveillance of nosocomial infections form the cornerstone of infection control in equine hospitals.

  7. Knowledge and attitudes of infection prevention and control among ...

    African Journals Online (AJOL)

    EB

    infection prevention and control is imparted early before they are introduced to the wards. ... professional nurses in Namibia instead of depending .... Table 3: ANOVA results for overall IPC Knowledge Score for gender, student area, high ...

  8. How to Treat Impetigo and Control This Common Skin Infection

    Science.gov (United States)

    ... Home For Consumers Consumer Updates How to Treat Impetigo and Control This Common Skin Infection Share Tweet ... Thomas D. Smith, MD, of FDA. What Causes Impetigo Two types of bacteria found on our skin ...

  9. 77 FR 4820 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2012-01-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... the Director, Division of Healthcare Quality Promotion regarding (1) the practice of healthcare... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  10. 77 FR 28392 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2012-05-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... the Director, Division of Healthcare Quality Promotion regarding 1) the practice of healthcare... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and 3...

  11. Public healthcare interests require strict competition enforcement.

    Science.gov (United States)

    Loozen, Edith M H

    2015-07-01

    Several countries have introduced competition in their health systems in order to maintain the supply of high quality health care in a cost-effective manner. The introduction of competition triggers competition enforcement. Since healthcare is characterized by specific market failures, many favor healthcare-specific competition enforcement in order not only to account for the competition interest, but also for the healthcare interests. The question is whether healthcare systems based on competition can succeed when competition enforcement deviates from standard practice. This paper analyzes whether healthcare-specific competition enforcement is theoretically sound and practically effective. This is exemplified by the Dutch system that is based on regulated competition and thus crucially depends on getting competition enforcement right. Governments are responsible for correcting market failures. Markets are responsible for maximizing the public healthcare interests. By securing sufficient competitive pressure, competition enforcement makes sure they do. When interpreted according to welfare-economics, competition law takes into account both costs and benefits specific market behavior may have for healthcare. Competition agencies and judiciary are not legitimized to deviate from standard evidentiary requirements. Dutch case law shows that healthcare-specific enforcement favors the healthcare undertakings concerned, but to the detriment of public health care. Healthcare-specific competition enforcement is conceptually flawed and counterproductive. In order for healthcare systems based on competition to succeed, competition enforcement should be strict. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. 7 CFR 28.406 - Strict Good Ordinary Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Good Ordinary Color. 28.406 Section 28.406... for the Color Grade of American Upland Cotton § 28.406 Strict Good Ordinary Color. Strict Good Ordinary Color is color which is within the range represented by a set of samples in the custody of the...

  13. 7 CFR 28.404 - Strict Low Middling Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Low Middling Color. 28.404 Section 28.404... for the Color Grade of American Upland Cotton § 28.404 Strict Low Middling Color. Strict Low Middling Color is color which is within the range represented by a set of samples in the custody of the United...

  14. 7 CFR 28.402 - Strict Middling Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Middling Color. 28.402 Section 28.402... for the Color Grade of American Upland Cotton § 28.402 Strict Middling Color. Strict Middling Color is color which is within the range represented by a set of samples in the custody of the United States...

  15. Infection control practices across Canada: do dentists follow the recommendations?

    Science.gov (United States)

    McCarthy, G M; Koval, J J; John, M A; MacDonald, J K

    1999-10-01

    This study investigated provincial and territorial differences in dentists' compliance with recommended infection control practices in Canada (1995). Questionnaires were mailed to a stratified random sample of 6,444 dentists, of whom 66.4% responded. Weighted analyses included Pearson's chi-square test and multiple logistic regression. Significant provincial and territorial differences included testing for immune response after hepatitis B virus (HBV) vaccination, HBV vaccination for all clinical staff, use of infection control manuals and post-exposure protocols, biological monitoring of heat sterilizers, handwashing before treating patients, using gloves and changing them after each patient, heat-sterilizing handpieces between patients, and using masks and uniforms to protect against splatter of blood and saliva. Excellent compliance (compliance with a combination of 18 recommended infection control procedures) ranged from 0% to 10%; the best predictors were more hours of continuing education on infection control in the last two years, practice location in larger cities (> 500,000) and sex (female). Clearly, improvements in infection control are desirable for dentists in all provinces and territories. Extending mandatory continuing education initiatives to include infection control may promote better compliance with current recommendations.

  16. Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

    Science.gov (United States)

    Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

    2016-07-01

    We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

  17. Multidrug-resistant opportunistic pathogens challenging veterinary infection control.

    Science.gov (United States)

    Walther, Birgit; Tedin, Karsten; Lübke-Becker, Antina

    2017-02-01

    Although the problems associated with healthcare-associated infections (HAI) and the emergence of zoonotic and multidrug-resistant pathogens in companion animal (dogs, cats and horses) medicine have been well-known for decades, current progress with respect to practical implementation of infection control programs in veterinary clinics has been limited. Clinical outbreak events reported for methicillin-resistant Staphylooccus aureus (MRSA) and Staphylococcus pseudintermedius (MRSP), extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and multidrug-resistant (MDR) Salmonella Serovars indicate the necessity of infection control strategies for protecting animal patients at risk as well as veterinary personnel. The close bond between humans and their companion animals provides opportunities for exchange of microorganisms, including MDR pathogens. This particular aspect of the "One Health" idea requires more representative surveillance efforts and infection control strategies with respect to animal-species specific characters. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Controlled Human Malaria Infection: Applications, Advances, and Challenges.

    Science.gov (United States)

    Stanisic, Danielle I; McCarthy, James S; Good, Michael F

    2018-01-01

    Controlled human malaria infection (CHMI) entails deliberate infection with malaria parasites either by mosquito bite or by direct injection of sporozoites or parasitized erythrocytes. When required, the resulting blood-stage infection is curtailed by the administration of antimalarial drugs. Inducing a malaria infection via inoculation with infected blood was first used as a treatment (malariotherapy) for neurosyphilis in Europe and the United States in the early 1900s. More recently, CHMI has been applied to the fields of malaria vaccine and drug development, where it is used to evaluate products in well-controlled early-phase proof-of-concept clinical studies, thus facilitating progression of only the most promising candidates for further evaluation in areas where malaria is endemic. Controlled infections have also been used to immunize against malaria infection. Historically, CHMI studies have been restricted by the need for access to insectaries housing infected mosquitoes or suitable malaria-infected individuals. Evaluation of vaccine and drug candidates has been constrained in these studies by the availability of a limited number of Plasmodium falciparum isolates. Recent advances have included cryopreservation of sporozoites, the manufacture of well-characterized and genetically distinct cultured malaria cell banks for blood-stage infection, and the availability of Plasmodium vivax -specific reagents. These advances will help to accelerate malaria vaccine and drug development by making the reagents for CHMI more widely accessible and also enabling a more rigorous evaluation with multiple parasite strains and species. Here we discuss the different applications of CHMI, recent advances in the use of CHMI, and ongoing challenges for consideration. Copyright © 2017 American Society for Microbiology.

  19. Dengue infection and miscarriage: a prospective case control study.

    Directory of Open Access Journals (Sweden)

    Peng Chiong Tan

    Full Text Available BACKGROUND: Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known. METHOD: We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1 antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy plus 45 controls (39 lost to follow up and six subsequent late miscarriages were excluded from analysis. FINDINGS: Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection was positive in 6/115 (5·2% cases and 5/296 (1·7% controls RR 3·1 (95% CI 1·0-10 P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2-14 P = 0·023. INTERPRETATION: Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained.

  20. [Infection prevention and control in neonatal intensive care unit].

    Science.gov (United States)

    Lorenzini, Elisiane; Lorenzini, Elisiane; da Costa, Tatiane Costa; da Silva, Eveline Franco

    2013-12-01

    This study was aimed to identify the knowledge of the nursing team of a Neonatal Intensive Care Unit (NICU) on infection control, identijfying the factors that facilitate or hinder the prevention and control of Healthcare Associated Infections (HICAI). A descriptive study using a qualitative research method conducted with three nurses and 15 nurse technicians, who work in a NICU of a charitable organization, in southern Brazil. It became evident that the nursing staff had great knowledge about the factors that facilitate the prevention and control of HCAI in NICU, the most important factor being proper hand hygiene. Among the factors that hinder infection prevention and control are to overcrowding and excessive workload. The efficient performance of the nursing staff is an important part of the strategy for prevention and control of HCAI.

  1. 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.

  2. Australian Infection Control Association members' use of skills and resources that promote evidence-based infection control.

    Science.gov (United States)

    Murphy, C L; McLaws, M

    2000-04-01

    To adopt an evidence-based approach, professionals must be able to access, identify, interpret, and critically appraise best evidence. Critical appraisal requires essential skills, such as computer literacy and an understanding of research principles. These skills also are required for professionals to contribute to evidence. In 1996, members of the Australian Infection Control Association were surveyed to establish a profile including the extent to which they were reading infection control publications, using specific documents for policy and guideline development, developing and undertaking research, publishing research, and using computers. The relationships between demographics, computer use, and research activity were examined. The response rate was 63. 4% (630/993). The study group comprised mostly women (96.1%), and most (66.4%) were older than 40 years of age. Median infection control experience was 4 years (mean, 5.4 years; range, Australian infection control professionals must be adequately prepared to contribute to, access, appraise, and where appropriate, apply best evidence to their practice. We suggest that computer literacy, an understanding of research principles, and familiarity with infection control literature are three essential skills that infection control professionals must possess and regularly exercise.

  3. Screening of Toxoplasma gondii infection among childbearing age females and assessment of nurses' role in prevention and control of toxoplasmosis.

    Science.gov (United States)

    Saleh, Ahmed Megahed Ahmed; Ali, Hisham abd El-Raouf; Ahmed, Salwa Abdalla Mohamed; Hosny, Samah Mostafa; Morsy, Tosson A

    2014-08-01

    Toxoplasmosis, caused by Toxoplasma gondii is an obligate intracellular zoonotic protozoan parasite, with a worldwide distribution particularly in Arab countries including Egypt. The study evaluated toxoplasmosis infection among childbearing age Egyptian females and assessed the military nursing staff knowledge, attitude and compliance to toxoplasmosis prevention and control measures. The study was conductedin a general military hospital. CROSS-section descriptive research design was used to conduct this study. The subjects consisted of 14 young females (11 were in-patients undergoing gynecological treatment in a military hospital and 3 were staff nurses. On the other hand, 44 staff nurses were available for assessment who met the inclusion criteria. 4 tools were used for data collection: first consisted of self-administered questionnaires to assess nurses' socio-demographic data and knowledge, second rating scale to assess nurses' attitude towards toxoplasmosis infection and its prevention, third performance check list to measure nurses' compliance to infection control measures, and fourth measured the anti-Toxoplasma antibodies by commercial indirect hemagglutination test (IHAT). The results showed that almost half of the nurses had satisfactory levels of knowledge, attitude, and compliance to toxoplasmosis infection control measures. 22.2% of the pregnant women and 20% of non-pregnant ones showed antibodies against T. gondii. Thus health education about toxoplasmosis should be tailored to women whether married or single to help in avoiding the risk of infection. Frequent periodic IHAT should be done for people who continuously contact with cats. Adherence to strict infection prevention measures is a must to eliminate exposure to toxoplasmosis infection. Training intervention should be implemented to achieve successful improvement in knowledge, attitude, and compliance of toxoplasmosis control measures.

  4. Staffing and structure of infection prevention and control programs.

    Science.gov (United States)

    Stone, Patricia W; Dick, Andrew; Pogorzelska, Monika; Horan, Teresa C; Furuya, E Yoko; Larson, Elaine

    2009-06-01

    The nature of infection prevention and control is changing; however, little is known about current staffing and structure of infection prevention and control programs. Our objectives were to provide a snapshot of the staffing and structure of hospital-based infection prevention and control programs in the United States. A Web-based survey was sent to 441 hospitals that participate in the National Healthcare Safety Network. The response rate was 66% (n = 289); data were examined on 821 professionals. Infection preventionist (IP) staffing was significantly negatively related to bed size, with higher staffing in smaller hospitals (P hospital epidemiologists were reported to have authority to close beds for outbreaks always or most of the time (n = 225, 78%). Only 32% (n = 92) reported using an electronic surveillance system to track infections. This study is the first to provide a comprehensive description of current infection prevention and control staffing, organization, and support in a select group of hospitals across the nation. Further research is needed to identify effective staffing levels for various hospital types as well as examine how the IP role is changing over time.

  5. Pandemic preparedness - Risk management and infection control for all respiratory infection outbreaks.

    Science.gov (United States)

    Nori, Annapurna; Williams, Mary-Anne

    2009-11-01

    There has been substantial effort and activity in regards to pandemic planning, preparedness and response, mainly in the realm of public health. However, general practitioners and other primary care providers are important players in the health response to a pandemic. To discuss the importance of general practice preparedness for managing respiratory infection outbreaks and to provide a model for the general practice response. Pandemic planning and preparedness in general practice is ultimately a crucial risk management exercise, the cornerstone of which is sound infection control. As planning will be significantly aided by, and should extend to, other respiratory outbreaks, we propose a framework for managing outbreaks of respiratory infections with a focus on planned, practised and habitual infection control measures, and a stepwise response according to the extent and severity of the outbreak.

  6. 78 FR 6329 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-01-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... charged with providing advice and guidance to the Director, Division of Healthcare Quality Promotion, the... regarding: (1) The practice of healthcare infection prevention and control; (2) strategies for surveillance...

  7. Coping with parvovirus infections in mice: health surveillance and control.

    Science.gov (United States)

    Janus, Lydia M; Bleich, Andre

    2012-01-01

    Parvoviruses of mice, minute virus of mice (MVM) and mouse parvovirus (MPV), are challenging pathogens to eradicate from laboratory animal facilities. Due to the impediment on rodent-based research, recent studies have focused on the assessment of re-derivation techniques and parvoviral potential to induce persistent infections. Summarizing recent data, this review gives an overview on studies associated with parvoviral impact on research, diagnostic methods, parvoviral persistence and re-derivation techniques, demonstrating the complex nature of parvovirus infection in mice and unfolding the challenge of controlling parvovirus infections in laboratory animal facilities.

  8. Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications

    OpenAIRE

    Reed, Deoine; Kemmerly, Sandra A.

    2009-01-01

    The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program ha...

  9. Glycerin-Based Hydrogel for Infection Control.

    Science.gov (United States)

    Stout, Edward I; McKessor, Angie

    2012-02-01

    Infection is a major problem in the health and wellbeing of patients in hospitals, nursing homes, and other medical facilities as well as the homecare patients and the general public. According to Scientia Advisors, wound care costs the healthcare system over $7 billion in 2009. After adding the cost associated with potential complications such as infections, extended physician care, and lengthy hospital stays, the annual wound care expenditures well exceeded over $20 billion. 1 There are 20 million reported cases of diabetes per year and more every day. Because of the fact that leg ulcers are the number one health problem of men coupled with the rise in drug resistance of infections, the importance of providing the professional and the public with relatively simple and affordable wound care is of extreme importance. Often the wounds can become chronic wounds, which then result in long-term nursing expense in time and supplies or, worse yet, can result in expensive amputations ranging from $5000 to $40,000 per patient. There are many dressing options now available for treating wounds with components such as glycerin, honey, salt, and many other natural products, with some dressings being more appropriate than others. In 1988, a patented glycerin-based dressing was introduced to the market, called Elasto-Gel™. 2. Elasto-Gel™ is a glycerin-based gel sheet (65%) combined with a hydrophilic polymer that causes the sheet to absorb the exudate from the wound and simultaneously release the glycerin from the gel, which adds many benefits to the wound for excellent healing outcomes. The gel sheet is 1/8th of an inch thick with a four-way stretch backing. It has the ability to absorb 3-4 times its own weight of fluids. The dressing will not dry out or allow the exudate to dry out, thus keeping the dressing from becoming bonded to the wound or the surrounding tissue. It does not have adhesive properties and, therefore, will not cause damage to the wound bed or periwound

  10. Infection Prevention and Control in Pediatric Ambulatory Settings.

    Science.gov (United States)

    Rathore, Mobeen H; Jackson, Mary Anne

    2017-11-01

    Since the American Academy of Pediatrics published its statement titled "Infection Prevention and Control in Pediatric Ambulatory Settings" in 2007, there have been significant changes that prompted this updated statement. Infection prevention and control is an integral part of pediatric practice in ambulatory medical settings as well as in hospitals. Infection prevention and control practices should begin at the time the ambulatory visit is scheduled. All health care personnel should be educated regarding the routes of transmission and techniques used to prevent the transmission of infectious agents. Policies for infection prevention and control should be written, readily available, updated every 2 years, and enforced. Many of the recommendations for infection control and prevention from the Centers for Disease Control and Prevention for hospitalized patients are also applicable in the ambulatory setting. These recommendations include requirements for pediatricians to take precautions to identify and protect employees likely to be exposed to blood or other potentially infectious materials while on the job. In addition to emphasizing the key principles of infection prevention and control in this policy, we update those that are relevant to the ambulatory care patient. These guidelines emphasize the role of hand hygiene and the implementation of diagnosis- and syndrome-specific isolation precautions, with the exemption of the use of gloves for routine diaper changes and wiping a well child's nose or tears for most patient encounters. Additional topics include respiratory hygiene and cough etiquette strategies for patients with a respiratory tract infection, including those relevant for special populations like patients with cystic fibrosis or those in short-term residential facilities; separation of infected, contagious children from uninfected children when feasible; safe handling and disposal of needles and other sharp medical devices; appropriate use of personal

  11. Patient safety and infection control: bases for curricular integration.

    Science.gov (United States)

    Silva, Andréa Mara Bernardes da; Bim, Lucas Lazarini; Bim, Felipe Lazarini; Sousa, Alvaro Francisco Lopes; Domingues, Pedro Castania Amadio; Nicolussi, Adriana Cristina; Andrade, Denise de

    2018-05-01

    To analyze curricular integration between teaching of patient safety and good infection prevention and control practices. Integrative review, designed to answer the question: "How does curricular integration of content about 'patient safety teaching' and content about 'infection prevention and control practices' occur in undergraduate courses in the health field?". The following databases were searched for primary studies: CINAHL, LILACS, ScienceDirect, Web of Science, Scopus, Europe PMC and MEDLINE. The final sample consisted of 13 studies. After content analysis, primary studies were grouped into two subject categories: "Innovative teaching practices" and "Curricular evaluation. Patient safety related to infection prevention and control practices is present in the curriculum of health undergraduate courses, but is not coordinated with other themes, is taught sporadically, and focuses mainly on hand hygiene.

  12. Infection control practice in private dental laboratories in Riyadh

    International Nuclear Information System (INIS)

    AlKheraif, Abdulaziz A; Mobarak, Fahmy A

    2008-01-01

    In view of the risk of infection of dental health care workers and patients, interruption of possible chains of infection is to be demanded. The objective of this study was to assess infection control practice in private dental laboratories in Riyadh City, Kingdom of Saudi Arabia. The study was conducted on thirty-two private dental laboratories in Riyadh City regarding infection control practiced by these laboratories. The instrument of the study consisted of ten open-ended questions that were asked from the laboratories directors. A large percentage of the surveyed laboratories (87.5 %) did not implement any infection control protocol during their practice. The mean number of impressions received per week was 16. Most of the surveyed laboratories (90.6 %) had no way of communication with the clinics regarding the disinfection procedures. The results indicated that 62.5 % of the laboratories reported that they were aware that they may get infection from non-disinfected items. Only a small percentage (6.2%) of the laboratories added disinfecting agent to pumice slurry. Wearing laboratory coats was reported by 75% of the laboratory workers. The use of gloves during work was reported by 59.3% of the laboratories while 56.2% reported the use protective eyewear. Only 21.8% of the laboratories use face masks during work. Construction of infection control manuals that contain updated and recommended guidelines to ensure aseptic practice in private dental laboratories is highly recommended. Also, a way of communication between dentists and dental technicians regarding disinfection of laboratory items should be strongly encouraged. (author)

  13. Post-infection immunodeficiency virus control by neutralizing antibodies.

    Directory of Open Access Journals (Sweden)

    Hiroyuki Yamamoto

    Full Text Available BACKGROUND: Unlike most acute viral infections controlled with the appearance of virus-specific neutralizing antibodies (NAbs, primary HIV infections are not met with such potent and early antibody responses. This brings into question if or how the presence of potent antibodies can contribute to primary HIV control, but protective efficacies of antiviral antibodies in primary HIV infections have remained elusive; and, it has been speculated that even NAb induction could have only a limited suppressive effect on primary HIV replication once infection is established. Here, in an attempt to answer this question, we examined the effect of passive NAb immunization post-infection on primary viral replication in a macaque AIDS model. METHODS AND FINDINGS: The inoculums for passive immunization with simian immunodeficiency virus mac239 (SIVmac239-specific neutralizing activity were prepared by purifying polyclonal immunoglobulin G from pooled plasma of six SIVmac239-infected rhesus macaques with NAb induction in the chronic phase. Passive immunization of rhesus macaques with the NAbs at day 7 after SIVmac239 challenge resulted in significant reduction of set-point plasma viral loads and preservation of central memory CD4 T lymphocyte counts, despite the limited detection period of the administered NAb responses. Peripheral lymph node dendritic cell (DC-associated viral RNA loads showed a remarkable peak with the NAb administration, and DCs stimulated in vitro with NAb-preincubated SIV activated virus-specific CD4 T lymphocytes in an Fc-dependent manner, implying antibody-mediated virion uptake by DCs and enhanced T cell priming. CONCLUSIONS: Our results present evidence indicating that potent antibody induction post-infection can result in primary immunodeficiency virus control and suggest direct and indirect contribution of its absence to initial control failure in HIV infections. Although difficulty in achieving requisite neutralizing titers for

  14. The rectal microbiota of cats infected with feline immunodeficiency virus infection and uninfected controls.

    Science.gov (United States)

    Weese, J S; Nichols, J; Jalali, M; Litster, A

    2015-10-22

    Rectal swabs were collected from 31 cats, 16 with FIV infection and 15 uninfected controls, to evaluate and compare the rectal bacterial microbiota in cats with feline immunodeficiency virus (FIV) infection and uninfected controls. The rectal microbiota was characterized via next generation sequencing of 16S rRNA gene (V4 region) polymerase chain reaction products. Eighteen different phyla were identified. Firmicutes dominated in both groups, followed by Proteobacteria and Actinobacteria, but there were no significant differences between groups. When predominant orders are compared, FIV-infected cats had significant higher median relative abundances of Bifidobacteriales (P=0.022), Lactobacillales (P=0.022) and Aeromonadales (P=0.043). No differences were identified in the 50 most common genera when adjusted for false discovery rate. There were significant differences in community membership (Jaccard index, unifrac P=0.008, AMOVA P<0.001) and community structure (Yue&Clayton index, unifrac P=0.03, AMOVA P=0.005) between groups. However, only one metacommunity (enterotype) was identified. The rectal microbiota differed between cats with FIV infection and uninfected controls. Some of the changes that were noted have been associated with 'dysbiosis' and proinflammatory states in other species, so it is possible that subclinical alteration in the intestinal microbiota could influence the health of FIV-infected cats. Evaluation of the reasons for microbiota alteration and the potential impact on cat health is required. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. [Infection control and safety culture in German hospitals].

    Science.gov (United States)

    Hansen, Sonja; Schwab, Frank; Gropmann, Alexander; Behnke, Michael; Gastmeier, Petra

    2016-07-01

    Healthcare-associated infections (HAI) are the most frequent adverse events in the healthcare setting and their prevention is an important contribution to patient safety in hospitals. To analyse to what extent safety cultural aspects with relevance to infection control are implemented in German hospitals. Safety cultural aspects of infection control were surveyed with an online questionnaire; data were analysed descriptively. Data from 543 hospitals with a median of [IQR] 275 [157; 453] beds were analysed. Almost all hospitals (96.6 %) had internal guidelines for infection control (IC) in place; 82 % defined IC objectives, most often regarding hand hygiene (HH) (93 %) and multidrug resistant organisms (72 %) and less frequently for antibiotic stewardship (48 %) or prevention of specific HAI. In 94 % of hospitals, a reporting system for adverse events was in place, which was also used to report low compliance with HH, outbreaks and Clostridium difficile-associated infections. Members of the IC team were most often seen to hold daily responsibility for IC in the hospital, but rarely other hospital staff (94 versus 19 %). Safety cultural aspects are not fully implemented in German hospitals. IC should be more strongly implemented in healthcare workers' daily routine and more visibly supported by hospital management.

  16. Infection control resources in New York State hospitals, 2007.

    Science.gov (United States)

    Stricof, Rachel L; Schabses, Karolina A; Tserenpuntsag, Boldtsetseg

    2008-12-01

    In July 2005, New York State legislation requiring the mandatory reporting of specific hospital-associated infections (HAIs) was passed by the legislature and signed by the governor. In an effort to measure the impact of this legislation on infection control resources, the New York State Department of Health (NYSDOH) conducted a baseline survey in March 2007. This report presents an overview of the methods and results of this survey. An electronic survey of infection control resources and responsibilities was conducted by the NYSDOH on their secure data network. The survey contained questions regarding the number and percent time for infection prevention and control professional (ICP) and hospital epidemiologist (HE) staff members, ICP/HE educational background and certification, infection control program support services, activities and responsibilities of infection prevention and control program staff, and estimates of time dedicated to various activities, including surveillance. Practitioners in 222 of 224 acute care hospitals (99%) responded. The average number of ICPs per facility depended on the average daily census of acute care beds and ranged from a mean of 0.64 full-time equivalent (FTE) ICP in facilities with an average daily census of or = 900 beds. Averaging the ICP resources over the health care settings for which they were responsible revealed that the "average full-time ICP" was responsible for 151 acute care facility beds, 1.3 intensive care units (ICUs) (average, 16 ICU beds), 21 long-term care facility beds, 0.6 dialysis centers, 0.5 ambulatory surgery centers, 4.8 ambulatory/outpatient clinics, and 1.1 private practice offices. The ICPs reported that 45% of their time is dedicated to surveillance. Other activities for which ICPs reported at least partial responsibility include staff education, quality assurance, occupational health, emergency preparedness, construction, central supply/processing, and risk management. This survey was designed to

  17. Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS)

    NARCIS (Netherlands)

    Willemsen, I.; Nelson-Melching, J.; Hendriks, Y.; Mulders, A.; Verhoeff, S.; Kluytmans-Vandenbergh, M.; Kluytmans, J.

    2014-01-01

    BACKGROUND: We developed a standardised method to assess the quality of infection control in Dutch Nursing Home (NH), based on a cross-sectional survey that visualises the results. The method was called the Infection control RIsk Infection Scan (IRIS). We tested the applicability of this new tool in

  18. Controlled Human Infection for Vaccination Against Streptococcus Pyogenes

    Science.gov (United States)

    2018-04-26

    Streptococcus Pyogenes Pharyngitis; Streptococcus Pharyngitis; Strep Throat; Streptococcus Pyogenes Infection; Group A Streptococcus: B Hemolytic Pharyngitis; Group A Streptococcal Infection; Gram-Positive Bacterial Infections; Bacterial Infections

  19. Why sensitive bacteria are resistant to hospital infection control.

    Science.gov (United States)

    van Kleef, Esther; Luangasanatip, Nantasit; Bonten, Marc J; Cooper, Ben S

    2017-01-01

    Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio (IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains. For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤ 0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while community acquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally. This follows from differences in their adaptation to hospital- and community-based transmission. Observed lack of

  20. Infection control in anaesthesia in regional, tertiary and central ...

    African Journals Online (AJOL)

    2012-09-10

    Sep 10, 2012 ... Describe how self-inflating resuscitation bags (Ambu®) are decontamined? Question 8. Do you feel that you have enough time between each case to adequately clean anaesthetic equipment and still perform your other duties? Table II: Definitions and classifications used in infection control practices.

  1. Role of antibodies in controlling dengue virus infection

    NARCIS (Netherlands)

    van der Schaar, Hilde M.; Wilschut, Jan C.; Smit, Jolanda M.

    The incidence and disease burden of arthropod-borne flavivirus infections have dramatically increased during the last decades due to major societal and economic changes, including massive urbanization, lack of vector control, travel, and international trade. Specifically, in the case of dengue virus

  2. Knowledge, attitude, and infection control practices of two tertiary ...

    African Journals Online (AJOL)

    2014-04-02

    Apr 2, 2014 ... This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt, ... malpractice suit in developing countries, not only for the ... Infection control policy has however been shown to reduce the burden of ..... SSIs‑activities that mirror the plan‑do‑check‑act that is applied in ...

  3. Control of pestivirus infections in the management of wildlife populations

    Science.gov (United States)

    The lack of host-specificity allow pestiviruses to infect domestic livestock as well as captive and free-ranging wildlife, posing unique challenges to different stakeholders. While current control measures for bovine viral diarrhea virus (BVDV) are focused only on cattle, increased attention on the ...

  4. Risk control of surgical site infection after cardiothoracic surgery

    NARCIS (Netherlands)

    Segers, P.; de Jong, A. P.; Kloek, J. J.; Spanjaard, L.; de Mol, B. A. J. M.

    2006-01-01

    The purpose of this prospective study was to investigate whether a risk control programme based on risk assessment, new treatment modalities and the presence of a surveillance programme reduces the incidence of surgical site infections (SSI). Between January 2001 and December 2003, 167 patients were

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

    OpenAIRE

    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 ...

  6. Modal Inclusion Logic: Being Lax is Simpler than Being Strict

    DEFF Research Database (Denmark)

    Hella, Lauri; Kuusisto, Antti Johannes; Meier, Arne

    2015-01-01

    We investigate the computational complexity of the satisfiability problem of modal inclusion logic. We distinguish two variants of the problem: one for strict and another one for lax semantics. The complexity of the lax version turns out to be complete for EXPTIME, whereas with strict semantics...

  7. 7 CFR 28.426 - Strict Good Ordinary Spotted Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Good Ordinary Spotted Color. 28.426 Section 28.426 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Spotted Color. Strict Good Ordinary Spotted Color is color which is within the range represented by a set...

  8. 7 CFR 28.433 - Strict Low Middling Tinged Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Low Middling Tinged Color. 28.433 Section 28.433 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Tinged Color. Strict Low Middling Tinged Color is color which is within the range represented by a set of...

  9. 7 CFR 28.422 - Strict Middling Spotted Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Middling Spotted Color. 28.422 Section 28.422 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Color. Strict Middling Spotted Color is color which is within the range represented by a set of samples...

  10. 7 CFR 28.424 - Strict Low Middling Spotted Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Low Middling Spotted Color. 28.424 Section 28.424 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Spotted Color. Strict Low Middling Spotted Color is color which is within the range represented by a set...

  11. 7 CFR 28.431 - Strict Middling Tinged Color.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Middling Tinged Color. 28.431 Section 28.431 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Color. Strict Middling Tinged Color is color which is better than Middling Tinged Color. ...

  12. 43 CFR 29.7 - Imposition of strict liability.

    Science.gov (United States)

    2010-10-01

    ... LIABILITY FUND § 29.7 Imposition of strict liability. (a) Notwithstanding the provisions of any other law... prove that the damages were caused by an act of war or by the negligence of the United States or other... negligence of such damaged party. (c)(1) Strict liability for all claims arising out of any one incident...

  13. Strictly-regular number system and data structures

    DEFF Research Database (Denmark)

    Elmasry, Amr Ahmed Abd Elmoneim; Jensen, Claus; Katajainen, Jyrki

    2010-01-01

    We introduce a new number system that we call the strictly-regular system, which efficiently supports the operations: digit-increment, digit-decrement, cut, concatenate, and add. Compared to other number systems, the strictly-regular system has distinguishable properties. It is superior to the re...

  14. STRICT CONVEXITY THROUGH EQUIVALENT NORMS IN SEPARABLES BANACH SPACES

    Directory of Open Access Journals (Sweden)

    Willy Zubiaga Vera

    2016-12-01

    Full Text Available Let E be a separable Banach space with norm || . ||. In the present work, the objective is to construct a norm || . ||1 that is equivalent to || . || in E, such that || . ||1 is strictly convex. In addition it is shown that its dual conjugate norm is also strictly convex.

  15. Control of Giardia infections with ronidazole and intensive hygiene management in a dog kennel.

    Science.gov (United States)

    Fiechter, Ruth; Deplazes, Peter; Schnyder, Manuela

    2012-06-08

    Infections with the intestinal protozoan parasite Giardia in dogs and cats are common. Clinical signs vary from asymptomatic to small bowel diarrhea and associated discomfort. The control of infections in dogs is frequently a frustrating issue for animal owners and veterinarians. Drugs with antiprotozoal activity such as fenbendazole and metronidazole are recommended, however, they do not show 100% efficacy and superinfections occur regularly. Ronidazole is currently the drug of choice for the treatment of Tritrichomonas foetus in cats and there is now limited information available about its efficacy against Giardia spp. In the kennel investigated, dogs regularly showed loose feces and the presence of Giardia (assemblage C, renamed as G. canis) cysts. An elimination strategy of this parasite involving strict hygiene management and disinfection of the enclosures with 4-chlorine-M-cresol, oral treatment with ronidazole (30-50mg/kg BW bid for 7 days) and two shampooings (containing chlorhexidine) at the beginning and the end of the treatments was implemented for a group of 6 dogs. As a control another group of 7 dogs was transferred to the disinfected enclosures and shampooed, but left untreated. Dog feces were tested for the presence of Giardia cysts (SAF concentration technique) or Giardia antigen with a commercial ELISA (NOVITEC(®)) and a quick immunochromatography-based test (SensPERT(®)) before and between 5 and 40 days after the last treatment. All ronidazole-treated dogs were negative for Giardia cysts and antigen up to 26 days after the last treatment, while between 1 and 5 of the control animals tested positive in each of the test series. At this point, also dogs of the control group were again moved into clean enclosures, shampooed twice and treated with ronidazole. Five, 12 and 19 days after the last treatment, the dogs in the control group tested negative for Giardia cysts and antigen. However, all animals had again positive results at later time points

  16. Perceptions of Clostridium difficile infections among infection control professionals in Taiwan.

    Science.gov (United States)

    Hung, Yuan-Pin; Lee, Jen-Chieh; Lin, Hsiao-Ju; Chiu, Chun-Wei; Wu, Jia-Ling; Liu, Hsiao-Chieh; Huang, I-Hsiu; Tsai, Pei-Jane; Ko, Wen-Chien

    2017-08-01

    High Clostridium difficile colonization and infection rates among hospitalized patients had been noted in Taiwan. Nevertheless, the cognition about clinical diagnosis and management of CDI among infection control professionals in Taiwan is not clear. A 24-item survey questionnaire about the diagnosis, therapy, or infection control policies toward CDI was distributed in the annual meeting of the Infectious Disease Society of Taiwan (IDST) in October 2015 and Infectious Control Society of Taiwan (ICST) in April 2016. Totally 441 individuals responded to the survey, and 280 (63.5%) participants would routinely monitor the prevalence of CDI and 347 (78.7%) reported the formulation of infection control policies of CDI in their hospital, including contact precaution (75.7%), wearing gloves (88.9%) or dressing (80.0%) at patient care, single room isolation (49.7%), preference of soap or disinfectant-based sanitizer (83.2%) and avoidance of alcohol-based sanitizer (63.3%), and environmental disinfection with 1000 ppm bleach (87.1%). For the timing of contact precaution discontinuation isolation for CDI patients, most (39.9%) participants suggested the time point of the absence of C. difficile toxin in feces. To treat mild CDI, most (61.9%) participants preferred oral metronidazole, and for severe CDI 26.1% would prescribe oral vancomycin as the drug of choice. There were substantial gaps in infection control polices and therapeutic choices for CDI between international guidelines and the perceptions of medical professionals in Taiwan. Professional education program and the setup of guideline for CDI should be considered in Taiwan. Copyright © 2017. Published by Elsevier B.V.

  17. Uniform-related infection control practices of dental students

    Directory of Open Access Journals (Sweden)

    Aljohani Y

    2017-04-01

    Full Text Available Yazan Aljohani,1 Mohammed Almutadares,1 Khalid Alfaifi,1 Mona El Madhoun,1 Maysoon H Albahiti,2 Nadia Al-Hazmi3 1Internship Program, Faculty of dentistry, King Abdulaziz University, 2Department of Endodontics, King Abdulaziz University, 3Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia Background: Uniform-related infection control practices are sometimes overlooked and underemphasized. In Saudi Arabia, personal protective equipment must meet global standards for infection control, but the country’s Islamic legislature also needs to be taken into account. Aim: To assess uniform-related infection control practices of a group of dental students in a dental school in Saudi Arabia and compare the results with existing literature related to cross-contamination through uniforms in the dental field. Method: A questionnaire was formulated and distributed to dental students at King Abdulaziz University Faculty of Dentistry in Jeddah, Saudi Arabia, which queried the students about their uniform-related infection control practices and their methods and frequency of laundering and sanitizing their uniforms, footwear, and name tags. Results: There is a significant difference between genders with regard to daily uniform habits. The frequency of uniform washing was below the standard and almost 30% of students were not aware of how their uniforms are washed. Added to this, there is no consensus on a unified uniform for male and female students. Conclusion: Information on preventing cross-contamination through wearing uniforms must be supplied, reinforced, and emphasized while taking into consideration the cultural needs of the Saudi society. Keywords: cross-contamination, infection control, dental students, uniforms

  18. Predictors of certification in infection prevention and control among infection preventionists: APIC MegaSurvey findings.

    Science.gov (United States)

    Kalp, Ericka L; Harris, Jeanette J; Zawistowski, Grace

    2018-06-06

    The 2015 APIC MegaSurvey was completed by 4,078 members to assess infection prevention practices. This study's purpose was to examine MegaSurvey results to relate infection preventionist (IP) certification status with demographic characteristics, organizational structure, compensation benefits, and practice and competency factors. Descriptive statistics were used to examine population characteristics and certification status. Bivariate logistic regression was performed to evaluate relationships between independent variables and certification status. Variables demonstrating statistical significance (P Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Humans, 'things' and space: costing hospital infection control interventions.

    Science.gov (United States)

    Page, K; Graves, N; Halton, K; Barnett, A G

    2013-07-01

    Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update.

    Science.gov (United States)

    Seto, W H; Conly, J M; Pessoa-Silva, C L; Malik, M; Eremin, S

    2013-01-01

    Viruses account for the majority of the acute respiratory tract infections (ARIs) globally with a mortality exceeding 4 million deaths per year. The most commonly encountered viruses, in order of frequency, include influenza, respiratory syncytial virus, parainfluenza and adenovirus. Current evidence suggests that the major mode of transmission of ARls is through large droplets, but transmission through contact (including hand contamination with subsequent self-inoculation) and infectious respiratory aerosols of various sizes and at short range (coined as "opportunistic" airborne transmission) may also occur for some pathogens. Opportunistic airborne transmission may occur when conducting highrisk aerosol generating procedures and airborne precautions will be required in this setting. General infection control measures effective for all respiratory viral infections are reviewed and followed by discussion on some of the common viruses, including severe acute respiratory syndrome (SARS) coronavirus and the recently discovered novel coronavirus.

  1. Host control of human papillomavirus infection and disease.

    Science.gov (United States)

    Doorbar, John

    2018-02-01

    Most human papillomaviruses cause inapparent infections, subtly affecting epithelial homeostasis, to ensure genome persistence in the epithelial basal layer. As with conspicuous papillomas, these self-limiting lesions shed viral particles to ensure population level maintenance and depend on a balance between viral gene expression, immune cell stimulation and immune surveillance for persistence. The complex immune evasion strategies, characteristic of high-risk HPV types, also allow the deregulated viral gene expression that underlies neoplasia. Neoplasia occurs at particular epithelial sites where vulnerable cells such as the reserve or cuboidal cells of the cervical transformation zone are found. Beta papillomavirus infection can also predispose an individual with immune deficiencies to the development of cancers. The host control of HPV infections thus involves local interactions between keratinocytes and the adaptive immune response. Effective immune detection and surveillance limits overt disease, leading to HPV persistence as productive microlesions or in a true latent state. Copyright © 2017. Published by Elsevier Ltd.

  2. The role of education in the prevention and control of infection: a review of the literature.

    Science.gov (United States)

    Ward, Deborah J

    2011-01-01

    This paper discusses a literature review which was undertaken prior to a research study about student nurses' and midwives' experiences of learning infection control in clinical practice. Its aim is to identify the role of education in the prevention and control of infection, with a specific focus on compliance with infection control precautions and reduction in infection rates. It also identifies the methods used for teaching infection control. The review concludes that there is no rigorous and convincing evidence that education improves compliance with infection control precautions or reduces rates of infection, particularly in the long-term. Areas for future research are identified. 2010 Elsevier Ltd. All rights reserved.

  3. Japanese encephalitis virus infection, diagnosis and control in domestic animals.

    Science.gov (United States)

    Mansfield, Karen L; Hernández-Triana, Luis M; Banyard, Ashley C; Fooks, Anthony R; Johnson, Nicholas

    2017-03-01

    Japanese encephalitis virus (JEV) is a significant cause of neurological disease in humans throughout Asia causing an estimated 70,000 human cases each year with approximately 10,000 fatalities. The virus contains a positive sense RNA genome within a host-derived membrane and is classified within the family Flaviviridae. Like many flaviviruses, it is transmitted by mosquitoes, particularly those of the genus Culex in a natural cycle involving birds and some livestock species. Spill-over into domestic animals results in a spectrum of disease ranging from asymptomatic infection in some species to acute neurological signs in others. The impact of JEV infection is particularly apparent in pigs. Although infection in adult swine does not result in symptomatic disease, it is considered a significant reproductive problem causing abortion, still-birth and birth defects. Infected piglets can display fatal neurological disease. Equines are also infected, resulting in non-specific signs including pyrexia, but occasionally leading to overt neurological disease that in extreme cases can lead to death. Veterinary vaccination is available for both pigs and horses. This review of JEV disease in livestock considers the current diagnostic techniques available for detection of the virus. Options for disease control and prevention within the veterinary sector are discussed. Such measures are critical in breaking the link to zoonotic transmission into the human population where humans are dead-end hosts. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  4. Randomized controlled trials for influenza drugs and vaccines: a review of controlled human infection studies

    Directory of Open Access Journals (Sweden)

    Shobana Balasingam

    2016-08-01

    Conclusions: Controlled human infection studies are an important research tool in assessing promising influenza vaccines and antivirals. These studies are performed quickly and are cost-effective and safe, with a low incidence of serious adverse events.

  5. The impact of economic recession on infection prevention and control.

    Science.gov (United States)

    O'Riordan, M; Fitzpatrick, F

    2015-04-01

    The economic recession that began in 2007 led to austerity measures and public sector cutbacks in many European countries. Reduced resource allocation to infection prevention and control (IPC) programmes is impeding prevention and control of tuberculosis, HIV and vaccine-preventable infections. In addition, higher rates of infectious disease in the community have a significant impact on hospital services, although the extent of this has not been studied. With a focus on quick deficit reduction, preventive services such IPC may be regarded as non-essential. Where a prevention programme succeeds in reducing disease burden to a low level, its very success can undermine the perceived need for the programme. To mitigate the negative effects of recession, we need to: educate our political leaders about the economic benefits of IPC; better quantify the costs of healthcare-associated infection; and evaluate the effects of budget cuts on healthcare outcomes and IPC activities. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Validation of a proposal for evaluating hospital infection control programs.

    Science.gov (United States)

    Silva, Cristiane Pavanello Rodrigues; Lacerda, Rúbia Aparecida

    2011-02-01

    To validate the construct and discriminant properties of a hospital infection prevention and control program. The program consisted of four indicators: technical-operational structure; operational prevention and control guidelines; epidemiological surveillance system; and prevention and control activities. These indicators, with previously validated content, were applied to 50 healthcare institutions in the city of São Paulo, Southeastern Brazil, in 2009. Descriptive statistics were used to characterize the hospitals and indicator scores, and Cronbach's α coefficient was used to evaluate the internal consistency. The discriminant validity was analyzed by comparing indicator scores between groups of hospitals: with versus without quality certification. The construct validity analysis was based on exploratory factor analysis with a tetrachoric correlation matrix. The indicators for the technical-operational structure and epidemiological surveillance presented almost 100% conformity in the whole sample. The indicators for the operational prevention and control guidelines and the prevention and control activities presented internal consistency ranging from 0.67 to 0.80. The discriminant validity of these indicators indicated higher and statistically significant mean conformity scores among the group of institutions with healthcare certification or accreditation processes. In the construct validation, two dimensions were identified for the operational prevention and control guidelines: recommendations for preventing hospital infection and recommendations for standardizing prophylaxis procedures, with good correlation between the analysis units that formed the guidelines. The same was found for the prevention and control activities: interfaces with treatment units and support units were identified. Validation of the measurement properties of the hospital infection prevention and control program indicators made it possible to develop a tool for evaluating these programs

  7. Hospital infection prevention and control issues relevant to extensive floods.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Mundy, Linda M; Khawcharoenporn, Thana; Glen Mayhall, C

    2013-02-01

    The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders.

  8. [Infection control team (ICT) in cooperation with microbiology laboratories].

    Science.gov (United States)

    Okazaki, Mitsuhiro

    2012-10-01

    Infection control as a medical safety measure is an important issue in all medical facilities. In order to tackle this measure, cooperation between the infection control team (ICT) and microbiological laboratory is indispensable. Multiple drug-resistant bacteria have shifted from Gram-positive bacteria to Gram-negative bacilli within the last ten years. There are also a variety of bacilli, complicating the examination method and test results further. Therefore, cooperation between the ICT and microbiological laboratory has become important to understand examination results and to use them. In order to maintain functional cooperation, explanatory and communicative ability between the microbiological laboratory and ICT is required every day. Such positive information exchange will develop into efficient and functional ICT activity.

  9. Maternal geohelminth infections are associated with an increased susceptibility to geohelminth infection in children: a case-control study.

    Directory of Open Access Journals (Sweden)

    Raaj S Mehta

    Full Text Available Children of mothers infected with soil-transmitted helminths (STH may have an increased susceptibility to STH infection.We did a case-control study nested in a birth cohort in Ecuador. Data from 1,004 children aged 7 months to 3 years were analyzed. Cases were defined as children with Ascaris lumbricoides and/or Trichuris trichiura, controls without. Exposure was defined as maternal infection with A. lumbricoides and/or T. trichiura, detected during the third trimester of pregnancy. The analysis was restricted to households with a documented infection to control for infection risk. Children of mothers with STH infections had a greater risk of infection compared to children of uninfected mothers (adjusted OR 2.61, 95% CI: 1.88-3.63, p<0.001. This effect was particularly strong in children of mothers with both STH infections (adjusted OR: 5.91, 95% CI: 3.55-9.81, p<0.001. Newborns of infected mothers had greater levels of plasma IL-10 than those of uninfected mothers (p=0.033, and there was evidence that cord blood IL-10 was increased among newborns who became infected later in childhood (p=0.060.Our data suggest that maternal STH infections increase susceptibility to infection during early childhood, an effect that was associated with elevated IL-10 in cord plasma.

