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Sample records for infection control consequences

  1. Consequences of Helicobacter pylori infection in children

    PubMed Central

    Pacifico, Lucia; Anania, Caterina; Osborn, John F; Ferraro, Flavia; Chiesa, Claudio

    2010-01-01

    Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the human stomach for many decades without adverse consequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent abdominal pain, chronic idiopathic thrombocytopenia, and poor growth. There is evidence of the role of H. pylori in childhood iron deficiency anemia, but the results are not conclusive. The possibility of an inverse relationship between H. pylori and gastroesophageal reflux disease, as well as childhood asthma, remains a controversial question. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. PMID:21049552

  2. Erosional Consequence of Saltcedar Control

    NASA Astrophysics Data System (ADS)

    Vincent, Kirk R.; Friedman, Jonathan M.; Griffin, Eleanor R.

    2009-08-01

    Removal of nonnative riparian trees is accelerating to conserve water and improve habitat for native species. Widespread control of dominant species, however, can lead to unintended erosion. Helicopter herbicide application in 2003 along a 12-km reach of the Rio Puerco, New Mexico, eliminated the target invasive species saltcedar ( Tamarix spp.), which dominated the floodplain, as well as the native species sandbar willow ( Salix exigua Nuttall), which occurred as a fringe along the channel. Herbicide application initiated a natural experiment testing the importance of riparian vegetation for bank stability along this data-rich river. A flood three years later eroded about 680,000 m3 of sediment, increasing mean channel width of the sprayed reach by 84%. Erosion upstream and downstream from the sprayed reach during this flood was inconsequential. Sand eroded from channel banks was transported an average of 5 km downstream and deposited on the floodplain and channel bed. Although vegetation was killed across the floodplain in the sprayed reach, erosion was almost entirely confined to the channel banks. The absence of dense, flexible woody stems on the banks reduced drag on the flow, leading to high shear stress at the toe of the banks, fluvial erosion, bank undercutting, and mass failure. The potential for increased erosion must be included in consideration of phreatophyte control projects.

  3. Erosional consequence of saltcedar control

    USGS Publications Warehouse

    Vincent, K.R.; Friedman, J.M.; Griffin, E.R.

    2009-01-01

    Removal of nonnative riparian trees is accelerating to conserve water and improve habitat for native species. Widespread control of dominant species, however, can lead to unintended erosion. Helicopter herbicide application in 2003 along a 12-km reach of the Rio Puerco, New Mexico, eliminated the target invasive species saltcedar (Tamarix spp.), which dominated the floodplain, as well as the native species sandbar willow (Salix exigua Nuttall), which occurred as a fringe along the channel. Herbicide application initiated a natural experiment testing the importance of riparian vegetation for bank stability along this data-rich river. A flood three years later eroded about 680,000 m3 of sediment, increasing mean channel width of the sprayed reach by 84%. Erosion upstream and downstream from the sprayed reach during this flood was inconsequential. Sand eroded from channel banks was transported an average of 5 km downstream and deposited on the floodplain and channel bed. Although vegetation was killed across the floodplain in the sprayed reach, erosion was almost entirely confined to the channel banks. The absence of dense, flexible woody stems on the banks reduced drag on the flow, leading to high shear stress at the toe of the banks, fluvial erosion, bank undercutting, and mass failure. The potential for increased erosion must be included in consideration of phreatophyte control projects. ?? 2009 U.S. Government.

  4. Erosional consequence of saltcedar control.

    PubMed

    Vincent, Kirk R; Friedman, Jonathan M; Griffin, Eleanor R

    2009-08-01

    Removal of nonnative riparian trees is accelerating to conserve water and improve habitat for native species. Widespread control of dominant species, however, can lead to unintended erosion. Helicopter herbicide application in 2003 along a 12-km reach of the Rio Puerco, New Mexico, eliminated the target invasive species saltcedar (Tamarix spp.), which dominated the floodplain, as well as the native species sandbar willow (Salix exigua Nuttall), which occurred as a fringe along the channel. Herbicide application initiated a natural experiment testing the importance of riparian vegetation for bank stability along this data-rich river. A flood three years later eroded about 680,000 m(3) of sediment, increasing mean channel width of the sprayed reach by 84%. Erosion upstream and downstream from the sprayed reach during this flood was inconsequential. Sand eroded from channel banks was transported an average of 5 km downstream and deposited on the floodplain and channel bed. Although vegetation was killed across the floodplain in the sprayed reach, erosion was almost entirely confined to the channel banks. The absence of dense, flexible woody stems on the banks reduced drag on the flow, leading to high shear stress at the toe of the banks, fluvial erosion, bank undercutting, and mass failure. The potential for increased erosion must be included in consideration of phreatophyte control projects.

  5. Long-term consequences of foodborne infections.

    PubMed

    Batz, Michael B; Henke, Evan; Kowalcyk, Barbara

    2013-09-01

    Foodborne infections with Campylobacter, E. coli O157:H7, Listeria monocytogenes, Salmonella, Shigella, Toxoplasma gondii, and other pathogens can result in long-term sequelae to numerous organ systems. These include irritable bowel syndrome, inflammatory bowel disease, reactive arthritis, hemolytic uremic syndrome, chronic kidney disease, Guillain-Barré Syndrome, neurological disorders from acquired and congenital listeriosis and toxoplasmosis, and cognitive and developmental deficits due to diarrheal malnutrition or severe acute illness. A full understanding of the long-term sequelae of foodborne infection is important both for individual patient management by clinicians, as well as to inform food safety and public health decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. The epidemiological consequences of leprosy-tuberculosis co-infection.

    PubMed

    Hohmann, N; Voss-Böhme, A

    2013-02-01

    While in antiquity both leprosy and tuberculosis were prevalent in Europe, leprosy declined thereafter and, simultaneously, tuberculosis prevalence increased. Since both diseases are caused by mycobacterial infections, it has been suggested that there might be a causal relationship between both epidemics. Chaussinand observed the inverse prevalence of leprosy and tuberculosis and suggested that individuals with a latent tuberculosis infection are protected from acquiring leprosy. His cross-immunity hypothesis has been countered more recently by a co-infection hypothesis. The latter suggestion, proposed by Donoghue, states that people being infected with multi-bacillary leprosy are more susceptible to tuberculosis, which leads to increased mortality from the disease. This study utilizes mathematical modeling to explore the epidemiological consequences of the co-infection hypothesis for realistically confined parameter values. While the co-infection hypothesis appears plausible at first glance, a second thought reveals that it comprises also substantial consequences for tuberculosis epidemics: if co-infection raises the mortality rate above that of purely tuberculosis infected persons, then tuberculosis might as well be eradicated by leprosy. It is the specific interplay of both increased susceptibility towards tuberculosis and increased death rate when co-infected that determines the epidemiological fate. As a result of this analysis, it is shown that there is a large parameter region where the eventual disappearance of leprosy could indeed be explained by co-infection. This parameter region is considerably larger than that predicted by the cross-immunity hypothesis. This shows that the co-infection hypothesis should be considered a significant alternative to the cross-immunity hypothesis. The time scales at which the effects of co-infection are observed depend critically on the spatial distribution of the individuals but reach epidemiologically realistic values for

  7. Infection prevention and control.

    PubMed

    Pegram, Anne; Bloomfield, Jacqueline

    2015-03-18

    All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the third essential skills cluster - infection prevention and control. It provides an overview and discussion of the key skills and behaviours that must be demonstrated to meet the standards set by the Nursing and Midwifery Council. In doing so, it considers the key principles of infection prevention and control, including local and national policies, standard infection control precautions, risk assessment, standard isolation measures and asepsis.

  8. [Toxoplasma infections in early pregnancy: consequences and management].

    PubMed

    Wallon, M; Gaucherand, P; Al Kurdi, M; Peyron, F

    2002-09-01

    To assess the consequences for the fetus of maternal toxoplasma infection acquired during the first 8 weeks of gestation and to set guidelines on how to manage these maternal infections. Data were prospectively analyzed on 360 pregnancies followed-up in our department due to a toxoplasma infection during the 8 first weeks of pregnancy. Estimates of the risk of fetal infection were based on all cases, including those which could not be followed up until infection was ruled out or confirmed. Severity of infection was estimated based on ultrasound findings during pregnancy, neonatal and long-term postnatal clinical, neurological and ophthalmologic work up. Out of the 360 included women, 336 gave birth to a live born child: 7 (2%) were infected, 302 (90%) were free of infection and follow-up was insufficient to conclude about the 27 (8%) remaining infants. The estimated risk of fetal infection ranged between 2 and 10% based on live born children and between 3 and 14% when the 24 interrupted pregnancies were included. At their last clinical evaluation at 70 months of age, all 7 children, including the 2 who had inactive peripheral eye lesions and the one who had a unique intracranial calcification were free of any ophthalmologic or neurological impairment. Our study confirms that in the event of a maternal infection during the first 8 weeks of pregnancy the risk of fetal infection is low and results mainly in a spontaneous termination of pregnancy. Future parents should be assured that conversely to a common opinion, the prognosis of congenital toxoplasmosis in live-born children is good. For these early maternal infections as for those acquired later, we recommend immediate treatment with spiramycin, monthly ultrasound surveillance, amniocentesis and treatment with pyrimethamine and sulphamides if the PCR is positive. Abortion should be restricted to cases with ultrasound lesions

  9. Advances in infection control

    PubMed Central

    Marra, Alexandre Rodrigues

    2016-01-01

    ABSTRACT Several initiatives took place in recent years in relation to nosocomial infection control in order to increase patient safety. Some of these initiatives will be commented in this brief review. PMID:27074240

  10. Infection control for norovirus

    PubMed Central

    Barclay, L.; Park, G. W.; Vega, E.; Hall, A.; Parashar, U.; Vinjé, J.; Lopman, B.