  10. Normal form and synchronization of strict-feedback chaotic systems

    International Nuclear Information System (INIS)

    Wang, Feng; Chen, Shihua; Yu Minghai; Wang Changping

    2004-01-01

    This study concerns the normal form and synchronization of strict-feedback chaotic systems. We prove that, any strict-feedback chaotic system can be rendered into a normal form with a invertible transform and then a design procedure to synchronize the normal form of a non-autonomous strict-feedback chaotic system is presented. This approach needs only a scalar driving signal to realize synchronization no matter how many dimensions the chaotic system contains. Furthermore, the Roessler chaotic system is taken as a concrete example to illustrate the procedure of designing without transforming a strict-feedback chaotic system into its normal form. Numerical simulations are also provided to show the effectiveness and feasibility of the developed methods

  11. Strict finitism and the logic of mathematical applications

    CERN Document Server

    Ye, Feng

    2011-01-01

    Exploring the logic behind applied mathematics to the physical world, this volume illustrates how radical naturalism, nominalism and strict finitism can account for the applications of classical mathematics in current theories about natural phenomena.

  12. The first step in infection control is hand hygiene.

    Science.gov (United States)

    Canham, Leslie

    2011-01-01

    A dental health care worker (DHCW) has an obligation to prevent the spread of health care associated infections. Adhering to proper hand hygiene procedures, selecting appropriate hand hygiene products and the use of gloves are all important elements of infection control. The CDC Guidelines for Hand Hygiene state that improved hand hygiene practices can reduce transmission of pathogenic microorganisms to patients and personnel in health care settings. DHCWs must also protect themselves by recognizing pitfalls such as irritants or allergies that may pose obstacles to proper hand hygiene. Occupational irritants and allergies can be caused by frequent hand washing, exposure to hand hygiene products, exposure to chemicals and shear forces associated with wearing or removing gloves. Since the primary defense against infection and transmission of pathogens is healthy, unbroken skin, DHCWs must take steps to ensure that their skin remains healthy and intact. These steps include evaluating different types of hand hygiene products, lotions and gloves for the best compatibility. If the DHCW sees a breakdown of his or her skin barrier, steps should be taken to determine the cause and remedy. Remedies can include the use of alcohol-based hand sanitizers containing emollients and moisturizers and regular use of a medical grade hand lotion. The bottom line: healthy skin protects you at work and at home. Selection and use of appropriate hand hygiene products, including moisturizers, are an essential part ofa dental office infection control program. My coworker lost the use of her thumb for several months due to complications of a staph infection. She was unable to work and found even simple tasks such as closing a button hard to do. Think of how difficult your work would be if something happened to your hands. Injury, irritation or allergies could alter your ability to work or even perform routine tasks. Our hands provide us with the ability to work in clinical dentistry. It makes

  13. Research progress on influencing factors of hospital infection and prevention and control measures

    Directory of Open Access Journals (Sweden)

    He Wenlong

    2015-03-01

    Full Text Available Hospital infections are associated with the emergence of hospitals. As the understanding of hospital infections deepen and prevention and control measures improve, hospital infections have become manageable. In recent years, affected by the increase in invasive treatment technology, antimicrobial abuse, and other factors, the control of hospital infection has encountered new problems. This paper reviews the influencing factors of hospital infections and their prevention and control measures.

  14. Why sensitive bacteria are resistant to hospital infection control

    Science.gov (United States)

    van Kleef, Esther; Luangasanatip, Nantasit; Bonten, Marc J; Cooper, Ben S

    2017-01-01

    Background: Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. Methods: We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio ( IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains. Results: For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤  0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while communityacquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Conclusions: Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally, following differences in their adaptation to hospital and community

  15. Two examples of non strictly convex large deviations

    OpenAIRE

    De Marco, Stefano; Jacquier, Antoine; Roome, Patrick

    2016-01-01

    We present two examples of a large deviations principle where the rate function is not strictly convex. This is motivated by a model used in mathematical finance (the Heston model), and adds a new item to the zoology of non strictly convex large deviations. For one of these examples, we show that the rate function of the Cramer-type of large deviations coincides with that of the Freidlin-Wentzell when contraction principles are applied.

  16. Strictly contractive quantum channels and physically realizable quantum computers

    International Nuclear Information System (INIS)

    Raginsky, Maxim

    2002-01-01

    We study the robustness of quantum computers under the influence of errors modeled by strictly contractive channels. A channel T is defined to be strictly contractive if, for any pair of density operators ρ, σ in its domain, parallel Tρ-Tσ parallel 1 ≤k parallel ρ-σ parallel 1 for some 0≤k 1 denotes the trace norm). In other words, strictly contractive channels render the states of the computer less distinguishable in the sense of quantum detection theory. Starting from the premise that all experimental procedures can be carried out with finite precision, we argue that there exists a physically meaningful connection between strictly contractive channels and errors in physically realizable quantum computers. We show that, in the absence of error correction, sensitivity of quantum memories and computers to strictly contractive errors grows exponentially with storage time and computation time, respectively, and depends only on the constant k and the measurement precision. We prove that strict contractivity rules out the possibility of perfect error correction, and give an argument that approximate error correction, which covers previous work on fault-tolerant quantum computation as a special case, is possible

  17. Latent Toxoplasma gondii infection leads to improved action control.

    Science.gov (United States)

    Stock, Ann-Kathrin; Heintschel von Heinegg, Evelyn; Köhling, Hedda-Luise; Beste, Christian

    2014-03-01

    The parasite Toxoplasma gondii has been found to manipulate the behavior of its secondary hosts to increase its own dissemination which is commonly believed to be to the detriment of the host (manipulation hypothesis). The manipulation correlates with an up-regulation of dopaminergic neurotransmission. In humans, different pathologies have been associated with T. gondii infections but most latently infected humans do not seem to display overt impairments. Since a dopamine plus does not necessarily bear exclusively negative consequences in humans, we investigated potential positive consequences of latent toxoplasmosis (and the presumed boosting of dopaminergic neurotransmission) on human cognition and behavior. For this purpose, we focused on action cascading which has been shown to be modulated by dopamine. Based on behavioral and neurophysiological (EEG) data obtained by means of a stop-change paradigm, we were able to demonstrate that healthy young humans can actually benefit from latent T. gondii infection as regards their performance in this task (as indicated by faster response times and a smaller P3 component). The data shows that a latent infection which is assumed to affect the dopaminergic system can lead to paradoxical improvements of cognitive control processes in humans. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Control of tropical theileriosis (Theileria annulata infection) of cattle.

    Science.gov (United States)

    Brown, C G

    1990-04-01

    Tropical bovine theileriosis caused by Theileria annulata and transmitted by ticks of the genus Hyalomma may be controlled by one or more of the following methods: i) management, with particular emphasis on movement control; ii) vector control by application of acaricides, preventing transmission of disease; iii) treatment of clinical disease using specific chemotherapeutics; iv) immunization with live vaccines; and v) the use of cattle resistant to ticks or the disease. Of these the most important and effective control method is the use of a live cell culture vaccine attenuated by prolonged culture in vitro of mononuclear cells persistently infected with macroschizonts of T. annulata. This vaccine, used chiefly in susceptible taurine dairy cattle, can now be complemented by using novel chemotherapeutic naphthoquinones--parvaquone and buparvaquone--which are very effective in treatment of the clinical disease in these valuable cattle.

  19. National infection prevention and control programmes: Endorsing quality of care.

    Science.gov (United States)

    Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

    2014-01-01

    Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

  20. Detection of low numbers of microplastics in North Sea fish using strict quality assurance criteria

    NARCIS (Netherlands)

    Hermsen, E.; Pompe, R.; Besseling, E.; Koelmans, A.A.

    2017-01-01

    We investigated 400 individual fish of four North Sea species: Atlantic Herring, Sprat, Common Dab, and Whiting on ingestion of > 20 μm microplastic. Strict quality assurance criteria were followed in order to control contamination during the study. Two plastic particles were found in only 1 (a

  1. Pregnancy and postpartum control in HIV infected women

    Directory of Open Access Journals (Sweden)

    Eduardo M. Warley

    2017-04-01

    Full Text Available Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(tides and 1 ritonavir potenciated protease inhibitor (PIr was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%, less than 200 cop/ml in 70 (67.3% and not available in 18 (17.3% of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period

  2. [Pregnancy and postpartum control in HIV infected women].

    Science.gov (United States)

    Warley, Eduardo M; Tavella, Silvina; Rosas, Alejandra

    2017-01-01

    Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(t)ides and 1 ritonavir potenciated protease inhibitor (PIr) was prescribed in 84.5%. Elective c-section was the most frequent mode of delivery. The viral load after 32 weeks of pregnancy was available in 82.7%, being less than 1000 cop/ml in 78 (75%), less than 200 cop/ml in 70 (67.3%) and not available in 18 (17.3%) of cases. We observed a considered high rate of adherence failure and loss of follow up after delivery. Reported data should alert programs on the need to implement strategies to promote early pregnancy control and increase adherence and retention in care, especially in the postpartum period.

  3. Comprehensive Control of Human Papillomavirus Infections and Related Diseases

    Science.gov (United States)

    Bosch, F. Xavier; Broker, Thomas R.; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L.; Doorbar, John; Stern, Peter L.; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E.; Schiller, John T.; Markowitz, Lauri E.; Fisher, William A.; Canfell, Karen; Denny, Lynette A.; Franco, Eduardo L.; Steben, Marc; Kane, Mark A.; Schiffman, Mark; Meijer, Chris J.L.M.; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J.; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

    2014-01-01

    Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of

  4. Role of the clinical microbiology laboratory in infection control - a Danish perspective

    DEFF Research Database (Denmark)

    Kolmos, H J

    2001-01-01

    for standardization and documentation of quality. Currently a national standard for infection control is being prepared. It consists of a main standard defining requirements for the management system and 12 subsidiary standards defining requirements for specific areas of infection control. Adoption of the standard...... will undoubtedly require additional resources for infection control at a local level, and some organizational changes may also be needed. Infection control should be maintained as an integrated part of clinical microbiology....

  5. A randomized controlled trial comparing mupirocin versus Polysporin Triple for the prevention of catheter-related infections in peritoneal dialysis patients (the MP3 study).

    Science.gov (United States)

    Jassal, Sarbjit V; Lok, Charmaine E

    2008-01-01

    Peritonitis remains the most serious complication of peritoneal dialysis (PD). Gram-positive organisms are among the most common causes of PD peritonitis; however, recent trends show increasing rates of gram-negative and fungal infections. Strategies to prevent peritonitis include the use of prophylactic topical mupirocin at the site where the PD catheter exits from the abdominal wall; however, mupirocin does not afford protection against gram-negative or fungal infections. The aim of this study is to determine if the incidence of catheter-related infections (exit-site infection, tunnel infection, or peritonitis) is significantly reduced by the routine application of Polysporin Triple antibiotic ointment (Pfizer Canada, Markham, Ontario, Canada) in comparison to mupirocin ointment. The Mupirocin Versus Polysporin Triple Study (MP3) is a multicenter, randomized, double-blinded controlled study comparing Polysporin Triple (P3) against the current standard of care. The aim of the study is to recruit 200 patients being treated with or starting on PD and randomize them to receive either mupirocin or P3 at the catheter exit site. Patients will be followed for 18 months or until death or transfer from PD to an alternate treatment modality. The primary outcome will be the time to first catheter-related infection. Catheter-related infections will be strictly defined using current guidelines and categorized into exit-site infections, infective peritonitis, or tunnel infections. The primary analysis will be an intention-to-treat analysis. The results of this study will help determine if the use of P3 is superior to mupirocin ointment in the prevention of catheter-related infections and will help guide evidence-based best practices.

  6. An Integrative Review of Infection Control Research in Korean Nursing Journals

    Directory of Open Access Journals (Sweden)

    Kyung Mi Kim, RN, PhD

    2014-06-01

    Conclusions: To enhance the quality of infection control studies and establish infection control studies as a nursing knowledge body, meta-analyses and systematic literature reviews as well as quantitative studies are needed. Moreover, studies employing behavioral science to identify factors influencing the level of knowledge and practice and to change infection control behaviors are also warranted.

  7. Healthcare Associated Infections of Methicillin-Resistant Staphylococcus aureus: A Case-Control-Control Study.

    Directory of Open Access Journals (Sweden)

    Zhenjiang Yao

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is one of the most widespread and dangerous pathogens in healthcare settings. We carried out this case-control-control study at a tertiary care hospital in Guangzhou, China, to examine the antimicrobial susceptibility patterns, risk factors and clinical outcomes of MRSA infections.A total of 57 MRSA patients, 116 methicillin-susceptible Staphylococcus aureus (MSSA patients and 102 S. aureus negative patients were included in this study. We applied the disk diffusion method to compare the antimicrobial susceptibilities of 18 antibiotics between MRSA and MSSA isolates. Risk factors of MRSA infections were evaluated using univariate and multivariate logistic regression models. We used Cox proportional hazards models and logistic regression analysis to assess the hospital stay duration and fatality for patients with MRSA infections.The MRSA group had significantly higher resistance rates for most drugs tested compared with the MSSA group. Using MSSA patients as controls, the following independent risk factors of MRSA infections were identified: 3 or more prior hospitalizations (OR 2.8, 95% CI 1.3-5.8, P = 0.007, chronic obstructive pulmonary disease (OR 5.9, 95% CI 1.7-20.7, P = 0.006, and use of a respirator (OR 3.6, 95% CI 1.0-12.9, P = 0.046. With the S. aureus negative patients as controls, use of a respirator (OR 3.8, 95% CI 1.0-13.9, P = 0.047 and tracheal intubation (OR 8.2, 95% CI 1.5-45.1, P = 0.016 were significant risk factors for MRSA infections. MRSA patients had a longer hospital stay duration and higher fatality in comparison with those in the two control groups.MRSA infections substantially increase hospital stay duration and fatality. Thus, MRSA infections are serious issues in this healthcare setting and should receive more attention from clinicians.

  8. Controlled human infection models for vaccine development: Zika virus debate.

    Science.gov (United States)

    Gopichandran, Vijayaprasad

    2018-01-01

    An ethics panel, convened by the National Institute of Health and other research bodies in the USA, disallowed researchers from the Johns Hopkins University and University of Vermont from performing controlled human infection of healthy volunteers to develop a vaccine against Zika virus infection. The members published their ethical analysis and recommendations in February 2017. They have elaborated on the risks posed by human challenge with Zika virus to the volunteers and other uninvolved third parties and have systematically analysed the social value of such a human challenge experiment. They have also posited some mandatory ethical requirements which should be met before allowing the infection of healthy volunteers with the Zika virus. This commentary elaborates on the debate on the ethics of the human challenge model for the development of a Zika virus vaccine and the role of systematic ethical analysis in protecting the interests of research participants. It further analyses the importance of this debate to the development of a Zika vaccine in India.

  9. 洁净手术室的医院感染管理环节控制%Control of nosocomial infections in laminar airflow operating rooms

    Institute of Scientific and Technical Information of China (English)

    江才秀; 李晓花

    2013-01-01

    OBJECTIVE To study the impact factors of surgical site infections (SSIs) in laminar airflow (LAF) operating rooms (OR) and ensure the air quality of the operating rooms so as to decrease the incidence of SSIs.METHODS The key point of the hospital infection control combined humanization management and mandatory management was implemented strictly in the work process of laminar airflow operating rooms.RESULTS The difficulties in the control of nosocomial infections in the operating rooms have been effectively overcome,the air quality of the clean operating rooms has been ensured,and the incidence of SSIs has been reduced.CONCLUSION It is the key point to overcome the difficulties in the control of nosocomial infections in the cleaning operating rooms through enhancement of the study and training,implementation of the system,and strict management.%目的 加强洁净手术室医院感染管理环节控制,确保洁净手术室空气质量,以降低手术切口感染率.方法 针对难以控制的环节,以学习、训练为基础,实行人性化管理与强制性管理相结合.结果 有效克服了洁净手术室医院感染管理环节控制难点,确保了洁净手术室的空气质量,降低了手术切口感染率.结论 加强学习、强化训练、制度落实、严格管理是克服洁净手术室医院感染管理环节控制难点的关键.

  10. Convergence theorems for strictly hemi-contractive maps

    International Nuclear Information System (INIS)

    Chidume, C.E.; Osilike, M.O.

    1992-04-01

    It is proved that each of two well-known fixed point iteration methods (the Mann and the Ishikawa iteration methods) converges strongly to the fixed point of strictly hemi-contractive map in real Banach spaces with property (U, λ, m+1,m), λ is an element of R, m is an element of IN. The class of strictly hemi-contractive maps includes all strictly pseudo-contractive maps with nonempty fixed point sets; and Banach spaces with property (U, λ, m+1, m), λ is an element of R, m is an element of IN include the L p (or l p ) spaces, p≥2. Our theorems generalize important known results. (author). 22 refs

  11. Visitation in the intensive care unit: impact on infection prevention and control.

    Science.gov (United States)

    Adams, Sheila; Herrera, Amando; Miller, Laura; Soto, Rhonda

    2011-01-01

    Evidence-based practice has shown that open visitation in the intensive care setting positively impacts patient outcomes. However, many intensive care units continue to strictly limit visitation hours. One concern for nurses is that open visitation will expose their vulnerable patients to an increased risk of infection. This fear is unfounded in professional literature as well as in the experience of a busy intensive care unit in San Antonio, Texas. Keeping our patients safe from hospital-acquired infections requires vigilant attention to infection prevention procedures. Meanwhile, what may actually be bugging our patients is a health care culture that is based on tradition and is blind to the many benefits provided by a more liberal visitation policy rooted in patient-centered care.

  12. Infection control challenges in deployed US military treatment facilities.

    Science.gov (United States)

    Hospenthal, Duane R; Crouch, Helen K

    2009-04-01

    Personnel sustaining combat-related injuries in current overseas conflicts continue to have their care complicated by infections caused by multidrug-resistant organisms, including Acinetobacter, Klebsiella, and Pseudomonas. Although presumed to be due to multiple factors both within and outside of the combat theater, concern has been raised about the difficulties in establishing and maintaining standard infection control (IC) practices in deployed medical treatment facilities and in the evacuation of the injured back to the United States. Level III facilities (hospitals capable of holding patients >72 hours) in Iraq and Afghanistan and the evacuation system from Iraq to the continental US were reviewed by an expert IC-infectious disease team. All reviewed facilities had established IC programs, but these were staffed by personnel with limited IC experience, often without perceived adequate time dedicated to perform their duties, and without uniform levels of command emphasis or support. Proper hand hygiene between patients was not always ideal. Isolation and cohorting of patients to decrease multidrug-resistant organism colonization and infection varied among facilities. Review of standard operating procedures found variability among institutions and in quality of these documents. Application of US national and theater-specific guidelines and of antimicrobial control measures also varied among facilities. Effective IC practices are often difficult to maintain in modern US hospitals. In the deployed setting, with ever-changing personnel in a less than optimal practice environment, IC is even more challenging. Standardization of practice with emphasis on the basics of IC practice (e.g., hand hygiene and isolation procedures) needs to be emplaced and maintained in the deployed setting.

  13. Candida auris: Disinfectants and Implications for Infection Control.

    Science.gov (United States)

    Ku, Tsun S N; Walraven, Carla J; Lee, Samuel A

    2018-01-01

    Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris . Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings.

  14. Candida auris: Disinfectants and Implications for Infection Control

    Directory of Open Access Journals (Sweden)

    Tsun S. N. Ku

    2018-04-01

    Full Text Available Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris. Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings.

  15. Prevention and Control Strategies to Counter Dengue Virus Infection.

    Science.gov (United States)

    Rather, Irfan A; Parray, Hilal A; Lone, Jameel B; Paek, Woon K; Lim, Jeongheui; Bajpai, Vivek K; Park, Yong-Ha

    2017-01-01

    Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV) has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  16. Prevention and Control Strategies to Counter Dengue Virus Infection

    Directory of Open Access Journals (Sweden)

    Irfan A. Rather

    2017-07-01

    Full Text Available Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  17. Overcoming T. gondii infection and intracellular protein nanocapsules as biomaterials for ultrasonically controlled drug release.

    Science.gov (United States)

    Aw, M S; Paniwnyk, L

    2017-09-26

    One of the pivotal matters of concern in intracellular drug delivery is the preparation of biomaterials containing drugs that are compatible with the host target. Nanocapsules for oral delivery are found to be suitable candidates for targeting Toxoplasma gondii (T. gondii), a maneuvering and smart protozoic parasite found across Europe and America that causes a subtle but deadly infection. To overcome this disease, there is much potential of integrating protein-based cells into bioinspired nanocompartments such as via biodegradable cross-linked disulfide polyelectrolyte nanoparticles. The inner membrane vesicle system of these protein-drugs is not as simple as one might think. It is a complex transport network that includes sequential pathways, namely, endocytosis, exocytosis and autophagy. Unfortunately, the intracellular trafficking routes for nanoparticles in cells have not been extensively and intensively investigated. Hence, there lies the need to create robust protein nanocapsules for precise tracing and triggering of drug release to combat this protozoic disease. Protein nanocapsules have the advantage over other biomaterials due to their biocompatibility, use of natural ingredients, non-invasiveness, patient compliance, cost and time effectiveness. They also offer low maintenance, non-toxicity to healthy cells and a strictly defined route toward intracellular elimination through controlled drug delivery within the therapeutic window. This review covers the unprecedented opportunities that exist for constructing advanced nanocapsules to meet the growing needs arising from many therapeutic fields. Their versatile use includes therapeutic ultrasound for tumor imaging, recombinant DNA, ligand and functional group binding, the delivery of drugs and peptides via protein nanocapsules and polyelectrolytes, ultrasound-(US)-aided drug release through the gastrointestinal (GI) tract, and the recent progress in targeting tumor cells and a vast range of cancer therapies

  18. Analytic properties of form factors in strictly confining models

    International Nuclear Information System (INIS)

    Csikor, F.

    1979-12-01

    An argument is presented showing that strict confinement implies the possible existence of an (unwanted) branch point at q 2 =0 in the form factors. In case of a bag extended to infinity in the relative time, the branch point is certainly there (provided that the form factor is non zero at q 2 =0). (author)

  19. Dominance on Strict Triangular Norms and Mulholland Inequality

    Czech Academy of Sciences Publication Activity Database

    Petrík, Milan

    2018-01-01

    Roč. 335, 15 March (2018), s. 3-17 ISSN 0165-0114 R&D Projects: GA ČR GJ15-07724Y Institutional support: RVO:67985807 Keywords : dominance relation * Mulholland inequality * strict triangular norm * transitivity Subject RIV: BA - General Mathematics Impact factor: 2.718, year: 2016

  20. Effects of strict prolonged bed rest on cardiorespiratory fitness

    DEFF Research Database (Denmark)

    Ried-Larsen, Mathias; Aarts, Hugo M; Joyner, Michael J

    2017-01-01

    The aim of this systematic review and meta-analysis [International Prospective Register of Systematic Reviews (PROSPERO) CRD42017055619] was to assess the effects of strict prolonged bed rest (without countermeasures) on maximal oxygen uptake (V̇o2max) and to explore sources of variation therein....

  1. Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection.

    Science.gov (United States)

    Ng, Brian E; Butler, Lisa M; Horvath, Tara; Rutherford, George W

    2011-03-16

    The transmission of sexually transmitted infections (STIs) is closely related to the sexual transmission of human immunodeficiency virus (HIV). Similar risk behaviours, such as frequent unprotected intercourse with different partners, place people at high risk of HIV and STIs, and there is clear evidence that many STIs increase the likelihood of HIV transmission. STI control, especially at the population or community level, may have the potential to contribute substantially to HIV prevention.This is an update of an existing Cochrane review. The review's search methods were updated and its inclusion and exclusion criteria modified so that the focus would be on one well-defined outcome. This review now focuses explicitly on population-based biomedical interventions for STI control, with change in HIV incidence being an outcome necessary for a study's inclusion. To determine the impact of population-based biomedical STI interventions on the incidence of HIV infection. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science/Social Science, PsycINFO, and Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS), for the period of 1 January1980 - 16 August 2010. We initially identified 6003 articles and abstracts. After removing 776 duplicates, one author (TH) removed an additional 3268 citations that were clearly irrelevant. Rigorously applying the inclusion criteria, three authors then independently screened the remaining 1959 citations and abstracts. Forty-six articles were chosen for full-text scrutiny by two authors. Ultimately, four studies were included in the review.We also searched the Aegis database of conference abstracts, which includes the Conference on Retroviruses and Opportunistic Infections (CROI), the International AIDS Conference (IAC), and International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS) meetings from their inception dates (1993, 1985 and

  2. Strict follow-up programme including CT and (18) F-FDG-PET after curative surgery for colorectal cancer

    DEFF Research Database (Denmark)

    Sørensen, N F; Jensen, A B; Wille-Jørgensen, P

    2010-01-01

    Aim The risk of local recurrence following curative surgery for colorectal cancer (CRC) is up to 50%. A rigorous follow-up program may increase survival. Guidelines on suitable methods for scheduled follow up examinations are needed. This study evaluates a strict follow-up program including...... supported a strict follow-up program following curative surgery for colorectal cancer. FDG-PET combined with CT should be included in control programs....

  3. Observations on the epidemiology and control of Strongylus vulgaris infections.

    Science.gov (United States)

    Eysker, M; Wemmenhove, R

    1987-01-01

    The epidemiology and control of helminth infections in the horse were studied in four small grazing experiments between 1981 and 1984 at the University of Utrecht. At autopsy in November or December negligible Strongylus vulgaris burdens were found in the cranial mesenteric artery of four groups of ponies, which had been treated with an anthelmintic in July and subsequently transferred to a clean pasture. Considerable arterial S. vulgaris burdens were seen in three groups of ponies which were treated with an anthelmintic in July without a move to clean pasture, and in another group of ponies in 1984, which was set stocked on a pasture used for horses in 1983 and which was treated with an anthelmintic (albendazole) 2 days before turnout in April and subsequently in May, June and July. A tracer pony, grazed with this group between the middle of September and the middle of November, harboured an even higher burden of arterial S. vulgaris larvae. The arterial S. vulgaris in the latter group could not be the result of contamination of the pasture with S. vulgaris eggs before July, as in the three other groups with considerable arterial S. vulgaris burdens. Pasture larval counts showed that S. vulgaris larvae do not only overwinter, but are able to survive in considerable numbers until autumn, longer than most other gastrointestinal nematodes. There were some indications that translation of infective larvae, which overwintered on pasture in some free living stage, occurred between May and July.

  4. Toxocara infection in psychiatric inpatients: a case control seroprevalence study.

    Directory of Open Access Journals (Sweden)

    Cosme Alvarado-Esquivel

    Full Text Available BACKGROUND: There is poor knowledge about the epidemiology of toxocariasis in psychiatric patients. AIMS: Determine the seroepidemiology of Toxocara infection in psychiatric patients. METHODS: Through a case-control seroprevalence study, 128 psychiatric inpatients and 276 control subjects were compared for the presence of anti-Toxocara IgG antibodies in Durango, Mexico. Socio-demographic, clinical, and behavioral characteristics of inpatients associated with toxocariasis were also investigated. RESULTS: Six of the 128 (4.7% psychiatric inpatients, and 3 (1.1% of the 276 controls were positive for anti-Toxocara IgG antibodies (P = 0.03. Stratification by age showed that Toxocara seroprevalence was significantly (P = 0.02 higher in patients aged ≤50 years old (6/90∶6.7% than controls of the same age (2/163∶1.2%. While Toxocara seroprevalence was similar in patients and controls aged >50 years old. Stratification by gender showed that Toxocara seroprevalence was significantly (P = 0.03 higher in female patients (2/37∶5.4% than in female controls (0/166∶0%. No statistically significant associations between Toxocara seropositivity and clinical characteristics were found. In contrast, Toxocara seropositivity was associated with consumption of goat meat and raw sea snail. CONCLUSIONS: This is the first report of toxocariasis in psychiatric inpatients in Mexico. Further studies with larger sample sizes are needed to elucidate the association of toxocariasis with psychiatric diseases. The role of the consumption of goat meat and raw sea snail in the transmission of Toxocara deserve further investigation.

  5. Viral infections as controlling factors for the deep biosphere? (Invited)

    Science.gov (United States)

    Engelen, B.; Engelhardt, T.; Sahlberg, M.; Cypionka, H.

    2009-12-01

    The marine deep biosphere represents the largest biotope on Earth. Throughout the last years, we have obtained interesting insights into its microbial community composition. However, one component that was completely overlooked so far is the viral inventory of deep-subsurface sediments. While viral infections were identified to have a major impact on the benthic microflora of deep-sea surface sediments (Danavaro et al. 2008), no studies were performed on deep-biosphere samples, so far. As grazers probably play only a minor role in anoxic and highly compressed deep sediments, viruses might be the main “predators” for indigenous microorganisms. Furthermore, the release of cell components, called “the viral shunt”, could have a major impact on the deep biosphere in providing labile organic compounds to non-infected microorganisms in these generally nutrient depleted sediments. However, direct counting of viruses in sediments is highly challenging due to the small size of viruses and the high background of small particles. Even molecular surveys using “universal” PCR primers that target phage-specific genes fail due to the vast phage diversity. One solution for this problem is the lysogenic viral life cycle as many bacteriophages integrate their DNA into the host genome. It is estimated that up to 70% of cultivated bacteria contain prophages within their genome. Therefore, culture collections (Batzke et al. 2007) represent an archive of the viral composition within the respective habitat. These prophages can be induced to become free phage particles in stimulation experiments in which the host cells are set under certain stress situations such as a treatment with UV exposure or DNA-damaging antibiotics. The study of the viral component within the deep biosphere offers to answer the following questions: To which extent are deep-biosphere populations controlled by viral infections? What is the inter- and intra-specific diversity and the host-specific viral

  6. Health care workers' knowledge, attitudes and practices on tuberculosis infection control, Nepal.

    Science.gov (United States)

    Shrestha, Anita; Bhattarai, Dipesh; Thapa, Barsha; Basel, Prem; Wagle, Rajendra Raj

    2017-11-17

    Infection control remains a key challenge for Tuberculosis (TB) control program with an increased risk of TB transmission among health care workers (HCWs), especially in settings with inadequate TB infection control measures. Poor knowledge among HCWs and inadequate infection control practices may lead to the increased risk of nosocomial TB transmission. An institution-based cross-sectional survey was conducted in 28 health facilities providing TB services in the Kathmandu Valley, Nepal. A total of 190 HCWs were assessed for the knowledge, attitudes and practices on TB infection control using a structured questionnaire. The level of knowledge on TB infection control among almost half (45.8%) of the HCWs was poor, and was much poorer among administration and lower level staff. The knowledge level was significantly associated with educational status, and TB training and/or orientation received. The majority (73.2%) of HCWs had positive attitude towards TB infection control. Sixty-five percent of HCWs were found to be concerned about being infected with TB. Use of respirators among the HCWs was limited and triage of TB suspects was also lacking. Overall knowledge and practices of HCWs on TB infection control were not satisfactory. Effective infection control measures including regular skill-based training and/or orientation for all categories of HCWs can improve infection control practices in health facilities.

  7. Improvements in cross-infection control in general dental practice.

    Science.gov (United States)

    Bentley, E M; Sarll, D W

    1995-07-08

    A questionnaire about cross-infection control was sent to all GDPs in five FHSAs in the North Western Region. Replies came from 312 dentists, a response rate of 74%. They worked in 185 practices, a response rate of 85%. Gloves were worn routinely by 86% of dentists and 80% of DSAs. Handpieces were autoclaved between patients in 77% of practices. Much however, remains to be improved. DSAs could be better protected if more ultrasonic cleaners were used, eye protection encouraged and heavy duty gloves were available for cleaning instruments. BDA guidelines were reported as being the most influential factor, though it would appear that the media did persuade many practitioners to use autoclavable handpieces and sterilise them after each use.

  8. Nuclear techniques in the control of parasitic infections

    International Nuclear Information System (INIS)

    Mulligan, W.

    1976-01-01

    The development of radiation-attenuated vaccines against economically important parasitic diseases of farm animals has met with mixed success. Examples are presented ranging from the highly effective and much used commercial vaccine against cattle lungworm to the almost completely unsuccessful attempts to immunize sheep against liver fluke. The results presented emphasize that this approach is likely to be successful only if there is evidence of a strong degree of acquired immunity to the natural infection. The extension of immunological control to those systems where the parasite provokes only a modest resistance by the host will probably depend on a much greater understanding of the mechanism of the immune response. Such fundamental studies are likely to rely heavily on nuclear techniques, e.g. in the labelling of antigens, antibodies and parasites with radioactive isotopes. (author)

  9. Strong Convergence Theorems for a Pair of Strictly Pseudononspreading Mappings

    Directory of Open Access Journals (Sweden)

    Bin-Chao Deng

    2013-01-01

    Full Text Available Let H be a real Hilbert space. Let T1,T2:H→H be k1-, k2-strictly pseudononspreading mappings; let αn and βn be two real sequences in (0,1. For given x0∈H, the sequence xn is generated iteratively by xn+1=βnxn+1-βnTw1αnγfxn+I-μαnBTw2xn, ∀n∈N, where Twi=1−wiI+wiTi with i=1,2 and B:H→H is strongly monotone and Lipschitzian. Under some mild conditions on parameters αn and βn, we prove that the sequence xn converges strongly to the set FixT1∩FixT2 of fixed points of a pair of strictly pseudononspreading mappings T1 and T2.

  10. Growth of a Strictly Anaerobic Bacterium on Furfural (2-Furaldehyde)

    OpenAIRE

    Brune, Gerhard; Schoberth, Siegfried M.; Sahm, Hermann

    1983-01-01

    A strictly anaerobic bacterium was isolated from a continuous fermentor culture which converted the organic constituents of sulfite evaporator condensate to methane and carbon dioxide. Furfural is one of the major components of this condensate. This furfural isolate could degrade furfural as the sole source of carbon and energy in a defined mineral-vitamin-sulfate medium. Acetic acid was the major fermentation product. This organism could also use ethanol, lactate, pyruvate, or fumarate and c...

  11. The Fixed-Point Theory of Strictly Causal Functions

    Science.gov (United States)

    2013-06-09

    functions were defined to be the functions that are strictly contracting with respect to the Cantor metric (also called the Baire distance) on signals...of Lecture Notes in Computer Science, pages 447–484. Springer Berlin / Heidelberg, 1992. [36] George Markowsky. Chain-complete posets and directed...Journal of Logic Programming, 42(2):59–70, 2000. [52] George M. Reed and A. William Roscoe. A timed model for communicating sequential processes. In Laurent

  12. The "RESEAU MATER": An efficient infection control for endometritis, but not for urinary tract infection after vaginal delivery.

    Science.gov (United States)

    Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Berland, Michel

    "RESEAU MATER" is useful to monitor nosocomial infections in maternity and contributes to the decreasing trend of it, since its implementation. Specifically, this network demonstrates its efficiency in the control of endometritis following vaginal deliveries, but not in the control of urinary tract infections. The aim of this study is to determine whether the difference between the control of endometritis and of urinary tract infection could be explained by an unsuitable regression model or by an unsuitable care policy concerning urinary cares. This study includes (1) the analysis of historic data of the network and (2) the description of French guidelines for maternity cares and available evaluations, concerning endometritis and urinary tract infection prevention. Univariate and multivariate odds ratios (ORs) were calculated for the total study period of 1999-2013, for these infections and their risk factors. The endometritis frequency is decreasing, in association with no significant evolution of associated risk factors, but urinary tract infection frequency is constant, in association with a increasing trend of its risk factors such as intermittent catheterization and epidural analgesia. In French guidelines, all preventive measures against endometritis are clearly broadcasted by all field operators, and repeated audits have reinforced the control of their application. But preventive measures against urinary tract infection seem to be broadcasted exclusively in the circle of infection prevention agencies and not in the obstetrics societies or in the Health Ministry communication. Urinary tract infection prevention requires a clearer public and professional policy in favor of a more efficient urinary cares, with a specific target to maternity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  13. Overview of Zika infection, epidemiology, transmission and control measures

    Directory of Open Access Journals (Sweden)

    Ali A. Rabaan

    2017-03-01

    Full Text Available The current Zika virus outbreak in the Americas and the proposed link to increases in microcephaly and neurological disorders have prompted the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. The virus is transmitted by Aedes mosquitoes and potentially by transfusion, perinatal and sexual transmission. The potential for spread into countries where Aedes mosquitoes are endemic is high. Previously, cases tended to be sporadic and associated with mild, non-specific symptoms. Prior outbreaks occurred in Yap Island in Micronesia in 2007, the first time Zika arose outside of Africa and Asia, and in French Polynesia in 2013. A birth data review has confirmed that the latter outbreak was followed by an increase in microcephaly cases. A coordinated international response is needed to address mosquito control; expedite development of diagnostic tests, vaccines and specific treatments for Zika; and address the proposed link to microcephaly and neurological diseases. Keywords: ZIKV, Zika infection, Epidemiology, Transmission, Control measures, Diagnostic test

  14. 76 FR 9577 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal

    Science.gov (United States)

    2011-02-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Federal Advisory Committee Act (Pub. L. 92-463) of October 6, 1972, that the Healthcare Infection Control..., Healthcare Infection Control Practices Advisory Committee, Department of Health and Human Services, 1600...

  15. 78 FR 6328 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal

    Science.gov (United States)

    2013-01-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Federal Advisory Committee Act (Pub. L. 92-463) of October 6, 1972, that the Healthcare Infection Control..., Healthcare Infection Control Practices Advisory Committee, Department of Health and Human Services, 1600...

  16. Cryptococcal meningitis management in Tanzania with strict schedule of serial lumber punctures using intravenous tubing sets: an operational research study.

    Science.gov (United States)

    Meda, John; Kalluvya, Samuel; Downs, Jennifer A; Chofle, Awilly A; Seni, Jeremiah; Kidenya, Benson; Fitzgerald, Daniel W; Peck, Robert N

    2014-06-01

    Cryptococcal meningitis (CM) has a mortality rate of ∼70% among HIV-infected adults in low-income countries. Controlling intracranial pressure (ICP) is essential in CM, but it is difficult in low-income countries because manometers and practical ICP management protocols are lacking. As part of a continuous quality improvement project, our Tanzanian hospital initiated a new protocol for ICP management for CM. All adult inpatients with CM are included in a prospective patient registry. At the time of analysis, this registry included data from 2 years before the initiation of this new ICP management protocol and for a 9-month period after. ICP was measured at baseline and at days 3, 7, and 14 by both manometer and intravenous (IV) tubing set. All patients were given IV fluconazole according to Tanzanian treatment guidelines and were followed until 30 days after admission. Among adult inpatients with CM, 32 of 35 patients (91%) had elevated ICP on admission. Cerebrospinal fluid pressure measurements using the improvised IV tubing set demonstrated excellent agreement (r = 0.96) with manometer measurements. Compared with historical controls, the new ICP management protocol was associated with a significant reduction in 30-day mortality (16/35 [46%] vs. 48/64 [75%] in historical controls; hazard ratio = 2.1 [95% CI: 1.1 to 3.8]; P = 0.018]. Increased ICP is almost universal among HIV-infected adults admitted with CM in Tanzania. Intensive ICP management with a strict schedule of serial lumbar punctures reduced in-hospital mortality compared with historical controls. ICP measurement with IV tubing sets may be a good alternative in resource-limited health facilities where manometers are not available.

  17. Controlling the spread of carbapenemase-producing Gram-negatives: therapeutic approach and infection control.

    Science.gov (United States)

    Carmeli, Y; Akova, M; Cornaglia, G; Daikos, G L; Garau, J; Harbarth, S; Rossolini, G M; Souli, M; Giamarellou, H

    2010-02-01

    Although the rapid spread of carbapenemase-producing Gram-negatives (CPGNs) is providing the scientific community with a great deal of information about the molecular epidemiology of these enzymes and their genetic background, data on how to treat multidrug-resistant or extended drug-resistant carbapenemase-producing Enterobacteriaceae and how to contain their spread are still surprisingly limited, in spite of the rapidly increasing prevalence of these organisms and of their isolation from patients suffering from life-threatening infections. Limited clinical experience and several in vitro synergy studies seem to support the view that antibiotic combinations should be preferred to monotherapies. But, in light of the data available to date, it is currently impossible to quantify the real advantage of drug combinations in the treatment of these infections. Comprehensive clinical studies of the main therapeutic options, broken down by pathogen, enzyme and clinical syndrome, are definitely lacking and, as carbapenemases keep spreading, are urgently needed. This spread is unveiling the substantial unpreparedness of European public health structures to face this worrisome emergency, although experiences from different countries-chiefly Greece and Israel-have shown that CPGN transmission and cross-infection can cause a substantial threat to the healthcare system. This unpreparedness also affects the treatment of individual patients and infection control policies, with dramatic scarcities of both therapeutic options and infection control measures. Although correct implementation of such measures is presumably cumbersome and expensive, the huge clinical and public health problems related to CPGN transmission, alongside the current scarcity of therapeutic options, seem to fully justify this choice.

  18. IFNγ and perforin cooperate to control infection and prevent fatal pathology during persistent gammaherpesvirus infection in mice

    DEFF Research Database (Denmark)

    Bartholdy, Christina; Høgh-Petersen, Mette; Storm, Pernille

    2014-01-01

    herpes virus infection, we infected IFNγ/perforin double deficient C57BL/6 mice and followed the outcome of infection. While absence of perforin prevented the splenic atrophy in IFNγ deficient mice, fibrosis did not disappear. Moreover, double deficient mice developed extreme splenomegaly, were unable...... in double deficient mice, other aspects are exaggerated, and the normal architecture of the spleen is completely destroyed. Thus, IFNγ and perforin work in concert to minimize pathology and control the viral load. In the absence of both effector molecules, the balancing race between the virus and the host...

  19. Detection of low numbers of microplastics in North Sea fish using strict quality assurance criteria.

    Science.gov (United States)

    Hermsen, Enya; Pompe, Renske; Besseling, Ellen; Koelmans, Albert A

    2017-09-15

    We investigated 400 individual fish of four North Sea species: Atlantic Herring, Sprat, Common Dab, and Whiting on ingestion of >20μm microplastic. Strict quality assurance criteria were followed in order to control contamination during the study. Two plastic particles were found in only 1 (a Sprat) out of 400 individuals (0.25%, with a 95% confidence interval of 0.09-1.1%). The particles were identified to consist of polymethylmethacrylate (PMMA) through FTIR spectroscopy. No contamination occurred during the study, showing the method applied to be suitable for microplastic ingestion studies in biota. We discuss the low particle count for North Sea fish with those in other studies and suggest a relation between reported particle count and degree of quality assurance applied. Microplastic ingestion by fish may be less common than thought initially, with low incidence shown in this study, and other studies adhering to strict quality assurance criteria. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Complement and the control of HIV infection: an evolving story.

    Science.gov (United States)

    Frank, Michael M; Hester, Christopher; Jiang, Haixiang

    2014-05-01

    Thirty years ago, investigators isolated and later determined the structure of HIV-1 and its envelope proteins. Using techniques that were effective with other viruses, they prepared vaccines designed to generate antibody or T-cell responses, but they were ineffective in clinical trials. In this article, we consider the role of complement in host defense against enveloped viruses, the role it might play in the antibody response and why complement has not controlled HIV-1 infection. Complement consists of a large group of cell-bound and plasma proteins that are an integral part of the innate immune system. They provide a first line of defense against microbes and also play a role in the immune response. Here we review the studies of complement-mediated HIV destruction and the role of complement in the HIV antibody response. HIV-1 has evolved a complex defense to prevent complement-mediated killing reviewed here. As part of these studies, we have discovered that HIV-1 envelope, on administration into animals, is rapidly broken down into small peptides that may prove to be very inefficient at provident the type of antigenic stimulation that leads to an effective immune response. Improving complement binding and stabilizing envelope may improve the vaccine response.

  1. Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses.

    Science.gov (United States)

    Colindres, C V; Bryce, E; Coral-Rosero, P; Ramos-Soto, R M; Bonilla, F; Yassi, A

    2018-06-01

    Nurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low- and middle-income countries. To examine the association between effort-reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador. A cross-sectional study linking psychosocial work environment indicators to infection control adherence. The study was conducted among 333 nurses in four Ecuadorian hospitals. Self-administered questionnaires assessed demographic variables, perceived infection risk, effort-reward imbalance, burnout and infection control adherence. Increased effort-reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self-reported adherence with infection control measures. Results suggest an effort-reward imbalance-burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic. This study highlights the contribution of effort-reward-imbalance-burnout continuum to the chain of infection by decreased adherence to infection control of nurses. Health authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort-reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort-reward imbalance and burnout in low- and middle

  2. Spatial Targeting for Bovine Tuberculosis Control: Can the Locations of Infected Cattle Be Used to Find Infected Badgers?

    Directory of Open Access Journals (Sweden)

    Catherine M Smith

    Full Text Available Bovine tuberculosis is a disease of historical importance to human health in the UK that remains a major animal health and economic issue. Control of the disease in cattle is complicated by the presence of a reservoir species, the Eurasian badger. In spite of uncertainty in the degree to which cattle disease results from transmission from badgers, and opposition from environmental groups, culling of badgers has been licenced in two large areas in England. Methods to limit culls to smaller areas that target badgers infected with TB whilst minimising the number of uninfected badgers culled is therefore of considerable interest. Here, we use historical data from a large-scale field trial of badger culling to assess two alternative hypothetical methods of targeting TB-infected badgers based on the distribution of cattle TB incidents: (i a simple circular 'ring cull'; and (ii geographic profiling, a novel technique for spatial targeting of infectious disease control that predicts the locations of sources of infection based on the distribution of linked cases. Our results showed that both methods required coverage of very large areas to ensure a substantial proportion of infected badgers were removed, and would result in many uninfected badgers being culled. Geographic profiling, which accounts for clustering of infections in badger and cattle populations, produced a small but non-significant increase in the proportion of setts with TB-infected compared to uninfected badgers included in a cull. It also provided no overall improvement at targeting setts with infected badgers compared to the ring cull. Cattle TB incidents in this study were therefore insufficiently clustered around TB-infected badger setts to design an efficient spatially targeted cull; and this analysis provided no evidence to support a move towards spatially targeted badger culling policies for bovine TB control.

  3. Modular PNML revisited: Some ideas for strict typing

    DEFF Research Database (Denmark)

    Kindler, Ekkart

    2007-01-01

    The Petri Net Markup Language (PNML) is currently standardised by ISO/IEC JTC1/SC7 WG 19 as Part 2 of ISO/IEC 15909. But, there is not yet a mechanism for structuring large Petri nets and for constructing Petri nets from modules. To this end, modular PNML has been proposed some time ago. But, mod...... of Petri net, but still has a strict type system. This paper focuses on the ideas and concepts; the technical details still need to be worked out. To this end, this paper also raises some issues and questions that need to be discussed before standardising modular PNML....

  4. Relaxation Methods for Strictly Convex Regularizations of Piecewise Linear Programs

    International Nuclear Information System (INIS)

    Kiwiel, K. C.

    1998-01-01

    We give an algorithm for minimizing the sum of a strictly convex function and a convex piecewise linear function. It extends several dual coordinate ascent methods for large-scale linearly constrained problems that occur in entropy maximization, quadratic programming, and network flows. In particular, it may solve exact penalty versions of such (possibly inconsistent) problems, and subproblems of bundle methods for nondifferentiable optimization. It is simple, can exploit sparsity, and in certain cases is highly parallelizable. Its global convergence is established in the recent framework of B -functions (generalized Bregman functions)

  5. Regional differences in infection control conditions in a sample of primary health care services in Brazil

    Directory of Open Access Journals (Sweden)

    Mauro Henrique Nogueira Guimarães de Abreu

    2017-11-01

    Full Text Available International guidelines have pointed out the importance of the physical environment of health care facilities in preventing and controlling infection. We aimed to describe the physical environment of dental care facilities in Brazil in 2014, focusing on characteristics designed to control infections. Exactly 16,202 dental offices in the Brazilian Unified National Health System (SUS participated in this survey. Trained researchers extracted information about the infection control characteristics of health facilities by using a structured instrument. We used data from 12 dichotomous questions that evaluated the wall, floor, sink and tap conditions, and the presence and condition of sterilization equipment. We calculated a score by summing the number of characteristics handled appropriately for infection control, which could range from 0 to 12. Hierarchical cluster analyses were developed. None of the 12 criteria were met by all the oral health teams. Only 208 (1.3% dental offices correctly performed all 12-infection control practices. Two clusters, with different frequencies of structure for infection control in dental offices, were identified. South and Southeast regions had the highest frequencies for Cluster 1, with better structure of infection control in dental offices. Dental care facilities of oral health teams were not typically meeting the infection control guidelines regarding clinic design and equipment. Adherence to the guidelines varied among the Brazilian geographic regions.

  6. Is There a Correlation Between Infection Control Performance and Other Hospital Quality Measures?

    Science.gov (United States)

    O'Hara, Lyndsay M; Morgan, Daniel J; Pineles, Lisa; Li, Shanshan; Sulis, Carol; Bowling, Jason; Drees, Marci; Jacob, Jesse T; Anderson, Deverick J; Warren, David K; Harris, Anthony D

    2017-06-01

    Quality measures are increasingly reported by hospitals to the Centers for Medicare and Medicaid Services (CMS), yet there may be tradeoffs in performance between infection control (IC) and other quality measures. Hospitals that performed best on IC measures did not perform well on most CMS non-IC quality measures. Infect Control Hosp Epidemiol 2017;38:736-739.

  7. A tool to assess knowledge, attitude and behavior of indonesian health care workers regarding infection control

    NARCIS (Netherlands)

    Duerink, D.O.; Hadi, U.; Lestari, E.S.; Roeshadi, D.; Wahyono, H.; Nagelkerke, N.J.; Meulen, R.G.; Broek, P.J.A. van den

    2013-01-01

    Aim: to investigate knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire and to evaluate the use of the questionnaire as a tool. Methods: we investigated knowledge, attitude and behaviour toward infection control in

  8. Low average blister-rust infection rates may mean high control costs

    Science.gov (United States)

    Robert Marty

    1965-01-01

    The Northeastern Forest Experiment Station, in cooperation with Federal and State forest-pest-control agencies, undertook a survey of blister-rust infection rates in the white pine region of the East during 1962 and 1963. Those engaged in blister-rust-control activities will not be surprised at the survey's results. We found that infection rates were significantly...

  9. Non-strictly black body spectrum from the tunnelling mechanism

    International Nuclear Information System (INIS)

    Corda, Christian

    2013-01-01

    The tunnelling mechanism is widely used to explain Hawking radiation. However, in many cases the analysis used to obtain the Hawking temperature only involves comparing the emission probability for an outgoing particle with the Boltzmann factor. Banerjee and Majhi improved this approach by explicitly finding a black body spectrum associated with black holes. Their result, obtained using a reformulation of the tunnelling mechanism, is in contrast to that of Parikh and Wilczek, who found an emission probability that is compatible with a non-strictly thermal spectrum. Using the recently identified effective state for a black hole, we solve this contradiction via a slight modification of the analysis by Banerjee and Majhi. The final result is a non-strictly black body spectrum from the tunnelling mechanism. We also show that for an effective temperature, we can express the corresponding effective metric using Hawking’s periodicity arguments. Potential important implications for the black hole information puzzle are discussed. -- Highlights: •We review an important result by Banerjee and Majhi on the tunnelling mechanism in the framework of Hawking radiation. •This result is in contrast to another result reported by Parikh and Wilczek. •We introduce the effective state of a black hole. •We explain the contrast via a slight modification of the analysis by Banerjee and Majhi. •We discuss potential important implications for the black hole information puzzle

  10. Glycolytic control of vacuolar-type ATPase activity: A mechanism to regulate influenza viral infection

    Energy Technology Data Exchange (ETDEWEB)

    Kohio, Hinissan P.; Adamson, Amy L., E-mail: aladamso@uncg.edu

    2013-09-15

    As new influenza virus strains emerge, finding new mechanisms to control infection is imperative. In this study, we found that we could control influenza infection of mammalian cells by altering the level of glucose given to cells. Higher glucose concentrations induced a dose-specific increase in influenza infection. Linking influenza virus infection with glycolysis, we found that viral replication was significantly reduced after cells were treated with glycolytic inhibitors. Addition of extracellular ATP after glycolytic inhibition restored influenza infection. We also determined that higher levels of glucose promoted the assembly of the vacuolar-type ATPase within cells, and increased vacuolar-type ATPase proton-transport activity. The increase of viral infection via high glucose levels could be reversed by inhibition of the proton pump, linking glucose metabolism, vacuolar-type ATPase activity, and influenza viral infection. Taken together, we propose that altering glucose metabolism may be a potential new approach to inhibit influenza viral infection. - Highlights: • Increased glucose levels increase Influenza A viral infection of MDCK cells. • Inhibition of the glycolytic enzyme hexokinase inhibited Influenza A viral infection. • Inhibition of hexokinase induced disassembly the V-ATPase. • Disassembly of the V-ATPase and Influenza A infection was bypassed with ATP. • The state of V-ATPase assembly correlated with Influenza A infection of cells.

  11. Glycolytic control of vacuolar-type ATPase activity: A mechanism to regulate influenza viral infection

    International Nuclear Information System (INIS)

    Kohio, Hinissan P.; Adamson, Amy L.

    2013-01-01

    As new influenza virus strains emerge, finding new mechanisms to control infection is imperative. In this study, we found that we could control influenza infection of mammalian cells by altering the level of glucose given to cells. Higher glucose concentrations induced a dose-specific increase in influenza infection. Linking influenza virus infection with glycolysis, we found that viral replication was significantly reduced after cells were treated with glycolytic inhibitors. Addition of extracellular ATP after glycolytic inhibition restored influenza infection. We also determined that higher levels of glucose promoted the assembly of the vacuolar-type ATPase within cells, and increased vacuolar-type ATPase proton-transport activity. The increase of viral infection via high glucose levels could be reversed by inhibition of the proton pump, linking glucose metabolism, vacuolar-type ATPase activity, and influenza viral infection. Taken together, we propose that altering glucose metabolism may be a potential new approach to inhibit influenza viral infection. - Highlights: • Increased glucose levels increase Influenza A viral infection of MDCK cells. • Inhibition of the glycolytic enzyme hexokinase inhibited Influenza A viral infection. • Inhibition of hexokinase induced disassembly the V-ATPase. • Disassembly of the V-ATPase and Influenza A infection was bypassed with ATP. • The state of V-ATPase assembly correlated with Influenza A infection of cells

  12. Status of infection control policies and organisation in European hospitals, 2001: the ARPAC study.

    NARCIS (Netherlands)

    Struelens, M.J.; Wagner, D.; Bruce, J.; MacKenzie, F.M.; Cookson, B.; Voss, A.; Broek, P.J.J.A. van den; Gould, I.

    2006-01-01

    Patient safety in hospital care depends on effective infection control (IC) programmes. The Antimicrobial Resistance Prevention and Control (ARPAC) study assessed the organisation, components and human resources of IC programmes in European hospitals. A questionnaire survey of policies and

  13. Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infections in Vulnerable Older Persons: A Double-Blind Randomized Placebo-Controlled Trial in Long-Term Care Facilities

    Science.gov (United States)

    Caljouw, Monique A A; van den Hout, Wilbert B; Putter, Hein; Achterberg, Wilco P; Cools, Herman J M; Gussekloo, Jacobijn

    2014-01-01

    Objectives To determine whether cranberry capsules prevent urinary tract infection (UTI) in long-term care facility (LTCF) residents. Design Double-blind randomized placebo-controlled multicenter trial. Setting Long-term care facilities (LTCFs). Participants LTCF residents (N = 928; 703 women, median age 84). Measurements Cranberry and placebo capsules were taken twice daily for 12 months. Participants were stratified according to UTI risk (risk factors included long-term catheterization, diabetes mellitus, ≥1 UTI in preceding year). Main outcomes were incidence of UTI according to a clinical definition and a strict definition. Results In participants with high UTI risk at baseline (n = 516), the incidence of clinically defined UTI was lower with cranberry capsules than with placebo (62.8 vs 84.8 per 100 person-years at risk, P = .04); the treatment effect was 0.74 (95% confidence interval (CI) = 0.57–0.97). For the strict definition, the treatment effect was 1.02 (95% CI = 0.68–1.55). No difference in UTI incidence between cranberry and placebo was found in participants with low UTI risk (n = 412). Conclusion In LTCF residents with high UTI risk at baseline, taking cranberry capsules twice daily reduces the incidence of clinically defined UTI, although it does not reduce the incidence of strictly defined UTI. No difference in incidence of UTI was found in residents with low UTI risk. PMID:25180378

  14. Facilitating central line-associated bloodstream infection prevention: a qualitative study comparing perspectives of infection control professionals and frontline staff.

    Science.gov (United States)

    McAlearney, Ann Scheck; Hefner, Jennifer L

    2014-10-01

    Infection control professionals (ICPs) play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central line-associated bloodstream infection (CLABSI) prevention program success. We conducted key informant interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called "On the CUSP: Stop BSI." We analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges. We identified 4 facilitators of CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples. Our results suggest that ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Plant RNA binding proteins for control of RNA virus infection

    Directory of Open Access Journals (Sweden)

    Sung Un eHuh

    2013-12-01

    Full Text Available Plant RNA viruses have effective strategies to infect host plants through either direct or indirect interactions with various host proteins, thus suppressing the host immune system. When plant RNA viruses enter host cells exposed RNAs of viruses are recognized by the host immune system through processes such as siRNA-dependent silencing. Interestingly, some host RNA binding proteins have been involved in the inhibition of RNA virus replication, movement, and translation through RNA-specific binding. Host plants intensively use RNA binding proteins for defense against viral infections in nature. In this mini review, we will summarize the function of some host RNA binding proteins which act in a sequence-specific binding manner to the infecting virus RNA. It is important to understand how plants effectively suppresses RNA virus infections via RNA binding proteins, and this defense system can be potentially developed as a synthetic virus defense strategy for use in crop engineering.

  16. Role of infection control in combating antibiotic resistance

    African Journals Online (AJOL)

    of multidrug-resistant organisms (MDROs) in healthcare settings and interventions to prevent infection. Transmission of multidrug-resistant ... healthcare workers (HCWs) or visitors), although transmission from environmental sources has also ...

  17. Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

    Science.gov (United States)

    Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

    Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

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

    Directory of Open Access Journals (Sweden)

    tahereh Toulabi

    2006-11-01

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

  19. Surveillance of surgical site infection after cholecystectomy using the hospital in Europe link for infection control through surveillance protocol.

    Science.gov (United States)

    Bogdanic, Branko; Bosnjak, Zrinka; Budimir, Ana; Augustin, Goran; Milosevic, Milan; Plecko, Vanda; Kalenic, Smilja; Fiolic, Zlatko; Vanek, Maja

    2013-06-01

    The third most common healthcare-associated infection is surgical site infection (SSI), accounting for 14%-16% of infections. These SSIs are associated with high morbidity, numerous deaths, and greater cost. A prospective study was conducted to assess the incidence of SSI in a single university hospital in Croatia. We used the Hospital in Europe Link for Infection Control through Surveillance (HELICS) protocol for surveillance. The SSIs were classified using the standard definition of the National Nosocomial Infections Surveillance (NNIS) system. The overall incidence of SSI was 1.44%. The incidence of infection in the open cholecystectomy group was 6.06%, whereas in the laparoscopic group, it was only 0.60%. The incidence density of in-hospital SSIs per 1,000 post-operative days was 5.76. Patients who underwent a laparoscopic cholecystectomy were significantly younger (53.65±14.65 vs. 64.42±14.17 years; pconcept for the monitoring of SSI, but in the case of cholecystectomy, additional factors such as antibiotic appropriateness, gallbladder entry, empyema of the gallbladder, and obstructive jaundice must be considered.

  20. Strict calculation of electron energy distribution functions in inhomogeneous plasmas

    International Nuclear Information System (INIS)

    Winkler, R.

    1996-01-01

    It is objective of the paper to report on strict calculations of the velocity or energy distribution function function and related macroscopic properties of the electrons from appropriate electron kinetic equations under various plasma conditions and to contribute to a better understanding of the electron behaviour in inhomogeneous plasma regions. In particular, the spatial relaxation of plasma electrons acted upon by uniform electric fields, the response of plasma electrons on spatial disturbances of the electric field, the electron kinetics under the impact of space charge field confinement in the dc column plasma and the electron velocity distribution is stronger field as occurring in the electrode regions of a dc glow discharge is considered. (author)

  1. Asymptotic state discrimination and a strict hierarchy in distinguishability norms

    Energy Technology Data Exchange (ETDEWEB)

    Chitambar, Eric [Department of Physics and Astronomy, Southern Illinois University, Carbondale, Illinois 62901 (United States); Hsieh, Min-Hsiu [Centre for Quantum Computation and Intelligent Systems (QCIS), Faculty of Engineering and Information Technology (FEIT), University of Technology Sydney - UTS, NSW 2007 (Australia)

    2014-11-15

    In this paper, we consider the problem of discriminating quantum states by local operations and classical communication (LOCC) when an arbitrarily small amount of error is permitted. This paradigm is known as asymptotic state discrimination, and we derive necessary conditions for when two multipartite states of any size can be discriminated perfectly by asymptotic LOCC. We use this new criterion to prove a gap in the LOCC and separable distinguishability norms. We then turn to the operational advantage of using two-way classical communication over one-way communication in LOCC processing. With a simple two-qubit product state ensemble, we demonstrate a strict majorization of the two-way LOCC norm over the one-way norm.

  2. Growth of a Strictly Anaerobic Bacterium on Furfural (2-Furaldehyde)

    Science.gov (United States)

    Brune, Gerhard; Schoberth, Siegfried M.; Sahm, Hermann

    1983-01-01

    A strictly anaerobic bacterium was isolated from a continuous fermentor culture which converted the organic constituents of sulfite evaporator condensate to methane and carbon dioxide. Furfural is one of the major components of this condensate. This furfural isolate could degrade furfural as the sole source of carbon and energy in a defined mineral-vitamin-sulfate medium. Acetic acid was the major fermentation product. This organism could also use ethanol, lactate, pyruvate, or fumarate and contained cytochrome c3 and desulfoviridin. Except for furfural degradation, the characteristics of the furfural isolate were remarkably similar to those of the sulfate reducer Desulfovibrio gigas. The furfural isolate has been tentatively identified as Desulfovibrio sp. strain F-1. Images PMID:16346423

  3. Effects of a strict cutoff on Quantum Field Theory

    International Nuclear Information System (INIS)

    Sturnfield, J.F.

    1987-01-01

    Standard Quantum Field Theory has a number of integrals which are infinite. Although these are eliminated for some cases by renormalization, this aspect of the theory is not fully satisfactory. A number of theories with fundamental lengths have been introduced as alternatives and it would be useful to be able to distinguish between them. In particular, the effects that a strict cutoff would have on Quantum Field Theory is studied. It is noted that care must be taken in the method used to apply a strict cutoff. This lead to considering a theory where the cutoffs are defined by restricting each internal line. This theory is only piece-wise analytic. The resulting scattering matrix is frame dependent, yet the theory still satisfies the special relativity view that all frames are subjectively identical. The renormalization of this theory is finite. The change in mass from the electron self-energy will be a spinor operator. The main distinctions of this theory from standard theory will occur at super high energies. New poles and resonances which arise from new endpoint singularities will be found. The locations of these singularities will be frame dependent. Some of these singularities will correspond to creations or interactions of the normal particles with tachyons. It will be shown that for the one loop diagram, the form of the cutoff singularities are closely related to the standard singularities. When there is more than one loop, there can appear some new type of behavior. In particular, a cube root type of behavior in the two loop self-energy diagram will be found. Also the asymptotic behavior of the ladder diagram is studied

  4. Infection control education: how to make an impact--tools for the job.

    Science.gov (United States)

    Farrington, Mark

    2007-06-01

    Infection control education is difficult and time consuming, but there is persuasive evidence to demonstrate its effectiveness. When Infection Control practitioners are educating and influencing healthcare workers, compliance with the well-established guidance on implementation of health service research is advisable, and thus educative efforts must be repeated and administered as part of a concerted and multifaceted approach. Infection Control education must be specifically designed for and targeted at the groups of staff concerned, and medical staff pose especial problems. Recruitment of clinical champions from peer groups, and direct approaches from medical members of the Infection Control team are usually needed. Familiarity with only a limited range of published evidence is needed to answer the majority of clinicians who challenge Infection Control practices, and referral to higher medical and managerial authority is required very infrequently and as a last resort. Some recent initiatives in the NHS in England may make Infection Control education more difficult, and these are reviewed. New sanctions have been made available to hospitals and Infection control teams in the UK with the passing of the Health Act in 2006, and the effects of these allied to educative interventions on benchmarks such as hospitals' MRSA bacteraemia rates will be observed with interest.

  5. A Cellular Automata Model of Infection Control on Medical Implants

    Science.gov (United States)

    Prieto-Langarica, Alicia; Kojouharov, Hristo; Chen-Charpentier, Benito; Tang, Liping

    2011-01-01

    S. epidermidis infections on medically implanted devices are a common problem in modern medicine due to the abundance of the bacteria. Once inside the body, S. epidermidis gather in communities called biofilms and can become extremely hard to eradicate, causing the patient serious complications. We simulate the complex S. epidermidis-Neutrophils interactions in order to determine the optimum conditions for the immune system to be able to contain the infection and avoid implant rejection. Our cellular automata model can also be used as a tool for determining the optimal amount of antibiotics for combating biofilm formation on medical implants. PMID:23543851

  6. PERTUSSIS IS COMING BACK? IMPROVEMENT OF FORGOTTEN CHILDHOOD INFECTION CONTROL

    Directory of Open Access Journals (Sweden)

    M. V. Fedoseenko

    2012-01-01

    Full Text Available Infection that more than 60 years ago was recognized one of the leading childhood diseases that caused infant mortality, is returning. Of course, with the introduction of vaccination against pertussis in the national programs, we rarely meet severe pertussis infection in our practice, considering that vaccinating children, we protect them. But why so far is this infectious disease remains a serious problem not only in Russia but throughout the world? Several global reasons contribute to the fact that until now vaccine-preventable diseases leads to a prolonged, exhausting cough in schoolchildren, deceiving the doctors with the correct diagnosis is still a real threat to infants. 

  7. Genotypic characterisation of human papillomavirus infections among persons living with HIV infection; a case-control study in Kumasi, Ghana.

    Science.gov (United States)

    Yar, Denis Dekugmen; Salifu, Samson Pandam; Darko, Samuel Nkansah; Annan, Augustina Angelina; Gyimah, Akosua Adumea; Buabeng, Kwame Ohene; Owusu-Dabo, Ellis

    2016-02-01

    The objective of this study is to describe the burden of human papillomavirus (HPV) infection among women living with HIV and non-infected women in Ghana. A case-control study was conducted involving 107 women living with HIV aged between 18 and 59 years (cases) and 100 non-HIV-infected apparently healthy women (controls) who were recruited from the Kumasi South Hospital, from July to December, 2014. Cervicovaginal swabs were taken from study participants to characterise 28 high- and low-risk HPV genotypes using a multiplex real-time PCR. The overall mean age for the participants was 40.10 ± 9.76 years. The prevalence of high-risk (hr)-HPV genotypes was significantly higher among the cases than the controls (77.4% vs. 41.6%, P < 0.0001). Overall, HPV 58 and 54 were the most predominant high-risk (18.8%) and low-risk (15.0%) genotypes detected. The two most common hr-HPV genotype isolates were 58 (18.8%) and 35 (15.9%) with 58 being the most prevalent among age group 35-44 years compared with hr-HPV 16, 18, 35 and 45, found predominantly among 18-34 age group. Significant variations exist in HPV genotypes among HIV-infected and uninfected women. © 2015 John Wiley & Sons Ltd.

  8. Strategies to promote infection prevention and control in acute care hospitals with the help of infection control link nurses: A systematic literature review.

    Science.gov (United States)

    Peter, Daniel; Meng, Michael; Kugler, Christiane; Mattner, Frauke

    2018-02-01

    Infection control link nurses (ICLNs) are important backup personnel for the prevention and control of infections in hospitals. To identify facilitators and barriers for the implementation of and long-term collaboration with ICLNs. We conducted a systematic literature review, following the preferred reporting items for systematic reviews and meta-analyses guidelines. Inclusion criteria were defined as description of de novo implementation of an ICLN system, strengthening of an existing ICLN system, or analysis of an ICLN system. In 10 publications, facilitators and barriers were identified for mode of selection of ICLN candidates, characteristics and responsibilities of ICLNs, composition of a training curriculum, educational strategies, and external influencing factors. Experienced nurses with an interest in infection control seemed appropriate candidates. The importance of psychological skills in addition to technical knowledge was emphasized. A clear definition of responsibilities was important. Viable tasks for ICLNs included surveillance and teaching activities and the implementation of prevention measures. Ongoing teaching was superior to a single course. Management support was pivotal for success. Research on ICLNs is scarce. The potential to decrease health care-associated infections with the help of ICLNs has been demonstrated. The training in psychological skills in addition to technical knowledge deserves more attention. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. The Aedes aegypti toll pathway controls dengue virus infection.

    Directory of Open Access Journals (Sweden)

    Zhiyong Xi

    2008-07-01

    Full Text Available Aedes aegypti, the mosquito vector of dengue viruses, utilizes its innate immune system to ward off a variety of pathogens, some of which can cause disease in humans. To date, the features of insects' innate immune defenses against viruses have mainly been studied in the fruit fly Drosophila melanogaster, which appears to utilize different immune pathways against different types of viruses, in addition to an RNA interference-based defense system. We have used the recently released whole-genome sequence of the Ae. aegypti mosquito, in combination with high-throughput gene expression and RNA interference (RNAi-based reverse genetic analyses, to characterize its response to dengue virus infection in different body compartments. We have further addressed the impact of the mosquito's endogenous microbial flora on virus infection. Our findings indicate a significant role for the Toll pathway in regulating resistance to dengue virus, as indicated by an infection-responsive regulation and functional assessment of several Toll pathway-associated genes. We have also shown that the mosquito's natural microbiota play a role in modulating the dengue virus infection, possibly through basal-level stimulation of the Toll immune pathway.

  10. Detection and control of lentiviral infections in sheep and goats

    NARCIS (Netherlands)

    Brinkhof, J.M.A.

    2009-01-01

    Infections caused by the small ruminant lentiviruses (SRLV) of sheep (maedi visna virus) and goats (caprine arthritis encephalitis virus) are a serious economical threat to small ruminant farming particularly in the more intensive settings like dairy farms. Revenue is ultimately negatively

  11. Infection Control Practices in Dental Settings - A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Mukhit Kazi

    2012-01-01

    Full Text Available In the era of HIV/ AIDS it is essential to follow the infection prevention protocols in all health care settings including dental settings. The present review article highlighted the various preventive protocols to be followed in dental settings. It includes right from the simple hand hygiene to biomedical waste segregation.

  12. Control of Clostridium difficile infection by defined microbial communities

    Science.gov (United States)

    Collins, James

    2017-01-01

    Summary Each year in the United States, billions of dollars are spent combating almost half a million Clostridium difficile infections (CDI) and trying to reduce the ~29,000 patient deaths where C. difficile has an attributed role (1). In Europe, disease prevalence varies by country and level of surveillance, though yearly costs are estimated at €3 billion (2). One factor contributing to the significant healthcare burden of C. difficile is the relatively high frequency of recurrent C. difficile infections(3). Recurrent C. difficile infection (rCDI), i.e., a second episode of symptomatic CDI occurring within eight weeks of successful initial CDI treatment, occurs in ~25% of patients with 35-65% of these patients experiencing multiple episodes of recurrent disease(4, 5). Using microbial communities to treat rCDI, either as whole fecal transplants or as defined consortia of bacterial isolates have shown great success (in the case of fecal transplants) or potential promise (in the case of defined consortia of isolates). This review will briefly summarize the epidemiology and physiology of C. difficile infection, describe our current understanding of how fecal microbiota transplants treat recurrent CDI, and outline potential ways through which that knowledge can be used to rationally-design and test alternative microbe-based therapeutics. PMID:28936948

  13. Infection Prevention and Control in Deployed Military Medical Treatment Facilities

    Science.gov (United States)

    2011-08-01

    to surgery in 1867.31 Supported by the discoveries of Louis Pasteur (in the 1850s–1860s) that germs (bacteria) were the cause of putrification (pus...Kirkup BC Jr, et al. Surveillance, characterisation, and preservation of multidrug-resistant bacteria. Lancet Infect Dis. 2011;11: 8–10. 50. Lesho E

  14. A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

    Science.gov (United States)

    Al-Rawajfah, Omar M; Tubaishat, Ahmad

    2017-10-01

    The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Virus-Induced Type I Interferon Deteriorates Control of Systemic Pseudomonas Aeruginosa Infection

    Directory of Open Access Journals (Sweden)

    Katja Merches

    2015-07-01

    Full Text Available Background: Type I interferon (IFN-I predisposes to bacterial superinfections, an important problem during viral infection or treatment with interferon-alpha (IFN-α. IFN-I-induced neutropenia is one reason for the impaired bacterial control; however there is evidence that more frequent bacterial infections during IFN-α-treatment occur independently of neutropenia. Methods: We analyzed in a mouse model, whether Pseudomonas aeruginosa control is influenced by co-infection with the lymphocytic choriomeningitis virus (LCMV. Bacterial titers, numbers of neutrophils and the gene-expression of liver-lysozyme-2 were determined during a 24 hours systemic infection with P. aeruginosa in wild-type and Ifnar-/- mice under the influence of LCMV or poly(I:C. Results: Virus-induced IFN-I impaired the control of Pseudomonas aeruginosa. This was associated with neutropenia and loss of lysozyme-2-expression in the liver, which had captured P. aeruginosa. A lower release of IFN-I by poly(I:C-injection also impaired the bacterial control in the liver and reduced the expression of liver-lysozyme-2. Low concentration of IFN-I after infection with a virulent strain of P. aeruginosa alone impaired the bacterial control and reduced lysozyme-2-expression in the liver as well. Conclusion: We found that during systemic infection with P. aeruginosa Kupffer cells quickly controlled the bacteria in cooperation with neutrophils. Upon LCMV-infection this cooperation was disturbed.

  16. T-cell-dependent control of acute Giardia lamblia infections in mice.

    Science.gov (United States)

    Singer, S M; Nash, T E

    2000-01-01

    We have studied immune mechanisms responsible for control of acute Giardia lamblia and Giardia muris infections in adult mice. Association of chronic G. lamblia infection with hypogammaglobulinemia and experimental infections of mice with G. muris have led to the hypothesis that antibodies are required to control these infections. We directly tested this hypothesis by infecting B-cell-deficient mice with either G. lamblia or G. muris. Both wild-type mice and B-cell-deficient mice eliminated the vast majority of parasites between 1 and 2 weeks postinfection with G. lamblia. G. muris was also eliminated in both wild-type and B-cell-deficient mice. In contrast, T-cell-deficient and scid mice failed to control G. lamblia infections, as has been shown previously for G. muris. Treatment of wild-type or B-cell-deficient mice with antibodies to CD4 also prevented elimination of G. lamblia, confirming a role for T cells in controlling infections. By infecting mice deficient in either alphabeta- or gammadelta-T-cell receptor (TCR)-expressing T cells, we show that the alphabeta-TCR-expressing T cells are required to control parasites but that the gammadelta-TCR-expressing T cells are not. Finally, infections in mice deficient in production of gamma interferon or interleukin 4 (IL-4) and mice deficient in responding to IL-4 and IL-13 revealed that neither the Th1 nor the Th2 subset is absolutely required for protection from G. lamblia. We conclude that a T-cell-dependent mechanism is essential for controlling acute Giardia infections and that this mechanism is independent of antibody and B cells.

  17. Controlled Human Malaria Infection of Tanzanians by Intradermal Injection of Aseptic, Purified, Cryopreserved Plasmodium falciparum Sporozoites

    NARCIS (Netherlands)

    Shekalaghe, S.; Rutaihwa, M.; Billingsley, P.F.; Chemba, M.; Daubenberger, C.A.; James, E.R.; Mpina, M.; Juma, O. Ali; Schindler, T.; Huber, E.; Gunasekera, A.; Manoj, A.; Simon, B.; Saverino, E.; Church, L.W.; Hermsen, C.C.; Sauerwein, R.W.; Plowe, C.; Venkatesan, M.; Sasi, P.; Lweno, O.; Mutani, P.; Hamad, A.; Mohammed, A.; Urassa, A.; Mzee, T.; Padilla, D.; Ruben, A.; Sim, B.K.; Tanner, M.; Abdulla, S.; Hoffman, S.L.

    2014-01-01

    Controlled human malaria infection (CHMI) by mosquito bite has been used to assess anti-malaria interventions in > 1,500 volunteers since development of methods for infecting mosquitoes by feeding on Plasmodium falciparum (Pf) gametocyte cultures. Such CHMIs have never been used in Africa. Aseptic,

  18. Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries.

    Science.gov (United States)

    Alp, Emine; Damani, Nizam

    2015-10-29

    Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

  19. Helicobacter pylori infection is not associated with failure to thrive: a case control study.

    Science.gov (United States)

    Chiu, Nan-Chang; Lin, Chien-Yu; Chi, Hsin; Yeung, Chun-Yan; Ting, Wei-Hsin; Chan, Wai-Tao; Jiang, Chuen-Bin; Li, Sung-Tse; Lin, Chao-Hsu; Lee, Hung-Chang

    2017-01-01

    The long-term impact of Helicobacter pylori infection is complex, and concerns about the need for eradication exist. We conducted this case control study to investigate the association between H. pylori infection and failure to thrive (FTT). From January 2009 to December 2011, 53 children with FTT group and matched children with the same sex and age and similar socioeconomic status without FTT (control group) were enrolled. A questionnaire was administered to the parents/guardian, and a 13 C-urea breath test was performed to detect H. pylori infection. We found that the total prevalence of H. pylori infection was 29.2% and that there was no association between FTT and H. pylori infection (FTT group: 32%; control group: 26.4%; P =0.67). Short stature was more common in the FTT group and abdominal pain in the control group (FTT group: 37.7%; control group: 11.3%; P =0.003). In a comparison between the H. pylori -positive and -negative groups, abdominal pain (87.1% vs 64%; P =0.032) and the frequency of endoscopy (74.2% vs 32%; P <0.001) were significantly more common in the H. pylori -positive group. We found that children with H. pylori infection are at an increased risk for abdominal pain and that FTT is not associated with H. pylori infection. The decision for eradication should be evaluated carefully and individualized.

  20. Efficient FPT Algorithms for (Strict) Compatibility of Unrooted Phylogenetic Trees.

    Science.gov (United States)

    Baste, Julien; Paul, Christophe; Sau, Ignasi; Scornavacca, Celine

    2017-04-01

    In phylogenetics, a central problem is to infer the evolutionary relationships between a set of species X; these relationships are often depicted via a phylogenetic tree-a tree having its leaves labeled bijectively by elements of X and without degree-2 nodes-called the "species tree." One common approach for reconstructing a species tree consists in first constructing several phylogenetic trees from primary data (e.g., DNA sequences originating from some species in X), and then constructing a single phylogenetic tree maximizing the "concordance" with the input trees. The obtained tree is our estimation of the species tree and, when the input trees are defined on overlapping-but not identical-sets of labels, is called "supertree." In this paper, we focus on two problems that are central when combining phylogenetic trees into a supertree: the compatibility and the strict compatibility problems for unrooted phylogenetic trees. These problems are strongly related, respectively, to the notions of "containing as a minor" and "containing as a topological minor" in the graph community. Both problems are known to be fixed parameter tractable in the number of input trees k, by using their expressibility in monadic second-order logic and a reduction to graphs of bounded treewidth. Motivated by the fact that the dependency on k of these algorithms is prohibitively large, we give the first explicit dynamic programming algorithms for solving these problems, both running in time [Formula: see text], where n is the total size of the input.

  1. Managing Hanford Site solid waste through strict acceptance criteria

    International Nuclear Information System (INIS)

    Jasen, W.G.; Pierce, R.D.; Willis, N.P.

    1993-02-01

    Various types of waste have been generated during the 50-year history of the Hanford Site. Regulatory changes in the last 20 years have provided the emphasis for better management of these wastes. Interpretations of the Atomic Energy Act of 1954 (AEA) and the Resource Conservation and Recovery Act of 1976 (RCRA) have led to the definition of a group of wastes called radioactive mixed wastes (RMW). As a result of the radioactive and hazardous properties of these wastes, strict management programs have been implemented for the management of these wastes. Solid waste management is accomplished through a systems performance approach to waste management that used best-demonstrated available technology (BDAT) and best management practices. The solid waste program at the Hanford Site strives to integrate all aspects of management relative to the treatment, storage and disposal (TSD) of solid waste. Often there are many competing and important needs. It is a difficult task to balance these needs in a manner that is both equitable and productive. Management science is used to help the process of making decisions. Tools used to support the decision making process include five-year planning, cost estimating, resource allocation, performance assessment, waste volume forecasts, input/output models, and waste acceptance criteria. The purpose of this document is to describe how one of these tools, waste acceptance criteria, has helped the Hanford Site manage solid wastes

  2. Development of a Clinical Data Warehouse for Hospital Infection Control

    Science.gov (United States)

    Wisniewski, Mary F.; Kieszkowski, Piotr; Zagorski, Brandon M.; Trick, William E.; Sommers, Michael; Weinstein, Robert A.

    2003-01-01

    Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse. PMID:12807807

  3. Development of a clinical data warehouse for hospital infection control.

    Science.gov (United States)

    Wisniewski, Mary F; Kieszkowski, Piotr; Zagorski, Brandon M; Trick, William E; Sommers, Michael; Weinstein, Robert A

    2003-01-01

    Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse.

  4. Fixed point iterations for strictly hemi-contractive maps in uniformly smooth Banach spaces

    International Nuclear Information System (INIS)

    Chidume, C.E.; Osilike, M.O.

    1993-05-01

    It is proved that the Mann iteration process converges strongly to the fixed point of a strictly hemi-contractive map in real uniformly smooth Banach spaces. The class of strictly hemi-contractive maps includes all strictly pseudo-contractive maps with nonempty fixed point sets. A related result deals with the Ishikawa iteration scheme when the mapping is Lipschitzian and strictly hemi-contractive. Our theorems generalize important known results. (author). 29 refs

  5. 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.

  6. Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections.

    Science.gov (United States)

    Solomkin, Joseph S; Mazuski, John; Blanchard, Joan C; Itani, Kamal M F; Ricks, Philip; Dellinger, E Patchen; Allen, George; Kelz, Rachel; Reinke, Caroline E; Berríos-Torres, Sandra I

    Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for the Prevention of SSI from the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). The Core section of the guideline addresses issues relevant to multiple surgical specialties and procedures. The second procedure-specific section focuses on a high-volume, high-burden procedure: Prosthetic joint arthroplasty. While many elements of the 1999 guideline remain current, others warrant updating to incorporate new knowledge and changes in the patient population, operative techniques, emerging pathogens, and guideline development methodology.

  7. Evaluation of Copper Supplementation to Control Haemonchus contortus Infections of Sheep in Sweden

    Directory of Open Access Journals (Sweden)

    Rydzik A

    2004-09-01

    Full Text Available A pen study was conducted to assess the effect of providing daily copper mineral supplement, or copper wire particle (COWP capsules, on established or incoming mixed nematode infections in young sheep. For lambs with established (6 week old infections, COWP resulted in 97% and 56% reduction of the adult and early L4 stages of H. contortus, respectively, compared with controls (p Teladorsagia circumcincta infections in the COWP lambs compared with controls (p H. contortus infections, but lack of parasites during the grazing season prevented an adequate assessment from being made. These results indicate that there is little, if any, benefit from a parasite control standpoint in recommending copper therapy, specifically to control parasites in Swedish sheep flocks.

  8. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial.

    NARCIS (Netherlands)

    Aardweg, M.T. van den; Boonacker, C.W.; Rovers, M.M.; Hoes, A.W.; Schilder, A.G.M.

    2011-01-01

    OBJECTIVE: To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections. DESIGN: Open randomised controlled trial. SETTING: 11 general hospitals and two academic centres. PARTICIPANTS: 111 children aged 1-6 with recurrent upper respiratory tract

  9. Impact of Glycemic Control on Risk of Infections in Patients with Type 2 Diabetes

    DEFF Research Database (Denmark)

    Mor, Anil; Dekkers, Olaf M; Nielsen, Jens S

    2017-01-01

    Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital.......51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients.......-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an Hb...

  10. Recent advances in understanding the biology, epidemiology and control of chlamydial infections in koalas.

    Science.gov (United States)

    Polkinghorne, Adam; Hanger, Jon; Timms, Peter

    2013-08-30

    The koala (Phascolarctos cinereus) is recognised as a threatened wildlife species in various parts of Australia. A major contributing factor to the decline and long-term viability of affected populations is disease caused by the obligate intracellular bacteria, Chlamydia. Two chlamydial species infect the koala, Chlamydia pecorum and Chlamydia pneumoniae, and have been reported in nearly all mainland koala populations. Chlamydial infections of koalas are associated with ocular infections leading to blindness and genital tract infections linked to infertility, among other serious clinical manifestations. Diagnosis can be based on clinical presentation alone, however, it is complicated by the observation that many koala chlamydial infections occur with no overt signs of clinical disease. Instead, accurate diagnosis requires detailed clinical assessment and confirmatory testing by a range of PCR-based assays. Antibiotic treatment for koala chlamydial infection is possible, however, results on its success are mixed. A more practical solution for the protection of diseased populations is the application of a koala Chlamydia vaccine, with recent trials indicating promising results. Interestingly, molecular epidemiology studies of koala C. pecorum infections and recent comparative genomic analyses of koala C. pneumoniae have revealed potential differences in their origin that will have wider ramifications for our understanding of human chlamydial infections and host adaptation of the chlamydiae. This review summarises changes to the taxonomy of koala chlamydial infections and recent advances in our understanding of the epidemiology, diagnosis, treatment, control and evolution of Chlamydia infections in this iconic wildlife species. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Control of mycobacterium bovis infection in two sika deer herds in ireland

    Directory of Open Access Journals (Sweden)

    Partridge Tom

    2008-01-01

    Full Text Available Abstract In a number of countries, tuberculosis (due to infection with Mycobacterium bovis is a significant health problem of captive deer. This paper describes outbreaks of bovine tuberculosis in sika deer (Cervus nippon on two farms in Ireland and the methods used to control the disease. On Farm A, infection was first detected during 1993. The infection was eradicated using a programme of test and removal, in association with segregation of young animals. A second outbreak (also due to infection with M. bovis, but a different RFLP profile was detected in 2002. In the latter outbreak, infection was particularly prevalent in two groups of young deer. M. bovis with the same RFLP profile was also isolated in a badger found dead on the farm. Control was achieved by test and removal in association with herd management changes. In Herd B, infection was first detected in 1995, and subsequently eradicated using test and removal alone. In Herd A, re-infection remains an ongoing risk. Control rather than eradication of infection may more realistic in the short-to medium-term.

  12. Job embeddedness factors as a predictor of turnover intention among infection control nurses in Korea.

    Science.gov (United States)

    Choi, Jeong Sil; Kim, Kyung Mi

    2015-11-01

    Job embeddedness indicates the degree to which an employee of an organization intends to remain in his or her position at that organization. This study examined how job embeddedness affects infection control nurses' turnover intention along with general characteristics, job satisfaction, and perceived job alternatives. We collected data from a total of 133 infection control nurses using self-reporting questionnaire methods. All questions were answered on a 5-point Likert scale. The average turnover intention was 3.01 ± 0.72 (100-point conversion, 60.2%), and average job satisfaction was 3.48 ± 0.79 (100-point conversion, 69.6%). The average perceived availability of job alternatives was 3.02 ± 0.78 (100-point conversion, 60.4%), and average job embeddedness was 3.33 ± 0.57 (100-point conversion, 66.6%). Predictors of turnover intention were monthly income, perceived availability of job alternatives, and job embeddedness. Job embeddedness among predictors has high explanatory power as a predictor of infection control nurses' turnover intention. Through this study we identified predictors of turnover intention and found that job embeddedness among predictors has high explanatory power as a predictor of infection control nurses' turnover intention. Strategies to enhance infection control nurses' job embeddedness are needed. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Infection,

    Science.gov (United States)

    1980-10-16

    characteristic in severe gram-negative sepsis. Hypertriglyceridemia results from an increase in hepatic synthesis in combination with diminished activity of...induced stress, and tissue repair (1). The magnitude and type of nutritional losses caused by an infection reflect both the severity and duration of an... several functional forms of nutrient loss must be anticipated. Functional losses are defined as the within-body losses of nutrients due to infection

  14. Translational models of infection prevention and control: lessons from studying high risk aging populations.

    Science.gov (United States)

    Mody, Lona

    2018-06-13

    The present review describes our research experiences and efforts in advancing the field of infection prevention and control in nursing facilities including postacute and long-term care settings. There are over two million infections in postacute and long-term care settings each year in the United States and $4 billion in associated costs. To define a target group most amenable to infection prevention and control interventions, we sought to quantify the relation between indwelling device use and microbial colonization in nursing facility patients. Using various methodologies including survey methods, observational epidemiology, randomized controlled studies, and collaboratives, we showed that indwelling device type is related to the site of multidrug-resistant organism (MDRO) colonization; multianatomic site colonization with MDROs is common; community-associated methicillin-resistant Staphylococcus aureus (MRSA) appeared in the nursing facility setting almost immediately following its emergence in acute care; (4) MDRO prevalence and catheter-associated infection rates can be reduced through a multimodal targeted infection prevention intervention; and (5) using a collaborative approach, such an intervention can be successfully scaled up. Our work advances the infection prevention field through translational research utilizing various methodologies, including quantitative and qualitative surveys, patient-oriented randomized controlled trials, and clinical microbiologic and molecular methods. The resulting interventions employ patient-oriented methods to reduce infections and antimicrobial resistance, and with partnerships from major national entities, can be implemented nationally.

  15. Gender inequities in sexually transmitted infections: implications for HIV infection and control in Lagos State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ezekiel Oluwagbemiga Adeyemi

    2011-08-01

    Full Text Available Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multi-stage random sampling procedure was employed in administration of 1358 questionnaires. For qualitative data, four focus group discussions (FGD were conducted to collect information from stakeholders within the study population, while In-depth interview was employed to collect information from 188 people living with HIV/AIDS through support groups in the State. The data collected were subjected to basic demographic analytical techniques. Combination of univariate, bivariate, and multivariate analysis were employed. Information from focus group discussions and in-depth interviews were transcribed and organized under broad headings that depict different aspects of the discussions. Majority of the respondents interviewed did not inform their partners about their infection in the study area. It was also discovered that stigmatization did not allow some women to disclose their status to their sexual partners. Some of the HIV-positive patients interviewed agreed that they did not attend the health facilities to treat the STI’s before they were finally confirmed positive. The study hypothesis revealed that communication between partners about STI’s was associated with an increase in risk reduction behaviour. The paper concluded that there is need for more information and education on communication about STI’s between the sexual partners; to reduce the spread of sexually transmitted diseases within the nation.

  16. [Hand hygiene: first measure to control nosocomial infection].

    Science.gov (United States)

    Christiaens, G; Barbier, C; Mutsers, J; Warnotte, J; De Mol, P; Bouffioux, C

    2006-01-01

    Hand hygiene prevents cross infection in hospi tals, however adherence to guidelines is commonly poor. The hand-hygiene promotion programme started on May 2004 at the University Hospital of Liège after a baseline survey of compliance. We attempted to promote hand hygiene and most par ticularly alcohol-based hand disinfection. We measured MRSA transmission rates and consumption of alcohol-based handrub solution and soap in parallel. During the campaign, consump tion of alcohol-based handrub solution and soap increased by 56% and 24% respectively and MRSA transmission rates decreased from 11,04 to 7,07 cases per 1000 admissions.

  17. Strict or Graduated Punishment? Effect of Punishment Strictness on the Evolution of Cooperation in Continuous Public Goods Games

    Science.gov (United States)

    Shimao, Hajime; Nakamaru, Mayuko

    2013-01-01

    Whether costly punishment encourages cooperation is one of the principal questions in studies on the evolution of cooperation and social sciences. In society, punishment helps deter people from flouting rules in institutions. Specifically, graduated punishment is a design principle for long-enduring common-pool resource institutions. In this study, we investigate whether graduated punishment can promote a higher cooperation level when each individual plays the public goods game and has the opportunity to punish others whose cooperation levels fall below the punisher’s threshold. We then examine how spatial structure affects evolutionary dynamics when each individual dies inversely proportional to the game score resulting from the social interaction and another player is randomly chosen from the population to produce offspring to fill the empty site created after a player’s death. Our evolutionary simulation outcomes demonstrate that stricter punishment promotes increased cooperation more than graduated punishment in a spatially structured population, whereas graduated punishment increases cooperation more than strict punishment when players interact with randomly chosen opponents from the population. The mathematical analysis also supports the results. PMID:23555826

  18. Strict or graduated punishment? Effect of punishment strictness on the evolution of cooperation in continuous public goods games.

    Directory of Open Access Journals (Sweden)

    Hajime Shimao

    Full Text Available Whether costly punishment encourages cooperation is one of the principal questions in studies on the evolution of cooperation and social sciences. In society, punishment helps deter people from flouting rules in institutions. Specifically, graduated punishment is a design principle for long-enduring common-pool resource institutions. In this study, we investigate whether graduated punishment can promote a higher cooperation level when each individual plays the public goods game and has the opportunity to punish others whose cooperation levels fall below the punisher's threshold. We then examine how spatial structure affects evolutionary dynamics when each individual dies inversely proportional to the game score resulting from the social interaction and another player is randomly chosen from the population to produce offspring to fill the empty site created after a player's death. Our evolutionary simulation outcomes demonstrate that stricter punishment promotes increased cooperation more than graduated punishment in a spatially structured population, whereas graduated punishment increases cooperation more than strict punishment when players interact with randomly chosen opponents from the population. The mathematical analysis also supports the results.