    2015-01-01

    Norovirus infections are notoriously difficult to prevent and control, owing to their low infectious dose, high shedding titre, and environmental stability. The virus can spread through multiple transmission routes, of which person-to-person and foodborne are the most important. Recent advances in molecular diagnostics have helped to establish norovirus as the most common cause of sporadic gastroenteritis and the most common cause of outbreaks of acute gastroenteritis across all ages. In this article, we review the epidemiology and virology of noroviruses, and prevention and control guidelines, with a focus on the principles of disinfection and decontamination. Outbreak management relies on sound infection control principles, including hand hygiene, limiting exposure to infectious individuals, and thorough environmental decontamination. Ideally, all infection control recommendations would rely on empirical evidence, but a number of challenges, including the inability to culture noroviruses in the laboratory and the challenges of outbreak management in complex environments, has made it difficult to garner clear evidence of efficacy in certain areas of infection control. New experimental data on cultivable surrogates for human norovirus and on environmental survivability and relative resistance to commonly used disinfectants are providing new insights for further refinining disinfection practices. Finally, clinical trials are underway to evaluate the efficacy of vaccines, which may shift the current infection control principles to more targeted interventions. PMID:24813073

  11. Metabolic consequences of Helicobacter pylori infection and eradication

    PubMed Central

    Buzás, György Miklós

    2014-01-01

    Helicobacter pylori (H. pylori) is still the most prevalent infection of the world. Colonization of the stomach by this agent will invariably induce chronic gastritis which is a low-grade inflammatory state leading to local complications (peptic ulcer, gastric cancer, lymphoma) and remote manifestations. While H. pylori does not enter circulation, these extragastric manifestations are probably mediated by the cytokines and acute phase proteins produced by the inflammed mucosa. The epidemiologic link between the H. pylori infection and metabolic changes is inconstant and controversial. Growth delay was described mainly in low-income regions with high prevalence of the infection, where probably other nutritional and social factors contribute to it. The timely eradication of the infection will lead to a more healthy development of the young population, along with preventing peptic ulcers and gastric cancer An increase of total, low density lipoprotein and high density liporotein cholesterol levels in some infected people creates an atherogenic lipid profile which could promote atherosclerosis with its complications, myocardial infarction, stroke and peripheral vascular disease. Well designed and adequately powered long-term studies are required to see whether eradication of the infection will prevent these conditions. In case of glucose metabolism, the most consistent association was found between H. pylori and insulin resistance: again, proof that eradication prevents this common metabolic disturbance is expected. The results of eradication with standard regimens in diabetics are significantly worse than in non-diabetic patients, thus, more active regimens must be found to obtain better results. Successful eradication itself led to an increase of body mass index and cholesterol levels in some populations, while in others no such changes were encountered. Uncertainities of the metabolic consequences of H. pylori infection must be clarified in the future. PMID:24833852

  12. [Infection prevention and control for foodborne infections].

    PubMed

    Mitsuda, Toshihiro

    2012-08-01

    Patients' care for foodborne infections is sometimes very critical, since these patients exerting high copy numbers of contagious pathogens. Recently, Norovirus infection became the most frequent pathogen for large outbreaks in the community and the hospital around the world. Norovirus is alcohol-resistant and highly contagious. For preventing outbreaks of foodborne infections, standard precaution(and contact precaution for diaper changing patients) is required by the CDC's isolation precaution guideline revised at 2007. We need to provide for infection prevention and control in the epidemic winter period not only in healthcare facilities but also for communities.

  13. Aquatic Plant Control and Environmental Consequences.

    DTIC Science & Technology

    1982-01-01

    4), insects, and plant pathogens (2,3), but biological control reivains only a potential tool for large-scale control of aquatic weeds. Researchers in...fishes often do not feed selectively, yet there is no requirement for specific food selection by them. Use of Plant Pathogens k. Lack of information...on aquatic plant pathogens . Most work on plant pathogens , such as fungi, has been done on terrestrial species. Little is known with regard to methods

  14. Infection control and prevention considerations.

    PubMed

    Daniels, Titus L; Talbot, Thomas R

    2014-01-01

    Due to the nature of their underlying illness and treatment regimens, cancer patients are at increased risk of infection. Though the advent and widespread use of anti-infective agents has allowed for the application of ever-greater immune-suppressing therapies with successful treatment of infectious complications, prevention of infection remains the primary goal. The evolutionary changes of microorganisms, whereby resistance to anti-infective therapy is increasingly common, have facilitated a paradigm shift in the field of healthcare epidemiology. No longer is the focus on "control" of infection once established in a healthcare environment. Rather, the emphasis is on prevention of infection before it occurs. The most basic tenet of infection prevention, and the cornerstone of all well-designed infection prevention and control programs, is hand hygiene. The hands of healthcare workers provide a common potential source for transmission of infectious agents, and effective decontamination of the hands reduces the risk of transmission of infectious material to other patients. Once infection is suspected or established; however, implementation of effective control strategies is important to limit the spread of infection within a healthcare environment. This chapter outlines the basic tenets of infection prevention, principles of isolation precautions and control measures, and elements for a successful infection control and prevention program.

  15. Controlled human malaria infection.

    PubMed

    Spring, Michele; Polhemus, Mark; Ockenhouse, Christian

    2014-06-15

    Since 1986, investigators at Walter Reed Army Institute of Research (WRAIR) have been using controlled human malaria challenge (CHMI) in malaria-naive adults in order to define the protective efficacy of a malaria vaccine and thus guide programmatic decisions on vaccine candidates. Adapting this model to the dengue field could provide similar evidential support for a vaccine or therapeutic product. After completing a vaccine regimen, volunteers are bitten by 5 malaria-infected female Anopheles mosquitoes in a controlled environment. Volunteers are then monitored daily for peripheral parasitemia in a hotel setting with 24-hour access to a nurse and physician. If a single verified parasite is detected, effective antimalarials are promptly administered. The vast majority of the over 1000 volunteers having participated in CHMI clinical studies have done so at US military research centers. Numerous pre-erythrocytic and erythrocytic vaccine candidates have been evaluated safely and without any related serious adverse events using this model, including the soon-to-be licensed RTS,S malaria vaccine. The lessons learned from over 25 years of experience in consistent, careful preparation and execution of the CHMI model at WRAIR can provide a foundation from which the dengue field can begin to develop a rigorous and safe "CHDI" model. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Biological consequences of environmental control through housing.

    PubMed Central

    Lee, D H

    1975-01-01

    Housing was originally devised as a control of the thermal environment, but numerous other functions have been added with resulting competition and confusion. Current design gives insufficient attention to thermal factors and relies upon supplementary heating and cooling to compensate for faults. These are wasteful of energy, and the exhaust from air conditioners adds to the heat island conditions in city cores. The impact of consumerism on domestic space and the importance of personal space and privacy are reviewed. PMID:1157791

  17. Biological consequences of environmental control through housing.

    PubMed

    Lee, D H

    1975-04-01

    Housing was originally devised as a control of the thermal environment, but numerous other functions have been added with resulting competition and confusion. Current design gives insufficient attention to thermal factors and relies upon supplementary heating and cooling to compensate for faults. These are wasteful of energy, and the exhaust from air conditioners adds to the heat island conditions in city cores. The impact of consumerism on domestic space and the importance of personal space and privacy are reviewed.

  18. Harmful cyanobacterial blooms: causes, consequences, and controls.

    PubMed

    Paerl, Hans W; Otten, Timothy G

    2013-05-01

    Cyanobacteria are the Earth's oldest oxygenic photoautotrophs and have had major impacts on shaping its biosphere. Their long evolutionary history (≈ 3.5 by) has enabled them to adapt to geochemical and climatic changes, and more recently anthropogenic modifications of aquatic environments, including nutrient over-enrichment (eutrophication), water diversions, withdrawals, and salinization. Many cyanobacterial genera exhibit optimal growth rates and bloom potentials at relatively high water temperatures; hence global warming plays a key role in their expansion and persistence. Bloom-forming cyanobacterial taxa can be harmful from environmental, organismal, and human health perspectives by outcompeting beneficial phytoplankton, depleting oxygen upon bloom senescence, and producing a variety of toxic secondary metabolites (e.g., cyanotoxins). How environmental factors impact cyanotoxin production is the subject of ongoing research, but nutrient (N, P and trace metals) supply rates, light, temperature, oxidative stressors, interactions with other biota (bacteria, viruses and animal grazers), and most likely, the combined effects of these factors are all involved. Accordingly, strategies aimed at controlling and mitigating harmful blooms have focused on manipulating these dynamic factors. The applicability and feasibility of various controls and management approaches is discussed for natural waters and drinking water supplies. Strategies based on physical, chemical, and biological manipulations of specific factors show promise; however, a key underlying approach that should be considered in almost all instances is nutrient (both N and P) input reductions; which have been shown to effectively reduce cyanobacterial biomass, and therefore limit health risks and frequencies of hypoxic events.

  19. Neutropenia during HIV Infection: Adverse Consequences and Remedies

    PubMed Central

    Shi, Xin; Sims, Matthew D; Hanna, Michel M; Xie, Ming; Gulick, Peter G; Zheng, Yong-Hui; Basson, Marc D; Zhang, Ping

    2016-01-01

    Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient’s association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients. PMID:24654626

  20. Neutropenia during HIV infection: adverse consequences and remedies.

    PubMed

    Shi, Xin; Sims, Matthew D; Hanna, Michel M; Xie, Ming; Gulick, Peter G; Zheng, Yong-Hui; Basson, Marc D; Zhang, Ping

    2014-01-01

    Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient's association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients.

  1. Quinolone-resistant Campylobacter infections: risk factors and clinical consequences.

    PubMed

    Engberg, Jørgen; Neimann, Jakob; Nielsen, Eva Møller; Aerestrup, Frank Møller; Fussing, Vivian

    2004-06-01

    We integrated data on quinolone and macrolide susceptibility patterns with epidemiologic and typing data from Campylobacter jejuni and C. coli infections in two Danish counties. The mean duration of illness was longer for 86 patients with quinolone-resistant C. jejuni infections (median 13.2 days) than for 381 patients with quinolone-sensitive C. jejuni infections (median 10.3 days, p = 0.001). Foreign travel, eating fresh poultry other than chicken and turkey, and swimming were associated with increased risk for quinolone-resistant C. jejuni infection. Eating fresh chicken (of presumably Danish origin) was associated with a decreased risk. Typing data showed an association between strains from retail food products and broiler chickens and quinolone-sensitive domestically acquired C. jejuni infections. An association between treatment with a fluoroquinolone before stool-specimen collection and having a quinolone-resistant C. jejuni infection was not observed.

  2. Long-term disease dynamics in lakes: causes and consequences of chytrid infections in Daphnia populations.

    PubMed

    Johnson, Pieter T J; Ives, Anthony R; Lathrop, Richard C; Carpenter, Stephen R

    2009-01-01

    Understanding the drivers and consequences of disease epidemics is an important frontier in ecology. However, long-term data on hosts, their parasites, and the corresponding environmental conditions necessary to explore these interactions are often unavailable. We examined the dynamics of Daphnia pulicaria, a keystone zooplankter in lake ecosystems, to explore the long-term causes and consequences of infection by a chytridiomycete parasitoid (Polycaryum laeve). After quantifying host-pathogen dynamics from vouchered samples collected over 15 years, we used autoregressive models to evaluate (1) hypothesized drivers of infection, including host density, water temperature, dissolved oxygen, host-food availability, and lake mixing; and (2) the effects of epidemics on host populations. Infection was present in most years but varied widely in prevalence, from < 1% to 34%, with seasonal peaks in early spring and late fall. Within years, lake stratification strongly inhibited P. laeve transmission, such that epidemics occurred primarily during periods of water mixing. Development of the thermocline likely reduced transmission by spatially separating susceptible hosts from infectious zoospores. Among years, ice duration and cumulative snowfall correlated negatively with infection prevalence, likely because of reductions in spring phytoplankton and D. pulicaria density in years with extended winters. Epidemics also influenced dynamics of the host population. Infected D. pulicaria rarely (< 1%) contained eggs, and P. laeve prevalence was positively correlated with sexual reproduction in D. pulicaria. Analyses of D. pulicaria density-dependent population dynamics predicted that, in the absence of P. laeve infection, host abundance would be 11-50% higher than what was observed. By underscoring the importance of complex physical processes in controlling host-parasite interactions and of epidemic disease in influencing host populations, our results highlight the value of long

  3. Pathological and ecological host consequences of infection by an introduced fish parasite.

    PubMed

    Britton, J Robert; Pegg, Josephine; Williams, Chris F

    2011-01-01

    The infection consequences of the introduced cestode fish parasite Bothriocephalus acheilognathi were studied in a cohort of wild, young-of-the-year common carp Cyprinus carpio that lacked co-evolution with the parasite. Within the cohort, parasite prevalence was 42% and parasite burdens were up to 12% body weight. Pathological changes within the intestinal tract of parasitized carp included distension of the gut wall, epithelial compression and degeneration, pressure necrosis and varied inflammatory changes. These were most pronounced in regions containing the largest proportion of mature proglottids. Although the body lengths of parasitized and non-parasitized fish were not significantly different, parasitized fish were of lower body condition and reduced weight compared to non-parasitized conspecifics. Stable isotope analysis (δ(15)N and δ(13)C) revealed trophic impacts associated with infection, particularly for δ(15)N where values for parasitized fish were significantly reduced as their parasite burden increased. In a controlled aquarium environment where the fish were fed ad libitum on an identical food source, there was no significant difference in values of δ(15)N and δ(13)C between parasitized and non-parasitized fish. The growth consequences remained, however, with parasitized fish growing significantly slower than non-parasitized fish, with their feeding rate (items s(-1)) also significantly lower. Thus, infection by an introduced parasite had multiple pathological, ecological and trophic impacts on a host with no experience of the parasite.

  4. Pathological and Ecological Host Consequences of Infection by an Introduced Fish Parasite

    PubMed Central

    Britton, J. Robert; Pegg, Josephine; Williams, Chris F.

    2011-01-01

    The infection consequences of the introduced cestode fish parasite Bothriocephalus acheilognathi were studied in a cohort of wild, young-of-the-year common carp Cyprinus carpio that lacked co-evolution with the parasite. Within the cohort, parasite prevalence was 42% and parasite burdens were up to 12% body weight. Pathological changes within the intestinal tract of parasitized carp included distension of the gut wall, epithelial compression and degeneration, pressure necrosis and varied inflammatory changes. These were most pronounced in regions containing the largest proportion of mature proglottids. Although the body lengths of parasitized and non-parasitized fish were not significantly different, parasitized fish were of lower body condition and reduced weight compared to non-parasitized conspecifics. Stable isotope analysis (δ15N and δ13C) revealed trophic impacts associated with infection, particularly for δ15N where values for parasitized fish were significantly reduced as their parasite burden increased. In a controlled aquarium environment where the fish were fed ad libitum on an identical food source, there was no significant difference in values of δ15N and δ13C between parasitized and non-parasitized fish. The growth consequences remained, however, with parasitized fish growing significantly slower than non-parasitized fish, with their feeding rate (items s−1) also significantly lower. Thus, infection by an introduced parasite had multiple pathological, ecological and trophic impacts on a host with no experience of the parasite. PMID:22022606

  5. Essentials of paediatric infection control

    PubMed Central

    Moore, Dorothy L

    2001-01-01

    Young children readily transmit and acquire nosocomial infections. Children are also vulnerable to endogenous infections as a result of the breakdown of their normal defences by disease, invasive procedures or therapy. The increasing acuity of illness in hospitalized children and therapeutic advances have resulted in a patient population that is increasingly at higher risk for nosocomial infections. Antibiotic resistance has emerged as a problem in some paediatric hospitals, usually in intensive care and oncology units. Infection rates are the highest in neonatal and paediatric intensive care units (where bloodstream infections are the most frequent), and are usually associated with intravascular devices. On general paediatric wards, respiratory and gastrointestinal infections predominate, reflecting the occurrence in the community. The surveillance of nosocomial infections identifies priorities for infection control activities and permits evaluation of interventions. The prevention of transmission between patients and to personnel requires that certain measures be taken with all patients, and that additional precautions be taken with some infections, based on the route of transmission. The prevention of transmission from personnel involves ensuring that personnel are appropriately immunized and counselled about working with infections. The prevention of nosocomial infection also involves control of visitors, appropriate management of invasive procedures and devices, sterilization and disinfection of equipment, provision of a clean environment and adequate staffing. Severely immunocompromised children require extra protection, including ventilation systems that reduce the risk of exposure to filamentous fungi. Infection control in paediatrics is an evolving field that must adapt to changes in the paediatric patient population and in health care technology. PMID:20084127

  6. Natural History and Clinical Consequences of Hepatitis B Virus Infection

    PubMed Central

    2005-01-01

    Despite the existence of Hepatitis B vaccination, hepatitis B virus (HBV) infection is still prevalent worldwide and accounts for significant morbidity and mortality. It is encouraging that majority of patients do recover from the acute infection, however, those that progress to chronic disease state is at great risk of developing complications such as hepatocellular carcinoma, cirrhosis and liver failure. Hepatitis B virus infection can be influenced by many factors such as host immune status, age at infection, and level of viral replication. The discovery about the existence of various genotypes and its association with different geographic distribution as well as the knowledge regarding mutant species has aid us in better understanding the nature of HBV infection and in delivering better care for patients. It is especially important to recognize those individuals with HBeAg-negative chronic HBV as they have a poorer prognosis compare with their counterparts, HBeAg-positive. Tremendous progress has been made over the years in understanding the behavior and clinical course of the disease; however, the natural history of HBV is complex and we still have much to explore and learn. PMID:15968338

  7. Natural History and Clinical Consequences of Hepatitis B Virus Infection.

    PubMed

    Pan, Calvin Q; Zhang, Jin X

    2005-01-01

    Despite the existence of Hepatitis B vaccination, hepatitis B virus (HBV) infection is still prevalent worldwide and accounts for significant morbidity and mortality. It is encouraging that majority of patients do recover from the acute infection, however, those that progress to chronic disease state is at great risk of developing complications such as hepatocellular carcinoma, cirrhosis and liver failure. Hepatitis B virus infection can be influenced by many factors such as host immune status, age at infection, and level of viral replication. The discovery about the existence of various genotypes and its association with different geographic distribution as well as the knowledge regarding mutant species has aid us in better understanding the nature of HBV infection and in delivering better care for patients. It is especially important to recognize those individuals with HBeAg-negative chronic HBV as they have a poorer prognosis compare with their counterparts, HBeAg-positive. Tremendous progress has been made over the years in understanding the behavior and clinical course of the disease; however, the natural history of HBV is complex and we still have much to explore and learn.

  8. [Potential neurocognitive consequences of infection by human respiratory syncytial virus].

    PubMed

    Flores, Juan Carlos; Bohmwald, Karen; Espinoza, Janyra; Jara, Crlstlna; Peña, Marcela; Hoyos-Bachiloglu, Rodrigo; Iturriaga, Carolina; Kalergis, Alexis M; Borzutzky, Arturo

    2016-10-01

    Human respiratory syncytial virus (RSV) infection remains as a major cause of morbidity and mortality among pediatric population. Immune response is poor and unable to establish a long term effective protection against this virus. Of particular interest has been the description of extrapulmonary manifestations of RSV infection in liver, kidney, endocrine system, heart and brain, associated to infection of peripheral blood. In the central nervous system (CNS), recent studies in animals have suggested long term neurocognitive impairment due to a direct damage from the virus. This was prevented in rats by a recombinant BCG vaccine expressing a nucleoprotein N of RSV that produces an effective immune response against the virus, not allowing its dissemination to the CNS. These findings in animal models highlight the importance of conducting more specific studies in children affected with severe infection by RSV. Therefore, our group is currently conducting an assessment of the possible long-term cognitive impairment in children under 2 years. The results of this study could be a strong argument to continue looking for an effective method for protecting against RSV infection.

  9. Consequence of Maternal Zika Virus Infection: A Narrative review.

    PubMed

    Niaz, Kamal; Abdollahi, Mohammad

    2016-10-18

    Zika virus (ZIKV) is a deadly flavivirus that has spread from Africa to Asia and European countries. The virus is associated with other viruses in the same genus or family, transmitted by the same mosquito species with known history of fatality. A sudden increase in the rate of infection from ZIKV has made it a global health concern, which necessitates close symptom monitoring, enhancing treatment options, and vaccine production. This paper reviewed current reports on birth defects associated with ZIKV, mode of transmission, body fluids containing the virus, diagnosis , possible preventive measures or treatments, and vaccine development. Google scholar was used as the major search engine for research and review articles, up to July, 2016. Search terms such as "ZIKV", "ZIKV infection", "ZIKV serotypes", "treatment of ZIKV infection", "co-infection with zika virus", "flavivirus", "microcephaly and zika", "birth defects and Zika", as well as "ZIKV vaccine" were used. ZIKV has been detected in several body fluids such as saliva, semen, blood, and amniotic fluid. This reveals the possibility of sexual and mother to child transmission. The ability of the virus to cross the placental barrier and the blood brain barrier (BBB) has been associated with birth defects such as microcephaly, ocular defects, and Guillian Barre syndrome (GBS). Preventive measures can reduce the spread and risk of the infection. Available treatments only target symptoms while vaccines are still under development. Birth defects are associated with ZIKV infection in pregnant women; hence the need for development of standard treatments, employment of strict preventive measures and development of effective vaccines.

  10. Day Care Infection Control Protocol.

    ERIC Educational Resources Information Center

    Seattle-King County Dept. of Public Health, Seattle, WA.

    This day care infection control manual was assembled to provide technical guidance for the prevention and control of communicable diseases to child day care facilities in Seattle and King County, Washington. For each disease, the manual provides background information, public health control recommendations, and letters that can be used to…

  11. Day Care Infection Control Protocol.

    ERIC Educational Resources Information Center

    Seattle-King County Dept. of Public Health, Seattle, WA.

    This day care infection control manual was assembled to provide technical guidance for the prevention and control of communicable diseases to child day care facilities in Seattle and King County, Washington. For each disease, the manual provides background information, public health control recommendations, and letters that can be used to…

  12. Consequences of Phytophthora ramorum infection in coast live oaks

    Treesearch

    Brice McPherson; David L. Wood; Sylvia R. Mori; Pavel Svihra; Richard B. Standiford; N. Maggi. Kelly

    2008-01-01

    Sudden oak death, caused by Phytophthora ramorum, has infected and killed large numbers of oaks (Quercus spp.) and tanoaks (Lithocarpus densiflorus) in California since the mid 1990s. Since March 2000 we have been investigating the interactions between patterns of disease progression and...