  19. A survey of cross-infection control procedures: knowledge and attitudes of Turkish dentists

    Directory of Open Access Journals (Sweden)

    Emir Yüzbasioglu

    2009-12-01

    Full Text Available OBJECTIVES: The objective of this study was to investigate the knowledge, attitudes and behavior of Turkish dentists in Samsun City regarding cross-infection control. MATERIAL AND METHODS: A questionnaire was designed to obtain information about procedures used for the prevention of cross-infection in dental practices and determine the attitudes and perceptions of respondent dental practitioners to their procedures. The study population included all dentists in the city of Samsun, Turkey, in April 2005 (n=184. The questionnaire collected data on sociodemographic characteristics, knowledge and practice of infection control procedures, sterilization, wearing of gloves, mask, use of rubber dam, method of storing instruments and disposal methods of contaminated material, etc. Questionnaire data was entered into a computer and analyzed by SPSS statistical software. RESULTS: From the 184 dentists to whom the questionnaires were submitted, 135 participated in the study (overall response rate of 73.36%. As much as 74.10% dentists expressed concern about the risk of cross-infection from patients to themselves and their dental assistants. Forty-three percent of the participants were able to define "cross-infection" correctly. The greatest majority of the respondents (95.60% stated that all patients have to be considered as infectious and universal precautions must apply to all of them. The overall responses to the questionnaire showed that the dentists had moderate knowledge of infection control procedures. CONCLUSIONS: Improved compliance with recommended infection control procedures is required for all dentists evaluated in the present survey. Continuing education programs and short-time courses about cross-infection and infection control procedures are suitable to improve the knowledge of dentists.

  20. Progress in research, control and elimination of helminth infections in Asia.

    Science.gov (United States)

    Utzinger, Jürg; Brattig, Norbert W; Leonardo, Lydia; Zhou, Xiao-Nong; Bergquist, Robert

    2015-01-01

    Global health has substantially improved over the past 20 years. In low- and middle-income countries, in particular, great strives have been made in the control of communicable diseases, including helminth infections. Nevertheless, the most marginalised communities still suffer from infectious diseases that are intimately connected with poverty and lack of access to essential commodities and services, such as clean water, improved sanitation and sufficient food. A two-pronged approach is thus necessary: (i) intensifying control in remaining high-endemicity areas and pockets of high transmission; and (ii) moving from morbidity control to interruption of disease transmission in low-endemicity areas with the goal of local elimination. The latter will require new tools and strategies, going hand-in-hand with strong partnerships and new strategic alliances. In this special issue of Acta Tropica, 35 articles are featured that, together, provide an up-to-date overview of the latest progress made in research, control and elimination of helminth infections in East and Southeast Asia. The first 12 articles expound tools and approaches for improved detection, surveillance and monitoring of helminth infections. Control and elimination approaches for the most important helminth infections are revisited in the next 20 articles. The three remaining articles are cross-cutting pieces examining the interface of agriculture, environment and helminth infections and providing a rationale for integrated, multi-sectorial control approaches that are necessary for sustaining helminthiasis control and progressively moving towards elimination. An interesting aspect revealed through an in-depth analysis of the provenance of the 35 contributions is that the People's Republic of China emerges as a key player in global health, which is documented through its prominent role in research and control of helminth infection and networking throughout Asia. Policy implications are discussed and will

  1. 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

  2. RELEVANCE OF SERVICE INFECTION CONTROL IN THE VISION OF NURSING TECHNICIANS

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    Patrick Leonardo Nogueira da Silva

    2013-09-01

    Full Text Available This study aimed to identify the relevance of Service Infection Control in an Intensive Care Unit in the view of licensed practical nurses. This is a qualitative, descriptive, exploratory and research field. We used an interview in which he applied a semi-structured to eleven practical nurses working in intensive care of a hospital foundation. As the understanding of the benefits arising from the Service Infection Control for the industry, contacted that the respondents cited more often by the prevention of infections, was also mentioned as a boon to the maintenance of the organization in the industry, the quality and safety of assistance as other benefits generated by this executor service standards. It is concluded that the nursing staff have a lack of knowledge about the activities undertaken by the service control infections since the actions of the members of the Commission executors encompass a series of regulatory actions.

  3. Biosynthesized silver nanoparticles to control fungal infections in indoor environments

    Science.gov (United States)

    Deyá, Cecilia; Bellotti, Natalia

    2017-06-01

    Fungi grow especially in dark and moist areas, deteriorating the indoor environment and causing infections that particularly affect immunosuppressed individuals. Antimicrobial coatings have as principal objective to prevent biofilm formation and infections by incorporation of bioactive additives. In this sense, metallic nanoparticles, such as silver, have proven to be active against different microorganisms specially bacteria. Biosynthesized method is a promising environmentally friendly option to obtain nanoparticles. The aim of this research was assess the employment of plants extracts of Aloysia triphylla (cedrón), Laurelia sempervirens (laurel) and Ruta chalepensis (ruda) to obtain silver nanoparticles to be used as an antimicrobial additive to a waterborne coating formulation. The products obtained were assessed against fungal isolates from biodeteriorated indoor coatings. The fungi were identified by conventional and molecular techniques as Chaetomium globosum and Alternaria alternate. The results revealed that the coating with silver nanoparticles obtained with L. sempervirens extract at 60 °C with a size of 9.8 nm was the most efficient against fungal biofilm development.

  4. Perspectives and control of hepatitis B virus infection in Taiwan

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    Chih-Lin Lin

    2015-10-01

    Full Text Available Hepatitis B virus (HBV infection is endemic in Taiwan. After the implementation of universal hepatitis B vaccination, there was a significant reduction of hepatitis B surface antigen (HBsAg seropositivity and HBV-related hepatocellular carcinoma (HCC incidence in children, teenagers, and young adults. However, the incidence of HBV-related HCC in adults remains high. Through several community- and hospital-based cohort studies, the viral factors affecting the prognosis of HBV carriers have been illustrated. Serum HBV DNA level > 2000 IU/mL at study entry starts to increase the risks of cirrhosis and HCC in adult patients with chronic HBV infection. In addition, serum HBsAg level > 1000 IU/mL is associated with a higher risk of HCC in HBeAg-negative patients with low viral load. Virologically, HBV genotype C/D and core promote/pre-S mutations correlate with an increased HCC risk. Recently, a risk calculator has been developed to predict HCC in noncirrhotic patients with external validation. Therapeutically, hospital-based cohort and population-based nationwide studies indicated that interferon and nucleos(tide analogue treatments could reduce the incidence of HCC over time. Towards the ultimate goal of HBV eradication, several novel agents aiming at viral and host targets are under development. In addition, the immune therapy may play a key role in HBV cure in the foreseeable future.

  5. Curcumin enhances human macrophage control of Mycobacterium tuberculosis infection.

    Science.gov (United States)

    Bai, Xiyuan; Oberley-Deegan, Rebecca E; Bai, An; Ovrutsky, Alida R; Kinney, William H; Weaver, Michael; Zhang, Gong; Honda, Jennifer R; Chan, Edward D

    2016-07-01

    With the worldwide emergence of highly drug-resistant tuberculosis (TB), novel agents that have direct antimycobacterial effects or that enhance host immunity are urgently needed. Curcumin is a polyphenol responsible for the bright yellow-orange colour of turmeric, a spice derived from the root of the perennial herb Curcuma longa. Curcumin is a potent inducer of apoptosis-an effector mechanism used by macrophages to kill intracellular Mycobacterium tuberculosis (MTB). An in vitro human macrophage infection model was used to determine the effects of curcumin on MTB survival. We found that curcumin enhanced the clearance of MTB in differentiated THP-1 human monocytes and in primary human alveolar macrophages. We also found that curcumin was an inducer of caspase-3-dependent apoptosis and autophagy. Curcumin mediated these anti-MTB cellular functions, in part, via inhibition of nuclear factor-kappa B (NFκB) activation. Curcumin protects against MTB infection in human macrophages. The host-protective role of curcumin against MTB in macrophages needs confirmation in an animal model; if validated, the immunomodulatory anti-TB effects of curcumin would be less prone to drug resistance development. © 2016 Asian Pacific Society of Respirology.

  6. Hospital adoption of automated surveillance technology and the implementation of infection prevention and control programs.

    Science.gov (United States)

    Halpin, Helen; Shortell, Stephen M; Milstein, Arnold; Vanneman, Megan

    2011-05-01

    This research analyzes the relationship between hospital use of automated surveillance technology (AST) for identification and control of hospital-acquired infections (HAI) and implementation of evidence-based infection control practices. Our hypothesis is that hospitals that use AST have made more progress implementing infection control practices than hospitals that rely on manual surveillance. A survey of all acute general care hospitals in California was conducted from October 2008 through January 2009. A structured computer-assisted telephone interview was conducted with the quality director of each hospital. The final sample includes 241 general acute care hospitals (response rate, 83%). Approximately one third (32.4%) of California's hospitals use AST for monitoring HAI. Adoption of AST is statistically significant and positively associated with the depth of implementation of evidence-based practices for methicillin-resistant Staphylococcus aureus and ventilator-associated pneumonia and adoption of contact precautions and surgical care infection practices. Use of AST is also statistically significantly associated with the breadth of hospital implementation of evidence-based practices across all 5 targeted HAI. Our findings suggest that hospitals using AST can achieve greater depth and breadth in implementing evidenced-based infection control practices. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Controlling the Seedbeds of Tuberculosis: Diagnosis and Treatment of Tuberculosis Infection

    Science.gov (United States)

    Rangaka, Molebogeng X.; Cavalcante, Solange C.; Marais, Ben J.; Thim, Sok; Martinson, Neil A.; Swaminathan, Soumya; Chaisson, Richard E.

    2015-01-01

    The billions of people with latent tuberculosis infection serve as the seedbeds for future cases of active tuberculosis. Virtually all episodes of tuberculosis disease are preceded by a period of asymptomatic Mycobacterium tuberculosis infection; therefore, identifying infected individuals most likely to progress to disease and treating such subclinical infections to prevent future disease provides a critical opportunity to interrupt tuberculosis transmission and reduce the global burden of tuberculosis disease. Programs focusing on single strategies rather than comprehensive programs that deliver an integrated arsenal for tuberculosis control may continue to struggle. Tuberculosis preventive therapy is a poorly utilized tool that is essential for controlling the reservoirs of disease that drive the current epidemic. Comprehensive control strategies that combine preventive therapy for the most high-risk populations and communities with improved case-finding and treatment, control of transmission and health systems strengthening could ultimately lead to worldwide tuberculosis elimination. This paper outlines challenges to implementation of preventive therapy and provides pragmatic suggestions for overcoming them. It further advocates for tuberculosis preventive therapy as the core of a renewed global focus to implement a comprehensive epidemic control strategy that would reduce new tuberculosis cases to elimination targets. This strategy would be underpinned by accelerated research to further understand the biology of subclinical tuberculosis infections, develop novel diagnostics, and drug regimens specifically for subclinical tuberculosis infection, strengthen health systems, community engagement, and enhance sustainable large scale implementation of preventive therapy programs. PMID:26515679

  8. Methods for computational disease surveillance in infection prevention and control: Statistical process control versus Twitter's anomaly and breakout detection algorithms.

    Science.gov (United States)

    Wiemken, Timothy L; Furmanek, Stephen P; Mattingly, William A; Wright, Marc-Oliver; Persaud, Annuradha K; Guinn, Brian E; Carrico, Ruth M; Arnold, Forest W; Ramirez, Julio A

    2018-02-01

    Although not all health care-associated infections (HAIs) are preventable, reducing HAIs through targeted intervention is key to a successful infection prevention program. To identify areas in need of targeted intervention, robust statistical methods must be used when analyzing surveillance data. The objective of this study was to compare and contrast statistical process control (SPC) charts with Twitter's anomaly and breakout detection algorithms. SPC and anomaly/breakout detection (ABD) charts were created for vancomycin-resistant Enterococcus, Acinetobacter baumannii, catheter-associated urinary tract infection, and central line-associated bloodstream infection data. Both SPC and ABD charts detected similar data points as anomalous/out of control on most charts. The vancomycin-resistant Enterococcus ABD chart detected an extra anomalous point that appeared to be higher than the same time period in prior years. Using a small subset of the central line-associated bloodstream infection data, the ABD chart was able to detect anomalies where the SPC chart was not. SPC charts and ABD charts both performed well, although ABD charts appeared to work better in the context of seasonal variation and autocorrelation. Because they account for common statistical issues in HAI data, ABD charts may be useful for practitioners for analysis of HAI surveillance data. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. A Legume Genetic Framework Controls Infection of Nodules by Symbiotic and Endophytic Bacteria

    Science.gov (United States)

    Zgadzaj, Rafal; James, Euan K.; Kelly, Simon; Kawaharada, Yasuyuki; de Jonge, Nadieh; Jensen, Dorthe B.; Madsen, Lene H.; Radutoiu, Simona

    2015-01-01

    Legumes have an intrinsic capacity to accommodate both symbiotic and endophytic bacteria within root nodules. For the symbionts, a complex genetic mechanism that allows mutual recognition and plant infection has emerged from genetic studies under axenic conditions. In contrast, little is known about the mechanisms controlling the endophytic infection. Here we investigate the contribution of both the host and the symbiotic microbe to endophyte infection and development of mixed colonised nodules in Lotus japonicus. We found that infection threads initiated by Mesorhizobium loti, the natural symbiont of Lotus, can selectively guide endophytic bacteria towards nodule primordia, where competent strains multiply and colonise the nodule together with the nitrogen-fixing symbiotic partner. Further co-inoculation studies with the competent coloniser, Rhizobium mesosinicum strain KAW12, show that endophytic nodule infection depends on functional and efficient M. loti-driven Nod factor signalling. KAW12 exopolysaccharide (EPS) enabled endophyte nodule infection whilst compatible M. loti EPS restricted it. Analysis of plant mutants that control different stages of the symbiotic infection showed that both symbiont and endophyte accommodation within nodules is under host genetic control. This demonstrates that when legume plants are exposed to complex communities they selectively regulate access and accommodation of bacteria occupying this specialized environmental niche, the root nodule. PMID:26042417

  10. Provoking "Eureka" moments for effective infection control strategies.

    Science.gov (United States)

    Pittet, Didier

    2014-01-01

    Safety is now a fundamental principle of patient care and a critical component of quality management. Health care-associated infection prevention strategies need to be constantly revisited and updated to be effective. The "Geneva hand hygiene model" is a typical example of a breakthrough innovatory campaign that caught fire and went viral worldwide, thanks to its adoption by the World Health Organization (WHO) as the First Global Patient Safety Challenge. The campaign remains an inspiration for further innovation. To encourage new and disruptive technologies with the potential to improve patient safety through the successful implementation of the WHO multimodal strategy, the University of Geneva Hospitals/WHO Collaborating Centre on Patient Safety, together with the Aesculap Academy, have created a series of "Hand Hygiene Excellence Awards" and "Hand Hygiene Innovation Awards" worldwide.

  11. Awareness of Infection Control Protocols Among Dental Students in Babylon Dental Faculty

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    Khalil Ibraheem Zaidan

    2018-02-01

    Full Text Available Infection control and knowledge of common "infectious diseases" is essential for safe dental practice. Conveyance of infectious diseases is likely "from one individual to another during dental procedures", thorough" blood-borne" viruses and bacteria   "such as hepatitis" , human immunodeficiency virus (HIV. Thence in dental practice, the  sterilization and particular protection  is of most importance Process in  dental procedures,  and patient sponsor settings seek specific strategies guide to prevent the  transmission of diseases among dental students , oral verdure care staffs and their patients. Aim: Current study highlight  the methods and behavior  to evaluate  the  benefits of awareness, stance and pursuit of infection control between dental students in training dental clinic at Babylon  dental collage . Materials and Methods: A cross-sectional wipe using a rear ordered questionnaire was executed. The reconnaissance consisted of 38 closed-ended questions that included the key areas of infection control, including hand hygiene, personal preservation, sterilization and disinfection and ecological infection monitoring. There were also questions to elicit perceptions regarding the treatment of HBV and HIV/AIDS patients. Results: Survey study was done for dental students replied to the reconnaissance. Their situation and realization across infection control in college teaching  clinic .The results were assorted between 100% were orderly using gloves and 96% mask   with patient to 6% were orderly wore eye glasses. The type of sterilization of instrument was 90% autoclave and 10% oven and from analysis of data revealed most teaching clinics devoid of instruction post about control of infection control measures   Conclusion: "Improved compliance with recommended infection control procedures is required for all dentists" and graduated dental students  predestined in the existing project. Enduring instruction "programs and short

  12. Successful human infection with P. falciparum using three aseptic Anopheles stephensi mosquitoes: a new model for controlled human malaria infection.

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    Matthew B Laurens

    Full Text Available Controlled human malaria infection (CHMI is a powerful method for assessing the efficacy of anti-malaria vaccines and drugs targeting pre-erythrocytic and erythrocytic stages of the parasite. CHMI has heretofore required the bites of 5 Plasmodium falciparum (Pf sporozoite (SPZ-infected mosquitoes to reliably induce Pf malaria. We reported that CHMI using the bites of 3 PfSPZ-infected mosquitoes reared aseptically in compliance with current good manufacturing practices (cGMP was successful in 6 participants. Here, we report results from a subsequent CHMI study using 3 PfSPZ-infected mosquitoes reared aseptically to validate the initial clinical trial. We also compare results of safety, tolerability, and transmission dynamics in participants undergoing CHMI using 3 PfSPZ-infected mosquitoes reared aseptically to published studies of CHMI using 5 mosquitoes. Nineteen adults aged 18-40 years were bitten by 3 Anopheles stephensi mosquitoes infected with the chloroquine-sensitive NF54 strain of Pf. All 19 participants developed malaria (100%; 12 of 19 (63% on Day 11. The mean pre-patent period was 258.3 hours (range 210.5-333.8. The geometric mean parasitemia at first diagnosis by microscopy was 9.5 parasites/µL (range 2-44. Quantitative polymerase chain reaction (qPCR detected parasites an average of 79.8 hours (range 43.8-116.7 before microscopy. The mosquitoes had a geometric mean of 37,894 PfSPZ/mosquito (range 3,500-152,200. Exposure to the bites of 3 aseptically-raised, PfSPZ-infected mosquitoes is a safe, effective procedure for CHMI in malaria-naïve adults. The aseptic model should be considered as a new standard for CHMI trials in non-endemic areas. Microscopy is the gold standard used for the diagnosis of Pf malaria after CHMI, but qPCR identifies parasites earlier. If qPCR continues to be shown to be highly specific, and can be made to be practical, rapid, and standardized, it should be considered as an alternative for diagnosis

  13. Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

    Science.gov (United States)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Background Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. Methods One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. Results The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). Conclusion The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB. PMID:24098461

  14. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.

    Science.gov (United States)

    Claassens, Mareli M; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J; Enarson, Donald A; Beyers, Nulda; Borgdorff, Martien W

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.

  15. Infection control in delivery care units, Gujarat state, India: A needs assessment

    Directory of Open Access Journals (Sweden)

    Ramani KV

    2011-05-01

    Full Text Available Abstract Background Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India. Methods Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009. Results Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%. Conclusions This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems

  16. The Ly49E receptor inhibits the immune control of acute Trypanosoma cruzi infection

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    Jessica Filtjens

    2016-11-01

    Full Text Available The protozoan parasite Trypanosoma cruzi (T. cruzi circulates in the blood upon infection and invades a variety of cells. Parasites intensively multiply during the acute phase of infection and persist lifelong at low levels in tissues and blood during the chronic phase. Natural killer (NK and NKT cells play an important role in the immune control of T. cruzi infection, mainly by releasing the cytokine IFN-γ that activates the microbicidal action of macrophages and other cells and shapes a protective type 1 immune response. The mechanisms by which immune cells are regulated to produce IFN-γ during T. cruzi infection are still incompletely understood. Here, we show that urokinase plasminogen activator (uPA is induced early upon T. cruzi infection, and remains elevated until day 20 post inoculation. We previously demonstrated that the inhibitory receptor Ly49E, which is expressed, among others, on NK and NKT cells, is triggered by uPA. Therefore, we compared wild type (WT to Ly49E knockout (KO mice for their control of experimental T. cruzi infection. Our results show that young, i.e. 4- and 6-week-old, Ly49E KO mice control the infection better than WT mice, indicated by a lower parasite load and less cachexia. The beneficial effect of Ly49E depletion is more obvious in 4-week-old male than in female mice and weakens in 8-week-old mice. In young mice, the lower T. cruzi parasitemia in Ly49E KO mice is paralleled by higher IFN-γ production compared to their WT controls. Our data indicate that Ly49E receptor expression inhibits the immune control of T. cruzi infection. This is the first demonstration that the inhibitory Ly49E receptor can interfere with the immune response to a pathogen in vivo.

  17. CISH controls bacterial burden early after infection with Mycobacterium tuberculosis in mice.

    Science.gov (United States)

    Carow, Berit; Gao, Yu; Terán, Graciela; Yang, Xuexian O; Dong, Chen; Yoshimura, Akihiko; Rottenberg, Martin E

    2017-12-01

    CISH gene has been associated with increased susceptibility to human tuberculosis. We found that cish -/- mice had higher M. tuberculosis load in spleens and lungs up to 2.5 weeks after infection but not later compared to controls. Cish mRNA levels were increased in lungs at early and late time points after M. tuberculosis infection. In relation, the titers of inos and tnf mRNA in lungs were reduced early after infection of cish -/- mice. The transfer of cish -/- and control T cells conferred rag1 -/- mice similar protection to infection with M. tuberculosis. Macrophages showed increased cish mRNA levels after M. tuberculosis infection in vitro. However, mycobacterial uptake and growth in cish -/- and control macrophages was similar. Thus, we here show that CISH mediates control of M. tuberculosis in mice early after infection via regulation of innate immune mechanisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Post-operative endophthalmitis: the application of hazard analysis critical control points (HACCP) to an infection control problem.

    Science.gov (United States)

    Baird, D R; Henry, M; Liddell, K G; Mitchell, C M; Sneddon, J G

    2001-09-01

    Hazard analysis critical control points (HACCP) is a quality assurance system widely used in the food industry to ensure safety. We adopted the HACCP approach when conventional infection control measures had failed to solve an ongoing problem with an increased incidence of postoperative endophthalmitis, and our ophthalmology unit was threatened with permanent cessation of intraocular surgery. Although time-consuming, the result was an entirely new set of protocols for the care of patients undergoing intraocular surgery, the development of an integrated care pathway, and a comprehensive and robust audit programme, which enabled intraocular surgery to continue in a new spirit of confidence. HACCP methodology has so far been little used in healthcare, but it might be usefully applied to a variety of apparently intractable infection control problems. Copyright 2001 The Hospital Infection Society.

  19. Communication interventions to improve adherence to infection control precautions: a randomised crossover trial.

    Science.gov (United States)

    Ong, Mei-Sing; Magrabi, Farah; Post, Jeffrey; Morris, Sarah; Westbrook, Johanna; Wobcke, Wayne; Calcroft, Ross; Coiera, Enrico

    2013-02-06

    Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers. Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient's infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia. 300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%). Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.

  20. Enabling Passive Immunization as an Alternative to Antibiotics for Controlling Enteric Infections in Production Animals

    DEFF Research Database (Denmark)

    Heegaard, Peter M. H.; Hald, Birthe; Madsen, M.

    Enteric infections cause major problems in most intensive animal production sectors, including poultry, pigs and cattle, leading to disease, reduced production and compromised welfare. In addition some of these infections are zoonotic, and they are to a large extent responsible for the continued ...... as a viable strategy for control of infectious diseases in the intensive animal production, with the potential to significantly reduce antibiotics consumption.......Enteric infections cause major problems in most intensive animal production sectors, including poultry, pigs and cattle, leading to disease, reduced production and compromised welfare. In addition some of these infections are zoonotic, and they are to a large extent responsible for the continued...... massive use of antibiotics in food animals. Thus there is a pressing need for economically feasible, efficient, non-antibiotics based means for controlling the problem. Passive immunization has been known for decades as an efficient way of endowing humans or animals with short-term (weeks) immunity...

  1. Infection Control Link Nurse Program: An interdisciplinary approach n targeting health care-acquired infection

    Science.gov (United States)

    Sopirala, Madhuri M.; Yahle-Dunbar, Lisa; Smyer, Justin; Wellington, Linda; Dickman, Jeanne; Zikri, Nancy; Martin, Jennifer; Kulich, Pat; Taylor, David; Mekhjian, Hagop; Nash, Mary; Mansfield, Jerry; Pancholi, Preeti; Howard, Mary; Chase, Linda; Brown, Susan; Kipp, Kristopher; Lefeld, Kristen; Myers, Amber; Pan, Xueliang; Mangino, Julie E.

    2014-01-01

    Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62–0.83, P Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped drive these results. PMID:24548456

  2. Association between canine leishmaniosis and Ehrlichia canis co-infection: a prospective case-control study.

    Science.gov (United States)

    Attipa, Charalampos; Solano-Gallego, Laia; Papasouliotis, Kostas; Soutter, Francesca; Morris, David; Helps, Chris; Carver, Scott; Tasker, Séverine

    2018-03-20

    In the Mediterranean basin, Leishmania infantum is a major cause of disease in dogs, which are frequently co-infected with other vector-borne pathogens (VBP). However, the associations between dogs with clinical leishmaniosis (ClinL) and VBP co-infections have not been studied. We assessed the risk of VBP infections in dogs with ClinL and healthy controls. We conducted a prospective case-control study of dogs with ClinL (positive qPCR and ELISA antibody for L. infantum on peripheral blood) and clinically healthy, ideally breed-, sex- and age-matched, control dogs (negative qPCR and ELISA antibody for L. infantum on peripheral blood) from Paphos, Cyprus. We obtained demographic data and all dogs underwent PCR on EDTA-blood extracted DNA for haemoplasma species, Ehrlichia/Anaplasma spp., Babesia spp., and Hepatozoon spp., with DNA sequencing to identify infecting species. We used logistic regression analysis and structural equation modelling (SEM) to evaluate the risk of VBP infections between ClinL cases and controls. From the 50 enrolled dogs with ClinL, DNA was detected in 24 (48%) for Hepatozoon spp., 14 (28%) for Mycoplasma haemocanis, 6 (12%) for Ehrlichia canis and 2 (4%) for Anaplasma platys. In the 92 enrolled control dogs, DNA was detected in 41 (45%) for Hepatozoon spp., 18 (20%) for M. haemocanis, 1 (1%) for E. canis and 3 (3%) for A. platys. No Babesia spp. or "Candidatus Mycoplasma haematoparvum" DNA was detected in any dog. No statistical differences were found between the ClinL and controls regarding age, sex, breed, lifestyle and use of ectoparasitic prevention. A significant association between ClinL and E. canis infection (OR = 12.4, 95% CI: 1.5-106.0, P = 0.022) was found compared to controls by multivariate logistic regression. This association was confirmed using SEM, which further identified that younger dogs were more likely to be infected with each of Hepatozoon spp. and M. haemocanis, and dogs with Hepatozoon spp. were more likely to

  3. Repurposing drugs for the treatment and control of helminth infections

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    Gordana Panic

    2014-12-01

    Full Text Available Helminth infections are responsible for a considerable public health burden, yet the current drug armamentarium is small. Given the high cost of drug discovery and development, the high failure rates and the long duration to develop novel treatments, drug repurposing circumvents these obstacles by finding new uses for compounds other than those they were initially intended to treat. In the present review, we summarize in vivo and clinical trial findings testing clinical candidates and marketed drugs against schistosomes, food-borne trematodes, soil-transmitted helminths, Strongyloides stercoralis, the major human filariases lymphatic filariasis and onchocerciasis, taeniasis, neurocysticercosis and echinococcosis. While expanding the applications of broad-spectrum or veterinary anthelmintics continues to fuel alternative treatment options, antimalarials, antibiotics, antiprotozoals and anticancer agents appear to be producing fruitful results as well. The trematodes and nematodes continue to be most investigated, while cestodal drug discovery will need to be accelerated. The most clinically advanced drug candidates include the artemisinins and mefloquine against schistosomiasis, tribendimidine against liver flukes, oxantel pamoate against trichuriasis, and doxycycline against filariasis. Preclinical studies indicate a handful of promising future candidates, and are beginning to elucidate the broad-spectrum activity of some currently used anthelmintics. Challenges and opportunities are further discussed.

  4. Infection control practices in dental school: A patient perspective from Saudi Arabia

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    Mohammad Abdul Baseer

    2013-01-01

    Conclusions: Patients revealed adequate knowledge towards the use of gloves, face mask and spectacles by dentist. However, their knowledge regarding the spread of Hepatitis-B, HIV infection and use of autoclave was poor. Previous visitor of dental clinics showed higher knowledge of infection control as compared to the first time visitors. Many patients expressed their negative attitudes towards dental care due to AIDS and Hepatitis-B concerns.

  5. Evaluating effectiveness of infection control efforts in hospitals using information in microbiological laboratory databases.

    Science.gov (United States)

    Saito, Norihiro; Itoga, Masamichi; Kimura, Masahiko; Inoue, Fumio; Minakawa, Satoko; Kimura, Toshiyuki; Ozaki, Hiromi; Saito, Yumiko; Takahashi, Mikiko; Fujishima, Tetsuhiro; Mizuno, Sumie; Ogawa, Shin; Kitayama, Yuko; Kudo, Kazumi; Minami, Kazushi; Abo, Fumiko; Takano, Yasuyuki; Ohdaira, Naotake; Hamada, Satoshi; Ueki, Shigeharu; Hirokawa, Makoto; Kayaba, Hiroyuki

    2017-12-01

    To analyze the quality of infection control activities, bacteriological data relevant to infection control was evaluated through the microbiological data warehouse networking hospitals in two medical regions. Data regarding bacterial test results of 19 hospitals were extracted from two microbiological laboratory information data bases. The rate of MRSA among total S. aureus was used as a general indicator of infection control activities. The occupancy rate of nasal or pharyngeal swabs among MRSA-positive bacteriological samples was used as an indicator of attention paid for infection control in intensive care wards. The number of blood culture sets per examined patient was utilized as an indicator for life-long vocational education on updated medical practice relevant to infectious diseases. The rate of MRSA was significantly higher in secondary private hospitals. The occupancy rate of nasal or pharyngeal swabs was significantly higher in tertiary hospitals. The average number of blood culture set per examined patient were 1.55, 1.54 and 1.39 in tertiary, secondary public and secondary private hospitals, respectively; however, there were no statistical differences between groups. Data bases of microbiological test results shared by hospital laboratories are useful for evaluating regional infection control activities.

  6. Staphylococcus aureus epidemic in a neonatal nursery: a strategy of infection control.

    Science.gov (United States)

    Bertini, Giovanna; Nicoletti, PierLuigi; Scopetti, Franca; Manoocher, Pourshaban; Dani, Carlo; Orefici, Graziella

    2006-08-01

    The risk of nosocomial infection due to Staphylococcus aureus in fullterm newborns is higher under hospital conditions where there are overcrowded nurseries and inadequate infection control techniques. We report on an outbreak of skin infection in a Maternity Nursery (May 21, 2000) and the measures undertaken to bring the epidemic under control. These measures included: separating neonates already present in the nursery on August 23, 2000 from ones newly arriving by creating two different cohorts, one of neonates born before this date and one of neonates born later; restricting healthcare workers caring for S. aureus- infected infants from working with non-infected infants; disallowing carrier healthcare workers from caring for patients; introducing contact and droplet precautions (including the routine use of gowns, gloves, and mask); ensuring appropriate disinfection of potential sources of contamination. A representative number of isolates were typed by genomic DNA restriction length polymorphism analysis by means of pulsed-field gel electrophoresis (PFGE). Among the 227 cases of skin lesions, microbiological laboratory analyses confirmed that 175 were staphylococcal infections. The outbreak showed a gradual reduction in magnitude when the overcrowding of the Nursery was reduced by separating the newborns into the two different Nurseries (two cohorts). The genotyping of the strains by PFGE confirmed the nurse-to-newborn transmission of S. aureus. The measures adopted for controlling the S. aureus outbreak can, in retrospect, be assessed to have been very effective.

  7. Cross-infection and infection control in dentistry: Knowledge, attitude and practice of patients attended dental clinics in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

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    Nahla K. Ibrahim

    2017-07-01

    Full Text Available The objective of the study was to determine the level of Knowledge, Attitude and Practice (KAP of patients attended dental clinics at King Abdulaziz University Hospital (KAUH regarding cross infections and infection control in dentistry. A cross-sectional study was conducted among 225 patients who attended the dental clinics of KAUH, Jeddah, Saudi Arabia, 2014. A standardized, confidential, anonymous, interviewing questionnaire was used. Knowledge about dental infections was assessed by 12 MCQs. The attitudes were assessed through answering seven statements on a three- point Likert scale. Patients’ self reported practices were also evaluated. Descriptive and inferential statistics were done.Results of the study revealed that 39.5%, 38.7% and 21.8% of the participants obtained poor, fair and satisfactory level of knowledge about infections and infection control in dentistry, respectively. Social media was the commonest source of information about dental infection. Participant's educational level was significantly associated with the level of knowledge about dental infection. Patients had positive attitudes towards infection control in dentistry. Regarding self-reported practice, only few participants would ask dentists about sterilization of dental instruments (9.3%, wearing face mask (13.3% and gloves (16.4% if they don’t do so. In conclusion, our participants had good attitudes towards infection control in dentistry. However, their knowledge and practice need improvements. Conduction of educational programs is needed through social media, mass media, schools and public places. These programs involve both patients and providers. Keywords: Patient safety, Cross infection, Dental infection, Infection control, Emerging diseases, KAP

  8. Role of infection control in combating antibiotic resistance

    African Journals Online (AJOL)

    ] that impacts on human health and may potentially have a major effect on the global economy.[2] The United States Centers for Disease Control and Prevention (CDC) has identified four core actions to combat this challenge, i.e. surveillance, ...

  9. Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients.

    Science.gov (United States)

    Al-Niaimi, Ahmed N; Ahmed, Mostafa; Burish, Nikki; Chackmakchy, Saygin A; Seo, Songwon; Rose, Stephen; Hartenbach, Ellen; Kushner, David M; Safdar, Nasia; Rice, Laurel; Connor, Joseph

    2015-01-01

    SSI rates after gynecologic oncology surgery vary from 5% to 35%, but are up to 45% in patients with diabetes mellitus (DM). Strict postoperative glucose control by insulin infusion has been shown to lower morbidity, but not specifically SSI rates. Our project studied continuous postoperative insulin infusion for 24h for gynecologic oncology patients with DM and hyperglycemia with a target blood glucose of controlled with intermittent subcutaneous insulin injections. Group 2 was composed of patients with DM and postoperative hyperglycemia whose blood glucose was controlled by insulin infusion. Group 3 was composed of patients with neither DM nor hyperglycemia. We controlled for all relevant factors associated with SSI. We studied a total of 372 patients. Patients in Group 2 had an SSI rate of 26/135 (19%), similar to patients in Group 3 whose rate was 19/89 (21%). Both were significantly lower than the SSI rate (43/148, 29%) of patients in Group 1. This reduction of 35% is significant (p = 0.02). Multivariate analysis showed an odd ratio = 0.5 (0.28-0.91) in reducing SSI rates after instituting this protocol. Initiating intensive glycemic control for 24h after gynecologic oncology surgery in patients with DM and postoperative hyperglycemia lowers the SSI rate by 35% (OR = 0.5) compared to patients receiving intermittent sliding scale insulin and to a rate equivalent to non-diabetics. Copyright © 2014. Published by Elsevier Inc.

  10. Daily corticosteroids reduce infection-associated relapses in frequently relapsing nephrotic syndrome: a randomized controlled trial.

    Science.gov (United States)

    Gulati, Ashima; Sinha, Aditi; Sreenivas, Vishnubhatla; Math, Aparna; Hari, Pankaj; Bagga, Arvind

    2011-01-01

    Relapses of nephrotic syndrome often follow minor infections, commonly of the upper respiratory tract. Daily administration of maintenance prednisolone during intercurrent infections was examined to determine whether the treatment reduces relapse rates in children with frequently relapsing nephrotic syndrome. In a randomized controlled trial (nonblind, parallel group, tertiary-care hospital), 100 patients with idiopathic, frequently relapsing nephrotic syndrome eligible for therapy with prolonged low-dose, alternate-day prednisolone with or without levamisole were randomized to either receive their usual dose of alternate-day prednisolone daily for 7 days during intercurrent infections (intervention group) or continue alternate-day prednisolone (controls). Primary outcome was assessed by comparing the rates of infection-associated relapses at 12-month follow-up. Secondary outcomes were the frequency of infections and the cumulative amount of prednisolone received in both groups. Patients in the intervention group showed significantly lower infection-associated (rate difference, 0.7 episodes/patient per year; 95% confidence intervals [CI] 0.3, 1.1) and lower total relapse rates (0.9 episodes/patient per year, 95% CI 0.4, 1.4) without increase in steroid toxicity. Poisson regression, adjusted for occurrence of infections, showed that daily administration of prednisolone during infections independently resulted in 59% reduction in frequency of relapses (rate ratio, 0.41; 95% CI 0.3, 0.6). For every six patients receiving this intervention, one showed a reduction of relapse frequency to less than three per year. Daily administration of maintenance doses of prednisolone, during intercurrent infections, significantly reduces relapse rates and the proportion of children with frequently relapsing nephrotic syndrome.

  11. The Success Rate of Initial {sup 131I} Ablation in Differentiated Thyroid Cancer: Comparison Between Less strict and Very Strict Low Iodine Diets

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    Yoo, Ik Dong; Kim, Sung Hoon; Seo, Ye Young; Oh, Jin Kyoung; O, Joo Hyun; Chung, Soo Kyo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-03-15

    To decrease the risk of recurrence or metastasis in differentiated thyroid cancer (DTC), selected patients receive radioactive iodine ablation of remnant thyroid tissue or tumor. A low iodine diet can enhance uptake of radioactive iodine. We compared the success rates of radioactive iodine ablation therapy in patients who followed two different low iodine diets (LIDs). The success rates of postsurgical radioactive iodine ablation in DTC patients receiving empiric doses of 150 mCi were retrospectively reviewed. First-time radioactive iodine ablation therapy was done in 71 patients following less strict LID. Less strict LID restricted seafood, iodized salt, egg yolk, dairy products, processed meat, instant prepared meals, and multivitamins. Very strict LID additionally restricted rice, freshwater fish, spinach, and soybean products. Radioactive iodine ablation therapy was considered successful when follow up {sup 123I} whole body scan was negative and stimulated serum thyroglobulin level was less than 2.0 ng/mL. The success rate of patients following less strict LID was 80.3% and for very strict LID 75.6%. There was no statistically significant difference in the success rates between the two LID groups (P=0.48). Very strict LID may not contribute to improving the success rate of initial radioactive iodine ablation therapy at the cost of great inconvenience to the patient.

  12. Respiratory viruses in transplant recipients: more than just a cold. Clinical syndromes and infection prevention principles

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    Salma Abbas

    2017-09-01

    Conclusions: RVIs are associated with high morbidity and mortality among SOT and HSCT recipients. Management options are currently limited or lack strong clinical evidence. As community and nosocomial spread has been reported for all reviewed RVIs, strict adherence to infection control measures is key to preventing outbreaks.

  13. Use of alcohol hand sanitizer as an infection control strategy in an acute care facility.

    Science.gov (United States)

    Hilburn, Jessica; Hammond, Brian S; Fendler, Eleanor J; Groziak, Patricia A

    2003-04-01

    Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care, substantial morbidity and mortality, and excess costs. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of an alcohol gel hand sanitizer by caregivers on infection types and rates in an acute care facility. Patients were educated about the study through a poster on the unit, and teachable patients were given portable bottles of the alcohol hand gel for bedside use, along with an educational brochure explaining how and why to practice good hand hygiene. Infection rate and type data were collected in 1 unit of a 498-bed acute care facility for 16 months (February 2000 to May 2001). An alcohol gel hand sanitizer was provided and used by caregivers in the orthopedic surgical unit of the facility during this period. The primary infection types (more than 80%) found were urinary tract (UTI) and surgical site (SSI) infections. Infection types and rates for the unit during the period the alcohol hand sanitizer (intervention) was used were compared with the infection types and rates for the same unit when the alcohol hand sanitizer was not used (baseline); the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities.

  14. Ag85-focused T-cell immune response controls Mycobacterium avium chronic infection.

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    Bruno Cerqueira-Rodrigues

    Full Text Available CD4+ T cells are essential players for the control of mycobacterial infections. Several mycobacterial antigens have been identified for eliciting a relevant CD4+ T cell mediated-immune response, and numerous studies explored this issue in the context of Mycobacterium tuberculosis infection. Antigen 85 (Ag85, a highly conserved protein across Mycobacterium species, is secreted at the early phase of M. tuberculosis infection leading to the proliferation of Ag85-specific CD4+ T cells. However, in the context of Mycobacterium avium infection, little is known about the expression of this antigen and the elicited immune response. In the current work, we investigated if a T cell receptor (TCR repertoire mostly, but not exclusively, directed at Ag85 is sufficient to mount a protective immune response against M. avium. We show that P25 mice, whose majority of T cells express a transgenic TCR specific for Ag85, control M. avium infection at the same level as wild type (WT mice up to 20 weeks post-infection (wpi. During M. avium infection, Ag85 antigen is easily detected in the liver of 20 wpi mice by immunohistochemistry. In spite of the propensity of P25 CD4+ T cells to produce higher amounts of interferon-gamma (IFNγ upon ex vivo stimulation, no differences in serum IFNγ levels are detected in P25 compared to WT mice, nor enhanced immunopathology is detected in P25 mice. These results indicate that a T cell response dominated by Ag85-specific T cells is appropriate to control M. avium infection with no signs of immunopathology.

  15. The final word. OSHA's final ruling offers firm deadlines for infection control.

    Science.gov (United States)

    West, K

    1992-03-01

    Departments that have put off program development while waiting for the final ruling to be published have a lot of work to do. Many departments have been cited and fined by OSHA in the past year for failure to begin infection-control programs or provide hepatitis-B vaccines to personnel. Under the new budget, OSHA was granted permission to up its fine structure sevenfold--thus, a small fine is $7,000, and the highest fine for a single violation is $70,000. Fines can have a greater impact on a department's budget than implementation of the program over time. A key point to remember is that a strong infection-control program will reduce exposure follow-up costs and worker-compensation claims. Infection control is a win-win situation.

  16. [Ethical issues linked to the professional practice of nurses in a hospital infection control committee].

    Science.gov (United States)

    Alves, Débora Cristina Ignácio; Evora, Yolanda Dora Martinez

    2002-01-01

    This qualitative work was developed according to Bardin's method of content analysis. It aimed at finding out the perceptions of nurses that are members of a Hospital Infection Control Commission about ethical issues that are inherent to their professional practice as well as understanding the clinical nurses opinion regarding the professional practice of the nurses that are members of the Hospital Infection Control Commission, considering the ethical aspects. In order to achieve an ethical, efficient and effective professional practice, there is a need for governmental changes and professional recognition through autonomy, respect and exclusivity in the Service of Hospital Infection Control, as well as improvements regarding information, the care provided to the patient and professional secret. The predominance of bureaucratic activities and team work were mentioned by the clinical nurses as differentiating factors of the activities performed by nurses that are members of the Commission.

  17. Effectiveness and efficiency of the two trolley system as an infection control mechanism in the operating theatre.

    Science.gov (United States)

    Tuisawana, Viliame

    2009-11-01

    A good infection control manager understands the need to prevent a complete cycle of infection. The Infection Control Working Group Manual of Fiji, emphasised that the Cycle of Infection is the series of stage in which infection is spread. Operating theatres have infection control protocols. Most equipments and instruments used in operating theatre circulate within the theatre. The theatre trolleys are a main component in managing an operating theatre but the least recognised. This paper reviews the effectiveness and efficiency of the current two-trolley system as an infection control mechanism in theatre. The paper will discuss infection control using the current trolley system in relation to the layout of Labasa Hospital operating theatre, human resource, equipment standard and random swab results. The following are random swab results of theatre equipments taken by the Infection Control Nurse from 2006 to 2008. The Labasa Hospital Infection Committee have discouraged random swab sample from mid 2008 based on new guidelines on infection control. The two trolley system, in which an allocated outside trolley transports patients from the ward to a semi-sterile area in theatre. The inside trolley which transports the patient to the operating table. The two trolley system means more trolleys, extra staffs for lifting, additional handling of very sick patients, congestion and delay in taking patients to operating table in theatres should be considered. The one-trolley system in theatre greatly reduces the chances of manually lifting patients, thus reducing the risk of patient injury from fall and risk of back injuries to nurses. There are other evident based practices which can compliment the one trolley system for an effective infection control mechanism in theatres. The Fiji Infection Control Manual (2002) emphases the importance of regularly cleaning the environment and equipments in theatre but there is never a mention about using a two trolley system as an

  18. Comparison of clinical and parasitological data from controlled human malaria infection trials.

    Directory of Open Access Journals (Sweden)

    Meta Roestenberg

    Full Text Available Exposing healthy human volunteers to Plasmodium falciparum-infected mosquitoes is an accepted tool to evaluate preliminary efficacy of malaria vaccines. To accommodate the demand of the malaria vaccine pipeline, controlled infections are carried out in an increasing number of centers worldwide. We assessed their safety and reproducibility.We reviewed safety and parasitological data from 128 malaria-naïve subjects participating in controlled malaria infection trials conducted at the University of Oxford, UK, and the Radboud University Nijmegen Medical Center, The Netherlands. Results were compared to a report from the US Military Malaria Vaccine Program.We show that controlled human malaria infection trials are safe and demonstrate a consistent safety profile with minor differences in the frequencies of arthralgia, fatigue, chills and fever between institutions. But prepatent periods show significant variation. Detailed analysis of Q-PCR data reveals highly synchronous blood stage parasite growth and multiplication rates.Procedural differences can lead to some variation in safety profile and parasite kinetics between institutions. Further harmonization and standardization of protocols will be useful for wider adoption of these cost-effective small-scale efficacy trials. Nevertheless, parasite growth rates are highly reproducible, illustrating the robustness of controlled infections as a valid tool for malaria vaccine development.

  19. Knowledge and attitudes of infection prevention and control among health sciences students at University of Namibia.

    Science.gov (United States)

    Ojulong, J; Mitonga, K H; Iipinge, S N

    2013-12-01

    Health Sciences students are exposed early to hospitals and to activities which increase their risk of acquiring infections. Infection control practices are geared towards reduction of occurrence and transmission of infectious diseases. To evaluate knowledge and attitudes of infection prevention and control among Health Science students at University of Namibia. To assess students' knowledge and attitudes regarding infection prevention and control and their sources of information, a self-administered questionnaire was used to look at standard precautions especially hands hygiene. One hundred sixty two students participated in this study of which 31 were medical, 17 were radiography and 114 were nursing students. Medical students had better overall scores (73%) compared to nursing students (66%) and radiology students (61%). There was no significant difference in scores between sexes or location of the high school being either in rural or urban setting. Serious efforts are needed to improve or review curriculum so that health sciences students' knowledge on infection prevention and control is imparted early before they are introduced to the wards.