  13. Infection control and prevention in perioperative practice.

    PubMed

    Williams, Marilyn

    2008-07-01

    The personal and financial consequences of avoidable infection are enormous in personal and global terms (DH 2003, Stone, Larson & Kawar 2002). Patients expect to be treated and cared for in clean conditions, and not be exposed to the risks of acquiring an infection by poor practice on the part of healthcare workers (DH 2005, Health Care Commission 2005). Infection control and prevention in perioperative settings assumes an even greater significance because of the vulnerability of patients who are already ill or injured, and because surgery, anaesthesia and immediate postoperative recovery may expose them to invasive procedures, allowing more portals of entry for infection. There is ample evidence, widely available, to support best practice in all healthcare settings. The methods are cheap, easy to apply and very effective (Wright 2004, Pratt et al 2007). This article will examine a range of evidence applicable to perioperative infection control and prevention, including an assessment of current practice and how it may be improved, with a particular emphasis on surgical site infection associated with Meticillin Resistant Staphylococcus Aureus (MRSA) and Clostridium Difficile (C.diff).

  14. Oxidative Stress during HIV Infection: Mechanisms and Consequences

    PubMed Central

    Kochetkov, Sergey N.; Starodubova, Elizaveta S.; Bartosch, Birke

    2016-01-01

    It is generally acknowledged that reactive oxygen species (ROS) play crucial roles in a variety of natural processes in cells. If increased to levels which cannot be neutralized by the defense mechanisms, they damage biological molecules, alter their functions, and also act as signaling molecules thus generating a spectrum of pathologies. In this review, we summarize current data on oxidative stress markers associated with human immunodeficiency virus type-1 (HIV-1) infection, analyze mechanisms by which this virus triggers massive ROS production, and describe the status of various defense mechanisms of the infected host cell. In addition, we have scrutinized scarce data on the effect of ROS on HIV-1 replication. Finally, we present current state of knowledge on the redox alterations as crucial factors of HIV-1 pathogenicity, such as neurotoxicity and dementia, exhaustion of CD4+/CD8+ T-cells, predisposition to lung infections, and certain side effects of the antiretroviral therapy, and compare them to the pathologies associated with the nitrosative stress. PMID:27829986

  15. Consequences of concurrent Ascaridia galli and Escherichia coli infections in chickens.

    PubMed

    Permin, A; Christensen, J P; Bisgaard, M

    2006-01-01

    Three experiments were carried out to examine the consequences of concurrent infections with Ascaridia galli and Escherichia coli in chickens raised for table egg production. Characteristic pathological lesions including airsacculitis, peritonitis and/or polyserositis were seen in all groups infected with E. coli. Furthermore, a trend for increased mortality rates was observed in groups infected with both organisms which, however, could not be confirmed statistically. The mean worm burden was significantly lower in combined infection groups compared to groups infected only with A. galli. It was also shown that combined infections of E. coli and A. galli had an added significant negative impact on weight gain.

  16. Consequences of concurrent Ascaridia galli and Escherichia coli infections in chickens

    PubMed Central

    Permin, A; Christensen, JP; Bisgaard, M

    2006-01-01

    Three experiments were carried out to examine the consequences of concurrent infections with Ascaridia galli and Escherichia coli in chickens raised for table egg production. Characteristic pathological lesions including airsacculitis, peritonitis and/or polyserositis were seen in all groups infected with E. coli. Furthermore, a trend for increased mortality rates was observed in groups infected with both organisms which, however, could not be confirmed statistically. The mean worm burden was significantly lower in combined infection groups compared to groups infected only with A. galli. It was also shown that combined infections of E. coli and A. galli had an added significant negative impact on weight gain. PMID:16722305

  17. Economic consequences for Medicaid of human immunodeficiency virus infection

    PubMed Central

    Baily, Mary Ann; Bilheimer, Linda; Wooldridge, Judith; well, Kathryn Lang; Greenberg, Warren

    1990-01-01

    Medicaid is currently a major source of financing for health care for those with acquired immunodeficiency syndrome (AIDS) and to a lesser extent, for those with other manifestations of human immunodeficiency virus (HIV) infection. It is likely to become even more important in the future. This article focuses on the structure of Medicaid in the context of the HIV epidemic, covering epidemiological issues, eligibility, service coverage and use, and reimbursement. A simple methodology for estimating HI\\'-related Medicaid costs under alternative assumptions about the future is also explained. PMID:10113503

  18. Infection control in operating theatres.

    PubMed

    Al-Benna, Sammy

    2012-10-01

    The operating theatre complex is the heart of any major surgical hospital. Good operating theatre design meets the functional needs of theatre care professionals. Operating theatre design must pay careful consideration to traffic patterns, the number and configuration of nearby operating rooms, the space required for staff, administration and storage, provisions for sterile processing and systems to control airborne contaminants (Wan et al 2011). There have been infection control issues with private finance initiative built operating theatres (Unison 2003, Ontario Health Coalition 2005). The aim of this article is to address these issues as they relate to infection control and prevention.

  19. Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial.

    PubMed

    Jackson, Louise J; Roberts, Tracy E; Fuller, Sebastian S; Sutcliffe, Lorna J; Saunders, John M; Copas, Andrew J; Mercer, Catherine H; Cassell, Jackie A; Estcourt, Claudia S

    2015-03-01

    The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial

    PubMed Central

    Jackson, Louise J; Roberts, Tracy E; Fuller, Sebastian S; Sutcliffe, Lorna J; Saunders, John M; Copas, Andrew J; Mercer, Catherine H; Cassell, Jackie A; Estcourt, Claudia S

    2015-01-01

    Background The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. Methods A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. Results There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Conclusions Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated. PMID:25512670

  1. Unintended consequences of Helicobacter pylori infection in children in developing countries

    PubMed Central

    Queiroz, Dulciene MM; Rocha, Andreia MC; Crabtree, Jean E

    2013-01-01

    Helicobacter pylori infection is predominantly acquired early in life. The prevalence of the infection in childhood is low in developed countries, whereas in developing countries most children are infected by 10 y of age. In poor resource settings, where malnutrition, parasitic/enteropathogen and H. pylori infection co-exist in young children, H. pylori might have potentially more diverse clinical outcomes. This paper reviews the impact of childhood H. pylori infection in developing countries that should now be the urgent focus of future research. The extra-gastric manifestations in early H. pylori infection in infants in poor resource settings might be a consequence of the infection associated initial hypochlorhydria. The potential role of H. pylori infection on iron deficiency, growth impairment, diarrheal disease, malabsorption and cognitive function is discussed in this review. PMID:23988829

  2. Infection control, ethics and accountability.

    PubMed

    Gilbert, Gwendolyn L; Cheung, Paul Y; Kerridge, Ian B

    2009-06-15

    Health care-associated infections (HAIs) are a major clinical and economic problem in Australian hospitals, and a significant proportion are preventable. HAIs are the result of complex environmental, microbiological, pathological, behavioural and organisational factors, and prevention requires a multifaceted ("bundled") approach, including appropriate policies, educational programs for health care workers, and adequate resources to implement them effectively. Failure to protect patients from avoidable harm, including HAIs, has significant ethical implications; it often reflects both organisational systems failure and non-compliance of health care workers with evidence-based policies, including hand hygiene. If implemented with appropriate safeguards, infection control "bundles" that include sanctions for poor compliance with hand hygiene and other infection control policies, will achieve sustained improvements where previous approaches have failed.

  3. Enterobiasis (Pinworm Infection): Prevention and Control

    MedlinePlus

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

  4. Noise in gene expression: origins, consequences, and control.

    PubMed

    Raser, Jonathan M; O'Shea, Erin K

    2005-09-23

    Genetically identical cells and organisms exhibit remarkable diversity even when they have identical histories of environmental exposure. Noise, or variation, in the process of gene expression may contribute to this phenotypic variability. Recent studies suggest that this noise has multiple sources, including the stochastic or inherently random nature of the biochemical reactions of gene expression. In this review, we summarize noise terminology and comment on recent investigations into the sources, consequences, and control of noise in gene expression.

  5. 42 CFR 460.74 - Infection control.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... at least the standard precautions developed by the Centers for Disease Control and Prevention. (b...) Prevents and controls the transmission of disease and infection. (c) Contents of infection control...

  6. The self-control consequences of political ideology

    PubMed Central

    Clarkson, Joshua J.; Chambers, John R.; Hirt, Edward R.; Otto, Ashley S.; Kardes, Frank R.; Leone, Christopher

    2015-01-01

    Evidence from three studies reveals a critical difference in self-control as a function of political ideology. Specifically, greater endorsement of political conservatism (versus liberalism) was associated with greater attention regulation and task persistence. Moreover, this relationship is shown to stem from varying beliefs in freewill; specifically, the association between political ideology and self-control is mediated by differences in the extent to which belief in freewill is endorsed, is independent of task performance or motivation, and is reversed when freewill is perceived to impede (rather than enhance) self-control. Collectively, these findings offer insight into the self-control consequences of political ideology by detailing conditions under which conservatives and liberals are better suited to engage in self-control and outlining the role of freewill beliefs in determining these conditions. PMID:26100890

  7. The self-control consequences of political ideology.

    PubMed

    Clarkson, Joshua J; Chambers, John R; Hirt, Edward R; Otto, Ashley S; Kardes, Frank R; Leone, Christopher

    2015-07-07

    Evidence from three studies reveals a critical difference in self-control as a function of political ideology. Specifically, greater endorsement of political conservatism (versus liberalism) was associated with greater attention regulation and task persistence. Moreover, this relationship is shown to stem from varying beliefs in freewill; specifically, the association between political ideology and self-control is mediated by differences in the extent to which belief in freewill is endorsed, is independent of task performance or motivation, and is reversed when freewill is perceived to impede (rather than enhance) self-control. Collectively, these findings offer insight into the self-control consequences of political ideology by detailing conditions under which conservatives and liberals are better suited to engage in self-control and outlining the role of freewill beliefs in determining these conditions.

  8. An experimental test of the physiological consequences of avian malaria infection.

    PubMed

    Schoenle, Laura A; Kernbach, Meredith; Haussmann, Mark F; Bonier, Frances; Moore, Ignacio T

    2017-09-08

    1.Chronic, low-intensity parasite infections can reduce host fitness through negative impacts on reproduction and survival, even if they produce few overt symptoms. As a result, these parasites can influence the evolution of host morphology, behavior, and physiology. The physiological consequences of chronic infection can provide insight into the processes underlying parasite-driven natural selection. 2.Here, we evaluate the physiological consequences of natural, low-intensity infection in an avian host-parasite system: adult male red-winged blackbirds (Agelaius phoeniceus) infected with haemosporidian parasites. Chronic haemosporidian infection has previously been shown to reduce both reproductive success and survival in several avian species. 3.We used anti-malarial medications to experimentally reduce haemosporidian parasitemia (the proportion of blood cells infected with haemosporidian parasites) and measured the effect of treatment on body condition, hematology, immune function, physiological stress, and oxidative state. 4.Treatment with an anti-malarial medication reduced parasitemia for the most prevalent haemosporidian parasites from the genus Plasmodium. Treatment also increased hemoglobin and hematocrit, and decreased red blood cell production rates. We detected no effect of treatment on body condition, immune metrics, plasma corticosterone concentrations, total antioxidant capacity, or reactive oxygen metabolites. 5.Our results suggest that the damage and replacement of red blood cells during infection could be important costs of chronic haemosporidian infection. Strong links between parasitemia and the physiological consequences of infection indicate that even for relatively low intensity infections, measuring parasitemia rather than only presence/absence could be important when evaluating the role of infection in influencing hosts' behavior, physiology, or fitness. This article is protected by copyright. All rights reserved. This article is protected

  9. Consequences of Nosema apis infection for male honey bees and their fertility.

    PubMed

    Peng, Yan; Baer-Imhoof, Barbara; Millar, A Harvey; Baer, Boris

    2015-06-30

    The queens of eusocial bees, ants and wasps mate only during a very short period early in life and males therefore produce ejaculates consisting of large numbers of high quality sperm. Such extreme selection for high fecundity resulted in males investing minimally into their somatic survival, including their immune system. However, if susceptible males are unable to protect their reproductive tissue from infections, they compromise queen fitness if they transfer pathogens during mating. We used the honey bee Apis mellifera and investigated the course of infection of the sexually transmitted pathogen Nosema apis. We predicted that honey bee males are susceptible but protect their reproductive tissues from infections. We investigated the effects of N. apis infections on the midgut, the accessory glands and the accessory testes and quantified the consequences of infection on male survival and fecundity. We found that N. apis is able to infect males, and as infections progressed, it significantly impacted fertility and survival in older males. Even though we confirm males to be able to minimize N. apis infections of their reproductive tissues, the parasite is present in ejaculates of older males. Consequently N. apis evolved alternative routes to successfully infect ejaculates and get sexually transmitted.

  10. Consequences of Nosema apis infection for male honey bees and their fertility

    PubMed Central

    Peng, Yan; Baer-Imhoof, Barbara; Harvey Millar, A.; Baer, Boris

    2015-01-01

    The queens of eusocial bees, ants and wasps mate only during a very short period early in life and males therefore produce ejaculates consisting of large numbers of high quality sperm. Such extreme selection for high fecundity resulted in males investing minimally into their somatic survival, including their immune system. However, if susceptible males are unable to protect their reproductive tissue from infections, they compromise queen fitness if they transfer pathogens during mating. We used the honey bee Apis mellifera and investigated the course of infection of the sexually transmitted pathogen Nosema apis. We predicted that honey bee males are susceptible but protect their reproductive tissues from infections. We investigated the effects of N. apis infections on the midgut, the accessory glands and the accessory testes and quantified the consequences of infection on male survival and fecundity. We found that N. apis is able to infect males, and as infections progressed, it significantly impacted fertility and survival in older males. Even though we confirm males to be able to minimize N. apis infections of their reproductive tissues, the parasite is present in ejaculates of older males. Consequently N. apis evolved alternative routes to successfully infect ejaculates and get sexually transmitted. PMID:26123530

  11. Infection control in healthcare settings in Japan.

    PubMed

    Morikane, Keita

    2012-01-01

    In Japan, the practice of infection control in healthcare settings has a short history of less than 3 decades. Before that, infection control practices were far from perfect and even ignored. This review summarizes changes in infection control in Japan since the 1980s and offers some comparisons with practices in foreign countries, especially the United States. Infection control is far better now than 25 years ago, but there remain fundamental issues that limit the development of better infection control practices. These problems include insufficient funding and human resources due to the socialized healthcare insurance system in Japan and the lack of interest in infection control research.

  12. The consequences of co-infections for parasite transmission in the mosquito Aedes aegypti.

    PubMed

    Duncan, Alison B; Agnew, Philip; Noel, Valérie; Michalakis, Yannis

    2015-03-01

    Co-infections may modify parasite transmission opportunities directly as a consequence of interactions in the within-host environment, but also indirectly through changes in host life history. Furthermore, host and parasite traits are sensitive to the abiotic environment with variable consequences for parasite transmission in co-infections. We investigate how co-infection of the mosquito Aedes aegypti with two microsporidian parasites (Vavraia culicis and Edhazardia aedis) at two levels of larval food availability affects parasite transmission directly, and indirectly through effects on host traits. In a laboratory infection experiment, we compared how co-infection, at low and high larval food availability, affected the probability of infection, within-host growth and the transmission potential of each parasite, compared to single infections. Horizontal transmission was deemed possible for both parasites when infected hosts died harbouring horizontally transmitting spores. Vertical transmission was judged possible for E. aedis when infected females emerged as adults. We also compared the total input number of spores used to seed infections with output number, in single and co-infections for each parasite. The effects of co-infection on parasite fitness were complex, especially for V. culicis. In low larval food conditions, co-infection increased the chances of mosquitoes dying as larvae or pupae, thus increasing opportunities for V. culicis' horizontal transmission. However, co-infection reduced larval longevity and hence time available for V. culicis spore production. Overall, there was a negative net effect of co-infection on V. culicis, whereby the number of spores produced was less than the number used to seed infection. Co-infections also negatively affected horizontal transmission of the more virulent parasite, E. aedis, through reduced longevity of pre-adult hosts. However, its potential transmission suffered less relative to V. culicis. Our results

  13. Hypopituitarism as consequence of late neonatal infection by Group B streptococcus: a case report

    PubMed Central

    Ferreira, Amanda Santana; Fernandes, Ana Lourdes Lima Araújo; Guaragna-Filho, Guilherme

    2015-01-01

    Hypopituitarism is a condition characterized by dysfunction of the pituitary gland hormone production. The insults of the perinatal period, which includes the late infection by Group B Streptococcus, consists in a rare etiology of this condition. We present the case of a 39-days-old infant with meningitis caused by Streptococcus Group B, which showed, among other consequences, hypopituitarism. PMID:26161231

  14. Hypopituitarism as consequence of late neonatal infection by Group B streptococcus: a case report.

    PubMed

    Ferreira, Amanda Santana; Fernandes, Ana Lourdes Lima Araújo; Guaragna-Filho, Guilherme

    2015-01-01

    Hypopituitarism is a condition characterized by dysfunction of the pituitary gland hormone production. The insults of the perinatal period, which includes the late infection by Group B Streptococcus, consists in a rare etiology of this condition. We present the case of a 39-days-old infant with meningitis caused by Streptococcus Group B, which showed, among other consequences, hypopituitarism.

  15. Control and Effort Costs Influence the Motivational Consequences of Choice

    PubMed Central

    Sullivan-Toole, Holly; Richey, John A.; Tricomi, Elizabeth

    2017-01-01

    The act of making a choice, apart from any outcomes the choice may yield, has, paradoxically, been linked to both the enhancement and the detriment of intrinsic motivation. Research has implicated two factors in potentially mediating these contradictory effects: the personal control conferred by a choice and the costs associated with a choice. Across four experiments, utilizing a physical effort task disguised as a simple video game, we systematically varied costs across two levels of physical effort requirements (Low-Requirement, High-Requirement) and control over effort costs across three levels of choice (Free-Choice, Restricted-Choice, and No-Choice) to disambiguate how these factors affect the motivational consequences of choosing within an effortful task. Together, our results indicated that, in the face of effort requirements, illusory control alone may not sufficiently enhance perceptions of personal control to boost intrinsic motivation; rather, the experience of actual control may be necessary to overcome effort costs and elevate performance. Additionally, we demonstrated that conditions of illusory control, while otherwise unmotivating, can through association with the experience of free-choice, be transformed to have a positive effect on motivation. PMID:28515705

  16. 42 CFR 483.65 - Infection control.

    Code of Federal Regulations, 2010 CFR

    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...

  17. 38 CFR 52.190 - Infection control.

    Code of Federal Regulations, 2010 CFR

    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...

  18. 42 CFR 460.74 - Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 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...

  19. 38 CFR 52.190 - Infection control.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 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. 42 CFR 483.65 - Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 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...

  1. 42 CFR 483.65 - Infection control.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 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...

  2. 38 CFR 52.190 - Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 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...

  3. 42 CFR 460.74 - Infection control.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 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...

  4. 42 CFR 460.74 - Infection control.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 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...

  5. 38 CFR 52.190 - Infection control.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 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...

  6. 38 CFR 52.190 - Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 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...

  7. HIV infection in the etiology of lung cancer: confounding, causality, and consequences.

    PubMed

    Kirk, Gregory D; Merlo, Christian A

    2011-06-01

    Persons infected with HIV have an elevated risk of lung cancer, but whether the increase simply reflects a higher smoking prevalence continues to be debated. This review summarizes existing data on the association of HIV infection and lung cancer, with particular attention to study design and adjustment for cigarette smoking. Potential mechanisms by which HIV infection may lead to lung cancer are discussed. Finally, irrespective of causality and mechanisms, lung cancer represents an important and growing problem confronting HIV-infected patients and their providers. Substantial efforts are needed to promote smoking cessation and to control lung cancer among HIV-infected populations.

  8. Tolerance of infection: A role for animal behavior, potential immune mechanisms, and consequences for parasite transmission.

    PubMed

    Adelman, James S; Hawley, Dana M

    2017-02-01

    Infected organisms can resist or tolerate infection, with tolerance of infection defined as minimizing per-parasite reductions in fitness. Although tolerance is well studied in plants, researchers have only begun to probe the mechanisms and transmission consequences of tolerance in animals. Here we suggest that research on tolerance in animals would benefit from explicitly incorporating behavior as a component of tolerance, given the importance of behavior for host fitness and parasite transmission. We propose two distinct manifestations of tolerance in animals: tissue-specific tolerance, which minimizes fitness losses due to tissue damage during infection, and behavioral tolerance, which minimizes fitness losses by maintaining normal, fitness-enhancing behaviors during infection. Here we briefly review one set of potential immune mechanisms underlying both responses in vertebrate animals: inflammation and its associated signaling molecules. Inflammatory responses, including broadly effective resistance mechanisms like the production of reactive oxygen species, can incur severe costs in terms of damage to a host's own tissues, thereby reducing tissue-specific tolerance. In addition, signaling molecules involved in these responses facilitate stereotypical behavioral changes during infection, which include lethargy and anorexia, reducing normal behaviors and behavioral tolerance. We consider how tissue-specific and behavioral tolerance may vary independently or in conjunction and outline potential consequences of such covariation for the transmission of infectious diseases. We put forward the distinction between tissue-specific and behavioral tolerance not as a definitive framework, but to help stimulate and broaden future research by considering animal behavior as intimately linked to the mechanisms and consequences of tolerance in animals. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. [Global consequences and control strategies of biological invasion].