  20. Infection prevention and control in outpatient settings in China-structure, resources, and basic practices.

    Science.gov (United States)

    Qiao, Fu; Huang, Wenzhi; Zong, Zhiyong; Yin, Weijia

    2018-01-25

    More than 7 billion visits are made by patients to ambulatory services every year in mainland China. Healthcare-associated infections are becoming a new source of illness for outpatients. Little is known about infection prevention, control structure, resources available, and basic practices in outpatient settings. In 2014, we conducted a multisite survey. Five provinces were invited to participate based on geographic dispersion. Self-assessment questionnaires regarding the structure, infrastructure, apparatus and materials, and basic activities of infection prevention and control were issued to 25 hospitals and 5 community health centers in each province. A weight was assigned to each question according to its importance. Overall, 146 of 150 facilities (97.3%) participated in this study. The average survey score was 77.6 (95% confidence interval 75.7-79.5) and varied significantly between the different gross domestic product areas (P infection prevention and control was practiced consistently, although there were lapses in some areas. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Observations of infection prevention and control practices in primary health care, Kenya.

    Science.gov (United States)

    Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana; Das, Jishnu

    2017-07-01

    To assess compliance with infection prevention and control practices in primary health care in Kenya. We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker's and facility's characteristics. Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility's characteristics (e.g. public or private, or level of specialization) and the health-care worker's knowledge of, and training in, infection prevention and control practices. The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required.

  2. A tool to assess knowledge, attitude and behavior of Indonesian health care workers regarding infection control.

    Science.gov (United States)

    Duerink, D O; Hadi, U; Lestari, E S; Roeshadi, Djoko; Wahyono, Hendro; Nagelkerke, N J D; Van der Meulen, R G; Van den Broek, P J

    2013-07-01

    to investigate knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire and to evaluate the use of the questionnaire as a tool. we investigated knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire to identify problem areas, barriers and facilitators. The target was to include at least 50% of all health care workers (physicians, nurses, assistant nurses and infection control nurses) in each hospital, department and profession. Differences between demographic variables and scores for individual questions and groups of questions were compared using the chi-square statistic and analysis of variance and Spearman's rho was used to test for correlations between knowledge, attitude, self-reported behaviour and perceived obstacles. more than half of the health care workers of the participating departments completed the questionnaire. Of the 1036 respondents (44% nurses, 37% physicians and 19% assistant nurses), 34% were vaccinated against hepatitis B, 77% had experienced needle stick accidents and 93% had been instructed about infection control. The mean of the correct answers to the knowledge questions was 44%; of the answers to the attitude questions 67% were in agreement with the correct attitude; obstacles to compliance with infection control guidelines were perceived in 30% of the questions and the mean self-reported compliance was 63%. Safe handling of sharps, hand hygiene and the use of personal protective equipment were identified as the most important aspects for interventions. Significant positive correlations were found between knowledge, attitude, self-reported behaviour and perceived obstacles. the questionnaire in conjunction with site visits and interviews was a valuable strategy to identify trouble spots in the hospitals and to determine barriers to facilitators of change that should be taken into

  3. Identifying Core Competencies of Infection Control Nurse Specialists in Hong Kong.

    Science.gov (United States)

    Chan, Wai Fong; Bond, Trevor G; Adamson, Bob; Chow, Meyrick

    2016-01-01

    To confirm a core competency scale for Hong Kong infection control nurses at the advanced nursing practice level from the core competency items proposed in a previous phase of this study. This would serve as the foundation of competency assurance in Hong Kong hospitals. A cross-sectional survey design was used. All public and private hospitals in Hong Kong. All infection control nurses in hospitals of Hong Kong. The 83-item proposed core competency list established in an earlier study was transformed into a questionnaire and sent to 112 infection control nurses in 48 hospitals in Hong Kong. They were asked to rate the importance of each infection prevention and control item using Likert-style response categories. Data were analyzed using the Rasch model. The response rate of 81.25% was achieved. Seven items were removed from the proposed core competency list, leaving a scale of 76 items that fit the measurement requirements of the unidimensional Rasch model. Essential core competency items of advanced practice for infection control nurses in Hong Kong were identified based on the measurement criteria of the Rasch model. Several items of the scale that reflect local Hong Kong contextual characteristics are distinguished from the overseas standards. This local-specific competency list could serve as the foundation for education and for certification of infection control nurse specialists in Hong Kong. Rasch measurement is an appropriate analytical tool for identifying core competencies of advanced practice nurses in other specialties and in other locations in a manner that incorporates practitioner judgment and expertise.

  4. Application of optimal control strategies to HIV-malaria co-infection dynamics

    Science.gov (United States)

    Fatmawati; Windarto; Hanif, Lathifah

    2018-03-01

    This paper presents a mathematical model of HIV and malaria co-infection transmission dynamics. Optimal control strategies such as malaria preventive, anti-malaria and antiretroviral (ARV) treatments are considered into the model to reduce the co-infection. First, we studied the existence and stability of equilibria of the presented model without control variables. The model has four equilibria, namely the disease-free equilibrium, the HIV endemic equilibrium, the malaria endemic equilibrium, and the co-infection equilibrium. We also obtain two basic reproduction ratios corresponding to the diseases. It was found that the disease-free equilibrium is locally asymptotically stable whenever their respective basic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. sic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. Then, the optimal control theory for the model was derived analytically by using Pontryagin Maximum Principle. Numerical simulations of the optimal control strategies are also performed to illustrate the results. From the numerical results, we conclude that the best strategy is to combine the malaria prevention and ARV treatments in order to reduce malaria and HIV co-infection populations.

  5. Integrated control of Strongylus vulgaris infection in horses using ivermectin.

    Science.gov (United States)

    Dunsmore, J D

    1985-05-01

    An attempt was made to control or eliminate Strongylus vulgaris from a closed group of three horses at pasture near Perth, Western Australia, by dosing with ivermectin on four occasions during the time of year when it was believed that environmental conditions would eliminate all the non-parasitic stages of that species. At necropsy, five months after the last dose of anthelmintic and after continually grazing the same pastures, no S vulgaris or arterial lesions were found in those horses and S edentatus, Draschia megastoma and Habronema species were also almost completely eliminated.

  6. Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

    Directory of Open Access Journals (Sweden)

    Peters, Claudia

    2014-09-01

    Full Text Available [english] Background: The increase of multidrug-resistant organisms (MDROs causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff.Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs.Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution.Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work.

  7. Antiviral immunity following smallpox virus infection: a case-control study.

    Science.gov (United States)

    Hammarlund, Erika; Lewis, Matthew W; Hanifin, Jon M; Mori, Motomi; Koudelka, Caroline W; Slifka, Mark K

    2010-12-01

    Outbreaks of smallpox (i.e., caused by variola virus) resulted in up to 30% mortality, but those who survived smallpox infection were regarded as immune for life. Early studies described the levels of neutralizing antibodies induced after infection, but smallpox was eradicated before contemporary methods for quantifying T-cell memory were developed. To better understand the levels and duration of immunity after smallpox infection, we performed a case-control study comparing antiviral CD4(+) and CD8(+) T-cell responses and neutralizing antibody levels of 24 smallpox survivors with the antiviral immunity observed in 60 smallpox-vaccinated (i.e., vaccinia virus-immune) control subjects. We found that the duration of immunity following smallpox infection was remarkably similar to that observed after smallpox vaccination, with antiviral T-cell responses that declined slowly over time and antiviral antibody responses that remained stable for decades after recovery from infection. These results indicate that severe, potentially life-threatening disease is not required for the development of sustainable long-term immunity. This study shows that the levels of immunity induced following smallpox vaccination are comparable in magnitude to that achieved through natural variola virus infection, and this may explain the notable success of vaccination in eradicating smallpox, one of the world's most lethal diseases.

  8. Antiviral Immunity following Smallpox Virus Infection: a Case-Control Study▿

    Science.gov (United States)

    Hammarlund, Erika; Lewis, Matthew W.; Hanifin, Jon M.; Mori, Motomi; Koudelka, Caroline W.; Slifka, Mark K.

    2010-01-01

    Outbreaks of smallpox (i.e., caused by variola virus) resulted in up to 30% mortality, but those who survived smallpox infection were regarded as immune for life. Early studies described the levels of neutralizing antibodies induced after infection, but smallpox was eradicated before contemporary methods for quantifying T-cell memory were developed. To better understand the levels and duration of immunity after smallpox infection, we performed a case-control study comparing antiviral CD4+ and CD8+ T-cell responses and neutralizing antibody levels of 24 smallpox survivors with the antiviral immunity observed in 60 smallpox-vaccinated (i.e., vaccinia virus-immune) control subjects. We found that the duration of immunity following smallpox infection was remarkably similar to that observed after smallpox vaccination, with antiviral T-cell responses that declined slowly over time and antiviral antibody responses that remained stable for decades after recovery from infection. These results indicate that severe, potentially life-threatening disease is not required for the development of sustainable long-term immunity. This study shows that the levels of immunity induced following smallpox vaccination are comparable in magnitude to that achieved through natural variola virus infection, and this may explain the notable success of vaccination in eradicating smallpox, one of the world's most lethal diseases. PMID:20926574

  9. Creating a meaningful infection control program: one home healthcare agency's lessons.

    Science.gov (United States)

    Poff, Renee McCoy; Browning, Sarah Via

    2014-03-01

    Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

  10. TLR-dependent control of Francisella tularensis infection and host inflammatory responses.

    Directory of Open Access Journals (Sweden)

    Allison L Abplanalp

    2009-11-01

    Full Text Available Francisella tularensis is the causative agent of tularemia and is classified as a Category A select agent. Recent studies have implicated TLR2 as a critical element in the host protective response to F. tularensis infection, but questions remain about whether TLR2 signaling dominates the response in all circumstances and with all species of Francisella and whether F. tularensis PAMPs are predominantly recognized by TLR2/TLR1 or TLR2/TLR6. To address these questions, we have explored the role of Toll-like receptors (TLRs in the host response to infections with F. tularensis Live Vaccine Strain (LVS and F. tularensis subspecies (subsp. novicida in vivo.C57BL/6 (B6 control mice and TLR- or MyD88-deficient mice were infected intranasally (i.n. or intradermally (i.d. with F. tularensis LVS or with F. tularensis subsp. novicida. B6 mice survived >21 days following infection with LVS by both routes and survival of TLR1(-/-, TLR4(-/-, and TLR6(-/- mice infected i.n. with LVS was equivalent to controls. Survival of TLR2(-/- and MyD88(-/- mice, however, was significantly reduced compared to B6 mice, regardless of the route of infection or the subspecies of F. tularensis. TLR2(-/- and MyD88(-/- mice also showed increased bacterial burdens in lungs, liver, and spleen compared to controls following i.n. infection. Primary macrophages from MyD88(-/- and TLR2(-/- mice were significantly impaired in the ability to secrete TNF and other pro-inflammatory cytokines upon ex vivo infection with LVS. TNF expression was also impaired in vivo as demonstrated by analysis of bronchoalveolar lavage fluid and by in situ immunofluorescent staining.We conclude from these studies that TLR2 and MyD88, but not TLR4, play critical roles in the innate immune response to F. tularensis infection regardless of the route of infection or the subspecies. Moreover, signaling through TLR2 does not depend exclusively on TLR1 or TLR6 during F. tularensis LVS infection.

  11. Studies on the epidemiology, diagnosis and control of Echinococcus granulosus infections

    International Nuclear Information System (INIS)

    Lalic, R.; Petrovic, M.; Movsesijan, M.; Jovanovic, B.; Radulovic, S.

    1988-01-01

    Serological and parasitological studies indicate that hydatidosis is a significant health and economic problem in Yugoslavia and that the percentage of infected sheep varies between regions. In some areas of the country the prevalence of hydatidosis is about 90%. Results of studies on the development of different serological tests for in vivo diagnosis of hydatidosis showed that the most reliable results were obtained with a radioactive antibody test if a metabolic antigen was used. No difference in worm burden or antibody titre was observed between sheep infected with Echinococcus granulosus and control animals after challenge with Dictyocaulus filaria infective larvae. Vaccination of dogs with two doses of irradiated protoscolices given over an interval of 30 days resulted in significantly reduced numbers of parasites developing from a challenge infection with normal parasites. Also, eggs removed from the terminal segments of tapeworms collected from the small intestine of vaccinated dogs were not developed. (author). 14 refs, 2 figs, 6 tabs

  12. Mosquito Passage Dramatically Changes var Gene Expression in Controlled Human Plasmodium falciparum Infections.

    Science.gov (United States)

    Bachmann, Anna; Petter, Michaela; Krumkamp, Ralf; Esen, Meral; Held, Jana; Scholz, Judith A M; Li, Tao; Sim, B Kim Lee; Hoffman, Stephen L; Kremsner, Peter G; Mordmüller, Benjamin; Duffy, Michael F; Tannich, Egbert

    2016-04-01

    Virulence of the most deadly malaria parasite Plasmodium falciparum is linked to the variant surface antigen PfEMP1, which is encoded by about 60 var genes per parasite genome. Although the expression of particular variants has been associated with different clinical outcomes, little is known about var gene expression at the onset of infection. By analyzing controlled human malaria infections via quantitative real-time PCR, we show that parasite populations from 18 volunteers expressed virtually identical transcript patterns that were dominated by the subtelomeric var gene group B and, to a lesser extent, group A. Furthermore, major changes in composition and frequency of var gene transcripts were detected between the parental parasite culture that was used to infect mosquitoes and Plasmodia recovered from infected volunteers, suggesting that P. falciparum resets its var gene expression during mosquito passage and starts with the broad expression of a specific subset of var genes when entering the human blood phase.

  13. Effectiveness of hospital-wide methicillin-resistant Staphylococcus aureus (MRSA infection control policies differs by ward specialty.

    Directory of Open Access Journals (Sweden)

    Rosemarie Sadsad

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies.

  14. Implementation of tuberculosis infection control measures in designated hospitals in Zhejiang Province, China: are we doing enough to prevent nosocomial tuberculosis infections?

    Science.gov (United States)

    Chen, Bin; Liu, Min; Gu, Hua; Wang, Xiaomeng; Qiu, Wei; Shen, Jian; Jiang, Jianmin

    2016-03-03

    Tuberculosis (TB) infection control measures are very important to prevent nosocomial transmission and protect healthcare workers (HCWs) in hospitals. The TB infection control situation in TB treatment institutions in southeastern China has not been studied previously. Therefore, the aim of this study was to investigate the implementation of TB infection control measures in TB-designated hospitals in Zhejiang Province, China. Cross-sectional survey using observation and interviews. All TB-designated hospitals (n=88) in Zhejiang Province, China in 2014. Managerial, administrative, environmental and personal infection control measures were assessed using descriptive analyses and univariate logistic regression analysis. The TB-designated hospitals treated a median of 3030 outpatients (IQR 764-7094) and 279 patients with confirmed TB (IQR 154-459) annually, and 160 patients with TB (IQR 79-426) were hospitalised in the TB wards. Most infection control measures were performed by the TB-designated hospitals. Measures including regular monitoring of TB infection control in high-risk areas (49%), shortening the wait times (42%), and providing a separate waiting area for patients with suspected TB (46%) were sometimes neglected. N95 respirators were available in 85 (97%) hospitals, although only 44 (50%) hospitals checked that they fit. Hospitals with more TB staff and higher admission rates of patients with TB were more likely to set a dedicated sputum collection area and to conduct annual respirator fit testing. TB infection control measures were generally implemented by the TB-designated hospitals. Measures including separation of suspected patients, regular monitoring of infection control practices, and regular fit testing of respirators should be strengthened. Infection measures for sputum collection and respirator fit testing should be improved in hospitals with lower admission rates of patients with TB. Published by the BMJ Publishing Group Limited. For permission to

  15. Roles of sunlight and natural ventilation for controlling infection: historical and current perspectives.

    Science.gov (United States)

    Hobday, R A; Dancer, S J

    2013-08-01

    Infections caught in buildings are a major global cause of sickness and mortality. Understanding how infections spread is pivotal to public health yet current knowledge of indoor transmission remains poor. To review the roles of natural ventilation and sunlight for controlling infection within healthcare environments. Comprehensive literature search was performed, using electronic and library databases to retrieve English language papers combining infection; risk; pathogen; and mention of ventilation; fresh air; and sunlight. Foreign language articles with English translation were included, with no limit imposed on publication date. In the past, hospitals were designed with south-facing glazing, cross-ventilation and high ceilings because fresh air and sunlight were thought to reduce infection risk. Historical and recent studies suggest that natural ventilation offers protection from transmission of airborne pathogens. Particle size, dispersal characteristics and transmission risk require more work to justify infection control practices concerning airborne pathogens. Sunlight boosts resistance to infection, with older studies suggesting potential roles for surface decontamination. Current knowledge of indoor transmission of pathogens is inadequate, partly due to lack of agreed definitions for particle types and mechanisms of spread. There is recent evidence to support historical data on the effects of natural ventilation but virtually none for sunlight. Modern practice of designing healthcare buildings for comfort favours pathogen persistence. As the number of effective antimicrobial agents declines, further work is required to clarify absolute risks from airborne pathogens along with any potential benefits from additional fresh air and sunlight. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. The barriers and motivators to learning infection control in clinical placements: interviews with midwifery students.

    Science.gov (United States)

    Ward, Deborah J

    2013-05-01

    To investigate the barriers to and motivators for learning infection prevention and control as identified by midwifery students. Semi-structured interviews were undertaken with 15 undergraduate midwifery students within one large university. Data were analysed using Framework Analysis. Barriers to good clinical practice were identified by students which were concordant with previous literature related to reasons for non-compliance with infection control precautions. Issues such as competing demands specific to midwifery were also identified. Factors which act as barriers to learning good practice in placements included conflicting information and practices from different staff and placement areas and staff attitudes towards students who tried to comply with precautions. Motivators to good practice included the perceived vulnerability of infants to infection, the role modelling of good practice to new mothers and the monitoring of practice. This study demonstrated that midwifery students perceive barriers and motivators to learning infection prevention and control in their clinical placements. Many of the barriers identified are related to the attitudes and practices of qualified staff. Some of the motivators are related specifically to midwifery practice. Midwives need to be aware of the effects of what is observed in practice on midwifery students and how their practices and attitudes can influence learning both positively and negatively. As healthcare-associated infection and poor compliance with precautions are a global problem, this research should be of benefit to midwives and midwifery educators worldwide in terms of addressing barriers and ensuring better clinical education. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Guide: Monitoring Programme for unannounced inspections undertaken against the National Standards for the Prevention and Control of Healthcare Associated Infections

    OpenAIRE

    2014-01-01

    This is a guide to the Health Information and Quality Authority?s (the Authority) programme of monitoring service providers? compliance with the National Standards for the Prevention and Control of Healthcare Associated Infections (referred to in this guide as the Infection, Prevention and Control Standards). This guide explains the approach that the Authority takes when monitoring the compliance of service providers ? including hospitals ? with the Infection, Prevention and Control Standards...

  18. Computational Evaluation of the Strict Master and Random Template Models of Endogenous Retrovirus Evolution

    Science.gov (United States)

    Nascimento, Fabrícia F.; Rodrigo, Allen G.

    2016-01-01

    Transposable elements (TEs) are DNA sequences that are able to replicate and move within and between host genomes. Their mechanism of replication is also shared with endogenous retroviruses (ERVs), which are also a type of TE that represent an ancient retroviral infection within animal genomes. Two models have been proposed to explain TE proliferation in host genomes: the strict master model (SMM), and the random template (or transposon) model (TM). In SMM only a single copy of a given TE lineage is able to replicate, and all other genomic copies of TEs are derived from that master copy. In TM, any element of a given family is able to replicate in the host genome. In this paper, we simulated ERV phylogenetic trees under variations of SMM and TM. To test whether current phylogenetic programs can recover the simulated ERV phylogenies, DNA sequence alignments were simulated and maximum likelihood trees were reconstructed and compared to the simulated phylogenies. Results indicate that visual inspection of phylogenetic trees alone can be misleading. However, if a set of statistical summaries is calculated, we are able to distinguish between models with high accuracy by using a data mining algorithm that we introduce here. We also demonstrate the use of our data mining algorithm with empirical data for the porcine endogenous retrovirus (PERV), an ERV that is able to replicate in human and pig cells in vitro. PMID:27649303

  19. H. pylori infection and gastric cancer in Bangladesh: a case-control study.

    Science.gov (United States)

    Sarker, Khandker Kawser; Kabir, Md Jahangir; Bhuyian, A K M Minhaj Uddin; Alam, Md Shahjadul; Chowdhury, Fazle Rabbi; Ahad, M Abdul; Rahman, Md Anisur; Rahman, M Mizanur

    2017-11-01

    Like that of other Asian countries gastric cancer (GC) is also a leading cancer in Bangladesh and also a cause for cancer-related mortality. Infection with Helicobacter pylori ( H. pylori ) is the strongest recognized risk factor for gastric adenocarcinoma. The infection is also prevalent in common people. This case-control study was carried out to find an association between GC and H. pylori infection in the community. To evaluate association of H. pylori and carcinoma of stomach this study was conducted at National Institute of Cancer Research & Hospital, Dhaka from January 2013 to December 2014. H. pylori status was determined serologically by using H. pylori kit in the department of Biochemistry laboratory of Bangabandhu Sheikh Mujib Medical University. In total, 114 patients with GC and 520 patients not having GC were studied as controls. Logistic regression method was used to calculate the odds ratio. Significantly more patients in the case group (86.8%) were found to be seropositive for H. pylori antigen in contrast to the control group (67.5%). All of the cases in the present study were in advanced stage. No significant association between H. pylori seropositivity and tumor location was found. It was noted that undifferentiated gastric carcinoma had slightly more association with H. pylori infection. Younger H. pylori -infected patients had been found to be at higher relative risk for GC than older patients. As there is a strong association found between GC and H. pylori infection special emphasis to eradicate H. pylori infection might reduce the incidence of this dreadly disease.

  20. Quantitative evaluation of infection control models in the prevention of nosocomial transmission of SARS virus to healthcare workers: implication to nosocomial viral infection control for healthcare workers.

    Science.gov (United States)

    Yen, Muh-Yong; Lu, Yun-Ching; Huang, Pi-Hsiang; Chen, Chen-Ming; Chen, Yee-Chun; Lin, Yusen E

    2010-07-01

    Healthcare workers (HCWs) are at high risk of acquiring emerging infections while caring for patients, as has been shown in the recent SARS and swine flu epidemics. Using SARS as an example, we determined the effectiveness of infection control measures (ICMs) by logistic regression and structural equation modelling (SEM), a quantitative methodology that can test a hypothetical model and validates causal relationships among ICMs. Logistic regression showed that installing hand wash stations in the emergency room (p = 0.012, odds ratio = 1.07) was the only ICM significantly associated with the protection of HCWs from acquiring the SARS virus. The structural equation modelling results showed that the most important contributing factor (highest proportion of effectiveness) was installation of a fever screening station outside the emergency department (51%). Other measures included traffic control in the emergency department (19%), availability of an outbreak standard operation protocol (12%), mandatory temperature screening (9%), establishing a hand washing setup at each hospital checkpoint (3%), adding simplified isolation rooms (3%), and a standardized patient transfer protocol (3%). Installation of fever screening stations outside of the hospital and implementing traffic control in the emergency department contributed to 70% of the effectiveness in the prevention of SARS transmission. Our approach can be applied to the evaluation of control measures for other epidemic infectious diseases, including swine flu and avian flu.

  1. The BRI1-associated kinase 1, BAK1, has a brassinolide-independent role in plant cell-death control

    NARCIS (Netherlands)

    Kemmerling, B.; Schwedt, A.; Rodriguez, P.; Mazzotta, S.; Frank, M.; Abu Qamar, S.; Mengiste, T.; Betsuyaku, S.; Parker, J.E.; Müssig, C.; Thomma, B.P.H.J.; Albrecht, C.; Vries, de S.C.; Hirt, H.; Nürnberger, T.

    2007-01-01

    Programmed cell death (PCD) is a common host response to microbial infection [1-3]. In plants, PCD is associated with immunity to biotrophic pathogens, but it can also promote disease upon infection by necrotrophic pathogens [4]. Therefore, plant cell-suicide programs must be strictly controlled.

  2. Update on bacterial nosocomial infections.

    Science.gov (United States)

    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.

  3. Infections and their control: a historical perspective Swb Newsom Infections and their control: a historical perspective Sage/Infection Prevention Society £17.95 235pp 9781849204538 1849204535 [Formula: see text].

    Science.gov (United States)

    2010-10-27

    BILL NEWSOM, an eminent, but now retired, medical microbiologist, provides a personal but engaging review of infections and our attempts to control them. it is a fascinating social history of what has become an essential service, and Newsom highlights the need to be aware of past struggles and avoid repeating mistakes.

  4. Parvovirus Capsid Structures Required for Infection: Mutations Controlling Receptor Recognition and Protease Cleavages.

    Science.gov (United States)

    Callaway, Heather M; Feng, Kurtis H; Lee, Donald W; Allison, Andrew B; Pinard, Melissa; McKenna, Robert; Agbandje-McKenna, Mavis; Hafenstein, Susan; Parrish, Colin R

    2017-01-15

    Parvovirus capsids are small but complex molecular machines responsible for undertaking many of the steps of cell infection, genome packing, and cell-to-cell as well as host-to-host transfer. The details of parvovirus infection of cells are still not fully understood, but the processes must involve small changes in the capsid structure that allow the endocytosed virus to escape from the endosome, pass through the cell cytoplasm, and deliver the single-stranded DNA (ssDNA) genome to the nucleus, where viral replication occurs. Here, we examine capsid substitutions that eliminate canine parvovirus (CPV) infectivity and identify how those mutations changed the capsid structure or altered interactions with the infectious pathway. Amino acid substitutions on the exterior surface of the capsid (Gly299Lys/Ala300Lys) altered the binding of the capsid to transferrin receptor type 1 (TfR), particularly during virus dissociation from the receptor, but still allowed efficient entry into both feline and canine cells without successful infection. These substitutions likely control specific capsid structural changes resulting from TfR binding required for infection. A second set of changes on the interior surface of the capsid reduced viral infectivity by >100-fold and included two cysteine residues and neighboring residues. One of these substitutions, Cys270Ser, modulates a VP2 cleavage event found in ∼10% of the capsid proteins that also was shown to alter capsid stability. A neighboring substitution, Pro272Lys, significantly reduced capsid assembly, while a Cys273Ser change appeared to alter capsid transport from the nucleus. These mutants reveal additional structural details that explain cell infection processes of parvovirus capsids. Parvoviruses are commonly found in both vertebrate and invertebrate animals and cause widespread disease. They are also being developed as oncolytic therapeutics and as gene therapy vectors. Most functions involved in infection or transduction

  5. Parvovirus Capsid Structures Required for Infection: Mutations Controlling Receptor Recognition and Protease Cleavages

    Science.gov (United States)

    Callaway, Heather M.; Feng, Kurtis H.; Lee, Donald W.; Pinard, Melissa; McKenna, Robert; Agbandje-McKenna, Mavis; Hafenstein, Susan

    2016-01-01

    ABSTRACT Parvovirus capsids are small but complex molecular machines responsible for undertaking many of the steps of cell infection, genome packing, and cell-to-cell as well as host-to-host transfer. The details of parvovirus infection of cells are still not fully understood, but the processes must involve small changes in the capsid structure that allow the endocytosed virus to escape from the endosome, pass through the cell cytoplasm, and deliver the single-stranded DNA (ssDNA) genome to the nucleus, where viral replication occurs. Here, we examine capsid substitutions that eliminate canine parvovirus (CPV) infectivity and identify how those mutations changed the capsid structure or altered interactions with the infectious pathway. Amino acid substitutions on the exterior surface of the capsid (Gly299Lys/Ala300Lys) altered the binding of the capsid to transferrin receptor type 1 (TfR), particularly during virus dissociation from the receptor, but still allowed efficient entry into both feline and canine cells without successful infection. These substitutions likely control specific capsid structural changes resulting from TfR binding required for infection. A second set of changes on the interior surface of the capsid reduced viral infectivity by >100-fold and included two cysteine residues and neighboring residues. One of these substitutions, Cys270Ser, modulates a VP2 cleavage event found in ∼10% of the capsid proteins that also was shown to alter capsid stability. A neighboring substitution, Pro272Lys, significantly reduced capsid assembly, while a Cys273Ser change appeared to alter capsid transport from the nucleus. These mutants reveal additional structural details that explain cell infection processes of parvovirus capsids. IMPORTANCE Parvoviruses are commonly found in both vertebrate and invertebrate animals and cause widespread disease. They are also being developed as oncolytic therapeutics and as gene therapy vectors. Most functions involved in

  6. What Makes a Tweet Fly? Analysis of Twitter Messaging at Four Infection Control Conferences.

    Science.gov (United States)

    Mitchell, Brett G; Russo, Philip L; Otter, Jonathan A; Kiernan, Martin A; Aveling, Landon

    2017-11-01

    OBJECTIVE To examine tweeting activity, networks, and common topics mentioned on Twitter at 4 international infection control and infectious disease conferences. DESIGN A cross-sectional study. METHODS An independent company was commissioned to undertake a Twitter 'trawl' each month between July 1, 2016, and November 31, 2016. The trawl identified any tweets that contained the official hashtags of the conferences for (1) the UK Infection Prevention Society, (2) IDWeek 2016, (3) the Federation of Infectious Society/Hospital Infection Society, and (4) the Australasian College for Infection Prevention and Control. Topics from each tweet were identified, and an examination of the frequency and timing of tweets was performed. A social network analysis was performed to illustrate connections between users. A multivariate binary logistic regression model was developed to explore the predictors of 'retweets.' RESULTS In total, 23,718 tweets were identified as using 1 of the 2 hashtags of interest. The results demonstrated that the most tweets were posted during the conferences. Network analysis demonstrated a diversity of twitter networks. A link to a web address was a significant predictor of whether a tweet would be retweeted (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.9-2.1). Other significant factors predicting a retweet included tweeting on topics such as Clostridium difficile (OR, 2.0; 95% CI, 1.7-2.4) and the media (OR, 1.8; 95% CI, 1.6-2.0). Tweets that contained a picture were significantly less likely to be retweeted (OR, 0.06; 95% CI, 0.05-0.08). CONCLUSION Twitter is a useful tool for information sharing and networking at infection control conferences. Infect Control Hosp Epidemiol 2017;38:1271-1276.

  7. Strict Liability Versus Policy and Regulation for Environmental Protection and Agricultural Waste Management in Malaysia

    Directory of Open Access Journals (Sweden)

    Mohd Bakri Ishak

    2010-01-01

    Full Text Available Basically, strict liability is part of the mechanism for expressing judgment or sentence by using direct evidence. This principle is very useful in order to obtain remedies from any damage either directly or indirectly. The principle in Rylands v Fletcher is responsible on imposing strict liability where if something brought onto land or collected there escapes liability under this rule can include not only the owner of land but also those who control or occupation on it. However, as a matter of fact, policy and regulation are also important in taking any action against any party who are responsible for environmental pollution or damage, which may include mismanagement of waste or industrial waste or agricultural waste. There are certain policies and regulations on environmental protection such as the National Environmental Policy, certain Acts and several regulations under the Environmental Quality Act 1974 (Act 127, which are very useful for agricultural waste management inter alia: Waters Act 1920 (Act 418, Environmental Quality (Prescribed Premises (Crude Palm Oil Regulations 1977, Environmental Quality (Prescribed Premises (Raw Natural Rubber Regulations 1978, Environmental Quality (Sewage and Industrial Effluents Regulations 1979, and Environmental Quality (Compounding of Offences Rules 1978. As a matter of fact, we should realize that time is of an essence for any parties which are involved in court cases and especially in avoiding the element of externality, which is commonly suffered by the government. In making this paper, therefore, some element of comparison with certain developed jurisdiction such as in the United Kingdom and Japan could not be avoided in order to obtain better outcome and to be more practical for the purpose of environmental protection and agricultural waste management.

  8. Control of tropical theileriosis (Theileria annulata infection in cattle in North Africa

    Directory of Open Access Journals (Sweden)

    Mohamed Gharbi

    2015-07-01

    Full Text Available Tropical theileriosis (Theileria annulata infection is a protozoan disease of cattle transmitted by Hyalomma ticks. This parasite is causing high losses in several countries in South Europe, North Africa and Asia. Indeed, both symptomatic and subclinical forms are present in infected animals causing live weight decrease, milk yield decrease, abortions and in some cases death. Due to its high medical and financial impact, the control of this disease is of paramount importance. It can be implemented through five control measures: (i treatment of infected animals with theilericidal drugs and other symptomatic treatments (this option is used for the treatment of animals and is insufficient to eradicate the parasite, (ii use of acaricides in animals which contain several side effects for humans, animals and the environment, (iii roughcasting and smoothing of the outer and inner surfaces of the cattle buildings for endophilic tick species (this control option is expensive but leads to the eradication of the parasite from the farm, (iv vaccination against ticks, a control option used with success against Rhipicephalus (Boophilus species but not still available for Hyalomma ticks and (v vaccination against the parasite with live attenuated vaccines. These control options were presented in the paper and their advantages and limits were discussed. The implementation of one (or more of these control options should take into account other considerations (social, political, etc.; they sometimes cause the failure of the control action.

  9. Validation of an automatic diagnosis of strict left bundle branch block criteria using 12-lead electrocardiograms

    DEFF Research Database (Denmark)

    Xia, Xiaojuan; Ruwald, Anne-Christine; Ruwald, Martin H

    2017-01-01

    AIMS: Strict left bundle branch block (LBBB) criteria were recently proposed to identify LBBB patients to benefit most from cardiac resynchronization therapy (CRT). The aim of our study was to automate identification of strict LBBB in order to facilitate its broader application. METHODS: We devel...

  10. The Effect of the Strictness of Consultation Requirements on Fraud Consultation

    NARCIS (Netherlands)

    Gold, A.H.; Knechel, W.R.; Wallage, P.

    2012-01-01

    We investigate how the strictness of a requirement to consult on potential client fraud affects auditors' propensity to consult with firm experts. We consider two specific forms of guidance about fraud consultations: (1) strict, i.e., mandatory and binding; and (2) lenient, i.e., advisory and

  11. Infection control in households of drug-resistant tuberculosis patients co-infected with HIV in Mumbai, India.

    Science.gov (United States)

    Albuquerque, T; Isaakidis, P; Das, M; Saranchuk, P; Andries, A; Misquita, D P; Khan, S; Dubois, S; Peskett, C; Browne, M

    2014-03-21

    Mumbai has a population of 21 million, and an increasingly recognised epidemic of drug-resistant tuberculosis (DR-TB). To describe TB infection control (IC) measures implemented in households of DR-TB patients co-infected with the human immunodeficiency virus (HIV) under a Médecins Sans Frontières programme. IC assessments were carried out in patient households between May 2012 and March 2013. A simplified, standardised assessment tool was utilised to assess the risk of TB transmission and guide interventions. Administrative, environmental and personal protective measures were tailored to patient needs. IC assessments were carried out in 29 houses. Measures included health education, segregating sleeping areas of patients, improving natural ventilation by opening windows, removing curtains and obstacles to air flow, installing fans and air extractors and providing surgical masks to patients for limited periods. Environmental interventions were carried out in 22 houses. TB IC could be a beneficial component of a comprehensive TB and HIV care programme in households and communities. Although particularly challenging in slum settings, IC measures that are feasible, affordable and acceptable can be implemented in such settings using simplified and standardised tools. Appropriate IC interventions at household level may prevent new cases of DR-TB, especially in households of patients with a lower chance of cure.

  12. Innovative Training for Occupational Health and Infection Control Workplace Assessment in Health Care

    Science.gov (United States)

    O'Hara, Lyndsay; Bryce, Elizabeth Ann; Scharf, Sydney; Yassi, Annalee

    2012-01-01

    A user-friendly, high quality workplace assessment field guide and an accompanying worksheet are invaluable tools for recognizing hazards in the hospital environment. These tools ensure that both front line workers as well as health and safety and infection control professionals can systematically evaluate hazards and formulate recommendations.…

  13. Infection dynamics and effective control strategies of tuberculosis in badgers and cattle in Ireland

    NARCIS (Netherlands)

    Aznar Asensio, J.I.

    2018-01-01

    Bovine tuberculosis (bTB) is a chronic inflammatory disease of cattle caused by infection with Mycobacterium bovis. In Ireland, a comprehensive control/eradication programme for M. bovis commenced in 1954, and by 1965, cattle incidence had been reduced by more than 95%. Despite

  14. Tackling wicked problems in infection prevention and control : a guideline for co-creation with stakeholders

    NARCIS (Netherlands)

    van Woezik, Anne F. G.; Braakman-Jansen, Louise M. A.; Kulyk, Olga; Siemons, Liseth; van Gemert-Pijnen, Julia E. W. C.

    2016-01-01

    Background: Infection prevention and control can be seen as a wicked public health problem as there is no consensus regarding problem definition and solution, multiple stakeholders with different needs and values are involved, and there is no clear end-point of the problem-solving process.

  15. Tackling wicked problems in infection prevention and control: a guideline for co-creation with stakeholders

    NARCIS (Netherlands)

    van Woezik, Anne; Braakman-Jansen, Louise Marie Antoinette; Kulyk, Olga Anatoliyivna; Tjin-Kam-Jet-Siemons, Liseth; van Gemert-Pijnen, Julia E.W.C.

    2016-01-01

    Background Infection prevention and control can be seen as a wicked public health problem as there is no consensus regarding problem definition and solution, multiple stakeholders with different needs and values are involved, and there is no clear end-point of the problem-solving process.

  16. Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial.

    Science.gov (United States)

    Bickel, Amitai; Gurevits, Michael; Vamos, Ronny; Ivry, Simon; Eitan, Arieh

    2011-04-01

    To assess the influence of hyperoxygenation on surgical site infection by using the most homogeneous study population. A randomized, prospective, controlled trial. Department of surgery in a government hospital. A total of 210 patients who underwent open surgery for acute appendicitis. In the study group, patients received 80% oxygen during anesthesia, followed by high-flow oxygen for 2 hours in the recovery room. The control group received 30% oxygen, as usual. Open appendectomy via incision in the right lower quadrant of the abdomen. Surgical site infection, mainly assessed by the ASEPSIS (additional treatment, serous discharge, erythema, purulent discharge, separation of deep tissues, isolation of bacteria, and stay in hospital prolonged >14 days) system score. Surgical site infections were recorded in 6 of 107 patients (5.6%) in the study group vs 14 of 103 patients (13.6%) in the control group (P = .04). Significant differences in the ASEPSIS score were also found. The mean hospital stay was longer in the control group (2.92 days) compared with the study group (2.51 days) (P = .01). The use of supplemental oxygen is advantageous in operations for acute appendicitis by reducing surgical site infection rate and hospital stay. clinicaltrials.gov Identifier: NCT01002365.

  17. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa

    NARCIS (Netherlands)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB

  18. Infection Control in Dentistry: The Challenge of “SARS” | Uti | Journal ...

    African Journals Online (AJOL)

    Severe acute respiratory syndrome (SARS), a newly discovered infectious disease poses a fresh threat to infection control in dental practice. This paper reviews the mode of transmission of SARS and its implication on dental practice. It gives practical guidelines for the prevention of its transmission in the dental environment.

  19. Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique

    NARCIS (Netherlands)

    Brouwer, Miranda; Coelho, Eliana; Mosse, Carla das Dores; Brondi, Luciana; Winterton, Laura; van Leth, Frank

    2014-01-01

    Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to

  20. The Role of Antiseptic in Infection Control. | Gibson | Journal of the ...

    African Journals Online (AJOL)

    Before the introduction of antibiotics, antiseptics were the only method of infection control. The emergence of organisms that are resistant to antibiotics has called for the increased use of relevant antiseptics in some cases. Antiseptics, like antibiotics, need to be tested in order to determine their antimicrobial activity against a ...

  1. Summary of Guidelines for Infection Prevention and Control for Flexible Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Lawrence Hookey

    2013-01-01

    Full Text Available BACKGROUND: High-quality processes to ensure infection prevention and control in the delivery of safe endoscopy services are essential. In 2010, the Public Health Agency of Canada and the Canadian Association of Gastroenterology (CAG developed a Canadian guideline for the reprocessing of flexible gastrointestinal endoscopy equipment.

  2. B cell follicle sanctuary permits persistent productive simian immunodeficiency virus infection in elite controllers.

    Science.gov (United States)

    Fukazawa, Yoshinori; Lum, Richard; Okoye, Afam A; Park, Haesun; Matsuda, Kenta; Bae, Jin Young; Hagen, Shoko I; Shoemaker, Rebecca; Deleage, Claire; Lucero, Carissa; Morcock, David; Swanson, Tonya; Legasse, Alfred W; Axthelm, Michael K; Hesselgesser, Joseph; Geleziunas, Romas; Hirsch, Vanessa M; Edlefsen, Paul T; Piatak, Michael; Estes, Jacob D; Lifson, Jeffrey D; Picker, Louis J

    2015-02-01

    Chronic-phase HIV and simian immunodeficiency virus (SIV) replication is reduced by as much as 10,000-fold in elite controllers (ECs) compared with typical progressors (TPs), but sufficient viral replication persists in EC tissues to allow viral sequence evolution and induce excess immune activation. Here we show that productive SIV infection in rhesus monkey ECs, but not TPs, is markedly restricted to CD4(+) follicular helper T (TFH) cells, suggesting that these EC monkeys' highly effective SIV-specific CD8(+) T cells can effectively clear productive SIV infection from extrafollicular sites, but their relative exclusion from B cell follicles prevents their elimination of productively infected TFH cells. CD8(+) lymphocyte depletion in EC monkeys resulted in a dramatic re-distribution of productive SIV infection to non-TFH cells, with restriction of productive infection to TFH cells resuming upon CD8(+) T cell recovery. Thus, B cell follicles constitute 'sanctuaries' for persistent SIV replication in the presence of potent anti-viral CD8(+) T cell responses, potentially complicating efforts to cure HIV infection with therapeutic vaccination or T cell immunotherapy.

  3. Dynamics and control of infections on social networks of population types

    Directory of Open Access Journals (Sweden)

    Brian G. Williams

    2018-06-01

    Full Text Available Random mixing in host populations has been a convenient simplifying assumption in the study of epidemics, but neglects important differences in contact rates within and between population groups. For HIV/AIDS, the assumption of random mixing is inappropriate for epidemics that are concentrated in groups of people at high risk, including female sex workers (FSW and their male clients (MCF, injecting drug users (IDU and men who have sex with men (MSM. To find out who transmits infection to whom and how that affects the spread and containment of infection remains a major empirical challenge in the epidemiology of HIV/AIDS. Here we develop a technique, based on the routine sampling of infection in linked population groups (a social network of population types, which shows how an HIV/AIDS epidemic in Can Tho Province of Vietnam began in FSW, was propagated mainly by IDU, and ultimately generated most cases among the female partners of MCF (FPM. Calculation of the case reproduction numbers within and between groups, and for the whole network, provides insights into control that cannot be deduced simply from observations on the prevalence of infection. Specifically, the per capita rate of HIV transmission was highest from FSW to MCF, and most HIV infections occurred in FPM, but the number of infections in the whole network is best reduced by interrupting transmission to and from IDU. This analysis can be used to guide HIV/AIDS interventions using needle and syringe exchange, condom distribution and antiretroviral therapy. The method requires only routine data and could be applied to infections in other populations. Keywords: Case reproduction number, R0, Social networks, Viet Nam, Epidemic control, Type reproduction number

  4. Toxoplasma Infection in Schizophrenia Patients: A Comparative Study with Control Group

    OpenAIRE

    Alipour, A; Shojaee, S; Mohebali, M; Tehranidoost, M; Abdi Masoleh, F; Keshavarz, H

    2011-01-01

    Background: Schizophrenia is a serious, chronic, and often debilitating neuropsychiatric disor­der. Its causes are still poorly understood. Besides genetic and non-genetic (environmental) fac­tors are thought to be important as the cause of the structural and functional deficits that character­ize schizophrenia. This study aimed to compare Toxoplasma gondii infection between schizo­phrenia patients and non-schizophrenia individuals as control group.Methods: A case-control study was designed i...

  5. BLEEDING PEPTIC ULCER, NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND HELICOBACTER PYLORI INFECTION – A PROSPECTIVE, CONTROLLED, RANDOMIZED STUDY

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2002-06-01

    Full Text Available Background. The explanation of peptic ulcer etiology has changed significantly in the past decade after the clarification of the significance of Helicobacter pylori infection.Aim. To evaluate the effectiveness of Helicobacter pylori eradication in patients with hemorrhaging peptic ulcer and patients with peptic ulcer without complications.Study ethics. The study was approved in 1998 by the Medical Ethics Committee of the Republic of Slovenia (No. 90/09/98.Type of study. Prospective, controlled and randomized study, carried out between 1998–2000.Patients and methods. The study included 80 patients (50 male and 30 female, av.age 57.5 years, SD ± 17.1, range 22– 80 in which endoscopy confirmed hemorrhage from peptic ulcer of stomach or duodenum and Helicobacter pylori infection. In all cases endoscopic hemostasis was performed: injection sclerotherapy with diluted adrenalin 1:10,000 and 1% polidocanol or argon plasma coagulation. The control group was made up of 80 patients (50 male and 30 female, av.age 56.8 years, SD ± 16.8, range 19–80 with peptic ulcer of stomach or duodenum and Helicobacter pylori infection. Infection was confirmed by a rapid urease test and histologic investigation of the gastric mucosa. In all cases the recommended drug combinations were used in the treatment of the infection: a proton pump inhibitor, omeprazol (4 weeks, and combination of antibiotics, claritromycin and metronidazole or with regard to the antibiogram (1 week. The therapeutic success was ascertained endoscopically four weeks after inclusion in the study. Infection eradication was confirmed by the rapid urease test and histologic investigation of the gastric mucosa.Results. Four weeks after inclusion in the study the success of infection eradication was 92.5% in the study group, in the control group it was 91.3% (p > 0.05. In 6 patients (7.5%, 6/ 80 from the study group and in 7 (8.8%, 7/80 from the control group we introduced a replacement treatment

  6. [Infection control management and practice in home care - analysis of structure quality].