    PubMed

    Xie, Zongqiang; Chen, Zhigang; Fan, Dayong; Xiong, Gaoming

    2003-10-01

    Biological invasion is a worldwide ecological phenomenon, but its mechanism is still not very clear. Invasive species give impacts on native species and ecosystems through competitions, predations, changing habitats, and dispersing diseases. They pose an increasing threat to the composition and structure of natural communities across the globe. Biological invasion has been greatly damaging the ecological and evolutionary integrity of natural ecosystems, which will weaken the functions of the ecosystems and frequently cause natural disasters. A better understanding of the causes, patterns, predictability, consequences, and management options associated with this threat to biodiversity is necessary to guide managers, policy makers, researchers, and general publics. Biological invasion also causes huge economic losses, and 137 billion dollar losses per year from biological invasion were estimated in USA. Invasive diseases impair human health and kill thousands and thousands of people, and invasive bacteria lead to so serious social panic and turbulence that people could feel uneasy even when eating and sleeping. Biological invasion largely decreases global biodiversity, which will threaten the survival and development of our descendants. Three steps are used in prevention and control of biological invasions. Comprehensive quarantine is the most effective way to prevent exotic invasion by accident. Ecological evaluation and monitoring is helpful to avoid disasters from species introduction. Physical methods, chemical approaches and biological controls are used to eradicate and control the spread of invaded species. Before biological controls are chosen, risk analysis of controlling organism is needed. Ideally, there should be both pre-eradication assessment to tailor removal to avoid unwanted ecological effects and post-removal assessment of eradication effects on both the target organism and the invaded ecosystem.

  10. Viral erythrocytic necrosis: Some physiological consequences of infection in chum salmon (Oncorhynchus keta)

    USGS Publications Warehouse

    MacMillan, John R.; Mulcahy, Daniel M.; Landolt, Marsha L.

    1980-01-01

    Erythroid cells in chum salmon (Oncorhynchus keta) susceptible to infection with erythrocytic necrosis virus (ENV) were examined by light and electron microscopy. Cells of stages II, III, IV, V, and VI contained complete eyrthrocytic necrosis virions in the cytoplasm. Viruses closely resembling ENV were also detected in the nuclei of some erythroblasts. Some secondary consequences of ENV infection were a threefold greater mortality rate from vibriosis, a significantly decreased tolerance to oxygen depletion, and a decreased ability to regulate serum sodium and potassium in saltwater.

  11. Social consequences of infected haemophilia cases in the Islamic Republic of Iran.

    PubMed

    Cheraghali, A M; Eshghi, P; Abolghasemi, H

    2011-06-01

    The unintentional contamination of haemophilia patients with HIV in the early 1980s raised serious questions about the safety of blood product supplies worldwide. The events initiated a cascade of consequences for both infected patients and the national health systems of many countries, including the Islamic Republic of Iran. Lawsuits have been filed in the courts mostly in developed countries, leading to the establishment of some kind of reimbursement programme for haemophilia patients who acquired viral infections. In the late 1990s the courts ordered the Iranian Ministry of Health, in addition to providing free care with the latest treatments to pay compensation to the haemophilia patients. The adverse consequences of these events on the equitable distribution of resources in the Iranian health care system are discussed in this paper.

  12. Extra-intestinal and long term consequences of Giardia duodenalis infections

    PubMed Central

    Halliez, Marie CM; Buret, André G

    2013-01-01

    Giardiasis is the most common waterborne parasitic infection of the human intestine worldwide. The etiological agent, Giardia duodenalis (syn. G. intestinalis, G. lamblia), is a flagellated, binucleated protozoan parasite which infects a wide array of mammalian hosts. Human giardiasis is a true cosmopolitan pathogen, with highest prevalence in developing countries. Giardiasis can present with a broad range of clinical manifestations from asymptomatic, to acute or chronic diarrheal disease associated with abdominal pain and nausea. Most infections are self-limiting, although re-infection and chronic infection can occur. Recent evidence indicating that Giardia may cause chronic post-infectious gastrointestinal complications have made it a topic of intense research. The causes of the post-infectious clinical manifestations due to Giardia, even after complete elimination of the parasite, remain obscure. This review offers a state-of-the-art discussion on the long-term consequences of Giardia infections, from extra-intestinal manifestations, growth and cognitive deficiencies, to post-infectious irritable bowel syndrome. The discussion also sheds light on some of the novel mechanisms recently implicated in the production of these post-infectious manifestations. PMID:24379622

  13. Extra-intestinal and long term consequences of Giardia duodenalis infections.

    PubMed

    Halliez, Marie C M; Buret, André G

    2013-12-21

    Giardiasis is the most common waterborne parasitic infection of the human intestine worldwide. The etiological agent, Giardia duodenalis (syn. G. intestinalis, G. lamblia), is a flagellated, binucleated protozoan parasite which infects a wide array of mammalian hosts. Human giardiasis is a true cosmopolitan pathogen, with highest prevalence in developing countries. Giardiasis can present with a broad range of clinical manifestations from asymptomatic, to acute or chronic diarrheal disease associated with abdominal pain and nausea. Most infections are self-limiting, although re-infection and chronic infection can occur. Recent evidence indicating that Giardia may cause chronic post-infectious gastrointestinal complications have made it a topic of intense research. The causes of the post-infectious clinical manifestations due to Giardia, even after complete elimination of the parasite, remain obscure. This review offers a state-of-the-art discussion on the long-term consequences of Giardia infections, from extra-intestinal manifestations, growth and cognitive deficiencies, to post-infectious irritable bowel syndrome. The discussion also sheds light on some of the novel mechanisms recently implicated in the production of these post-infectious manifestations.

  14. Nursing homes infection control audit.

    PubMed

    Holliday, A J; Murdoch, S

    2001-11-01

    To carry out a telephone audit looking at the number of nursing homes adhering to the recommendations that nursing homes should-. have a trained infection control link nurse have appropriate reference material respond appropriately to enteric outbreaks record residents with previously identified MRSA and C. diff. be aware of clients with possible infections offer influenza vaccination to all residents. An initial telephone survey of all 23 nursing homes within Forth Valley Health Board area in February 2000 was followed by offering a training programme and repeating the survey in December 2000 to find out if improvements had been made. In February 2000 there were 17(74%) nursing homes with link nurses. In December 2000 this was 19(83%). The numbers who had attended a PHICN induction course were low (11% vs 16%). The lack of availability of reference material in a number of homes gave cause for concern. About one third of nursing homes had residents with diarrhoea and vomiting in the last three months and had called the GP. In February none and in December one of the respondents said that Public Health had been informed. The number of homes which took specimens was 33% in February vs 88% in December and with carriers of MRSA was 75% vs 83%. Those flagging notes increased from 73% to 100%. The number with residents with C.diff was extremely small (1vs2) and all notes were reported to be flagged. Staff retention and training were highlighted as areas to be addressed. Improvements in availability of reference material in nursing homes, standardisation of "flagging" or marking of notes and increased notification of possible outbreaks to the Communicable Disease Team are required.

  15. Management of infection control in dental practice.

    PubMed

    Smith, A; Creanor, S; Hurrell, D; Bagg, J; McCowan, M

    2009-04-01

    This was an observational study in which the management policies and procedures associated with infection control and instrument decontamination were examined in 179 dental surgeries by a team of trained surveyors. Information relating to the management of a wide range of infection control procedures, in particular the decontamination of dental instruments, was collected by interview and by examination of practice documentation. This study found that although the majority of surgeries (70%) claimed to have a management policy on infection control, only 50% of these were documented. For infection control policies, 79% of surgeries had access to the British Dental Association Advice Sheet A12. Infection control policies were claimed to be present in 89% of surgeries, of which 62% were documented. Seventy-seven per cent of staff claimed to have received specific infection control training, but for instrument decontamination this was provided mainly by demonstration (97%) or observed practice (88%). Many dental nurses (74%) and dental practitioners (57%) did not recognise the symbol used to designate a single-use device. Audit of infection control or decontamination activities was undertaken in 11% of surgeries. The majority of surgeries have policies and procedures for the management of infection control in dental practice, but in many instances these are not documented. The training of staff in infection control and its documentation is poorly managed and consideration should be given to development of quality management systems for use in dental practice.

  16. Infection control in design and construction work.

    PubMed

    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.

  17. Infection Control in the Dental Office.

    PubMed

    Sebastiani, Francesco R; Dym, Harry; Kirpalani, Tarun

    2017-04-01

    The goal of an infection control program is to provide a safe working environment for dental health care personnel and their patients. Practitioners can achieve this by adopting measures that reduce health care-associated infections among patients and occupational exposures among dental health care personnel. It is crucial for all dental practitioners to be up to date on current Centers for Disease Control and Prevention guidelines, equipment, and techniques for proper infection control. Continuous evaluation of infection control practices is important. Patients and dental providers should be confident that oral health care can be delivered and received in a safe manner.

  18. Impact of HIV-1 infection on the feto-maternal crosstalk and consequences for pregnancy outcome and infant health.

    PubMed

    Altfeld, Marcus; Bunders, Madeleine J

    2016-11-01

    Adaptation of the maternal immune system to establish maternal/fetal equilibrium is required for a successful pregnancy. Viral infections, including HIV-1 infection, can alter this maternal/fetal equilibrium, with significant consequences for pregnancy outcome, including miscarriages, impaired fetal growth, and premature delivery. Furthermore, maternal HIV-1 infection has been shown to have a long-term impact on the developing fetal immune system also when the infant is not infected with the virus. In this review, we discuss the consequences of maternal HIV-1 infection and antiretroviral therapy on pregnancy outcome and the health of the uninfected HIV-1-exposed infant.

  19. Consequences and controls of bacterial sulfate reduction in marine sediments

    SciTech Connect

    Westrich, J.T.

    1983-01-01

    Bacterial sulfate reduction is an integral part of the geochemical cycles of carbon and sulfur. To better understand the environmental consequences of sulfate reduction and to further clarify the factors controlling this important biogeochemical process, rates of sulfate reduction were measured in Long Island Sound sediments and in controlled laboratory experiments using the /sup 35/S-SO/sub 4/= radiotracer technique. Four sediment localities (NWC, FOAM, Sachem, and BH) in the Sound, with different sedimentation rates and different macrofaunal populations, were chosen for study. Geochemical evidence from the FOAM site, based on the rate data, supports the use of a simple stoichiometric model for overall organic matter decomposition in the zone of sulfate reduction. Once other less important factors affecting the rate of sulfate reduction have been considered, both the laboratory and field work in the present study show that the rate of organic matter decomposition via sulfate reduction is ultimately dependant on the quality and quantity of the organic matter undergoing decomposition. In order to quantify this widely accepted statement, a multiple, first-order rate equation for organic matter decomposition in marine sediments is developed and its validity proven by laboratory experiments. The salient feature of this model is developed and its validity proven by laboratory experiments. The salient feature of this model is the hypothesis that a finite number of organic matter types exist, each with their own particular decay constant. The significance of the different organic matter fractions in the model is discussed in terms of general models for organic matter diagenesis and preservation.

  20. 42 CFR 483.65 - Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES Requirements for Long Term Care Facilities § 483.65 Infection control. The facility must establish and maintain an infection... prohibit employees with a communicable disease or infected skin lesions from direct contact with residents...

  1. Small strongyle infection: consequences of larvicidal treatment of horses with fenbendazole and moxidectin.

    PubMed

    Steinbach, Tanja; Bauer, Christian; Sasse, Hermann; Baumgärtner, Wolfgang; Rey-Moreno, Cecilia; Hermosilla, Carlos; Damriyasa, I Made; Zahner, Horst

    2006-06-30

    The study was undertaken to evaluate adverse effects of larvicidal treatment in horses naturally infected with cyathostomins. Out of 24 ponies kept on pasture, four animals were housed in September and anthelmintically cured to serve as worm-free controls (group C-0). The others were housed in December. Eight animals each were treated 8 weeks later with 5 x 7.5mg/kg fenbendazole (FBZ) or 1 x 0.4 mg/kg moxidectin (MOX). Four animals remained untreated (group C-i). Two, 4, 6 and 14 days after the end of treatment two animals of each of the treated groups were necropsied together with group C-0 and C-i animals. Infected animals before treatment showed weight loss, eosinophilia, increased plasma protein and globulin contents. Treatment was followed by weight gain and temporal plasma protein and globulin increase. Proportions of CD4+ and CD8+ T lymphocytes in the peripheral blood did not differ between the groups before treatment but dropped significantly temporally after FBZ treatment. Group C-0 was worm-free at necropsy. Group C-i animals contained variable numbers of luminal and tissue cyathostomins. Histological sections showed larval stages in the lamina propria und submucosa surrounded by macrophages. Either treatment was effective against luminal parasites and reduced the number of larvae in the bowel wall beginning 4-6 days after FBZ and 6-14 days after MOX treatment. Histologically, as a first reaction after FBZ application T lymphocytes accumulated around morphologically intact L4 in the submucosa. Subsequently T lymphocytes associated with eosinophils infiltrated the submucosa. Parasites became enclosed by granulomas with eosinophils adhering to and invading the larvae which started to disintegrate on day 4. Later on, particularly on day 14 inflammation extended into the mucosa and was frequently associated with ulcerations. Third stage larvae in general and L4 in the lamina propria, however, seemed not to be affected until day 14 and even then, parasites did

  2. 38 CFR 51.190 - Infection control.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Infection control. 51.190 Section 51.190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility...

  3. 38 CFR 51.190 - Infection control.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Infection control. 51.190 Section 51.190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility...

  4. 38 CFR 51.190 - Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Infection control. 51.190 Section 51.190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility...

  5. 38 CFR 51.190 - Infection control.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Infection control. 51.190 Section 51.190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility...

  6. 38 CFR 51.190 - Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Infection control. 51.190 Section 51.190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility...

  7. 75 FR 63844 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... healthcare infection control and strategies for surveillance, prevention, and control of healthcare... (NICU); draft guideline for Infection Control in Healthcare Personnel; and discussion of ]...

  8. Infection control in colon surgery.

    PubMed

    Fry, Donald E

    2016-08-01

    The aim of this study is to provide a comprehensive review of strategies that should be employed in the prevention of infection at the surgical site in patients undergoing colon surgery. The world's literature on the pathogenesis and prevention of infections at the surgical site in colon resection were reviewed to identify those methods that are associated with improved rates of infection at the surgical site. The pathogenesis, microbiology, diagnosis, and surveillance of surgical site infection have been reviewed in the context of better understanding the accepted methods for prevention. Recommendations are provided based upon evidence-based information when available. Surgical site infection rates in colon surgery have been reduced consistently over the last 60 years of surgical practice. Preoperative and intraoperative techniques are described which have been useful in this improvement, while postoperative methods including the extension of postoperative systemic antibiotics have not been of value. Many methods have been demonstrated to improve surgical site infection rates in colon surgery. However, consistent and standardized applications of these principals in prevention currently do not exist. Application of evidence-based practices can further reduce the morbidity and cost of infection following colon surgery.

  9. Maternofetal consequences of Coxiella burnetii infection in pregnancy: a case series of two outbreaks

    PubMed Central

    2012-01-01

    Background A high complication rate of Q fever in pregnancy is described on the basis of a limited number of cases. All pregnant women with proven Q fever regardless of clinical symptoms should therefore receive long-term cotrimoxazole therapy. But cotrimoxazole as a folic acid antagonist may cause harm to the fetus. We therefore investigated the Q fever outbreaks, Soest in 2003 and Jena in 2005, to determine the maternofetal consequences of Coxiella burnetii infection contracted during pregnancy. Methods Different outbreak investigation strategies were employed at the two sides. Antibody screening was performed with an indirect immunofluorescence test. Medical history and clinical data were obtained and serological follow up performed at delivery. Available placental tissue, amniotic fluid and colostrum/milk were further investigated by polymerase chain reaction and by culture. Results 11 pregnant women from Soest (screening rate: 49%) and 82 pregnant women from Jena (screening rate: 27%) participated in the outbreak investigation. 11 pregnant women with an acute C. burnetii infection were diagnosed. Three women had symptomatic disease. Three women, who were infected in the first trimester, were put on long-term therapy. The remaining women received cotrimoxazole to a lesser extent (n=3), were treated with macrolides for three weeks (n=1) or after delivery (n=1), were given no treatment at all (n=2) or received antibiotics ineffective for Q fever (n=1). One woman and her foetus died of an underlying disease not related to Q fever. One woman delivered prematurely (35th week) and one child was born with syndactyly. We found no obvious association between C. burnetii infection and negative pregnancy outcome. Conclusions Our data do not support the general recommendation of long-term cotrimoxazole treatment for Q fever infection in pregnancy. Pregnant women with symptomatic C. burnetii infections and with chronic Q fever should be treated. The risk-benefit ratio of

  10. Hepatitis A virus vaccination in persons with hepatitis C virus infection: consequences of quality measure implementation.

    PubMed

    Rowe, Ian A; Parker, Richard; Armstrong, Matthew J; Houlihan, Diarmaid D; Mutimer, David J

    2012-08-01

    Hepatitis A virus (HAV) superinfection in persons with hepatitis C virus (HCV) infection has been associated with a high mortality rate, and vaccination is recommended. The incidence of HAV is low, and the aim of this study was to determine the mortality risk of HAV superinfection and the consequences of routine vaccination in persons with HCV infection. To determine the mortality risk of HAV superinfection, a meta-analysis including studies reporting mortality in HCV-infected persons was performed. Data were extracted independently by two investigators and recorded on a standardized spreadsheet. The pooled mortality estimate was used to determine the number needed to vaccinate (NNV) to prevent mortality from HAV superinfection. The total vaccine cost was also calculated. A total of 239 studies were identified using a defined search strategy. Of these, 11 appeared to be relevant, and of these, 10 were suitable for inclusion in the meta-analysis. The pooled odds ratio (OR) for mortality risk in HAV superinfection of HCV-infected persons was 7.23 (95% confidence interval: 1.24-42.12) with significant heterogeneity (I(2) = 56%; P = 0.03) between studies. Using the pooled OR for mortality, this translates to 1.4 deaths per 1,000,000 susceptible persons with HCV per year. The NNV to prevent one death per year is therefore 814,849, assuming 90% vaccine uptake and 94.3% vaccine efficiency. The vaccine cost for this totals $162 million, or $80.1 million per death prevented per year. These data challenge the use of routine HAV vaccination in HCV-infected persons and its incorporation into clinical practice guidelines. HAV vaccination of all HCV-infected persons is costly and likely to expose many individuals to an intervention that is of no direct benefit. Copyright © 2012 American Association for the Study of Liver Diseases.

  11. Infection control in paediatric office settings

    PubMed Central

    2008-01-01

    Transmission of infection in the paediatric office is of increasing concern. The present document discusses routes of transmission of infection and the principles of current infection control measures. Prevention includes appropriate office design and administrative policies, triage, routine practices for the care of all patients (eg, hand hygiene; use of gloves, masks, eye protection and gowns for specific procedures; adequate cleaning, disinfection and sterilization of surfaces and equipment including toys, and aseptic technique for invasive procedures), and additional precautions for specific infections. Personnel should be adequately immunized, and those infected should follow work-restriction policies. PMID:19412374

  12. Infection control in severely burned patients

    PubMed Central

    Coban, Yusuf Kenan

    2012-01-01

    In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood stream infections. Universal application of early excision of burned tissues has made a substantial improvement in the control of wound-related infections in burns. Additionally, the development of new technologies in wound care have helped to decrease morbidity and mortality in severe burn victims. Many examples can be given of the successful control of wound infection, such as the application of an appropriate antibiotic solution to invasive wound infection sites with simultaneous vacuum-assisted closure, optimal preservation of viable tissues with waterjet debridement systems, edema and exudate controlling dressings impregnated with Ag (Silvercel, Aquacell-Ag). The burned patient is at high risk for NI. Invasive interventions including intravenous and urinary chateterization, and entubation pose a further risk of NIs. The use of newly designed antimicrobial impregnated chateters or silicone devices may help the control of infection in these immunocomprimised patients. Strict infection control practices (physical isolation in a private room, use of gloves and gowns during patient contact) and appropriate empirical antimicrobial therapy guided by laboratory surveillance culture as well as routine microbial burn wound culture are essential to help reduce the incidance of infections due to antibiotic resistant microorganisms. PMID:24701406

  13. Neurobehavioral Consequences of HTLV-III Brain Infection and Acquired Immune Deficiency Syndrome (AIDS) Encephalopathy: A Prospective Study

    DTIC Science & Technology

    1990-02-15

    AD-A220 180 +++AAD-A22 0t Available Copy FUNDING NO.: 87PP7856 TITLE: Neurobehavioral Consequences of HTLV -III Brain Infection and Acquired Immune...TITLE (Include Securty Classifiat:on) Neurobehavioral Consequences of HTLV -1II Brain Infection and Acquired Immune Deficiency Syndrome (AIDS...abnormalities in CSF & specific cognitive tasks of atten- tion & information processing. This latter occurs in a subgroup of HIV+ patients, but not in

  14. Control of blood-transmitted infections in dentistry.

    PubMed

    Neguţ, Eugenia Aurora; Bălteanu, Monica; Ionescu, G; Băncescu, A; Iliescu, A; Skaug, N

    2007-01-01

    As knowledge has accumulated on the blood-transmitted pathogenic agents, the contact with biological fluids (blood, plasma, saliva, etc.) from apparently healthy individuals has started to be regarded as a real professional risk for dentists. Theoretically, exposure to a contaminated biological specimen may have as a consequence transmission of infection from patient to dentist, from dentist to patient and from patient to patient via inadequately decontaminated and sterilized dental equipment. The present study is concerned with the analysis of the specific conditions that favor the occurrence of the epidemic process, the estimation of the risk degree of transmission of infections caused by hepatitis B, C viruses as well as of HIV infection in Romania. The data for the study were collected using two processes. First a self reporting survey and secondly an experimental procedure were performed. The testing of dentists' knowledge of blood transmissible diseases and infection control in their offices were performed using a questionnaire with 129 questions. The professional incidents/accidents representing a potential risk were counted using a questionnaire (with 37 questions). Serological markers were tested with ELISA kits. The monitoring of sterilization was accomplished with a questionnaire and biological tests. Many conclusions result from the study. There is an extremely reduced probability and infection transmission from the dentist to the patient. The transmission of infection from the patient to the dentist represents a low risk (for all that, the risk should not be minimized). The rigorous control and observation of infection prevention measures in dental offices is necessary to stop the infection transmission from patient to patient. The dentists' postgraduate training in infection control measures should be completed with knowledge regarding the blood transmissible infections epidemiology. Learning more about the epidemiological process enables the dentists

  15. Infection control during filoviral hemorrhagic Fever outbreaks.

    PubMed

    Raabea, Vanessa N; Borcherta, Matthias

    2012-01-01

    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.