    Science.gov (United States)

    Spegel, H; Höller, C; Randzio, O; Liebl, B; Herr, C

    2013-02-01

    Surveillance of infection control management and practices in home care is an important task of the public health service. While infection control aspects in residential homes for the aged and nursing are increasingly being discussed this subject has been poorly recognised in home care. The aim of this study was to identify problems in hygiene regarding the transmission of infectious diseases as well as quality assessment in home care. Based on the results of this study implications for infection control in home care facilities for public health services should be developed. Statistical analyses were performed on the primary quality assessment data of home care facilities collected by the medical service of health insurances via computer-assisted personal interviews between March 2006 and March 2009. Structure quality in 194 home care facilities was analysed as well as human resources and organisational conditions. Analyses were also done in the context of the clients' risk factor load. All analyses were performed by stratifying for the size of the home care services. To assess how the involved characteristics vary according to the size of the home care services chi-square tests and non-parametric tests were calculated. About 80% of the assessed home care services disposed of an infection control management plan. Compared to larger services smaller home care services, especially services with less than 10 clients had a poor structure in infection control management and practice. They also carried a higher load of risk factors in clients. The larger services had significantly less human resources. Surveillance of infection control management and practices by the public health services should focus on the structure of the smaller home care services. At the same time smaller home care services should be supported by offering training for the staff or counselling regarding hygiene-related aspects. Furthermore, the outcome quality of the larger home care services with

  7. Impact of an International Nosocomial Infection Control Consortium multidimensional approach on catheter-associated urinary tract infections in adult intensive care units in the Philippines: International Nosocomial Infection Control Consortium (INICC findings

    Directory of Open Access Journals (Sweden)

    Josephine Anne Navoa-Ng

    2013-10-01

    Full Text Available Summary: Objectives: To assess the impact of a multidimensional infection control approach on the reduction of catheter-associated urinary tract infection (CAUTI rates in adult intensive care units (AICUs in two hospitals in the Philippines that are members of the International Nosocomial Infection Control Consortium. Materials and methods: This was a before–after prospective active surveillance study to determine the rates of CAUTI in 3183 patients hospitalized in 4 ICUS over 14,426 bed-days. The study was divided into baseline and intervention periods. During baseline, surveillance was performed using the definitions of the US Centers for Disease Control and Prevention and the National Healthcare Safety Network (CDC/NHSN. During intervention, we implemented a multidimensional approach that included: (1 a bundle of infection control interventions, (2 education, (3 surveillance of CAUTI rates, (4 feedback on CAUTI rates, (5 process surveillance and (6 performance feedback. We used random effects Poisson regression to account for the clustering of CAUTI rates across time. Results: We recorded 8720 urinary catheter (UC-days: 819 at baseline and 7901 during intervention. The rate of CAUTI was 11.0 per 1000 UC-days at baseline and was decreased by 76% to 2.66 per 1000 UC-days during intervention [rate ratio [RR], 0.24; 95% confidence interval [CI], 0.11–0.53; P-value, 0.0001]. Conclusions: Our multidimensional approach was associated with a significant reduction in the CAUTI rates in the ICU setting of a limited-resource country. Keywords: Philippines, Catheter-associated urinary tract infections, Developing countries, Adult intensive care unit, Multidimensional approach, Bundle

  8. Outbreak of Serratia marcescens postsurgical bloodstream infection due to contaminated intravenous pain control fluids.

    Science.gov (United States)

    Chiang, Ping-Cherng; Wu, Tsu-Lan; Kuo, An-Jing; Huang, Yhu-Chering; Chung, Ting-Ying; Lin, Chun-Sui; Leu, Hsieh-Shong; Su, Lin-Hui

    2013-09-01

    Serratia marcescens is an important nosocomial pathogen causing significant outbreaks. Here we report an outbreak of bloodstream infection caused by S. marcescens at a 3500-bed hospital in Taiwan. The effective cooperative efforts of both laboratory personnel and infection control practitioners (ICPs) jointly contributed to the total control of the outbreak. A sudden increase in the isolation of S. marcescens from blood cultures was noted in the Clinical Microbiology Laboratory. The information was passed to the ICPs and an investigation was initiated. Pulsed-field gel electrophoresis was used to study the relationships among the isolates. Pulsotype A was identified in 43 (82.7%) of the 52 blood isolates studied. They were isolated from 52 patients distributed across 22 wards that were surveyed by seven ICPs. All patients had undergone surgery before the infection, and fentanyl-containing intravenous fluids were used for pain control in 43 of them. Isolates from 42 belonged to pulsotype A. Three S. marcescens isolates, all from fentanyl-containing fluids and demonstrating pulsotype A, were identified from 251 environmental cultures. All fentanyl-containing fluids that were in use were withdrawn and the outbreak was stopped. The outbreak of S. marcescens bloodstream infection apparently occurred through the use of fentanyl-containing fluids contaminated by a pulsotype A S. marcescens. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  9. Knowledge, attitude and practices about hepatitis B and Infection Control Measures among dental students in Patiala

    Directory of Open Access Journals (Sweden)

    Vishal Malhotra

    2017-01-01

    Full Text Available Background: Hepatitis B is highly infectious, but preventable diseases and dentists are at increased risk of exposure to saliva and blood of patients during their clinical practice, and so it is of utmost importance that they follow standard guidelines for infection control. Aims: To assess knowledge, attitude, and practices regarding infection control measures among dental students of Government Dental College in Punjab. Materials and Methods: A cross-sectional survey using a self-administered pretested questionnaire to dental students and responses were statistically analyzed. The analysis of variance was used to compare means of knowledge, attitude, and practice scores between four groups of study subjects and P < 0.05 is considered statistically significant. Results: Although the students have sufficient knowledge regarding hepatitis B, still there are gaps in putting their knowledge into practice. Third and final year students have significantly less mean knowledge and practice scores compared to interns and postgraduate students. The majority of students have a positive attitude and were willing to perform any procedure on hepatitis B-infected patients. Conclusions: Dental students have adequate knowledge and good attitude but still there are some misconceptions. There is poor implementation of standard infection control measures in their practice. Rigorous training programs on preventive practices and regular workshops must be organized on an annual basis in dental colleges. Moreover, hepatitis B vaccination must be made mandatory for students before they start their clinical practice.

  10. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol.

    Science.gov (United States)

    Furberg, Robert D; Ortiz, Alexa M; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

    2016-06-27

    Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care-related infections were reviewed to develop the infection control protocol to support tablet maintenance. This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings.

  11. Rural Indonesian health care workers' constructs of infection prevention and control knowledge.

    Science.gov (United States)

    Marjadi, Brahmaputra; McLaws, Mary-Louise

    2010-06-01

    Understanding the constructs of knowledge behind clinical practices in low-resource rural health care settings with limited laboratory facilities and surveillance programs may help in designing resource-appropriate infection prevention and control education. Multiple qualitative methods of direct observations, individual and group focus discussions, and document analysis were used to examine health care workers' knowledge of infection prevention and control practices in intravenous therapy, antibiotic therapy, instrument reprocessing, and hand hygiene in 10 rural Indonesian health care facilities. Awareness of health care-associated infections was low. Protocols were in the main based on verbal instructions handed down through the ranks of health care workers. The evidence-based knowledge gained across professional training was overridden by empiricism, nonscientific modifications, and organizational and societal cultures when resources were restricted or patients demanded inappropriate therapies. This phenomenon remained undetected by accreditation systems and clinical educators. Rural Indonesian health care workers would benefit from a formal introduction to evidence-based practice that would deconstruct individual protocols that include nonscientific knowledge. To achieve levels of acceptable patient safety, protocols would have to be both evidence-based and resource-appropriate. Copyright 2010 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  12. HIV-Infected Adolescent, Young Adult and Pregnant Smokers: Important Targets for Effective Tobacco Control Programs

    Directory of Open Access Journals (Sweden)

    Gerome Escota

    2013-06-01

    Full Text Available Tobacco use is inextricably linked to a number of health risks both in the general and HIV-infected populations. There is, however, a dearth of research on effective tobacco control programs among people living with HIV, and especially among adolescents, young adults and pregnant women, groups with heightened or increased vulnerability secondary to tobacco use. Adolescents and young adults constitute a growing population of persons living with HIV infection. Early and continued tobacco use in this population living with a disease characterized by premature onset multimorbidity and chronic inflammation is of concern. Additionally, there is an increased acuity for tobacco control among HIV-infected pregnant women to reduce pregnancy morbidity and improve fetal outcome. This review will provide an important summary of current knowledge of tobacco use among HIV-infected adolescents, young adults and pregnant women. The effects of tobacco use in these specific populations will be presented and the current state of tobacco control within these populations, assessed.

  13. Can Good Infection Control Be Obtained in One-stage Exchange of the Infected TKA to a Rotating Hinge Design? 10-year Results.

    Science.gov (United States)

    Zahar, Akos; Kendoff, Daniel O; Klatte, Till O; Gehrke, Thorsten A

    2016-01-01

    Prosthetic joint infection (PJI) occurs in 1% to 2% of total knee arthroplasties (TKAs). Although two-stage exchange is the preferred management method of patients with chronic PJI in TKA in North America, one-stage exchange is an alternative treatment method, but long-term studies of this approach have not been conducted. We reviewed our minimum 9-year results of 70 patients who underwent one-stage exchange arthroplasty with a rotating hinge design to determine: (1) What was the proportion of patients free of infection? (2) What was the patient rate of survival free of any reoperation? (3) What were the clinical outcomes as measured by Hospital for Special Surgery scores? (4) What proportion of patients developed radiographic evidence of loosening? All one-stage revision TKAs for infection between January 1 and December 31, 2002, with a minimum 9-year followup (mean, 10 years; range, 9-11 years), in which patients had been seen within the last 1 year, were included in this retrospective review. During that period, 11 patients with infected TKAs were treated with other approaches (including two-stage approaches in eight); the general indication for one-stage revision was the diagnosis of PJI with a known causative organism. Exclusion criteria were culture-negative preoperative aspiration, known allergy to local antibiotics or bone cement, or cases in which radical débridement was impossible as a result of the involvement of important anatomical structures. Eighty-one patients with PJI were seen during this period; 70 underwent one-stage exchange using our strict protocol and were reimplanted with a rotating hinge TKA. Eleven patients (15.7%) were lost to followup. Hospital for Special Surgery scores were recorded and all radiographs were evaluated for prosthetic loosening. Failure was defined as revision surgery for infection or any other cause. Our 10-year infection-free survival was 93% (mean, 4.1; 95% confidence interval [CI], 89%-96%; p exchange techniques for

  14. Knowledge, Attitude and Performance of Shiraz General Dentists about Infection Control Principles during Preparing Intraoral Radiographies

    Directory of Open Access Journals (Sweden)

    Abdolaziz Hagh Negahdar

    2017-02-01

    Full Text Available Background & Objective: Infection control in dental centers is affected by the persons’ attitude and knowledge about mechanisms of infection transmission. This study was designed to evaluate the knowledge and the attitude of Shiraz dentists about infection control during intraoral radiographies preparation. Materials & Methods: In this cross-sectional, and analytical research, the attitude and the knowledge of 45 male and 25 female, randomly selected dentists, were obtained through completion of a researcher- planed questioner which its validity and reliability had been confirmed. Data were analyzed using Cronbach`s alpha, one-way ANOVA, student’s t-test, and Pearson’s correlation coefficient in SPSS (V.21. Results: The average of the dentists’ age was 40.59±10.72 and their average occupational experience was 13.49±9.75 years. The mean score obtained for knowledge about infection control during intraoral radiographic procedures was less than fifty percent of total obtainable score, and was assessed as weak knowledge. There was no significant difference in the level of knowledge between studied male and female dentists (P>0.05. In addition, no significant relationship was detected between level, age/experience, and the university of education (P>0.05. The attitude of the dentists about infection control during intraoral radiography preparation assessed as moderate to good level. Conclusions: The results showed that the main reason for the present problems is insufficient knowledge of the dentists in related subjects. Therefore, the solution, which is recommended among dentists, is to raise their awareness and to change their attitudes and culture in order to improve their performance.

  15. Current biomedical waste management practices and cross-infection control procedures of dentists in India.

    Science.gov (United States)

    Singh, Balendra Pratap; Khan, Suleman A; Agrawal, Neeraj; Siddharth, Ramashanker; Kumar, Lakshya

    2012-06-01

    To investigate the knowledge, attitudes and behaviour of dentists working in dental clinics and dental hospitals regarding biomedical waste management and cross-infection control. A national survey was conducted. Self-administered questionnaires were sent to 800 dentists across India. A total of 494 dentists responded, giving a response rate of 61.8%. Of these, 228 of 323 (70.6%) general dentists reported using boiling water as a sterilising medium and 339 (68.6%) dentists reported disposing of hazardous waste such as syringes, blades and ampoules in dustbins and emptying these into municipal corporation bins. Dentists should undergo continuing education programmes on biomedical waste management and infection control guidelines. Greater cooperation between dental clinics and hospitals and pollution control boards is needed to ensure the proper handling and disposal of biomedical waste. © 2012 FDI World Dental Federation.

  16. Humans with chimpanzee-like major histocompatibility complex-specificities control HIV-1 infection

    DEFF Research Database (Denmark)

    Hoof, Ilka; Kesmir, Can; Lund, Ole

    2008-01-01

    and the progression rate to AIDS. Chimpanzees control HIV-1 viral replication and develop a chronic infection without progressing to AIDS. A similar course of disease is observed in human long-term non-progressors. Objective: To investigate if long-term non-progressors and chimpanzees have functional similarities...... in their MHC class I repertoire. Methods: We compared the specificity of groups of human MHC molecules associated with different levels of viremia in HIV-1 infected individuals with those of chimpanzee. Results and conclusion: We demonstrate that human MHC with control of HIV-1 viral load share binding motifs...... with chimpanzee MHC. Moreover, we find that chimpanzee and human MHC associated with low viral load are predicted to elicit broader Gag-specific immune responses than human MHC associated with high viral load, thus supporting earlier findings that Gag-specific immune responses are essential for HIV-1 control....

  17. Helicobacter pylori infection is not associated with failure to thrive: a case–control study

    Directory of Open Access Journals (Sweden)

    Chiu NC

    2017-02-01

    Full Text Available Nan-Chang Chiu,1,2,* Chien-Yu Lin,3,* Hsin Chi,1 Chun-Yan Yeung,1,2 Wei-Hsin Ting,1 Wai-Tao Chan,1 Chuen-Bin Jiang,1 Sung-Tse Li,3,4 Chao-Hsu Lin,3 Hung-Chang Lee1,2 1Department of Pediatrics, MacKay Children’s Hospital, 2Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei, 3Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City, 4Department of Statistics and Information Science, Fu Jen Catholic University, New Taipei, Taiwan *These authors contributed equally to this work Purpose: The long-term impact of Helicobacter pylori infection is complex, and concerns about the need for eradication exist. We conducted this case control study to investigate the association between H. pylori infection and failure to thrive (FTT.Patients and methods: From January 2009 to December 2011, 53 children with FTT group and matched children with the same sex and age and similar socioeconomic status without FTT (control group were enrolled. A questionnaire was administered to the parents/guardian, and a 13C-urea breath test was performed to detect H. pylori infection.Results: We found that the total prevalence of H. pylori infection was 29.2% and that there was no association between FTT and H. pylori infection (FTT group: 32%; control group: 26.4%; P=0.67. Short stature was more common in the FTT group and abdominal pain in the control group (FTT group: 37.7%; control group: 11.3%; P=0.003. In a comparison between the H. pylori-positive and -negative groups, abdominal pain (87.1% vs 64%; P=0.032 and the frequency of endoscopy (74.2% vs 32%; P<0.001 were significantly more common in the H. pylori-positive group.Conclusion: We found that children with H. pylori infection are at an increased risk for abdominal pain and that FTT is not associated with H. pylori infection. The decision for eradication should be evaluated carefully and individualized. Keywords: Helicobacter pylori, 13C-urea breath test, failure

  18. Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection

    DEFF Research Database (Denmark)

    Calum, H.; Moser, C.; Jensen, P. O.

    2009-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6% third-degree burn...... injury was induced in mice with a hot-air blower. The third-degree burn was confirmed histologically. The mice were allocated into five groups: control, shave, burn, infection and burn infection group. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group...... of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization...

  19. Control of HIV infection by IFN-α: implications for latency and a cure.

    Science.gov (United States)

    Bourke, Nollaig M; Napoletano, Silvia; Bannan, Ciaran; Ahmed, Suaad; Bergin, Colm; McKnight, Áine; Stevenson, Nigel J

    2018-03-01

    Viral infections, including HIV, trigger the production of type I interferons (IFNs), which in turn, activate a signalling cascade that ultimately culminates with the expression of anti-viral proteins. Mounting evidence suggests that type I IFNs, in particular IFN-α, play a pivotal role in limiting acute HIV infection. Highly active anti-retroviral treatment reduces viral load and increases life expectancy in HIV positive patients; however, it fails to fully eliminate latent HIV reservoirs. To revisit HIV as a curable disease, this article reviews a body of literature that highlights type I IFNs as mediators in the control of HIV infection, with particular focus on the anti-HIV restriction factors induced and/or activated by IFN-α. In addition, we discuss the relevance of type I IFN treatment in the context of HIV latency reversal, novel therapeutic intervention strategies and the potential for full HIV clearance.

  20. Using human factors engineering to improve the effectiveness of infection prevention and control.

    Science.gov (United States)

    Anderson, Judith; Gosbee, Laura Lin; Bessesen, Mary; Williams, Linda

    2010-08-01

    Human factors engineering is a discipline that studies the capabilities and limitations of humans and the design of devices and systems for improved performance. The principles of human factors engineering can be applied to infection prevention and control to study the interaction between the healthcare worker and the system that he or she is working with, including the use of devices, the built environment, and the demands and complexities of patient care. Some key challenges in infection prevention, such as delayed feedback to healthcare workers, high cognitive workload, and poor ergonomic design, are explained, as is how human factors engineering can be used for improvement and increased compliance with practices to prevent hospital-acquired infections.

  1. Low level of regulatory T cells and maintenance of balance between regulatory T cells and TH17 cells in HIV-1-infected elite controllers

    DEFF Research Database (Denmark)

    Brandt, Lea; Benfield, Thomas Lars; Mens, Helene

    2011-01-01

    A subgroup of HIV-1-infected individuals, elite controllers, have spontaneous viral control and offer an exceptional opportunity to study virological and immunolocigal factors of possible involvement in control of HIV-1 infection....

  2. Thresholds for HLB vector control in infected commercial citrus and compatibility with biological control

    OpenAIRE

    Monzo, C.; Hendricks, K.; Roberts, P.; Stansly, P. A.

    2014-01-01

    Control of the HLB vector, Diaphorina citri Kuwayama, is considered a basic component for management this disease, even in a high HLB incidence scenario. Such control is mostly chemically oriented. However, over use of insecticides would increase costs and be incompatible with biological control. Establishment of economic thresholds for psyllid control under different price scenarios could optimize returns on investment.

  3. Optimising Controlled Human Malaria Infection Studies Using Cryopreserved P. falciparum Parasites Administered by Needle and Syringe.

    Directory of Open Access Journals (Sweden)

    Susanne H Sheehy

    Full Text Available Controlled human malaria infection (CHMI studies have become a routine tool to evaluate efficacy of candidate anti-malarial drugs and vaccines. To date, CHMI trials have mostly been conducted using the bite of infected mosquitoes, restricting the number of trial sites that can perform CHMI studies. Aseptic, cryopreserved P. falciparum sporozoites (PfSPZ Challenge provide a potentially more accurate, reproducible and practical alternative, allowing a known number of sporozoites to be administered simply by injection.We sought to assess the infectivity of PfSPZ Challenge administered in different dosing regimens to malaria-naive healthy adults (n = 18. Six participants received 2,500 sporozoites intradermally (ID, six received 2,500 sporozoites intramuscularly (IM and six received 25,000 sporozoites IM.Five out of six participants receiving 2,500 sporozoites ID, 3/6 participants receiving 2,500 sporozoites IM and 6/6 participants receiving 25,000 sporozoites IM were successfully infected. The median time to diagnosis was 13.2, 17.8 and 12.7 days for 2,500 sporozoites ID, 2,500 sporozoites IM and 25,000 sporozoites IM respectively (Kaplan Meier method; p = 0.024 log rank test.2,500 sporozoites ID and 25,000 sporozoites IM have similar infectivities. Given the dose response in infectivity seen with IM administration, further work should evaluate increasing doses of PfSPZ Challenge IM to identify a dosing regimen that reliably infects 100% of participants.ClinicalTrials.gov NCT01465048.

  4. Dynamics and control of infections on social networks of population types.

    Science.gov (United States)

    Williams, Brian G; Dye, Christopher

    2017-10-26

    Random mixing in host populations has been a convenient simplifying assumption in the study of epidemics, but neglects important differences in contact rates within and between population groups. For HIV/AIDS, the assumption of random mixing is inappropriate for epidemics that are concentrated in groups of people at high risk, including female sex workers (FSW) and their male clients (MCF), injecting drug users (IDU) and men who have sex with men (MSM). To find out who transmits infection to whom and how that affects the spread and containment of infection remains a major empirical challenge in the epidemiology of HIV/AIDS. Here we develop a technique, based on the routine sampling of infection in linked population groups (a social network of population types), which shows how an HIV/AIDS epidemic in Can Tho Province of Vietnam began in FSW, was propagated mainly by IDU, and ultimately generated most cases among the female partners of MCF (FPM). Calculation of the case reproduction numbers within and between groups, and for the whole network, provides insights into control that cannot be deduced simply from observations on the prevalence of infection. Specifically, the per capita rate of HIV transmission was highest from FSW to MCF, and most HIV infections occurred in FPM, but the number of infections in the whole network is best reduced by interrupting transmission to and from IDU. This analysis can be used to guide HIV/AIDS interventions using needle and syringe exchange, condom distribution and antiretroviral therapy. The method requires only routine data and could be applied to infections in other populations. Copyright © 2017. Published by Elsevier B.V.

  5. [Helsinki declaration on patient safety in anaesthesiology -part 10: infection control/hygiene].

    Science.gov (United States)

    Kerwat, Klaus; Wulf, Hinnerk

    2013-11-01

    There is a plethora of laws, regulations, guidelines and recommendations relating to infection control and hygiene. Major issues are the prevention of nosocomial infections, staff protection and environmental protection. Of the highest relevance are the infection control law [Infektionsschutzgesetz (IfSG)], the hygiene regulations of the German federal states [Hygieneverordnungen der Bundesländer], the German technical rules for biological materials [Technische Regel Biologische Arbeitsstoffe 250 (TRBA 250)] - biological materials in health-care and welfare work [Biologische Arbeitsstoffe im Gesundheitswesen und in der Wohlfahrtspflege], the guidelines for hospital hygiene and prevention of infection of the commission for hospital hygiene and prevention of infection of the Robert-Koch Institute [Richtlinie für Krankenhaushygiene und Infektionsprävention von der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut], the recommendations of the commission on anti-infectives, resistance and therapy of the Robert-Koch Institute [Empfehlungen der Kommission Antiinfektiva, Resistenz und Therapie (ART) beim Robert Koch-Institut]. Of subordinate importance are, e.g., the recommendations of the German Society for Anesthesiology and Intensive Medicine (DGAI). It is practically impossible for an anesthesiologist working in a hospital to have knowledge of all laws, regulations, guidelines and recommendations. And this is also not reasonable. Thus it is necessary to distinguish the relevant from the irrelevant. Checklists can be useful here. The most important and effective individual action in hospital hygiene is and remains hand hygiene as is propagated in the action "clean hands", irrespective of all laws, regulations, guidelines and recommendations. © Georg Thieme Verlag Stuttgart · New York.

  6. Update on Mycoplasma hyopneumoniae infections in pigs: Knowledge gaps for improved disease control.

    Science.gov (United States)

    Maes, D; Sibila, M; Kuhnert, P; Segalés, J; Haesebrouck, F; Pieters, M

    2017-08-23

    Mycoplasma hyopneumoniae (M. hyopneumoniae) is the primary pathogen of enzootic pneumonia, a chronic respiratory disease in pigs. Infections occur worldwide and cause major economic losses to the pig industry. The present paper reviews the current knowledge on M. hyopneumoniae infections, with emphasis on identification and analysis of knowledge gaps for optimizing control of the disease. Close contact between infected and susceptible pigs is the main route of M. hyopneumoniae transmission. Management and housing conditions predisposing for infection or disease are known, but further research is needed to better understand M. hyopneumoniae transmission patterns in modern pig production systems, and to assess the importance of the breeding population for downstream disease control. The organism is primarily found on the mucosal surface of the trachea, bronchi and bronchioles. Different adhesins and lipoproteins are involved in the adherence process. However, a clear picture of the virulence and pathogenicity of M. hyopneumoniae is still missing. The role of glycerol metabolism, myoinositol metabolism and the Mycoplasma Ig binding protein-Mycoplasma Ig protease system should be further investigated for their contribution to virulence. The destruction of the mucociliary apparatus, together with modulating the immune response, enhances the susceptibility of infected pigs to secondary pathogens. Clinical signs and severity of lesions depend on different factors, such as management, environmental conditions and likely also M. hyopneumoniae strain. The potential impact of strain variability on disease severity is not well defined. Diagnostics could be improved by developing tests that may detect virulent strains, by improving sampling in live animals and by designing ELISAs allowing discrimination between infected and vaccinated pigs. The currently available vaccines are often cost-efficient, but the ongoing research on developing new vaccines that confer protective

  7. The application of strict criminal liabilities to spillage of oil: the practical impact on effective spill response

    International Nuclear Information System (INIS)

    Gallagher, J.J.

    2002-01-01

    The Federal Water Pollution Control Act as amended by the Oil Pollution Act of 1990 provides criminal penalties in oil spills that result from criminal activity, gross negligence or wilful misconduct on the part of the spiller. Nevertheless, the Department of Justice has seen fit to reach into unrelated legislation to potentially apply strict criminal liability to any oil spill regardless of intent. Strict criminalization of accidental oil spills is demonstrably counterproductive to effective protection of the environment from the effect of spills since it poses a serious impediment to cooperation and coordination by and between those charged by law to respond to them. This impediment is particularly dangerous since it threatens the proper functioning of the inherently sensitive ''troika'' Unified Command Structure that has evolved in spill response management in response to OPA-90 management requirements. Introduction of strict criminal liability for accidental spills is also particularly troublesome in that it must enlist unrelated law to influence an area that has been addressed specifically by legislation designed for that purpose; legislation that has worked well in the past 30 years to both regulate the target activities while successfully achieving the objective of protecting and improving environment quality. (author)

  8. Infection control in intensive care units and prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Bonten, M J; Weinstein, R A

    2000-12-01

    Ventilator-associated pneumonia (VAP) is considered the most frequent infection in the intensive care unit (ICU), although incidence rates depend on the diagnostic methods. Because VAP has been associated with increased mortality and greater costs for medical care, prevention remains an important goal for intensive care medicine. Selective digestive decontamination (SDD), the most frequently studied method of infection prevention, is still controversial despite more than 30 prospective randomized trials and 6 metaanalyses. SDD reduces the incidence of VAP diagnoses, but beneficial effects on duration of ventilation or ICU stay, antibiotic use, and patient survival have not been shown unequivocally. Although recent metaanalyses suggest a 20% to 40% decrease in ICU mortality for SDD used with systemic prophylaxis, this benefit should be confirmed in a large, prospective, randomized study, preferably with a cost-benefit analysis. Selection of pathogens resistant to the antibiotics used in SDD remains the most important drawback of SDD, rendering SDD contraindicated in wards with endemic resistant problems. Other methods of infection prevention that do not create a selective growth advantage for resistant microorganisms may be more useful. Among these are the use of endotracheal tubes with the possibility of continuous aspiration of subglottic secretions, oropharyngeal decontamination with antiseptics, or the semirecumbent treatment position of patients. Although these methods were successful in single studies, more data are needed. Notwithstanding the potential benefits of these interventions, such classic infection control measures as handwashing remain the cornerstone of infection prevention.

  9. Countering a bioterrorist introduction of pathogen-infected mosquitoes through mosquito control.

    Science.gov (United States)

    Tabachnick, Walter J; Harvey, William R; Becnel, James J; Clark, Gary G; Connelly, C Roxanne; Day, Jonathan F; Linser, Paul J; Linthicum, Kenneth J

    2011-06-01

    The release of infected mosquitoes or other arthropods by bioterrorists, i.e., arboterrorism, to cause disease and terror is a threat to the USA. A workshop to assess mosquito control response capabilities to mount rapid and effective responses to eliminate an arboterrorism attack provided recommendations to improve capabilities in the USA. It is essential that mosquito control professionals receive training in possible responses, and it is recommended that a Council for Emergency Mosquito Control be established in each state to coordinate training, state resources, and actions for use throughout the state.

  10. Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): A summary, review, and strategies for implementation.

    Science.gov (United States)

    O'Hara, Lyndsay M; Thom, Kerri A; Preas, Michael Anne

    2018-03-07

    Surgical site infections remain a common cause of morbidity, mortality, and increased length of stay and cost amongst hospitalized patients in the United States. This article summarizes the evidence used to inform the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017), and highlights key updates and new recommendations. We also present specific suggestions for how infection preventionists can play a central role in guideline implementation by translating these recommendations into evidence-based policies and practices in their facility. Copyright © 2018. Published by Elsevier Inc.

  11. Prevalence and sustainable control of Balantidium coli infection in pigs of Ranchi, Jahrkahnd, India

    Directory of Open Access Journals (Sweden)

    R K Bauri

    2012-04-01

    Full Text Available Pigs had a higher degree of gastrointestinal protozoa infection 93 out of 100 faecal samples. Balantidium coli infected pigs were controlled effectively by oxytetracycline (100% on 3rd day of observation and Metronidazole +Furazolidone combination (100% on 5th day of observation. Initially B. coli infected pigs had decreased haemoglobin, pack cell volume and total erythrocyte count values, but these pigs returned towards normal ranges after 7th day of observation. The differential leukocyte count values of B. coli infected pigs showed decreased values of neutrophils, and lymphocytes, and increased eosinophils values come towards normal range on 7th day of observation. The average body weight gain in oxytetracycline and metronidazole + furazolidone combination treated Tampworth & Desi piglets showed higher viz.35.25 ± 1.64 kg and 28.08 ± 1.75 kg of body weight respectively than untreated infected control piglets (15.75 ± 2.39. The average body weight gain in Oxytetracycline and metronidazole + furazolidone combination treated desi piglets were higher body weight viz. 36.67±1.07 kg and 32.50±0.96 kg respectively than untreated infected control piglets (22.00±0.88 kg. In both the treatment group, the group treated with Oxytetracycline had significantly higher body weight gain 35.25 ± 1.64 kg and 36.67±1.07 kg in both T & D and desi piglets respectively than metronidazole +furazolidone combination treated T & D and desi piglets (28.08 ± 1.75 kg, 32.50±0.96 kg respectively. The observation on different hematological parameters during B. coli infection and their treatment indicated that the harm caused by B. coli in pigs could be reduced to a greater extent by suitable therapeutic management. Application of suitable control packages were found to be very encouraging for maintaining optimum health and economical pig production. Oxytetracycline drugs showed higher efficacy than metronidazole + furazolidone combination and it show significantly

  12. Divergent changes in serum sterols during a strict uncooked vegan diet in patients with rheumatoid arthritis.

    Science.gov (United States)

    Agren, J J; Tvrzicka, E; Nenonen, M T; Helve, T; Hänninen, O

    2001-02-01

    The effects of a strict uncooked vegan diet on serum lipid and sterol concentrations were studied in patients with rheumatoid arthritis. The subjects were randomized into a vegan diet group (n 16), who consumed a vegan diet for 2-3 months, or into a control group (n 13), who continued their usual omnivorous diets. Serum total and LDL-cholesterol and -phospholipid concentrations were significantly decreased by the vegan diet. The levels of serum cholestanol and lathosterol also decreased, but serum cholestanol:total cholesterol and lathosterol:total cholesterol did not change. The effect of a vegan diet on serum plant sterols was divergent as the concentration of campesterol decreased while that of sitosterol increased. This effect resulted in a significantly greater sitosterol:campesterol value in the vegan diet group than in the control group (1.48 (SD 0.39) v. 0.72 (SD 0.14); P vegan diet changes the relative absorption rates of these sterols and/or their biliary clearance.

  13. Generalized mechanical pain sensitivity over nerve tissues in patients with strictly unilateral migraine.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Arendt-Nielsen, Lars; Cuadrado, María Luz; Pareja, Juan A

    2009-06-01

    No study has previously analyzed pressure pain sensitivity of nerve trunks in migraine. This study aimed to examine the differences in mechanical pain sensitivity over specific nerves between patients with unilateral migraine and healthy controls. Blinded investigators assessed pressure pain thresholds (PPT) over the supra-orbital nerves (V1) and peripheral nerve trunks of both upper extremities (median, radial, and ulnar nerves) in 20 patients with strictly unilateral migraine and 20 healthy matched controls. Pain intensity after palpation over both supra-orbital nerves was also assessed. A pressure algometer was used to quantify PPT, whereas a 10-point numerical pain rate scale was used to evaluate pain to palpation over the supra-orbital nerve. The analysis of covariance revealed that pain to palpation over the supra-orbital nerve was significantly higher (P0.6). In patients with unilateral migraine, we found increased mechano-sensitivity of the supra-orbital nerve on the symptomatic side of the head. Outside the head, the same patients showed increased mechano-sensitivity of the main peripheral nerves of both upper limbs, without asymmetries. Such diffuse hypersensitivity of the peripheral nerves lends further evidence to the presence of a state of hyperexcitability of the central nervous system in patients with unilateral migraine.

  14. Effect of a strict vegan diet on energy and nutrient intakes by Finnish rheumatoid patients.

    Science.gov (United States)

    Rauma, A L; Nenonen, M; Helve, T; Hänninen, O

    1993-10-01

    Dietary intake data of 43 Finnish rheumatoid arthritis patients were collected using 7-day food records. The subjects were randomized into a control and a vegan diet groups, consisting of 22 and 21 subjects, respectively. The subjects in the vegan diet group received an uncooked vegan diet ('living food') for 3 months, and they were tutored daily by a living-food expert. The subjects in the control group continued their usual diets and received no tutoring. Adherence to the strict vegan diet was assessed on the basis of urinary sodium excretion and by the information on consumption of specific food items (wheatgrass juice and the rejuvelac drink). The use of these drinks was variable, and some boiled vegetables were consumed occasionally. However, only one of the subjects in the vegan diet group lacked a clear decrease in urinary sodium excretion. Rheumatoid patients had lower than recommended intakes of iron, zinc and niacin, and their energy intake was low compared to mean daily energy intake of the healthy Finnish females of the same age. Shifting to the uncooked vegan diet significantly increased the intakes of energy and many nutrients. In spite of the increased energy intake, the group on the vegan diet lost 9% of their body weight during the intervention period, indicating a low availability of energy from the vegan diet.

  15. Proactive approach to containment of enterovirus infection in the nursery.

    Science.gov (United States)

    Fuchs, Inbal; Golan, Agneta; Borer, Abraham; Shemer-Avni, Yonat; Dagan, Ron; Greenberg, David

    2013-07-01

    Administration of prophylactic intravenous immunoglobulins to contacts of infants actively shedding enterovirus during a hospital nursery outbreak may attenuate severity of disease in those contacts and aid in containment of the outbreak. Four cases of neonatal enteroviral disease were treated in our hospital nursery in July and August 2011; 3 were presumed or proven vertical transmission cases and 1 was a presumed horizontal transmission. We aimed to prevent development of severe illness in contacts of affected neonates following a ministry of health advisory during the summer of 2011 warning of increased neonatal enteroviral morbidity and mortality in Israel. Strict infection control measures were implemented, including meticulous decontamination of the nursery environment and administration of intravenous immunoglobulin prophylaxis to contacts. No further horizontal transmission occurred after infection control interventions. Immunoglobulin prophylaxis to control enteroviral infection in the nursery should be considered as an auxiliary infection control intervention during a nursery outbreak.

  16. Irritable bowel syndrome and chronic fatigue 6 years after giardia infection: a controlled prospective cohort study.

    Science.gov (United States)

    Hanevik, Kurt; Wensaas, Knut-Arne; Rortveit, Guri; Eide, Geir Egil; Mørch, Kristine; Langeland, Nina

    2014-11-15

    Functional gastrointestinal disorders and fatigue may follow acute infections. This study aimed to estimate the persistence, prevalence, and risk of irritable bowel syndrome and chronic fatigue 6 years after Giardia infection. We performed a controlled prospective study of a cohort of 1252 individuals who had laboratory-confirmed Giardia infection during a waterborne outbreak in 2004. In total, 748 cohort cases (exposed) and 878 matched controls responded to a postal questionnaire 6 years later (in 2010). Responses were compared to data from the same cohort 3 years before (in 2007). The prevalences of irritable bowel syndrome (39.4%) by Rome III criteria and chronic fatigue (30.8%) in the exposed group 6 years after giardiasis were significantly elevated compared with controls, with adjusted relative risks (RRs) of 3.4 (95% confidence interval [CI], 2.9-3.9) and 2.9 (95% CI, 2.3-3.4), respectively. In the exposed group, the prevalence of irritable bowel syndrome decreased by 6.7% (RR, 0.85 [95% CI, .77-.93]), whereas the prevalence of chronic fatigue decreased by 15.3% from 3 to 6 years after Giardia infection (RR, 0.69 [95% CI, .62-.77]). Giardia exposure was a significant risk factor for persistence of both conditions, and increasing age was a risk factor for persisting chronic fatigue. Giardia infection in a nonendemic setting is associated with an increased risk for irritable bowel syndrome and chronic fatigue 6 years later. The prevalences of both conditions decrease over time, indicating that this intestinal protozoan parasite may elicit very long-term, but slowly self-limiting, complications. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  17. Controlling urinary tract infections associated with intermittent bladder catheterization in geriatric hospitals.

    Science.gov (United States)

    Girard, R; Gaujard, S; Pergay, V; Pornon, P; Martin Gaujard, G; Vieux, C; Bourguignon, L

    2015-07-01

    Controlling urinary tract infections (UTIs) associated with intermittent catheterization in geriatric patients. After a local epidemiological study identified high rates of UTI, a multi-disciplinary working group implemented and evaluated corrective measures. In 2009, a one-month prospective study measured the incidence of UTI, controlled for risk factors and exposure, in six geriatric hospitals. In 2010, a self-administered questionnaire on practices was administered to physicians and nurses working in these geriatric units. In 2011, the working group developed a multi-modal programme to: improve understanding of micturition, measurement of bladder volume and indications for catheter drainage; limit available medical devices; and improve prescription and traceability procedures. Detailed training was provided to all personnel on all sites. The epidemiological study was repeated in 2012 to assess the impact of the programme. Over 1500 patients were included in the 2009 study. The incidence of acquired infection was 4.8%. The infection rate was higher in patients with intermittent catheters than in patients with indwelling catheters (29.7 vs 9.9 UTI per 100 patients, P = 0.1013) which contradicts the literature. In 2010, the 269 responses to the questionnaire showed that staff did not consider catheterization to place patients at risk of infection, staff had poor knowledge of the recommended indications and techniques, and the equipment varied widely between units. Following implementation of the programme, the study was repeated in 2012 with over 1500 patients. The frequency of UTI in patients with intermittent catheters fell to rates in the published literature. Multi-modal programmes are an effective means to control UTI. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Impact of a bundle on prevention and control of healthcare associated infections in intensive care unit.

    Science.gov (United States)

    Gao, Fang; Wu, Yan-yan; Zou, Jun-ning; Zhu, Ming; Zhang, Jie; Huang, Hai-yan; Xiong, Li-juan

    2015-04-01

    Inpatients in the intensive care unit (ICU) are at high risk for healthcare-associated infections (HAIs). In the current study, a bundle of interventions and measures for preventing and controlling HAIs were developed and implemented in the ICU by trained personnel, and the impact of the bundle was evaluated. The incidence of HAIs, the adjusted daily incidence of HAIs and the incidence of three types of catheter-related infections before and after the bundle implementation were compared. The execution rate of the bundle for preventing and controlling ventilator-associated pneumonia (VAP) was increased from 82.06% in 2012 to 96.88% in 2013. The execution rate was increased from 83.03% in 2012 to 91.33% in 2013 for central line-associated bloodstream infection (CLABSI), from 87.00% to 94.40% for catheter-associated urinary tract infection (CAUTI), and from 82.05% to 98.55% for multidrug-resistant organisms (MDROs), respectively. In total, 136 cases (10.37%) in 2012 and 113 cases (7.72%) in 2013 involved HAIs, respectively. Patients suffered from infection of the lower respiratory tract, the most common site of HAIs, in 134 cases (79.29%) in 2012 and 107 cases (74.30%) in 2013 respectively. The incidence of VAP was 32.72‰ and 24.60‰, the number of strains of pathogens isolated was 198 and 173, and the number of MDROs detected in the ICU was 91 and 74 in 2012 and 2013, respectively. The percentage of MDROs among the pathogens causing HAIs was decreased in each quarter of 2013 as compared with the corresponding percentage in 2012. In 2013, the execution rate of the bundle for preventing and controlling HAIs was increased, whereas the incidence of HAIs and VAP decreased as compared with that in 2012.

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

    Science.gov (United States)

    2013-01-01

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

  20. Evolution of an audit and monitoring tool into an infection prevention and control process.

    Science.gov (United States)

    Denton, A; Topping, A; Humphreys, P

    2016-09-01

    In 2010, an infection prevention and control team in an acute hospital trust integrated an audit and monitoring tool (AMT) into the management regime for patients with Clostridium difficile infection (CDI). To examine the mechanisms through which the implementation of an AMT influenced the care and management of patients with CDI. A constructivist grounded theory approach was used, employing semi-structured interviews with ward staff (N=8), infection prevention and control practitioners (IPCPs) (N=7) and matrons (N=8), and subsequently a theoretical sample of senior managers (N=4). All interviews were transcribed verbatim and analysed using a constant comparison approach until explanatory categories emerged. The AMT evolved into a daily review process (DRP) that became an essential aspect of the management of all patients with CDI. Participants recognized that the DRP had positively influenced the care received by patients with CDI. Two main explanatory themes emerged to offer a framework for understanding the influence of the DRP on care management: education and learning, and the development and maintenance of relationships. The use of auditing and monitoring tools as part of a daily review process may enable ward staff, matrons, and IPCPs to improve patient outcomes and achieve the required levels of environmental hygiene if they act as a focal point for interaction, education, and collaboration. The findings offer insights into the behavioural changes and improved patient outcomes that ensue from the implementation of a DRP. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Horizontal infection control strategy decreases methicillin-resistant Staphylococcus aureus infection and eliminates bacteremia in a surgical ICU without active surveillance.

    Science.gov (United States)

    Traa, Maria X; Barboza, Lorena; Doron, Shira; Snydman, David R; Noubary, Farzad; Nasraway, Stanley A

    2014-10-01

    Methicillin-resistant Staphylococcus aureus infection is a significant contributor to morbidity and mortality in hospitalized patients worldwide. Numerous healthcare bodies in Europe and the United States have championed active surveillance per the "search and destroy" model. However, this strategy is associated with significant economic, logistical, and patient costs without any impact on other hospital-acquired pathogens. We evaluated whether horizontal infection control strategies could decrease the prevalence of methicillin-resistant S. aureus infection in the ICU, without the need for active surveillance. Retrospective, observational study in the surgical ICU of a tertiary care medical center in Boston, MA, from 2005 to 2012. A total of 6,697 patients in the surgical ICU. Evidence-based infection prevention strategies were implemented in an iterative fashion, including 1) hand hygiene program with refresher education campaign, 2) chlorhexidine oral hygiene program, 3) chlorhexidine bathing, 4) catheter-associated bloodstream infection program, and 5) daily goals sheets. The prevalence of methicillin-resistant S. aureus infection fell from 2.66 to 0.69 per 1,000 patient days from 2005 to 2012, an average decrease of 21% per year. The biggest decline in rate of infection was detected in 2008, which may suggest that the catheter-associated bloodstream infection prevention program was particularly effective. Among 4,478 surgical ICU admissions over the last 5 years, not a single case of methicillin-resistant S. aureus bacteremia was observed. Aggressive multifaceted horizontal infection control is an effective strategy for reducing the prevalence of methicillin-resistant S. aureus infection and eliminating methicillin-resistant S. aureus bacteremia in the ICU without the need for active surveillance and decontamination.

  2. Heat treatment eliminates 'Candidatus Liberibacter asiaticus' from infected citrus trees under controlled conditions.

    Science.gov (United States)

    Hoffman, Michele T; Doud, Melissa S; Williams, Lisa; Zhang, Mu-Qing; Ding, Fang; Stover, Ed; Hall, David; Zhang, Shouan; Jones, Lisa; Gooch, Mark; Fleites, Laura; Dixon, Wayne; Gabriel, Dean; Duan, Yong-Ping

    2013-01-01

    Huanglongbing (HLB) is one of the most destructive diseases of citrus worldwide. The three known causal agents of HLB are species of α-proteobacteria: 'Candidatus Liberibacter asiaticus', 'Ca. L. africanus', and 'Ca. L. americanus'. Previous studies have found distinct variations in temperature sensitivity and tolerance among these species. Here, we describe the use of controlled heat treatments to cure HLB caused by 'Ca. L. asiaticus', the most prevalent and heat-tolerant species. Using temperature-controlled growth chambers, we evaluated the time duration and temperature required to suppress or eliminate the 'Ca. L. asiaticus' bacterium in citrus, using various temperature treatments for time periods ranging from 2 days to 4 months. Results of quantitative polymerase chain reaction (qPCR) after treatment illustrate significant decreases in the 'Ca. L. asiaticus' bacterial titer, combined with healthy vigorous growth by all surviving trees. Repeated qPCR testing confirmed that previously infected, heat-treated plants showed no detectable levels of 'Ca. L. asiaticus', while untreated control plants remained highly infected. Continuous thermal exposure to 40 to 42°C for a minimum of 48 h was sufficient to significantly reduce titer or eliminate 'Ca. L. asiaticus' bacteria entirely in HLB-affected citrus seedlings. This method may be useful for the control of 'Ca. Liberibacter'-infected plants in nursery and greenhouse settings.

  3. Helicobacter pylori infection in women with Hashimoto thyroiditis: A case-control study.

    Science.gov (United States)

    Shmuely, Haim; Shimon, Ilan; Gitter, Limor Azulay

    2016-07-01

    An association between Helicobacter pylori (H pylori) infection as environmental risk factors for Hashimoto thyroiditis (HT) has been reported. We investigated this hypothesis in women in which HT is more common. Serum immunoglobulin G antibodies against H pylori (enzyme-linked immunosorbent assay), CagA protein (Western blot assay), circulating antibodies to thyroid antigens, mainly thyroperoxidase (TPOAbs) and thyroglobulin (TgAbs), were tested in 101 females with HT and 111 non-HT control women without a history of autoimmune disease. Thyroid function, socioeconomic status at childhood, and family history of thyroid malfunction were also studied. Forty-seven HT women (46.5%) tested seropositive for H pylori versus 48 controls (43.2%; P = 0.63). The prevalence of anti-CagA antibodies was 21.3% in HT-infected patients and 31.2% in infected controls (P = 0.352). Women with HT were older than the controls at a significance level of 0.03, and higher prevalence of hypothyroidism (69% vs 13.5%, respectively) and family history of thyroid malfunction (59% vs 34%, respectively) (P thyroid malfunction was independently associated with an increased risk of HT (odds ratio 3.39, 95% confidence interval 1.86-6.18, P thyroid malfunction is a risk factor for HT.

  4. Evaluation of mupirocin ointment in control of central venous catheter related infections: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Rezaei J

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Central venous catheter (CVC related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections."n"nMethods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups; in "case group" patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for "control group" mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors."n"nResults: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8% patients (16 in control versus 13 in case group had catheter colonization (p=NS. Catheter related bloodstream infection was observed in 16(9.3% patients (6 in

  5. New approaches to infection prevention and control: implementing a risk-based model regionally.

    Science.gov (United States)

    Wale, Martin; Kibsey, Pamela; Young, Lisa; Dobbyn, Beverly; Archer, Jana

    2016-06-01

    Infectious disease outbreaks result in substantial inconvenience to patients and disruption of clinical activity. Between 1 April 2008 and 31 March 2009, the Vancouver Island Health Authority (Island Health) declared 16 outbreaks of Vancomycin Resistant Enterococci and Clostridium difficile in acute care facilities. As a result, infection prevention and control became one of Island Health's highest priorities. Quality improvement methodology, which promotes a culture of co-production between front-line staff, physicians and Infection Control Practitioners, was used to develop and test a bundle of changes in practices. A series of rapid Plan-Do-Study-Act cycles, specific to decreasing hospital-acquired infections, were undertaken by a community hospital, selected for its size, clinical specialty representation, and enthusiasm amongst staff and physicians for innovation and change. Positive results were incorporated into practice at the test site, and then introduced throughout the rest of the Health Authority. The changes implemented as a result of this study have enabled better control of antibiotic resistant organisms and have minimized disruption to routine activity, as well as saving an estimated $6.5 million per annum. When outbreaks do occur, they are now controlled much more promptly, even in existing older facilities. Through this process, we have changed our approach in Infection Prevention and Control (IPAC) from a rules-based approach to one that is risk-based, focusing attention on identifying and managing high-risk situations. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  6. Modelling approach for biological control of insect pest by releasing infected pest

    International Nuclear Information System (INIS)

    Tan Yuanshun; Chen Lansun

    2009-01-01

    Models of biological control have a long history of theoretical development that have focused on the interactions between a predator and a prey. Here we have extended the classical epidemic model to include a continuous and impulsive pest control strategies by releasing the infected pests bred in laboratory. For the continuous model, the results imply that the susceptible pest goes to extinct if the threshold condition R 0 0 > 1, the positive equilibrium of continuous model is globally asymptotically stable. Similarly, the threshold condition which guarantees the global stability of the susceptible pest-eradication periodic solution is obtained for the model with impulsive control strategy. Consequently, based on the results obtained in this paper, the control strategies which maintain the pests below an acceptably low level are discussed by controlling the release rate and impulsive period. Finally, the biological implications of the results and the efficiency of two control strategies are also discussed

  7. Catheter Associated Urinary Tract Infection Prevention bundle

    Directory of Open Access Journals (Sweden)

    O. Zarkotou

    2017-01-01

    Full Text Available Catheter-associated urinary tract infections (CAUTI are among the most common healthcare-associated infections, and potentially lead to significant morbidity and mortality. Multifaceted infection control strategies implemented as bundles can prevent nosocomial infections associated with invasive devices such as CAUTIs. The components of the CAUTI bundle proposed herein, include appropriate indications for catheterization and recommendations for the procedures of catheter insertion and catheter maintenance and care. Avoiding unnecessary urinary catheter use is the most effective measure for their prevention. To minimize the risk of CAUTI, urinary catheters should be placed only when a clinical valid indication is documented and they should be removed as soon as possible; alternatives to catheterization should also be considered. Aseptic insertion technique, maintenance of closed drainage system and strict adherence to hand hygiene are essential for preventing CAUTI. The successful implementation of the bundle requires education and training for all healthcare professionals and evaluation of surveillance data.

  8. Control beliefs and health locus of control in Ugandan, German and migrated sub-Saharan African HIV infected individuals.

    Science.gov (United States)

    Milz, Ruth U; Husstedt, Ingo-W; Reichelt, Doris; Evers, Stefan

    2016-04-01

    Little is known about the influence of control beliefs on antiretroviral drug adherence in patients who migrated from sub-Saharan Africa to Europe. The aim of this study was to explore the differences in health locus of control and control beliefs between HIV infected patients from sub-Saharan Africa with and without a lifetime experience of migration. A sample of 62 HIV infected consecutive patients referred to the HIV clinics at the University Hospital of Münster (Germany) and at the Rubaga Hospital Kampala (Uganda) were enrolled into this study. We compared three groups of patients: sub-Saharan African migrants, German patients, and local Ugandan patients. We used the German health and illness related control beliefs questionnaire (KKG), the Competence and control beliefs questionnaire (FKK), and the Powe Fatalism Inventory-HIV/AIDS-Version (PFI-HIV/AIDS-Version) and translated these scales into English and Luganda. In addition, the patients' sociodemographic, acculturation, clinical, and immunological data were registered. Significant results were shown in HIV related external locus of control between migrated sub-Saharan African and local Ugandan patients compared to German patients. General control beliefs showed no significant differences. In the PFI-HIV-Version, there was a significant difference between migrated sub-Saharan African and Ugandan patients compared to German patients. Our data suggest that the experience of migration does not influence the locus of control. Compared to German HIV patients, African patients in general showed a significantly higher external health locus of control which might have implications for drug adherence. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. ESOPHAGEAL REFLUX DISEASE, PEPTIC ULCER AND HELICOBACTER PYLORI INFECTION – A PROSPECTIVE, CONTROLLED STUDY

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2003-02-01

    Full Text Available Background. A possible association of esophageal reflux disease with peptic ulcer, Helicobacter pylori infection or the results of eradication, has not been elucidated. It is an alarming fact that in developed countries the incidence of esophageal adenocarcinoma, which is associated with reflux disease, is increasing.Aim. The aim of the study was to establish the prevalence of esophageal reflux disease after eradication of H. pylori infection in patients with hemorrhaging and nonhemorrhaging peptic ulcer of stomach or duodenum.Patients and methods. Study was approved in 1998 by the Slovenian Medical Ethics Committee (No. 90/09/98. Prospective, controlled and randomized, carried out between 1998– 2000.The study included 80 patients (50 male and 30 female, av. age 57.5 years, SD ± 17.1, range 22–80 years in which endoscopy confirmed hemorrhage from peptic ulcer of stomach or duodenum and HP infection. The control group was made up of 80 patients (50 male and 30 female, av. age 56.8 years, SD ± 16.8, range 19–80 years with peptic ulcer of stomach or duodenum and H.pylori infection in the same period of time. In all cases the recommended drug combinations were used in the treatment of the infection: a proton pump inhibitor, omeprazol (4 weeks, and combination of antibiotics, claritromycin and metronidazole or with regard to the antibiogram (1 week. The therapeutic success was ascertained endoscopically four weeks after inclusion in the study. Infection eradication was confirmed by the rapid urease test and histologic investigation of the gastric mucosa. One year later, in the course of follow-up, in patients with endoscopic investigations, 24-hour pH-metry or fiberoptic spectrophotometric bilirubin determination, bilimetry, we tried to establish signs of esophageal reflux disease.Results. Four weeks after inclusion in the study the success of infection eradication was 92.5% in the study group while in the control group reached 91.25%, p > 0

  10. Does Extracellular DNA Production Vary in Staphylococcal Biofilms Isolated From Infected Implants versus Controls?

    Science.gov (United States)

    Zatorska, Beata; Groger, Marion; Moser, Doris; Diab-Elschahawi, Magda; Lusignani, Luigi Segagni; Presterl, Elisabeth

    2017-08-01

    Prosthetic implant infections caused by Staphylococcus aureus and epidermidis are major challenges for early diagnosis and treatment owing to biofilm formation on the implant surface. Extracellular DNA (eDNA) is actively excreted from bacterial cells in biofilms, contributing to biofilm stability, and may offer promise in the detection or treatment of such infections. (1) Does DNA structure change during biofilm formation? (2) Are there time-dependent differences in eDNA production during biofilm formation? (3) Is there differential eDNA production between clinical and control Staphylococcal isolates? (4) Is eDNA production correlated to biofilm thickness? We investigated eDNA presence during biofilm formation in 60 clinical and 30 control isolates of S aureus and S epidermidis. The clinical isolates were isolated from patients with infections of orthopaedic prostheses and implants: 30 from infected hip prostheses and 30 from infected knee prostheses. The control isolates were taken from healthy volunteers who had not been exposed to antibiotics and a hospital environment during the previous 3 and 12 months, respectively. Control S epidermidis was isolated from the skin of the antecubital fossa, and control S aureus was isolated from the nares. For the biofilm experiments the following methods were used to detect eDNA: (1) fluorescent staining with 4',6-diamidino-2-phenylindole (DAPI), (2) eDNA extraction using a commercial kit, and (3) confocal laser scanning microscopy for 24-hour biofilm observation using propidium iodide and concanavalin-A staining; TOTO ® -1 and SYTO ® 60 staining were used for observation and quantification of eDNA after 6 and 24 hours of biofilm formation. Additionally antibiotic resistance was described. eDNA production as observed by confocal laser scanning microscopy was greater in clinical isolates than controls (clinical isolates mean ± SD: 1.84% ± 1.31%; control mean ± SD: 1.17% ± 1.37%; p biofilm formation. After 24 hours, the

  11. Faecal Escherichia coli from patients with E. coli urinary tract infection and healthy controls who have never had a urinary tract infection

    DEFF Research Database (Denmark)

    Nielsen, Karen L; Dynesen, Pia; Larsen, Preben

    2014-01-01

    Urinary tract infections (UTIs) are primarily caused by Escherichia coli with the patient's own faecal flora acting as a reservoir for the infecting E. coli. Here we sought to characterize the E. coli faecal flora of UTI patients and healthy controls who had never had a UTI. Up to 20 E. coli...... colonies from each rectal swab were random amplified polymorphic DNA (RAPD) typed for clonality, dominance in the sample and correlation to the infecting UTI isolate in patients. Each distinct clone was phylotyped and tested for antimicrobial susceptibility. Eighty-seven per cent of the UTI patients...... carried the infecting strain in their faecal flora, and faecal clones causing UTI were more often dominant in the faecal flora. Patients had a larger diversity of E. coli in their gut flora by carrying more unique E. coli clones compared to controls, and patient faecal clones were more often associated...

  12. Follow up of natural infection with Trypanosoma cruzi in two mammals species, Nasua narica and Procyon lotor (Carnivora: Procyonidae): evidence of infection control?

    Science.gov (United States)

    Martínez-Hernández, Fernando; Rendon-Franco, Emilio; Gama-Campillo, Lilia María; Villanueva-García, Claudia; Romero-Valdovinos, Mirza; Maravilla, Pablo; Alejandre-Aguilar, Ricardo; Rivas, Nancy; Córdoba-Aguilar, Alex; Muñoz-García, Claudia Irais; Villalobos, Guiehdani

    2014-08-29

    A large variety of mammals act as natural reservoirs of Trypanosoma cruzi (the causal agent of Chagas disease) across the American continent. Related issues are infection and parasite burden in these reservoirs, and whether they are able to control T. cruzi infections. These parameters can indicate the real role of mammals as T. cruzi reservoirs and transmitters. Here, two species of mammals, white-nosed coati (Nasua narica) and raccoon (Procyon lotor), were examined for to determine: a) T. cruzi presence, and; b) their ability to control T. cruzi infection. Multiple capture-recaptures of both species were carried out in semi-wild conditions in Villahermosa, Tabasco, Mexico, for 5 years. Two samplings per year (summer and winter) took place. Prevalence and pattern of T. cruzi infection were determined by PCR from both mammals' blood samples. Raccoon samples had a higher relative infection values (26.6%) compared to those of white-nosed coati (9.05%), being this difference significant in summer 2012 (P mammals are able to tolerate the infection). However, while infected, they may also be able to approach human dwellings and play a role important in linking sylvatic and domestic cycles.

  13. Particularly acute intestinal infections in children with atopic dermatitis. Case-control study

    Directory of Open Access Journals (Sweden)

    S. V. Khaliullina

    2016-01-01

    Full Text Available Aim — determine the clinical and laboratory features of acute intestinal infection in children, occurring in conjunction with atopic dermatitis (AD.Material and methods. We conducted a study of «case-control», which included observation of 144 children hospitalized in the infectious hospital with a clinic of acute infectious diarrhea in the period from January to December 2012. In the study group were selected 72 children with atopic dermatitis clinic and acute infectious diarrhea in a couple of which, from the group of patients without burdened premorbid background were selected 72 «controls» matched by sex, age and etiology developed acute intestinal infection. The observation time was 5±2 days, which corresponds to the average length of stay of the child, patients with moderate forms of acute intestinal infection in the hospital.Results and discussion. About 2 times more often than in the control, acute intestinal infections in children with atopic dermatitis lesions were characterized by clinic middle and lower gastrointestinal — 31.9% (CI 21,1–42,7 vs. 15.3% (CI 7–23 6, p=0.03. A number of bowel movements 6 or more times per day significantly more frequently observed in children with a combination of acute intestinal infections and atopic dermatitis — 54.1% (CI 42,6–65,6 vs. 33.3% (CI 22,4–43.9 in the control, p=0.011. The duration of diarrhea was higher in the study group (Med 6 IQR 4–7 days and Med 5 IQR 3–6 days, respectively, p=0.046. The proportion of patients with high fever was also higher in the study group than in the controls –15.3% (CI 7–23,6 vs. 2,8% (CI 1–6,6, p=0.016.Conclusion. Acute intestinal infections in children with atopic dermatitis have a more pronounced clinical symptoms, which is characterized by clinic enterocolitis, severity and duration of diarrhea syndrome, usually accompanied by a high fever. 

  14. Impact of an International Nosocomial Infection Control Consortium multidimensional approach on catheter-associated urinary tract infections in adult intensive care units in the Philippines: International Nosocomial Infection Control Consortium (INICC) findings.

    Science.gov (United States)

    Navoa-Ng, Josephine Anne; Berba, Regina; Rosenthal, Victor D; Villanueva, Victoria D; Tolentino, María Corazon V; Genuino, Glenn Angelo S; Consunji, Rafael J; Mantaring, Jacinto Blas V

    2013-10-01

    To assess the impact of a multidimensional infection control approach on the reduction of catheter-associated urinary tract infection (CAUTI) rates in adult intensive care units (AICUs) in two hospitals in the Philippines that are members of the International Nosocomial Infection Control Consortium. This was a before-after prospective active surveillance study to determine the rates of CAUTI in 3183 patients hospitalized in 4 ICUS over 14,426 bed-days. The study was divided into baseline and intervention periods. During baseline, surveillance was performed using the definitions of the US Centers for Disease Control and Prevention and the National Healthcare Safety Network (CDC/NHSN). During intervention, we implemented a multidimensional approach that included: (1) a bundle of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI rates, (5) process surveillance and (6) performance feedback. We used random effects Poisson regression to account for the clustering of CAUTI rates across time. We recorded 8720 urinary catheter (UC)-days: 819 at baseline and 7901 during intervention. The rate of CAUTI was 11.0 per 1000 UC-days at baseline and was decreased by 76% to 2.66 per 1000 UC-days during intervention [rate ratio [RR], 0.24; 95% confidence interval [CI], 0.11-0.53; P-value, 0.0001]. Our multidimensional approach was associated with a significant reduction in the CAUTI rates in the ICU setting of a limited-resource country. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  15. Impact of a multidimensional infection control approach on catheter-associated urinary tract infection rates in an adult intensive care unit in Lebanon: International Nosocomial Infection Control Consortium (INICC) findings.

    Science.gov (United States)

    Kanj, Souha S; Zahreddine, Nada; Rosenthal, Victor Daniel; Alamuddin, Lamia; Kanafani, Zeina; Molaeb, Bassel

    2013-09-01

    The objective of this study was to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) in an adult intensive care unit (ICU) of a hospital member of the International Nosocomial Infection Control Consortium (INICC) in Lebanon. A before-after prospective active surveillance study was carried out to determine rates of CAUTI in 1506 ICU patients, hospitalized during 10 291 bed-days. The study period was divided into two phases: phase 1 (baseline) and phase 2 (intervention). During phase 1, surveillance was performed applying the definitions of the US Centers for Disease Control and Prevention National Healthcare Safety Network (CDC/NHSN). In phase 2, we adopted a multidimensional approach that included: (1) a bundle of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI rates, (5) process surveillance, and (6) performance feedback. We used random effects Poisson regression to account for clustering of CAUTI rates across time-periods. We recorded a total of 9829 urinary catheter-days: 306 in phase 1 and 9523 in phase 2. The rate of CAUTI was 13.07 per 1000 urinary catheter-days in phase 1, and was decreased by 83% in phase 2 to 2.21 per 1000 urinary catheter-days (risk ratio 0.17; 95% confidence interval 0.06-0.5; p=0.0002). Our multidimensional approach was associated with a significant reduction in the CAUTI rate. Copyright © 2013. Published by Elsevier Ltd.

  16. Infection control and quality assurance of health services provided in ICU: development of an ICU website.

    Science.gov (United States)

    Diomidous, Marianna; Ponirou, Paraskevi; Mpizopoulou, Zoi; Tzalera, Vaia; Mechili, Aggelos

    2013-01-01

    The aim of this study is to examine the infections control methods in ICU as well as the issue of quality in health services provided, as they constitute an important quality assurance indicator. Moreover, nowadays the causes of Nosocomial infections are known and so do the measures for their control. There is a need however for an information resource that will promote specialized and general guidelines. The measures include the appropriate use of gloves, cleaning and disinfection of the ICU environment and hand washing which is the most important of all. Therefore an effort was made to develop an easy to navigate webpage with practical and comprehensible clinical guidelines. Additionally, it gives to all visitors the opportunity for further information research with the use of the included links. For the development of the web side existing clinical guide lines were scrutinizes as well as studies that concern the effectiveness of the measures mentioned and for the identification of quality assurance criteria.

  17. Waterborne microorganisms and biofilms related to hospital infections: strategies for prevention and control in healthcare facilities.

    Science.gov (United States)

    Capelletti, Raquel Vannucci; Moraes, Ângela Maria

    2016-02-01

    Water is the main stimulus for the development of microorganisms, and its flow has an important role in the spreading of contaminants. In hospitals, the water distribution system requires special attention since it can be a source of pathogens, including those in the form of biofilms often correlated with resistance of microorganisms to various treatments. In this paper, information relevant to cases of nosocomial infections involving water circuits as a source of contaminants is compiled, with emphasis on the importance of microbiological control strategies to prevent the installation, spreading and growth of microorganisms in hospitals. An overview of the worldwide situation is provided, with emphasis on Brazilian hospitals. Different approaches normally used to control the occurrence of nosocomial infections due to waterborne contaminants are analyzed, and the use of the polysaccharide chitosan for this specific application is briefly discussed.

  18. Strict deformation quantization for actions of a class of symplectic lie groups

    International Nuclear Information System (INIS)

    Bieliavsky, Pierre; Massar, Marc

    2002-01-01

    We present explicit universal strict deformation quantization formulae for actions of Iwasawa subgroups AN of SN(1, n). This answers a question raised by Rieffel in [Contemp. Math. 228 (1998), 315]. (author)

  19. Epidemiological Study and Control Trial of Taeniid Cestode Infection in Farm Dogs in Qinghai Province, China

    OpenAIRE

    GUO, Zhihong; LI, Wei; PENG, Mao; DUO, Hong; SHEN, Xiuying; FU, Yong; IRIE, Takao; GAN, Tiantian; KIRINO, Yumi; NASU, Tetsuo; HORII, Yoichiro; NONAKA, Nariaki

    2013-01-01

    ABSTRACT An epidemiological study and control trial were conducted to assess taeniid infection in farm dogs in Qinghai Province, China. To improve egg detection by fecal examination, a deworming step with praziquantel was incorporated into the sampling methodology. As a result, a marked increase in the number of egg-positive samples was observed in samples collected at 24 hr after deworming. Then, the fecal examination and barcoding of egg DNA were performed to assess the prevalence of taenii...

  20. Entamoeba histolytica Infection in Female Sex Workers: A Matched Case-Control Study in Durango, Mexico.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sanchez-Anguiano, Luis Francisco; Hernandez-Tinoco, Jesus; Estrada-Martinez, Sergio; Perez-Alamos, Alma Rosa; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

    2017-07-01

    Infection with Entamoeba histolytica ( E. histolytica ) can be potentially transmitted by sexual contact. The seroepidemiology of E. histolytica in female sex workers has not been studied. The aim of the study was to determine whether E. histolytica is associated with the occupation of female sex work. In addition, the correlates of E. histolytica seroprevalence in female sex workers were also investigated. We performed an age- and gender-matched case-control study of 187 female sex workers and 374 women without sex work. Cases and controls were tested for the presence of E. histolytica IgG antibodies using a commercially available enzyme-linked immunoassay. Seroprevalence association with the characteristics of female sex workers was determined by bivariate analysis. Anti- E. histolytica IgG antibodies were found in five (2.7%) of 187 female sex workers and in 16 (4.3%) of 374 controls (odds ratios (OR) = 0.61; 95% confidence intervals (CI): 0.22 - 1.70; P = 0.34). Mean optical density of the immunoassay in seropositive cases and controls was 1.35 ± 0.93 and 0.73 ± 0.45, respectively (P = 0.05). Seroprevalence of E. histolytica infection did not vary significantly with age, education, socioeconomic level, or health status of sex workers. Seropositivity to E. histolytica did not correlate with work characteristics such as duration in the occupation, condom use, type of sex, or a history of sexually transmitted diseases, or with behavioral variables such as washing hands before eating, or consumption of untreated water. Results indicate that female sex workers do not have an increased risk for E. histolytica infection in Durango City, Mexico. Further studies to determine the risk of infection with E. histolytica by sexual contact should be conducted.

  1. Placental vascular complications in HIV-infected pregnant women: a case-control study

    OpenAIRE

    CANLORBE, Geoffroy

    2012-01-01

    Background: Data from international literature suggest a link between HIV infection and placental vascular complications during pregnancy. Current studies on the subject are conflicting.Objective: The aim of the study was to evaluate the incidence of placental vascular complications during pregnancy among HIV+ and HIV- patients.Study Design: It is a single-center case-control study comparing the rates of gestational hypertension, preeclampsia, eclampsia and vascular intrauterine growth retard...

  2. Do strict rules and moving images increase the reliability of sequential identification procedures?.

    OpenAIRE

    Valentine, Tim; Darling, Stephen; Memon, Amina

    2007-01-01

    Live identification procedures in England and Wales have been replaced by use of video, which provides a sequential presentation of facial images. Sequential presentation of photographs provides some protection to innocent suspects from mistaken identification when used with strict instructions designed to prevent relative judgements (Lindsay, Lea & Fulford, 1991). However, the current procedure in England and Wales is incompatible with these strict instructions. The reported research investi...

  3. Strict optical orthogonal codes for purely asynchronous code-division multiple-access applications

    Science.gov (United States)

    Zhang, Jian-Guo

    1996-12-01

    Strict optical orthogonal codes are presented for purely asynchronous optical code-division multiple-access (CDMA) applications. The proposed code can strictly guarantee the peaks of its cross-correlation functions and the sidelobes of any of its autocorrelation functions to have a value of 1 in purely asynchronous data communications. The basic theory of the proposed codes is given. An experiment on optical CDMA systems is also demonstrated to verify the characteristics of the proposed code.

  4. Factors Leading to the Loss of Natural Elite Control of HIV-1 Infection.

    Science.gov (United States)

    Pernas, María; Tarancón-Diez, Laura; Rodríguez-Gallego, Esther; Gómez, Josep; Prado, Julia G; Casado, Concepción; Dominguez-Molina, Beatriz; Olivares, Isabel; Coiras, Maite; León, Agathe; Rodriguez, Carmen; Benito, Jose Miguel; Rallón, Norma; Plana, Montserrat; Martinez-Madrid, Onofre; Dapena, Marta; Iribarren, Jose Antonio; Del Romero, Jorge; García, Felipe; Alcamí, José; Muñoz-Fernández, M Ángeles; Vidal, Francisco; Leal, Manuel; Lopez-Galindez, Cecilio; Ruiz-Mateos, Ezequiel

    2017-12-06

    HIV-1 elite controllers (EC) maintain undetectable viral load (VL) in the absence of antiretroviral treatment. However, these subjects have heterogeneous clinical outcomes including a proportion loosing HIV-1 control over time. In this work we compared, in a longitudinal design, transient EC, analyzed before and after the loss of virological control, versus persistent EC. The aim was to identify factors leading to the loss of natural virological control of HIV-1-infection with a longitudinal retrospective study design. Gag-specific T-cell response was assessed by in vitro intracellular poly-cytokine production quantified by flow cytometry. Viral diversity and sequence-dating were performed in proviral DNA by PCR amplification at limiting dilution in env and gag genes. The expression profile of 70 serum cytokines and chemokines was assessed by multiplex immunoassays. We identified transient EC as subjects with low Gag-specific T-cell polyfunctionality, high viral diversity and high proinflammatory cytokines levels before the loss of control. Gag-specific T-cell polyfunctionality was inversely associated with viral diversity in transient controllers before the loss of control (r=-0.8; p =0.02). RANTES was a potential biomarker of transient control. This study identified, virological and immunological factors including inflammatory biomarkers associated with two different phenotypes within EC. These results may allow a more accurate definition of EC, which could help in a better clinical management of these individuals and in the development of future curative approaches. IMPORTANCE There is a rare group of HIV-infected patients who have the extraordinary capacity to maintain undetectable viral load levels in the absence of antiretroviral treatment, the so called HIV-1 elite controllers (EC). However, there is a proportion within these subjects that eventually loses this capability. In this work we found differences in virological and immune factors including soluble

  5. Host control of malaria infections: constraints on immune and erythropoeitic response kinetics.

    Directory of Open Access Journals (Sweden)

    Philip G McQueen

    2008-08-01

    Full Text Available The two main agents of human malaria, Plasmodium vivax and Plasmodium falciparum, can induce severe anemia and provoke strong, complex immune reactions. Which dynamical behaviors of host immune and erythropoietic responses would foster control of infection, and which would lead to runaway parasitemia and/or severe anemia? To answer these questions, we developed differential equation models of interacting parasite and red blood cell (RBC populations modulated by host immune and erythropoietic responses. The model immune responses incorporate both a rapidly responding innate component and a slower-responding, long-term antibody component, with several parasite developmental stages considered as targets for each type of immune response. We found that simulated infections with the highest parasitemia tended to be those with ineffective innate immunity even if antibodies were present. We also compared infections with dyserythropoiesis (reduced RBC production during infection to those with compensatory erythropoiesis (boosted RBC production or a fixed basal RBC production rate. Dyserythropoiesis tended to reduce parasitemia slightly but at a cost to the host of aggravating anemia. On the other hand, compensatory erythropoiesis tended to reduce the severity of anemia but with enhanced parasitemia if the innate response was ineffective. For both parasite species, sharp transitions between the schizont and the merozoite stages of development (i.e., with standard deviation in intra-RBC development time control parasitemia. Finally, our simulations suggest that P. vivax can induce severe anemia as readily as P. falciparum for the same type of immune response, though P. vivax attacks a much smaller subset of RBCs. Since most P. vivax infections are nonlethal (if debilitating clinically, this suggests that P

  6. Toxoplasma gondii infection in interstate truck drivers: a case-control seroprevalence study.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Pacheco-Vega, Sandy Janet; Hernández-Tinoco, Jesús; Salcedo-Jáquez, Misael; Sánchez-Anguiano, Luis Francisco; Berumen-Segovia, Luis Omar; Rábago-Sánchez, Elizabeth; Liesenfeld, Oliver

    2015-02-05

    Infection with Toxoplasma gondii can be acquired via the ingestion of undercooked or raw meat containing tissue cysts, or via ingestion of water contaminated with oocysts. Professional long distance truck driving may have epidemiological importance for food-borne infections since drivers eat out of home and in places where hygiene and cooking practices are uncertain. We aimed to determine whether interstate truck drivers in Durango, Mexico have an increased risk of infection with T. gondii as indicated by seropositivity; and to determine the socio-demographic, work, clinical, and behavioral characteristics associated with T. gondii seropositivity in interstate truck drivers. Through a case-control study design, 192 truck drivers and 192 controls from the general population of the same region matched by gender and age were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from the truck drivers were obtained. Anti-T. gondii IgG antibodies were found in 23 (12.0%) of 192 truck drivers and in 13 (6.8%) of 192 controls (OR = 21.0; 95% CI: 1.23-358.38; P = 0.002). Anti-T. gondii IgM antibodies were found in 7 (3.6%) cases and in 7 (3.6%) controls (P = 1.00). The seroprevalence of T. gondii infection was higher in drivers with reflex impairment than in those without this impairment (4/13, 30.8% vs 19/179, 10.6%, respectively; P = 0.05), and in drivers with hearing impairment than in those without this impairment (3/7, 42.9% vs 20/185, 10.8%, respectively; P = 0.03). Multivariate analysis of work and behavioral characteristics of truck drives showed positive associations of T. gondii exposure with trips to the south of Mexico (OR = 3.11; 95% CI: 1.02-9.44; P = 0.04) and consumption of horse meat (OR = 5.18; 95% CI: 1.62-16.55; P = 0.005). Results suggest that interstate truck drivers may have an increased risk for T

  7. JC polyomavirus infection is strongly controlled by human leucocyte antigen class II variants.

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    Emilie Sundqvist

    2014-04-01

    Full Text Available JC polyomavirus (JCV carriers with a compromised immune system, such as in HIV, or subjects on immune-modulating therapies, such as anti VLA-4 therapy may develop progressive multifocal leukoencephalopathy (PML which is a lytic infection of oligodendrocytes in the brain. Serum antibodies to JCV mark infection occur only in 50-60% of infected individuals, and high JCV-antibody titers seem to increase the risk of developing PML. We here investigated the role of human leukocyte antigen (HLA, instrumental in immune defense in JCV antibody response. Anti-JCV antibody status, as a surrogate for JCV infection, were compared to HLA class I and II alleles in 1621 Scandinavian persons with MS and 1064 population-based Swedish controls and associations were replicated in 718 German persons with MS. HLA-alleles were determined by SNP imputation, sequence specific (SSP kits and a reverse PCR sequence-specific oligonucleotide (PCR-SSO method. An initial GWAS screen displayed a strong HLA class II region signal. The HLA-DRB1*15 haplotype was strongly negatively associated to JCV sero-status in Scandinavian MS cases (OR = 0.42, p = 7×10(-15 and controls (OR = 0.53, p = 2×10(-5. In contrast, the DQB1*06:03 haplotype was positively associated with JCV sero-status, in Scandinavian MS cases (OR = 1.63, p = 0.006, and controls (OR = 2.69, p = 1×10(-5. The German dataset confirmed these findings (OR = 0.54, p = 1×10(-4 and OR = 1.58, p = 0.03 respectively for these haplotypes. HLA class II restricted immune responses, and hence CD4+ T cell immunity is pivotal for JCV infection control. Alleles within the HLA-DR1*15 haplotype are associated with a protective effect on JCV infection. Alleles within the DQB1*06:03 haplotype show an opposite association. These associations between JC virus antibody response and human leucocyte antigens supports the notion that CD4+ T cells are crucial in the immune defence to JCV and

  8. Why sensitive bacteria are resistant to hospital infection control [version 2; referees: 2 approved

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    Esther van Kleef

    2017-11-01

    Full Text Available Background: Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. Methods: We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio (IRR associated with the intervention was calculated for hospital- and community-acquired infections of both strains. Results: For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6 and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤  0.9. These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9, while communityacquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2. The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Conclusions: Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally, following differences in their adaptation to hospital and

  9. From expert data collectors to interventionists: changing the focus for infection control professionals.

    Science.gov (United States)

    Murphy, Denise M

    2002-04-01

    The current economic and political environments challenge health care organizations in the United States to provide affordable, accessible, and comprehensive health services. However, changes in reimbursement to health care providers can affect their ability to offer access to cutting-edge services while reducing costs. Consequently, organizations are restructuring, re-engineering, right-sizing, downsizing, and redesigning, all in an effort to save money while also hoping to maintain a reputation for quality and customer service. Dr Vicky Fraser, in her keynote address at the APIC conference in 2000, reminded us that ICHE programs are cost centers rather than revenue generators, and are often targets for budget cuts. Although Haley's Study on the Efficacy of Nosocomial Infection Control (SENIC), published in 1985, was a landmark event demonstrating the importance of our profession's mission, it is becoming dated. Infection control professionals (ICPs) must continue Haley's work, finding innovative ways to market or demonstrate the value of ICHE programs to health care executives. Closing the 1999 APIC conference with a symposium entitled "Breaking Out of the Box," Jackson and Massanari challenged ICPs to educate themselves about the changing health care environment, to be proactive, and constructively help organizations "re-engineer" more efficiently, rather than feel victimized and helplessly await being re-engineered out of existence. The threat of downsizing prompted ICPs at BJC HealthCare to realize that the time had come to change their own culture and attitudes and to focus on the business of infection control. This change required challenging the traditional roles of solo practitioner, data collector, and keeper of infection control data and knowledge. The goals now include leading intervention teams committed to reducing health care-associated infections, partnering rather than accepting sole responsibility for lowering infection rates, and learning to

  10. A case-control study of risk factors associated with scrub typhus infection in Beijing, China.

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    Yanning Lyu

    Full Text Available To investigate the risk factors of scrub typhus infection in Beijing, China, a case-control study was carried out. Cases (n = 56 were defined as persons who were diagnosed by PCR and serological method within three years. Three neighborhood control subjects were selected by matching for age and occupation. Living at the edge of the village, living in the houses near grassland, vegetable field or ditch, house yard without cement floor, piling weeds in the house or yard, all of these were risk factors for scrub typhus infection. Working in vegetable fields and hilly areas, and harvesting in autumn posed the highest risks, with odds ratios (ORs and 95% confidence intervals (CIs of 3.7 (1.1-11.9, 8.2 (1.4-49.5, and 17.2 (5.1-57.9, respectively. These results would be useful for the establishment of a detail control strategy for scrub typhus infection in Beijing, China.

  11. [Role of medium-sized independent laboratories in control of healthcare-associated infection].

    Science.gov (United States)

    Anzai, Eiko; Fukui, Toru

    2009-05-01

    In 2006, the Ministry of Health and Welfare revised the regulations regarding the Medical Service Law. The amendments stipulate that all healthcare institutions are required to implement infection control programs. However, small hospitals and clinics have no clinical microbiology laboratories, whereas medium-sized hospitals have few medical technologists and the outsourcing of microbiology tests to independent laboratories is common. The decreasing number of laboratories and recent outsourcing tendency reflect the increasing commercialization, and, with it, the escalating number of commercially operating chains. Each independent laboratory is responsible for supporting activities related to the surveillance, control, and prevention of healthcare-associated infections in the associated small and medium-sized hospitals. The people responsible for infection control in these hospitals usually do not have a background in microbiology. The evaluation of communication between independent laboratory staff and hospital personnel, and rapid turnaround time of microbiology laboratory test reports are important elements ensuring the quality of independent laboratory work. With the pressures of financial constraints in the Japanese medical insurance system, the development of a cost-effective and practical protocol for quality assurance is a real dilemma.

  12. Helicobacter pylori infection amongst Arab Israeli women with hyperemesis gravidarum--a prospective, controlled study.

    Science.gov (United States)

    Boltin, Doron; Perets, Tsachi Tsadok; Elheiga, Sami Abu; Sharony, Asher; Niv, Yaron; Shamaly, Hussein; Dickman, Ram

    2014-12-01

    Helicobacter pylori has been associated with hyperemesis gravidarum in some geographical regions. The prevalence of H. pylori in Arab Israeli women in the Upper Galilee and its association with hyperemesis gravidarum has not been studied previously. We aimed to examine if hyperemesis gravidarum is associated with H. pylori in this population. Subjects with hyperemesis gravidarum carrying a singleton fetus were recruited prospectively. Women with an uncomplicated pregnancy served as controls. All patients underwent (13)C-urea breath testing to assess for H. pylori infection. A total of 72 subjects, including 24 patients with hyperemesis gravidarum and 48 controls, aged 28.8±5.3 years, were included. H. pylori infection was identified in 75.0% (18/24) of cases and 60.4% (29/48) of controls (p=not significant). H. pylori infection did not correlate with age, fetal sex, or the number of previous pregnancies (p=not significant). H. pylori does not seem to increase the likelihood of hyperemesis gravidarum in Arab Israeli women. However, given the high background prevalence of H. pylori in this population, a larger study is required to corroborate these findings. (MOH20110066). Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Integrated control programmes for schistosomiasis and other helminth infections in P.R. China.

    Science.gov (United States)

    Xu, Jing; Xu, Jun-Fang; Li, Shi-Zhu; Zhang, Li-Juan; Wang, Qiang; Zhu, Hui-Hui; Zhou, Xiao-Nong

    2015-01-01

    The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. 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.

  15. Fermentation of animal components in strict carnivores: a comparative study with cheetah fecal inoculum.

    Science.gov (United States)

    Depauw, S; Bosch, G; Hesta, M; Whitehouse-Tedd, K; Hendriks, W H; Kaandorp, J; Janssens, G P J

    2012-08-01

    The natural diet of felids contains highly digestible animal tissues but also fractions resistant to small intestinal digestion, which enter the large intestine where they may be fermented by the resident microbial population. Little information exists on the microbial degradability of animal tissues in the large intestine of felids consuming a natural diet. This study aimed to rank animal substrates in their microbial degradability by means of an in vitro study using captive cheetahs fed a strict carnivorous diet as fecal donors. Fresh cheetah fecal samples were collected, pooled, and incubated with various raw animal substrates (chicken cartilage, collagen, glucosamine-chondroitin, glucosamine, rabbit bone, rabbit hair, and rabbit skin; 4 replicates per substrate) for cumulative gas production measurement in a batch culture technique. Negative (cellulose) and positive (casein and fructo-oligosaccharides; FOS) controls were incorporated in the study. Additionally, after 72 h of incubation, short-chain fatty acids (SCFA), including branched-chain fatty acids (BCFA), and ammonia concentrations were determined for each substrate. Glucosamine and glucosamine-chondroitin yielded the greatest organic matter cumulative gas volume (OMCV) among animal substrates (P carnivore, and indicates that animal tissues have potentially similar functions as soluble or insoluble plant fibers in vitro. Further research is warranted to assess the impact of fermentation of each type of animal tissue on gastro-intestinal function and health in the cheetah and other felid species.

  16. Mission impossible or border security – Practical and effective infection control on air ambulances

    Directory of Open Access Journals (Sweden)

    M. Kuhn*

    2013-12-01

    These principles have been applied to our air ambulance system based from Lanseria International Airport. By combining preventative and control measures, there has been no breach in our infection control strategies, as evidenced by no growth noted on specific and random swabs even when more and more ”super bugs” are being identified in hospital. As an air ambulance service flying patients from various African countries, we have the responsibility to conduct our own ”Border Security” to keep our hospitals, patients, aircraft and crews clean and safe. In this presentation we will share our ”Border Security” principles and experiences with the audience.

  17. Perceptions of healthcare professionals regarding the main challenges and barriers to effective hospital infection control in Mongolia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ider Bat-Erdene

    2012-07-01

    Full Text Available Abstract Background It is not fully understood why healthcare decision-makers of developing countries often give low priority to infection control and why they are unable to implement international guidelines. This study aimed to identify the main perceived challenges and barriers that hinder the effective implementation of infection control programmes in Mongolia. Methods In 2008, qualitative research involving 4 group and 55 individual interviews was conducted in the capital city of Mongolia and two provincial centres. Results A total of 87 health professionals participated in the study, including policy and hospital-level managers, doctors, nurses and infection control practitioners. Thematic analysis revealed a large number of perceived challenges and barriers to the formulation and implementation of infection control policy. These challenges and barriers were complex in nature and related to poor funding, suboptimal knowledge and attitudes, and inadequate management. The study results suggest that the availability of infection control policy and guidelines, and the provision of specific recommendations for low-resource settings, do not assure effective implementation of infection control programmes. Conclusions The current infection control system in Mongolia is likely to remain ineffective unless the underlying barriers and challenges are adequately addressed. Multifaceted interventions with logistical, educational and management components that are specific to local circumstances need to be designed and implemented in Mongolia. The importance of international peer support is highlighted.

  18. The value of intermittent point-prevalence surveys of healthcare-associated infections for evaluating infection control interventions at Angkor Hospital for Children, Siem Reap, Cambodia.

    Science.gov (United States)

    Stoesser, N; Emary, K; Soklin, S; Peng An, K; Sophal, S; Chhomrath, S; Day, N P J; Limmathurotsakul, D; Nget, P; Pangnarith, Y; Sona, S; Kumar, V; Moore, C E; Chanpheaktra, N; Parry, C M

    2013-04-01

    There are limited data on the epidemiology of paediatric healthcare-associated infection (HCAI) and infection control in low-income countries. We describe the value of intermittent point-prevalence surveys for monitoring HCAI and evaluating infection control interventions in a Cambodian paediatric hospital. Hospital-wide, point-prevalence surveys were performed monthly in 2011. Infection control interventions introduced during this period included a hand hygiene programme and a ventilator-associated pneumonia (VAP) care bundle. Overall HCAI prevalence was 13.8/100 patients at-risk, with a significant decline over time. The highest HCAI rates (50%) were observed in critical care; the majority of HCAIs were respiratory (61%). Klebsiella pneumoniae was most commonly isolated and antimicrobial resistance was widespread. Hand hygiene compliance doubled to 51.6%, and total VAP cases/1000 patient-ventilator days fell from 30 to 10. Rates of HCAI were substantial in our institution, and antimicrobial resistance a major concern. Point-prevalence surveys are effective for HCAI surveillance, and in monitoring trends in response to infection control interventions.

  19. The role of 'no-touch' automated room disinfection systems in infection prevention and control.

    Science.gov (United States)

    Otter, J A; Yezli, S; Perl, T M; Barbut, F; French, G L

    2013-01-01

    Surface contamination in hospitals is involved in the transmission of pathogens in a proportion of healthcare-associated infections. Admission to a room previously occupied by a patient colonized or infected with certain nosocomial pathogens increases the risk of acquisition by subsequent occupants; thus, there is a need to improve terminal disinfection of these patient rooms. Conventional disinfection methods may be limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. These problems can be reduced by the use of 'no-touch' automated room disinfection (NTD) systems. To summarize published data related to NTD systems. Pubmed searches for relevant articles. A number of NTD systems have emerged, which remove or reduce reliance on the operator to ensure distribution, contact time and process repeatability, and aim to improve the level of disinfection and thus mitigate the increased risk from the prior room occupant. Available NTD systems include hydrogen peroxide (H(2)O(2)) vapour systems, aerosolized hydrogen peroxide (aHP) and ultraviolet radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. Typically, there is a trade-off between time and effectiveness among NTD systems. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints. NTD systems are gaining acceptance as a useful tool for infection prevention and control. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Complement-related proteins control the flavivirus infection of Aedes aegypti by inducing antimicrobial peptides.

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    Xiaoping Xiao

    2014-04-01

    Full Text Available The complement system functions during the early phase of infection and directly mediates pathogen elimination. The recent identification of complement-like factors in arthropods indicates that this system shares common ancestry in vertebrates and invertebrates as an immune defense mechanism. Thioester (TE-containing proteins (TEPs, which show high similarity to mammalian complement C3, are thought to play a key role in innate immunity in arthropods. Herein, we report that a viral recognition cascade composed of two complement-related proteins limits the flaviviral infection of Aedes aegypti. An A. aegypti macroglobulin complement-related factor (AaMCR, belonging to the insect TEP family, is a crucial effector in opposing the flaviviral infection of A. aegypti. However, AaMCR does not directly interact with DENV, and its antiviral effect requires an A. aegypti homologue of scavenger receptor-C (AaSR-C, which interacts with DENV and AaMCR simultaneously in vitro and in vivo. Furthermore, recognition of DENV by the AaSR-C/AaMCR axis regulates the expression of antimicrobial peptides (AMPs, which exerts potent anti-DENV activity. Our results both demonstrate the existence of a viral recognition pathway that controls the flaviviral infection by inducing AMPs and offer insights into a previously unappreciated antiviral function of the complement-like system in arthropods.

  1. Collaboration between infection control and occupational health in three continents: a success story with international impact

    Directory of Open Access Journals (Sweden)

    Ndelu Lindiwe

    2011-11-01

    Full Text Available Abstract Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO. Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international

  2. Collaboration between infection control and occupational health in three continents: a success story with international impact.

    Science.gov (United States)

    Yassi, Annalee; Bryce, Elizabeth A; Breilh, Jaime; Lavoie, Marie-Claude; Ndelu, Lindiwe; Lockhart, Karen; Spiegel, Jerry

    2011-11-08

    Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work.The products developed have been widely heralded as innovative and interactive, leading to their inclusion into "toolkits" used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational

  3. Perceptions of dental outpatients toward cross-infection control measures in Jabalpur city

    Directory of Open Access Journals (Sweden)

    Suryakant C Deogade

    2016-01-01

    Full Text Available Introduction: Infection control practices are crucial and important elements in clinical dentistry as there is an enormous increase in the prevalence of infectious diseases among dental patients. This necessitates the application of recommended procedures for infection control in the dental schools and clinics. Aim: The aim of this study was to assess patients' perception toward the use of protective barriers (such as gloves, face masks, and eye goggles by working dentists in a private dental teaching school in Jabalpur, Madhya Pradesh (India. Materials and Methods: A cross-sectional descriptive study of a convenient sample of patients visiting the dental school of RDU was conducted in 2015. A structured, close-ended, self-administered questionnaire was distributed among 700 patients and a response rate of 89% was obtained. The questionnaire consisted of a series of questions related to awareness, knowledge, attitude, and perception of patients toward infection control measures. Data analysis included frequency distribution tables. Results: Of 664 patients (298 males and 366 females, 97.7%, 93.5%, and 43.6% of the patients believed that dentist should wear gloves, face masks, and eye goggles, respectively, when treating patients. The majority of them (95.3% refused to undergo treatment if the dentist is not wearing gloves and face masks. More than two-thirds (73.3% denied receiving treatment from a dentist, who is not immunized against hepatitis B. Nearly 79.2% of patients refused to attend school if they knew that human immunodeficiency virus (HIV and hepatitis B virus (HBV patients treated there. The majority of patients (92.7%, 72.3%, and 23.1% believed that gloves, facemasks, and eye goggles protect both dentist and patient, respectively. Only 44.9% said that autoclave is the best method of sterilization. A significantly higher knowledge of infection control was observed among the previous dental visitors compared to the first-time visitors

  4. Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control.

    Science.gov (United States)

    Alfaraj, Sarah H; Al-Tawfiq, Jaffar A; Altuwaijri, Talal A; Alanazi, Marzouqa; Alzahrani, Nojoom; Memish, Ziad A

    2018-02-01

    Many outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred in health care settings and involved health care workers (HCWs). We describe the occurrence of an outbreak among HCWs and attempt to characterize at-risk exposures to improve future infection control interventions. This study included an index case and all HCW contacts. All contacts were screened for MERS-CoV using polymerase chain reaction. During the study period in 2015, the index case was a 30-year-old Filipino nurse who had a history of unprotected exposure to a MERS-CoV-positive case on May 15, 2015, and had multiple negative tests for MERS-CoV. Weeks later, she was diagnosed with pulmonary tuberculosis and MERS-CoV infection. A total of 73 staff were quarantined for 14 days, and nasopharyngeal swabs were taken on days 2, 5, and 12 postexposure. Of those contacts, 3 (4%) were confirmed positive for MERS-CoV. An additional 18 staff were quarantined and had MERS-CoV swabs. A fourth case was confirmed positive on day 12. Subsequent contact investigations revealed a fourth-generation transmission. Only 7 (4.5%) of the total 153 contacts were positive for MERS-CoV. The role of HCWs in MERS-CoV transmission is complex. Although most MERS-CoV-infected HCWs are asymptomatic or have mild disease, fatal infections can occur and HCWs can play a major role in propagating health care facility outbreaks. This investigation highlights the need to continuously review infection control guidance relating to the role of HCWs in MERS-CoV transmission in health care outbreaks, especially as it relates to the complex questions on definition of risky exposures, who to test, and the frequency of MERS-CoV testing; criteria for who to quarantine and for how long; and clearance and return to active duty criteria. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Cost-Effectiveness of a Model Infection Control Program for Preventing Multi-Drug-Resistant Organism Infections in Critically Ill Surgical Patients.

    Science.gov (United States)

    Jayaraman, Sudha P; Jiang, Yushan; Resch, Stephen; Askari, Reza; Klompas, Michael

    2016-10-01

    Interventions to contain two multi-drug-resistant Acinetobacter (MDRA) outbreaks reduced the incidence of multi-drug-resistant (MDR) organisms, specifically methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile in the general surgery intensive care unit (ICU) of our hospital. We therefore conducted a cost-effective analysis of a proactive model infection-control program to reduce transmission of MDR organisms based on the practices used to control the MDRA outbreak. We created a model of a proactive infection control program based on the 2011 MDRA outbreak response. We built a decision analysis model and performed univariable and probabilistic sensitivity analyses to evaluate the cost-effectiveness of the proposed program compared with standard infection control practices to reduce transmission of these MDR organisms. The cost of a proactive infection control program would be $68,509 per year. The incremental cost-effectiveness ratio (ICER) was calculated to be $3,804 per aversion of transmission of MDR organisms in a one-year period compared with standard infection control. On the basis of probabilistic sensitivity analysis, a willingness-to-pay (WTP) threshold of $14,000 per transmission averted would have a 42% probability of being cost-effective, rising to 100% at $22,000 per transmission averted. This analysis gives an estimated ICER for implementing a proactive program to prevent transmission of MDR organisms in the general surgery ICU. To better understand the causal relations between the critical steps in the program and the rate reductions, a randomized study of a package of interventions to prevent healthcare-associated infections should be considered.

  6. 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.

  7. Tuberculosis Infection Control in Health-Care Facilities: Environmental Control and Personal Protection.

    Science.gov (United States)

    Lee, Ji Yeon

    2016-10-01

    Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. The literature review suggests that implementation of combination control measures reduces the risk of TB transmission. Guidelines suggest a three-level hierarchy of controls including administrative, environmental, and respiratory protection. Among environmental controls, installation of ventilation systems is a priority because ventilation reduces the number of infectious particles in the air. Natural ventilation is cost-effective but depends on climatic conditions. Supplemented intervention such as air-cleaning methods including high efficiency particulate air filtration and ultraviolet germicidal irradiation should be considered in areas where adequate ventilation is difficult to achieve. Personal protective equipment including particulate respirators provides additional benefit when administrative and environmental controls cannot assure protection.

  8. A survey of infection control practices of consultant anaesthesiologists in teaching hospitals of pakistan

    International Nuclear Information System (INIS)

    Yaqub, K.M.; Tariq, M.; Janjua, S.; Masroor, R.

    2007-01-01

    To determine the infection control practices of Anaesthesiologist in the teaching hospitals of Pakistan. Cross-sectional survey. The survey was closed after allowing 6 months for return of the replies. A questionnaire was distributed to 170 consultant anaesthesiologist randomly selected from all over Pakistan. Out of these, 90 (53%) were returned and analyzed. To reduce self-report bias, the forms were filled anonymously. Thirty four percent of the respondents always used masks, and only 9% used gloves in their every day practice. Only 18% of respondents stated that they always washed their hands after every patient contact and 54% reported that they always used aseptic technique for placing an indwelling cannula. Most respondents had a good knowledge of universal precautions for prevention of occupational transmission of infection. Five percent of the anaesthetists reported frequently or always reusing syringes for more than one patient. The practice of reusing syringes was significantly greater when the same consultants were anaesthetizing patients in private clinics rather than in their primary institutions (p 5, in 58% of cases. Whereas most responding anaesthesiologist exhibit appropriate infection control behaviour, there are several potentially hazardous practices that continue unabated. (author)

  9. Barriers and motivators affecting tuberculosis infection control practices of Russian health care workers.

    Science.gov (United States)

    Woith, W; Volchenkov, G; Larson, J

    2012-08-01

    Five in-patient and out-patient tuberculosis (TB) care facilities in two regions of Russia. To identify barriers and motivators to the use of infection control measures among Russian TB health care workers. In this qualitative study, a convenience sample of 96 health care workers (HCWs) was used to generate 15 homogeneous focus groups, consisting of physicians, nurses, and laboratory or support staff. Barriers and motivators related to knowledge, attitudes and beliefs, and practices were identified. The three main barriers were 1) knowledge deficits, including the belief that TB was transmitted by dust, linens and eating utensils; 2) negative attitudes related to the discomfort of respirators; and 3) practices with respect to quality and care of respirators. Education and training, fear of infecting loved ones, and fear of punishment were the main motivators. Our results point to the need for evaluation of current educational programs. Positive health promotion messages that appeal to fear might also be successful in promoting TB infection control. Individualized rewards based on personal motivators or group rewards that build on collectivist theory could be explored.

  10. Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

    Science.gov (United States)

    Brouwer, Miranda; Coelho, Eliana; Mosse, Carla das Dores; Brondi, Luciana; Winterton, Laura; van Leth, Frank

    2014-01-01

    Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures. Focus group discussion. Analysis according content method. Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff. HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures. HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.

  11. Iron deficiency anemia in Helicobacter pylori infection: meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Yuan, Wenzhen; Li Yumin; Yang Kehu; Ma Bin; Guan Quanlin; Wang, Donghai; Yang, Lijuan

    2010-06-01

    Helicobacter pylori (H. pylori) infection and iron deficiency anemia are prevalent in disadvantaged populations worldwide. The benefit of H. pylori eradiation for iron deficiency anemia has been extensively studied, but data are still equivocal. A search in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials (RCTs) comparing anti-H. pylori plus oral iron to oral iron alone for the iron deficiency patients in whom H. pylori was positive were selected for meta-analysis. Reviev Manager 5.0 software was used for the performance of meta-analysis. Sixteen randomized controlled trials totaling 956 patients were included. The meta-analysis showed that the difference from baseline to endpoint of hemoglobin (Hb), serum iron (SI), and serum ferritin (SF) was statistically significantly different between anti-H. pylori treatment plus oral iron and oral iron alone (SMD, Hb 1.48; 95% CI, 0.96, 2.00; p infection could be effective in improving anemia and iron statue in IDA patients infected by H. pylori, particularly in patients with moderate or severe anemia.

  12. Development of a HACCP-based approach to control paratuberculosis in infected Irish dairy herds.

    Science.gov (United States)

    McAloon, Conor G; Whyte, Paul; More, Simon J; O'Grady, Luke; Doherty, Michael L

    2015-06-15

    Paratuberculosis is a challenging disease to control at farm level, in part due to the poor sensitivity of diagnostic tests and a prolonged incubation period. Simulation studies have highlighted on-farm management to be the most important factor in preventing on-farm spread. A risk assessment (RA) and management plan (MP) approach (collectively, RAMP) has been adopted around the world as the most appropriate method of controlling disease in infected farms. However, there are problems with RAMP that remain to be resolved. The RA relies heavily on farmer recollection and estimation resulting in subjectivity and substantial inter-observer variability. MPs consist of a series of qualitative, farm specific recommendations showing how management can be improved. However, MP assessment is generally conducted informally, and progress is monitored through 'end-point' diagnostic testing of adult animals and repeated risk assessments. Hazard analysis and critical control point (HACCP) has been developed as a proactive alternative to end-point testing. We hypothesise that farm-based HACCP systems may be a useful alternative to RAMP on farms where more intensive monitoring and evaluation of controls for paratuberculosis is required. Therefore, the objective of this methodological study was to develop a HACCP-based system for paratuberculosis control. Critical control points (CCPs) relating to peri-parturient area management, calving, new-born calf management and colostrum management were identified as areas where additional control could be exerted above existing methods. Novel monitoring systems were developed for each CCP, along with targets and corrective actions. This system is intended for use in high prevalence herds, or farms where more robust monitoring of key control points may be beneficial. It is currently being trialled on infected commercial dairy herds in Ireland. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Administration of Phyllanthus niruri to control IMNV (myonecrosis infectious virus infection white shrimp Litopenaeus vannamei

    Directory of Open Access Journals (Sweden)

    Sukenda .

    2015-04-01

    Full Text Available ABSTRACTInfectious myonecrosis (IMN disease is a major disease in Indonesia shrimp farming. The disease is caused by infectious myonecrosis virus (IMNV. Currently, treatment and drug has not been obtained to control the virus. This research was conducted to determine the effect of Phyllanthus niruri extract in white shrimp (Litopenaeus vannamei against IMNV infection. Healthy shrimp was given P. niruri extract 20 mg/kg of feed for seven days and after that the shrimp was challenged by orally with IMNV infected shrimp tissue. The positive control was given feed without P. niruri extract and challenged with IMNV infected shrimp tissue, while negative control was not challenged with IMNV infected shrimp tissue. IMNV infection gave a significantly different effect on survival rate. In the shrimp P. niruri previously (86.7% gave higher survival rate compared to shrimp without P. niruri (66.67%. Survival rate of negative control was 93.33%. IMNV clinical signs in general was white necrotic areas in striated muscles. Histological examination showed that cell necrosis appeared on the mussel tissues. In conclusion the addition of P. niruri to the commercial feed can give the survival rate of shrimp better when challenged with IMNV.Keywords: IMNV, Phyllanthus niruri, Litopenaeus vannameiABSTRAKPenyakit infectious myonecrosis (IMN merupakan penyakit utama pada budidaya udang di Indonesia. Penyakit ini disebabkan oleh infectious myonecrosis virus (IMNV. Saat ini, belum diperoleh cara dan obat untuk mengendalikan virus IMNV. Penelitian ini dilakukan untuk mengevaluasi pengaruh immunostimulan tepung meniran (Phyllanthus niruri yang diberikan melalui pakan pada udang vaname (Litopenaeus vannamei yang diinfeksi IMNV. Udang vaname yang sehat diberi pakan yang mengandung meniran dengan dosis 20 mg/kg pakan selama tujuh hari dan kemudian diuji tantang secara oral dengan memberikan jaringan udang yang telah terinfeksi IMNV. Udang kontrol positif dilakukan dengan

  14. A simulation-based assessment of strategies to control Clostridium difficile transmission and infection.

    Directory of Open Access Journals (Sweden)

    Michael A Rubin

    Full Text Available BACKGROUND: Clostridium difficile is one of the most common and important nosocomial pathogens, causing severe gastrointestinal disease in hospitalized patients. Although "bundled" interventions have been proposed and promoted, optimal control strategies remain unknown. METHODS: We designed an agent-based computer simulation of nosocomial C. difficile transmission and infection, which included components such as: patients and health care workers, and their interactions; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C. difficile via contact with contaminated rooms or health care workers; and patient antimicrobial use. We then introduced six interventions, alone and "bundled" together: aggressive C. difficile testing; empiric isolation and treatment of symptomatic patients; improved adherence to hand hygiene and contact precautions; improved use of soap and water for hand hygiene; and improved environmental cleaning. All interventions were tested using values representing base-case, typical intervention, and optimal intervention scenarios. FINDINGS: In the base-case scenario, C. difficile infection rates ranged from 8-21 cases/10,000 patient-days, with a case detection fraction between 32%-50%. Implementing the "bundle" at typical intervention levels had a large impact on C. difficile acquisition and infection rates, although intensifying the intervention to optimal levels had much less additional impact. Most of the impact came from improved hand hygiene and empiric isolation and treatment of suspected C. difficile cases. CONCLUSION: A "bundled" intervention is likely to reduce nosocomial C. difficile infection rates, even under typical implementation conditions. Real-world implementation of the "bundle" should focus on those components of the intervention that are likely to produce the greatest impact on C. difficile infection rates, such as hand hygiene and empiric

  15. CCR5 controls immune and metabolic functions during Toxoplasma gondii infection.

    Directory of Open Access Journals (Sweden)

    Giuliano Bonfá

    Full Text Available CCR5, an important receptor related to cell recruitment and inflammation, is expressed during experimental Toxoplasma gondii infection. However, its role in the immunopathology of toxoplasmosis is not clearly defined yet. Thus, we inoculated WT and CCR5(-/- mice with a sub lethal dose of the parasite by oral route. CCR5(-/- mice were extremely susceptible to infection, presenting higher parasite load and lower tissue expression of IL-12p40, IFN-γ, TNF, IL-6, iNOS, Foxp3, T-bet, GATA-3 and PPARα. Although both groups presented inflammation in the liver with prominent neutrophil infiltration, CCR5(-/- mice had extensive tissue damage with hepatocyte vacuolization, steatosis, elevated serum triglycerides and transaminases. PPARα agonist Gemfibrozil improved the vacuolization but did not rescue CCR5(-/- infected mice from high serum triglycerides levels and enhanced mortality. We also found intense inflammation in the ileum of CCR5(-/- infected mice, with epithelial ulceration, augmented CD4 and decreased frequency of NK cells in the gut lamina propria. Most interestingly, these findings were accompanied by an outstanding accumulation of neutrophils in the ileum, which seemed to be involved in the gut immunopathology, once the depletion of these cells was accompanied by reduced local damage. Altogether, these data demonstrated that CCR5 is essential to the control of T. gondii infection and to maintain the metabolic, hepatic and intestinal integrity. These findings add novel information on the disease pathogenesis and may be relevant for directing future approaches to the treatment of multi-deregulated diseases.

  16. Iron supplementation in HIV-infected Malawian children with anemia: a double-blind, randomized, controlled trial

    NARCIS (Netherlands)

    Esan, Michael O.; van Hensbroek, Michael Boele; Nkhoma, Ernest; Musicha, Crispin; White, Sarah A.; ter Kuile, Feiko O.; Phiri, Kamija S.

    2013-01-01

    It is unknown whether iron supplementation in human immunodeficiency virus (HIV)-infected children living in regions with high infection pressure is safe or beneficial. A 2-arm, double-blind, randomized, controlled trial was conducted to examine the effects of iron supplementation on hemoglobin, HIV

  17. Treatment of helicobacter pylori infection; a controlled randomized comparative clinical trial

    International Nuclear Information System (INIS)

    Mehmood, A.; Usmanghani, K.; Mohiuddin, E.; Akram, M.

    2010-01-01

    Helicobacter pylori induces chronic inflammation of the underlying gastric mucosa and is strongly linked to the development of duodenal and gastric carcinoma. A study was conducted to evaluate the efficacy of Pylorex, a herbal formulation, for treatment of H. pylori infection as compared to triple allopathic therapy (Omeprazole, Amoxicillin, Metronidazole). The therapeutic evaluations of these medicines were conducted on 97 clinically and immunologically diagnosed cases of H. pylori infection. H. pylori was eradicated in 16 (32.6%) out of 49 patients by the use of triple allopathic therapy (Control drugs), and in 9 (18.7%) out of 48 patients by the use of Pylorex (Test drug). Pylorex possesses a therapeutic value for the treatment of H. pylori associated symptoms but the eradication rate is superior in triple allopathic therapy. (author)

  18. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies.

    Science.gov (United States)

    Borg, M A; Waisfisz, B; Frank, U

    2015-05-01

    It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  19. Translating infection control guidelines into practice: implementation process within a health care institution.

    Science.gov (United States)

    Raveis, Victoria H; Conway, Laurie J; Uchida, Mayuko; Pogorzelska-Maziarz, Monika; Larson, Elaine L; Stone, Patricia W

    2014-04-01

    Health-care-associated infections (HAIs) remain a major patient safety problem even as policy and programmatic efforts designed to reduce HAIs have increased. Although information on implementing effective infection control (IC) efforts has steadily grown, knowledge gaps remain regarding the organizational elements that improve bedside practice and accommodate variations in clinical care settings. We conducted in-depth, semistructured interviews in 11 hospitals across the United States with a range of hospital personnel involved in IC (n = 116). We examined the collective nature of IC and the organizational elements that can enable disparate groups to work together to prevent HAIs. Our content analysis of participants' narratives yielded a rich description of the organizational process of implementing adherence to IC. Findings document the dynamic, fluid, interactional, and reactive nature of this process. Three themes emerged: implementing adherence efforts institution-wide, promoting an institutional culture to sustain adherence, and contending with opposition to the IC mandate.

  20. New technologies in the prevention and control of healthcare-associated infection.

    LENUS (Irish Health Repository)

    Humphreys, H

    2010-06-01

    The increased interest in healthcare-associated infection (HCAI) among the public, patients and politicians has led to the development of potential new approaches to its prevention by industrial concerns and others. Such developments include better methods of assessing hospital hygiene, enhanced decontamination of the healthcare environment, biosynthetic tissue alternatives, antibiotic-impregnated medical devices and information technology that can help improve professional practice. Although promising, many of these have not been adequately evaluated in the clinical setting, highlighting the need for greater collaboration between industry and infection prevention and control practitioners to maximise the benefit of new products and to complement conventional approaches to HCAI prevention such as education, professional practice and the provision of better facilities.

  1. Impact of antibiotic exposure on occurrence of nosocomial carbapenem-resistant Acinetobacter baumannii infection: a case control study.

    Science.gov (United States)

    Chusri, Sarunyou; Silpapojakul, Kachornsakdi; McNeil, Edward; Singkhamanan, Kamonnut; Chongsuvivatwong, Virasakdi

    2015-02-01

    Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is one of the most important healthcare associated diseases worldwide. Although antibiotic use is recognized as a risk factor for CRAB infection, the impact of antibiotic class and length of use on CRAB infection is still unclear. A case-control study was conducted in adult intensive care units and general wards of Songklanagarind Hospital, a tertiary-care hospital in southern Thailand, to investigate the effect of different antibiotic exposure and the duration of use on the risk of developing CRAB infection. Cases were defined as patients with carbapenem-susceptible A. baumannii (CSAB) or CRAB infection. Controls were randomly selected from patients and matched 1:1 with cases using ward and date of admission. Multinomial logistic regression was used to compute relative risk ratios (RRR) and 95% confidence intervals (CI) for CRAB infection. Of 197 cases with A. baumannii infection, there were 139 with CRAB infection and 58 with CSAB infection. Compared to the control group, use of fluoroquinolones, broad-spectrum cephalosporins and carbapenems for more than three days increased the risk of CRAB infection with RRR (95% CI) of 81.2 (38.1-862.7), 31.3 (9.9-98.7) and 112.1 (7.1-1770.6), respectively. The RRR (95% CI) for one to three day treatment of fluoroquinolones, broad-spectrum cephalosporins and carbapenems were 5.4 (0.8-38.7), 6.2 (0.1-353.2) and 63.3 (15.6-256.9), respectively. Long-term use of certain antibiotics and even short term use of carbapenems increased the risk of CRAB infection. In this setting, use of these antibiotics, especially carbapenems, should be limited to reduce CRAB infection. Copyright © 2014. Published by Elsevier Ltd.

  2. Hospital-acquired Legionella infections: an update on the procedures for controlling environmental contamination.

    Science.gov (United States)

    Borella, P; Bargellini, A; Marchegiano, P; Vecchi, E; Marchesi, I

    2016-01-01

    The waterborne healthcare-associated infections are mainly sustained by Legionella and Pseudomonas spp. Various water factors and plumbing characteristics, and the interaction with other water microorganisms are considered to be predictive of Legionella contamination. It is therefore mandatory to organize plans of surveillance, prevention and control in order to avoid disease appearance in immunosuppressed patients, with higher risk of death. Guidelines for the prevention of Legionnaires' disease have been published, benefiting those who face this problem, but definitive standardized solutions do not exist yet. Here we describe fifteen years of activity, during which our study group gathered interesting data on the control of Legionella contamination. Water disinfection is not generally sufficient to control the risk of infection, but a complex water safety plan should be developed, including system maintenance, training of staff and implementation of a clinical surveillance system aimed at early detection of cases. Concerning the control measures, we evaluated the effectiveness of different treatments suggested to reduce Legionella spp contamination, comparing our results with the current literature data. The performance ranking was highest for the filter, followed by boilers at high temperature, monochloramine and, at a lower level, chlorine dioxide; the effectiveness of hyperchlorination was limited, and thermal shock was even more ineffective.

  3. Glycemic control strategies and the occurrence of surgical site infection: a systematic review.

    Science.gov (United States)

    Domingos, Caroline Maria Herrero; Iida, Luciana Inaba Senyer; Poveda, Vanessa de Brito

    2016-01-01

    To analyze the evidence available in the scientific literature regarding the relationship between the glycemic control strategies used and the occurrence of surgical site infection in adult patients undergoing surgery. This is a systematic review performed through search on the databases of CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews and EMBASE. Eight randomized controlled trials were selected. Despite the diversity of tested interventions, studies agree that glycemic control is essential to reduce rates of surgical site infection, and should be maintained between 80 and 120 mg/dL during the perioperative period. Compared to other strategies, insulin continuous infusion during surgery was the most tested and seems to get better results in reducing rates of surgical site infection and achieving success in glycemic control. Tight glycemic control during the perioperative period benefits the recovery of surgical patients, and the role of the nursing team is key for the successful implementation of the measure. Analisar as evidências disponíveis na literatura científica sobre a relação entre as estratégias de controle glicêmico efetuadas e a ocorrência de infecção do sítio cirúrgico em pacientes adultos submetidos à cirurgia. Trata-se de revisão sistemática, por meio das bases de dados CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews e EMBASE. Foram selecionados oito ensaios clínicos randomizados. Apesar da diversidade de intervenções testadas, os estudos concordam que o controle glicêmico é essencial para a redução das taxas de infecção do sítio cirúrgico e deve ser mantido entre 80 e 120 mg/dL durante o perioperatório. A infusão contínua de insulina no transoperatório foi a mais testada e parece obter melhores resultados na redução das taxas de infecção do sítio cirúrgico e sucesso no controle glicêmico comparada às demais estratégias. O controle glicêmico rigoroso durante o perioperat

  4. The network approach for prevention of healthcare-associated infections: long-term effect of participation in the Duke Infection Control Outreach Network.

    Science.gov (United States)

    Anderson, Deverick J; Miller, Becky A; Chen, Luke F; Adcock, Linda H; Cook, Evelyn; Cromer, A Lynn; Louis, Susan; Thacker, Paul A; Sexton, Daniel J

    2011-04-01

    To describe the rates of several key outcomes and healthcare-associated infections (HAIs) among hospitals that participated in the Duke Infection Control Outreach Network (DICON). Prospective, observational cohort study of patients admitted to 24 community hospitals from 2003 through 2009. The following data were collected and analyzed: incidence of central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTIs), and HAIs caused by methicillin-resistant Staphylococcus aureus (MRSA); employee exposures to bloodborne pathogens (EBBPs); physician EBBPs; patient-days; central line-days; ventilator-days; and urinary catheter-days. Poisson regression was used to determine whether incidence rates of these HAIs and exposures changed during the first 5 and 7 years of participation in DICON; nonrandom clustering of each outcome was controlled for. Cost saved and lives saved were calculated on the basis of published estimates. In total, we analyzed 6.5 million patient-days, 4,783 EBPPs, 2,948 HAIs due to MRSA, and 2,076 device-related infections. Rates of employee EBBPs, HAIs due to MRSA, and device-related infections decreased significantly during the first 5 years of participation in DICON (Pprevented. Each hospital saved approximately $100,000 per year of participation, and collectively the hospitals may have prevented 52-105 deaths from CLABSI or VAP. The 7-year analysis demonstrated that these trends continued with further participation. Hospitals with long-term participation in an infection control network decreased rates of significant HAIs by approximately 50%, decreased costs, and saved lives.

  5. Efficacy and safety of nanohybrids comprising silver nanoparticles and silicate clay for controlling Salmonella infection

    Directory of Open Access Journals (Sweden)

    Bau IJ

    2012-05-01

    Full Text Available Shu-Her Chiao,1* Siou-Hong Lin,1* Ching-I Shen,2* Jiunn-Wang Liao,3 I-Jiuan Bau,1 Jiun-Chiou Wei,4 Li-Ping Tseng,1 Shan-hui Hsu,4 Ping-Shan Lai,2 Shinn-Zong Lin,5–7 Jiang-Jen Lin,4 Hong-Lin Su,1,8 1Department of Life Sciences, Agricultural Biotechnology Center, National Chung Hsing University, 2Department of Chemistry, Agricultural Biotechnology Center, National Chung Hsing University, 3Graduate Institute of Veterinary Pathobiology, Agricultural Biotechnology Center, National Chung Hsing University, Taichung, Taiwan; 4Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan; 5Center for Neuropsychiatry, China Medical University and Hospital, Taichung, Taiwan; 6Department of Neurosurgery, China Medical University Beigan Hospital, Yunlin, Taiwan; 7Graduate Institute of Immunology, China Medical University, Taichung, Taiwan; 8Department of Physical Therapy, China Medical University, Taichung, Taiwan*These three authors contributed equallyAbstract: Developing effective and safe drugs is imperative for replacing antibiotics and controlling multidrug-resistant microbes. Nanoscale silicate platelet (NSP and its nanohybrid, silver nanoparticle/NSP (AgNP/NSP, have been developed, and the nanohybrids show a strong and general antibacterial activity in vitro. Here, their efficacy for protecting Salmonella-infected chicks from fatality and septicemia was evaluated. Both orally administrated NSP and AgNP/NSP, but not AgNPs alone, effectively reduced the systemic Salmonella infection and mortality. In addition, quantitative Ag analyses demonstrated that Ag deposition from AgNP/NSP in the intestines was less than that from conventional AgNPs, indicating that the presence of NSP for immobilizing AgNPs reduced Ag accumulation in tissue and improved the safety of AgNPs. These in vivo results illustrated that both NSP and AgNP/NSP nanohybrid represent potential agents for controlling enteric bacterial infections.Keywords: silver

  6. Case control study to identify risk factors for acute hepatitis C virus infection in Egypt

    Directory of Open Access Journals (Sweden)

    Kandeel Amr M

    2012-11-01

    Full Text Available Abstract Background Identification of risk factors of acute hepatitis C virus (HCV infection in Egypt is crucial to develop appropriate prevention strategies. Methods We conducted a case–control study, June 2007-September 2008, to investigate risk factors for acute HCV infection in Egypt among 86 patients and 287 age and gender matched controls identified in two infectious disease hospitals in Cairo and Alexandria. Case-patients were defined as: any patient with symptoms of acute hepatitis; lab tested positive for HCV antibodies and negative for HBsAg, HBc IgM, HAV IgM; and 7-fold increase in the upper limit of transaminase levels. Controls were selected from patients’ visitors with negative viral hepatitis markers. Subjects were interviewed about previous exposures within six months, including community-acquired and health-care associated practices. Results Case-patients were more likely than controls to have received injection with a reused syringe (OR=23.1, CI 4.7-153, to have been in prison (OR=21.5, CI 2.5-479.6, to have received IV fluids in a hospital (OR=13.8, CI 5.3-37.2, to have been an IV drug user (OR=12.1, CI 4.6-33.1, to have had minimal surgical procedures (OR=9.7, CI 4.2-22.4, to have received IV fluid as an outpatient (OR=8, CI 4–16.2, or to have been admitted to hospital (OR=7.9, CI 4.2-15 within the last 6 months. Multivariate analysis indicated that unsafe health facility practices are the main risk factors associated with transmission of HCV infection in Egypt. Conclusion In Egypt, focusing acute HCV prevention measures on health-care settings would have a beneficial impact.

  7. Drug addiction is not an independent risk factor for oncogenic human papillomavirus infections or high-grade cervical intraepithelial neoplasia: case-control study nested within the Latin American Screening study cohort.

    Science.gov (United States)

    Syrjänen, K; Naud, P; Derchain, S; Roteli-Martins, C; Longatto-Filho, A; Tatti, S; Branca, M; Erzen, M; Hammes, L S; Matos, J; Gontijo, R; Sarian, L; Bragança, J; Arlindo, F C; Maeda, M Y S; Lörincz, A; Dores, G B; Costa, S; Syrjänen, S

    2008-04-01

    Drug abuse (addiction) has been listed among the risk factors for human papillomavirus (HPV) infections, but no case-control studies exist to rule out sexual behaviour and other potential confounders. The aim of this study is to evaluate the role of drug addiction as an independent predictor of HR-HPV infections and (cervical intraepithelial neoplasia) CIN2+ in an age-matched case-control (1:4) study nested within the prospective Latin American Screening (LAMS) study cohort. All 109 women in the LAMS cohort (n=12,114) reporting drug abuse/addiction were matched with four controls (n = 436) of non-abusers strictly by age. Conditional logistic regression analysis was used to estimate the co-variates of drug abuse, and the whole series (n=545) was analysed for predictors of HR-HPV and CIN2+ using univariate and multivariate regression models. Oncogenic HPV infections were significantly (P=0.019) more prevalent among abusers (37.7%) than in controls (21.9%), but there was no difference in high-grade squamous intraepithelial lesions (P=0.180) or CIN2+ lesions (P=0.201). In multivariate conditional logistic regression, number of lifetime sexual partners (P=0.0001), ever smokers (P=0.0001), non-use of OCs (P=0.013), ever having sexually transmitted diseases (STD) (P=0.041) and no previous Pap smear (P=0.027) were independent co-variates of drug addiction. Drug abuse was not an independent risk factor of high-risk (HR)-HPV infection, which was significantly predicted by (1) age below 30 years (P=0.045), (2) more than five lifetime sexual partners (P=0.046) and (3) being current smoker (P=0.0001). In multivariate model, only HR-HPV infection was an independent risk factor of CIN2+ (P=0.031), with adjusted OR=11.33 (95% CI 1.25-102.50). These data indicate that drug addiction is not an independent risk factor of either HR-HPV infections or CIN2+, but the increased prevalence of HR-HPV infections is explained by the high-risk sexual behaviour and smoking habits of these women.

  8. Glycemic control in type 2 diabetes mellitus prevents coronary arterial wall infection

    Directory of Open Access Journals (Sweden)

    Morteza Izadi

    2014-05-01

    Full Text Available BACKGROUND: Diabetes mellitus (DM is a very well-known risk factor for development of atherosclerosis, and it has been hypothesized that poor glycemic control and hyperglycemia plays a major role in this process. In the current study, we aimed to evaluate the associates of poor glycemic control in Iranian patients who have already undergone coronary artery bypass grafting (CABG, with especial focus on the inhabitation of infectious agents within the coronary arterial wall. METHODS: In January 2010, 52 consecutive patients with type 2 DM who undergone CABG at the Department of Cardiovascular Surgery of Baqiyatallah University of Medical Sciences (Tehran, Iran were included into this cross-sectional study and biopsy specimens from their coronary plaques were taken and analyzed by polymerase chain reaction (PCR methods for detecting Helicobacter species, cytomegalovirus (CMV and Chlamydia pneumoniae, and their potential relation to the glycemic control status in these patients. RESULTS: Compared to that in diabetic patients with mean fasting blood sugar (FBS levels FBS < 126, atherosclerotic lesions in type 2 diabetic patients with poor glycemic control (FBS > 126 were significantly more likely to be positive for CMV PCR test (41% vs. 9%, respectively; P = 0.05. In laboratorial test results, mean triglyceride level was significantly higher among patients of poor glycemic control (168 ± 89 vs. 222 ± 125 mg/dl, respectively; P = 0.033. Hypertension was also significantly more prevalent in this population (73% vs. 36%, respectively; P = 0.034. CONCLUSION: Type 2 diabetic patients with poor glycemic control can be at higher risk for developing CMV infection in their coronary arterial wall, which can promote atherosclerosis formation process in this patient population. According to the findings of this study, we recommend better control of serum glucose levels in type 2 diabetic patients to prevent formation/progression of atherosclerosis.   Keywords

  9. Isolated abnormal strict morphology is not a contraindication for intrauterine insemination.

    Science.gov (United States)

    Lockwood, G M; Deveneau, N E; Shridharani, A N; Strawn, E Y; Sandlow, J I

    2015-11-01

    This study sought to investigate whether isolated abnormal strict morphology (<5% normal forms) and very low strict morphology (0-1% normal forms) affects pregnancy rates in intrauterine insemination (IUI). This was a retrospective study performed at an Academic Medical Center/Reproductive Medicine Center. Four hundred and eight couples were included for 856 IUI cycles. 70 IUI cycles were performed in couples with abnormal strict morphology and otherwise normal semen parameters. Outcomes were measured as clinical pregnancy rate per IUI cycle as documented by fetal heart activity on maternal ultrasound. Clinical pregnancy rate did not significantly differ between the group with abnormal strict morphology [11/70 (15.7%)] and the normal morphology group [39/281 (13.9%)]. Additionally, there was no significant difference between the pregnancy rate in the abnormal morphology group compared to that of our overall institutional IUI pregnancy rate [145/856 (16.9%)]. Furthermore, there was no significant difference between pregnancy rate in the very low morphology group [3/14 (21.4%)] compared to those with normal morphology or the overall IUI pregnancy rate. Patients with isolated abnormal strict morphology have clinical pregnancy rates similar to those with normal morphology for IUI. Even in those with very low normal forms, consideration of IUI for assisted reproduction should not be excluded. © 2015 American Society of Andrology and European Academy of Andrology.

  10. A European map regarding the strictness of the transfer pricing regulations

    Directory of Open Access Journals (Sweden)

    Ioana Ignat

    2017-12-01

    Full Text Available In the context in which transfer pricing may represent a mechanism through which multinationals have the possibility to move funds internationally, in order to prevent the base erosion and profit shifting between multinationals, countries over the world have adopted various transfer pricing regulations. Furthermore, some of the countries adopted stricter regulations than others. The objective of our research was to identify the level of strictness for the transfer pricing regulations from the European countries. To achieve this objective, we analyzed the transfer pricing regulations of all European countries and we built a transfer pricing strictness index, based on which we defined 4 categories of countries (where category 1 includes the countries with the least strict transfer pricing regulations and category 4 countries with the strictest regulations. After that, we illustrated how these categories are distributed on the European map. In order to collect the information, we used the transfer pricing guides issued by the Big Four companies for the year 2015. The study`s results show that the strictness of the transfer pricing regulations decreases from the west of Europe to east. Moreover, most of the countries were included in category 2, respectively category 3, meaning that the transfer pricing regulations from the European continent are not so flexible, but in the same time are not so strict.

  11. Beta Human Papillomavirus Infection Is Prevalent in Elephantiasis and Exhibits a Productive Phenotype: A Case-Control Study.

    Science.gov (United States)

    Carlson, John Andrew; Rady, Peter; Kadam, Pooja; He, Qin; Simonette, Rebecca; Tyring, Stephen

    2017-06-01

    Elephantiasis is considered a cutaneous region of immune deficiency with cobblestone-like surface caused by a wart-like eruption. Verrucosis is a diffuse human papillomavirus (HPV) infection linked to immunodeficiency disorders. The objective of this study was to examine the prevalence of HPV infection in lymphedema and its pathogenic role in elephantiasis. A retrospective case-control study was performed examining lymphedematous skin and controls of peritumoral normal skin. HPV infection was evaluated at the DNA, protein, and histopathologic levels by polymerase chain reaction, immunohistochemistry, and light microscopy, respectively. Overall, 540 HPV DNAs were detected in 120 of 122 cutaneous samples (median 4 HPV DNAs per sample, range 0-9). Compared with controls, no differences existed in type or number of HPVs identified. Instead, a diverse spectrum of HPV-related histopathologies were evident, likely reflecting the multiplicity of HPV genotypes detected. Most notably, increasing histopathologic lymphedema stage significantly correlated with markers of productive HPV infection such as altered keratohyaline granules and HPV L1 capsid expression. Limitations of this study are the absence of normal skin controls not associated with neoplasia or subclinical lymphedema, and lack of assessment of HPV copy number per keratinocyte infected. In conclusion, productive HPV infection, not HPV type or numbers detected, distinguished lymphedematous skin from controls. These findings support the theory that lymphedema creates a region of depressed immunity that permits productive HPV infection, manifested clinically by diffuse papillomatosis, characteristic of elephantiasis.

  12. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people.

    Science.gov (United States)

    Hughes, Carmel; Smith, Michael; Tunney, Michael; Bradley, Marie C

    2011-12-07

    Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin-resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonisation and infection. It is recognised that infection prevention and control strategies are important in preventing and controlling MRSA transmission. To determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2011, Issue 2), the Cochrane Wounds Group Specialised Register (searched May 27th, 2011). We also searched Ovid MEDLINE (from 1950 to April Week 2 2011), OVID MEDLINE (In-process and Other Non-Indexed Citations, April 26th 2011) Ovid EMBASE (1980 to 2011 Week 16), EBSCO CINAHL (1982 to April 21st 2011), DARE (1992 to 2011, week 16), Web of Science (1981 to May 2011), and the Health Technology Assessment (HTA) website (1988 to May 2011). Research in progress was sought through Current Clinical Trials (www.controlled-trials.com), Medical Research Council Research portfolio, and HSRPRoj (current USA projects). All randomised and controlled clinical trials, controlled before and after studies and interrupted time series studies of infection prevention and control interventions in nursing homes for older people were eligible for inclusion. Two review authors independently reviewed the results of the searches. Another review author appraised identified papers and undertook data extraction which was checked by a second review author. For this second update only one study was identified, therefore it was not possible to undertake a meta-analysis. A cluster randomised controlled trial in 32 nursing homes evaluated the effect of an infection control education and training programme on MRSA prevalence. The primary outcome was MRSA prevalence in residents and staff, and a change in infection

  13. Screening and contact precautions – A survey on infection control measures for multidrug-resistant bacteria in German university hospitals

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    Lena M. Biehl

    2017-04-01

    Full Text Available Abstract To assess the scope of infection control measures for multidrug-resistant bacteria in high-risk settings, a survey among university hospitals was conducted. Fourteen professionals from 8 sites participated. Reported policies varied largely with respect to the types of wards conducting screening, sample types used for screening and implementation of contact precautions. This variability among sites highlights the need for an evidence-based consensus of current infection control policies.

  14. Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation.

    Directory of Open Access Journals (Sweden)

    Nina Katharina Stock

    Full Text Available This study presents the results of a multidisciplinary, nosocomial MRSA outbreak investigation in an 8-bed medical intensive care unit (ICU. The identification of seven MRSA positive patients in the beginning of 2014 led to the closure of the ward for several weeks. A multidisciplinary, retrospective investigation was initiated in order to identify the reason and the source for the outbreak, describe MRSA transmission in the department and identify limitations in infection control.The investigation comprised an epidemiological description of MRSA cases from 2012 to 2014 and a characterization of MRSA isolates, including phage-, spa- and PFGE-typing. Additionally, MRSA screening was performed from the hospital staff and the environment. To identify the reason for the outbreak, work-related, psychological and behavioral factors were investigated by impartial audits and staff interviews.Thirty-one MRSA cases were registered during the study period, and 36 isolates were investigated. Molecular typing determined the outbreak strain (phage type 54/812, PFGE type A4, spa type t003 and identified the probable index case. Nasal carriage in one employee and a high environmental contamination with the outbreak strain was documented. Important gaps in nursing procedures and general management were identified. Elevated stress levels and communication problems preceded the outbreak. Compliance with hand hygiene and isolation procedures was evaluated as appropriate.This study demonstrates the complexity of controlling hospital-associated infections. The combined use of different typing methods is beneficial for outbreak investigations. Psychological, behavioral and other work-related factors have an important impact on the spread of nosocomial pathogens. These factors should be addressed and integrated in routine infection control practice.

  15. The assessment of infection control in dental practices in the municipality of São Paulo

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    Jacqueline Kimiko Matsuda

    Full Text Available OBJECTIVE: The goal of this study was to evaluate the infection control measures actually implemented by dental surgeons during dental practice, as patients and professionals are exposed to high biological risk in dental care environments. METHOD: 614 questionnaires (90.69% were answered by professionals registered in updating or in post-graduate courses in the Municipality of São Paulo. RESULTS: Out of surveyed professionals 30.62% admitted that surface protection barriers were not used, whereas 34.17% were using non ideal or outdated pre-disinfection practices. The autoclave was used by 69.38% of participants, although 33.80% were not monitoring control of the sterilization cycles. Chemical and biological indicators were not used simultaneously by 83.21% of respondents and were not employed on a daily or weekly basis by at least 81.75%. Dubious methods of sterilization were cited by 44.77%. Occupational accidents caused by cutting and piercing objects were reported by 47.88%; however, the biologic risk was underestimated by 74.15% of the professionals who suffered the accidents. Irritant solutions were used as an antiseptic agent by 18.55%. CONCLUSIONS: Infection control measures reported by dental surgeons during their practices are deficient. It is necessary to educate, raise awareness of professionals, and promote constant updating courses on procedures which aim at improving safety of dental care.

  16. Use of irradiation to control infectivity of food-borne parasites

    International Nuclear Information System (INIS)

    1993-01-01

    Food-borne parasitic diseases are common throughout the world, pose significant health problems and cause economic losses in terms of agricultural commodities and human productivity. The diseases usually occur through consumption of raw or partially cooked foods with are infected by various parasites (e.g. tapeworms, roundworms, flukes, parasitic protozoa, etc.). The problem is significant in developing countries where the population has the habit of consuming raw food of animal origin. Available data, with the exception of data on Trichinella spiralis, a parasitic nematode, were insufficient for the use of irradiation technology to control food-borne parasites. Therefore, a Co-ordinated Research Programme (CRP) on the Use of Irradiation to Control Infectivity of Food-Borne Parasites was implemented by the FAO/IAEA in 1986. The results of the work carried out over five years (1986-1991) by twelve researchers participating in the programme, have established conclusively the potential for application of food irradiation in the control of liver flukes, tapeworms, roundworms, trichinosis, toxoplasmosis, etc. This report includes the conclusions and recommendations of the participants concerning the results obtained and need for further research. Refs, figs and tabs

  17. New strict left bundle branch block criteria reflect left ventricular activation differences

    DEFF Research Database (Denmark)

    Emerek, Kasper Janus Grønn; Risum, Niels; Hjortshøj, Søren Pihlkjær

    2015-01-01

    AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left ven....... CONCLUSION: Interventricular electrical delay predicts left ventricular remodeling after CRT and new, strict ECG criteria of LBBB are superior in predicting remodeling.......AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left...... ventricular electrical delay (RV-LV-IED) was measured. Response to CRT was defined as ≥15% decrease in left ventricular end-systolic volume. RESULTS: Eighteen of 20 (90%) patients with non-ischemic dilated cardiomyopathy (DCM) and 18 of 29 (62%) with ischemic heart disease (IHD) responded to CRT, p

  18. Actions of a separately strict cpo-monoid on pointed directed complete posets

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    Halimeh Moghbeli Damaneh

    2015-07-01

    Full Text Available ‎ In the present article‎, ‎we study some categorical properties of the category {$bf‎ Cpo_{Sep}$-$S$} of all {separately strict $S$-cpo's}; cpo's equipped with‎ a compatible right action of a separately strict cpo-monoid $S$ which is‎ strict continuous in each component‎. ‎In particular‎, we show that this category is reflective and coreflective in the‎ category of $S$-cpo's‎, ‎find the free and cofree functors‎, characterize products and coproducts‎. ‎Furthermore‎, ‎epimorphisms and‎  monomorphisms in {$bf Cpo_{Sep}$-$S$} are studied‎, ‎and show that‎ {$bf Cpo_{Sep}$-$S$} is not cartesian closed‎.

  19. SAMHD1 controls cell cycle status, apoptosis and HIV-1 infection in monocytic THP-1 cells

    International Nuclear Information System (INIS)

    Bonifati, Serena; Daly, Michele B.; St Gelais, Corine; Kim, Sun Hee; Hollenbaugh, Joseph A.; Shepard, Caitlin; Kennedy, Edward M.; Kim, Dong-Hyun; Schinazi, Raymond F.; Kim, Baek; Wu, Li

    2016-01-01

    SAMHD1 limits HIV-1 infection in non-dividing myeloid cells by decreasing intracellular dNTP pools. HIV-1 restriction by SAMHD1 in these cells likely prevents activation of antiviral immune responses and modulates viral pathogenesis, thus highlighting a critical role of SAMHD1 in HIV-1 physiopathology. Here, we explored the function of SAMHD1 in regulating cell proliferation, cell cycle progression and apoptosis in monocytic THP-1 cells. Using the CRISPR/Cas9 technology, we generated THP-1 cells with stable SAMHD1 knockout. We found that silencing of SAMHD1 in cycling cells stimulates cell proliferation, redistributes cell cycle population in the G_1/G_0 phase and reduces apoptosis. These alterations correlated with increased dNTP levels and more efficient HIV-1 infection in dividing SAMHD1 knockout cells relative to control. Our results suggest that SAMHD1, through its dNTPase activity, affects cell proliferation, cell cycle distribution and apoptosis, and emphasize a key role of SAMHD1 in the interplay between cell cycle regulation and HIV-1 infection.

  20. SAMHD1 controls cell cycle status, apoptosis and HIV-1 infection in monocytic THP-1 cells

    Energy Technology Data Exchange (ETDEWEB)

    Bonifati, Serena [Center for Retrovirus Research, Department of Veterinary Biosciences, The Ohio State University, Columbus, OH (United States); Daly, Michele B. [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); St Gelais, Corine; Kim, Sun Hee [Center for Retrovirus Research, Department of Veterinary Biosciences, The Ohio State University, Columbus, OH (United States); Hollenbaugh, Joseph A.; Shepard, Caitlin [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); Kennedy, Edward M. [Department of Molecular Genetics and Microbiology, Duke University, Durham, NC (United States); Kim, Dong-Hyun [Department of Pharmacy, School of Pharmacy, Kyung-Hee University, Seoul (Korea, Republic of); Schinazi, Raymond F. [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); Kim, Baek, E-mail: baek.kim@emory.edu [Center for Drug Discovery, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA (United States); Department of Pharmacy, School of Pharmacy, Kyung-Hee University, Seoul (Korea, Republic of); Wu, Li, E-mail: wu.840@osu.edu [Center for Retrovirus Research, Department of Veterinary Biosciences, The Ohio State University, Columbus, OH (United States)

    2016-08-15

    SAMHD1 limits HIV-1 infection in non-dividing myeloid cells by decreasing intracellular dNTP pools. HIV-1 restriction by SAMHD1 in these cells likely prevents activation of antiviral immune responses and modulates viral pathogenesis, thus highlighting a critical role of SAMHD1 in HIV-1 physiopathology. Here, we explored the function of SAMHD1 in regulating cell proliferation, cell cycle progression and apoptosis in monocytic THP-1 cells. Using the CRISPR/Cas9 technology, we generated THP-1 cells with stable SAMHD1 knockout. We found that silencing of SAMHD1 in cycling cells stimulates cell proliferation, redistributes cell cycle population in the G{sub 1}/G{sub 0} phase and reduces apoptosis. These alterations correlated with increased dNTP levels and more efficient HIV-1 infection in dividing SAMHD1 knockout cells relative to control. Our results suggest that SAMHD1, through its dNTPase activity, affects cell proliferation, cell cycle distribution and apoptosis, and emphasize a key role of SAMHD1 in the interplay between cell cycle regulation and HIV-1 infection.