  16. Infection Control During Filoviral Hemorrhagic Fever Outbreaks

    PubMed Central

    Vanessa, N Raabe; Matthias, Borchert

    2012-01-01

    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. PMID:22529631

  17. Infection control: old problems and new challenges.

    PubMed

    Macías, Alejandro E; Ponce-de-León, Samuel

    2005-01-01

    Infection control faces radical changes at the beginning of the third millennium. The first part of this review focuses on problems not yet solved, such as 1) surveillance systems, which should be active and extremely flexible; 2) infection outbreaks in hospitals and strategies to avoid them; 3) hand washing and alternatives such as rapid hand antisepsis; 4) water and food in the hospital as potential reservoirs of nosocomial pathogens; 5) upgrading of infection control programs to turn them into systems to improve the quality of care; 6) fatal Gram-negative bacteremias in hospitals from developing countries, which can be avoided with better standards of care; 7) the elemental role of the microbiology laboratory in the prevention and control of infections; 8) the unprecedented crisis due to the emergence of specific multi-resistant pathogens; 9) the risks for healthcare workers, such as tuberculosis, hepatitis, HIV, SARS, and hemorrhagic fevers; and 10) the need for the consistent application of guidelines. The second part of this review focuses on new challenges for infection control, such as 1) the ever-growing number of immunocompromised patients and basic control measures to avoid opportunistic infections; 2) the concerns about the capacity of the public health systems to deal with terrorist acts; 3) the practice of high-risk procedures in facilities lacking trained personnel, efficient laboratories, and protective items; and 4) gene therapy and its potential infectious complications. Consideration is given to the asymmetric development of infection control globally.

  18. Evaluation of Possible Consequences of Zika Virus Infection in the Developing Nervous System.

    PubMed

    Walter, Lais Takata; Higa, Guilherme Shigueto Vilar; Ikebara, Juliane Midori; Vedovello, Danila; Salvador, Felipe Scassi; Takada, Silvia Honda; Kinjo, Erika Reime; Whalley, Benjamin J; Sperança, Márcia Aparecida; Kihara, Alexandre Hiroaki

    2017-02-11

    The Zika virus (ZIKV) outbreak that occurred in the northeast of Brazil in 2015 led to alarming numbers of babies born with microcephaly in this region. Since then, several studies have evaluated the relationship between ZIKV infection and development of the malformation although the specific mechanistic interaction between ZIKV and human physiological processes that ultimately manifest as microcephaly remains debated. Importantly, most current studies did not consider the specificities of the biology and life cycle of ZIKV. As a consequence, specificities of the infection on the developing central nervous system (CNS) were frequently disregarded. In order to begin to address this important gap in our knowledge, we have collated and critically reviewed the existing evidence in this area to identify any emerging consensus on this topic and thereafter describe possible mechanisms by which ZIKV infection could interfere with specific processes of CNS development, such as neuronal proliferation, and the complex interactions of immature neurons with radial glial cells. With this, we were able to present the current knowledge on this important topic in the neurobiology field.

  19. Improving infection control in general practice.

    PubMed

    Farrow, S C; Zeuner, D; Hall, C

    1999-03-01

    Infection control measures in the health care setting should protect patients and staff from cross-infection. The prevention of harm is an essential part of good medical practice and failure might result in professional misconduct proceedings by the General Medical Council (GMC) and prosecution under the Health and Safety at Work legislation, as well as civil liability. For a health authority, overall responsibility for public health includes arrangements for the control of communicable diseases and infection in hospital and the community (NHS Management Executive, 1993), a function usually led by the Consultant in Communicable Disease Control (CCDC). This paper describes one district's collaborative approach between public health and GPs to assess and improve local infection control standards.

  20. Opioid Drug Abuse and Modulation of Immune Function: Consequences in the Susceptibility to Opportunistic Infections

    PubMed Central

    Roy, Sabita; Ninkovic, Jana; Banerjee, Santanu; Charboneau, Richard; Das, Subhas; Dutta, Raini; Kirchner, Varvara; Koodie, Lisa; Ma, Jing; Meng, Jingjing

    2013-01-01

    Infection rate among intravenous drug users (IDU) is higher than the general public, and is the major cause of morbidity and hospitalization in the IDU population. Epidemiologic studies provide data on increased prevalence of opportunistic bacterial infections such as TB and pneumonia, and viral infections such as HIV-1 and hepatitis in the IDU population. An important component in the intravenous drug abuse population and in patients receiving medically indicated chronic opioid treatment is opioid withdrawal. Data on bacterial virulence in the context of opioid withdrawal suggest that mice undergoing withdrawal had shortened survival and increased bacterial load in response to Salmonella infection. As the body of evidence in support of opioid dependency and its immunosuppressive effects is growing, it is imperative to understand the mechanisms by which opioids exert these effects and identify the populations at risk that would benefit the most from the interventions to counteract opioid immunosuppressive effects. Thus, it is important to refine the existing animal model to closely match human conditions and to cross-validate these findings through carefully controlled human studies. Better understanding of the mechanisms will facilitate the search for new therapeutic modalities to counteract adverse effects including increased infection rates. This review will summarize the effects of morphine on innate and adaptive immunity, identify the role of the mu opioid receptor in these functions and the signal transduction activated in the process. The role of opioid withdrawal in immunosuppression and the clinical relevance of these findings will also be discussed. PMID:21789507

  1. The role of the infection control doctor.

    PubMed

    Daschner, F D

    1988-02-01

    The ideal infection control doctor would be a combination of an infectious disease specialist, microbiologist, epidemiologist, social worker, psychologist, teacher, researcher, antibiotic therapy specialist, policeman, priest, supervisor for housekeeping, architect, partner for the infection control nurse, and who should combine the qualities of Mary Poppins, Sherlock Holmes, Francis von Assisi and Margaret Thatcher. A new role is that of a specialist in environmental pollution by detergents, disinfectants and certain disposables.

  2. Post-treatment control of HIV infection

    SciTech Connect

    Conway, Jessica M.; Perelson, Alan S.

    2015-04-13

    Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies suggest that ART, initiated early during primary infection, may induce post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50 copies per mL. We investigate the hypothesis that ART initiated early during primary infection permits PTC by limiting the size of the latent reservoir, which, if small enough at treatment termination, may allow the adaptive immune response to prevent viral rebound (VR) and control infection. We use a mathematical model of within host HIV dynamics to capture interactions among target cells, productively infected cells, latently infected cells, virus, and cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL response strengths where a patient may show either VR or PTC, depending on the size of the latent reservoir at treatment termination. Below this range, patients will always rebound, whereas above this range, patients are predicted to behave like elite controllers. As a result, using data on latent reservoir sizes in patients treated during primary infection, we also predict population-level VR times for non-controllers consistent with observations.

  3. Slow infection control by vaccination: paratuberculosis.

    PubMed

    Juste, Ramon A

    2012-07-15

    Classical causality models for infectious diseases have fulfilled an important role in the progress of medical sciences, however, new forms of association where weakly pathogenic agents cause widespread infections that mostly do not progress to disease, but that if they do so, cause protracted clinical courses where the host resources are exhausted fit better with the slow infection concept proposed over half a century ago. This model could show an infectious cause behind some diseases that have never fulfilled the conventional criteria. While new mechanisms of causation are defined, these diseases still need to be controlled to allow sustainable animal production. Here, I discuss the case of paratuberculosis control by vaccination as an example of the benefits of using a theoretically preventive treatment to modify the course of infection towards preventing clinical disease even though the infection itself might not be fully controlled. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Periductal Mastitis: An Inflammatory Disease Related to Bacterial Infection and Consequent Immune Responses?

    PubMed Central

    Liu, Lu; Zhou, Fei; Wang, Pin; Yu, Lixiang; Ma, Zhongbing; Li, Yuyang; Gao, Dezong; Zhang, Qiang

    2017-01-01

    Periductal mastitis (PDM) is a prolonged inflammatory disease, but the cause of PDM is poorly understood. In the present case control study, 87 PDM and 87 healthy controls were enrolled and the results were evaluated to identify the significant risk factors for PDM. To investigate the roles of bacterial infection and critical cytokines expression, 16S rRNA gene sequencing and bacterial culturing were conducted. We also measured the levels of interferon-γ, interleukin-12A, and interleukin-17A by semiquantitative immunohistochemistry method. In a multivariable logistic regression model, we identified overweight/obesity and late onset of menarche as independent risk factors for PDM. In contrast, age of first birth >27 years had a protective effect. With 16S rRNA gene sequencing, we confirmed bacterial infections were found in all PDM patients, but none of the control patients was positive on the gene expression of 16S rRNA. Our results also demonstrated significant increases of the IFN-γ and IL-12A expression in PDM, but there was no difference in IL-17A expression in these two groups. Taken together, this study suggests that reproductive factors and overweight/obesity are possible predisposing risk factors for PDM. Bacterial infection and the increased expression of some proinflammatory cytokines are associated with the pathogenesis of this disease. PMID:28182101

  5. Biotic Invasions: Causes, Epidemiology, Global Consequences and Control

    EPA Pesticide Factsheets

    The module provides a link to an article in a series of articles in Issues in Ecology. This article presents information on biotic invaders, their destruction, controlling their detriment and the effects aquaculture is having on world fish supplies.

  6. Consequences of Food Restriction for Immune Defense, Parasite Infection, and Fitness in Monarch Butterflies.

    PubMed

    McKay, Alexa Fritzsche; Ezenwa, Vanessa O; Altizer, Sonia

    2016-01-01

    Organisms have a finite pool of resources to allocate toward multiple competing needs, such as development, reproduction, and enemy defense. Abundant resources can support investment in multiple traits simultaneously, but limited resources might promote trade-offs between fitness-related traits and immune defenses. We asked how food restriction at both larval and adult life stages of the monarch butterfly (Danaus plexippus) affected measures of immunity, fitness, and immune-fitness interactions. We experimentally infected a subset of monarchs with a specialist protozoan parasite to determine whether parasitism further affected these relationships and whether food restriction influenced the outcome of infection. Larval food restriction reduced monarch fitness measures both within the same life stage (e.g., pupal mass) as well as later in life (e.g., adult lifespan); adult food restriction further reduced adult lifespan. Larval food restriction lowered both hemocyte concentration and phenoloxidase activity at the larval stage, and the effects of larval food restriction on phenoloxidase activity persisted when immunity was sampled at the adult stage. Adult food restriction reduced only adult phenoloxidase activity but not hemocyte concentration. Parasite spore load decreased with one measure of larval immunity, but food restriction did not increase the probability of parasite infection. Across monarchs, we found a negative relationship between larval hemocyte concentration and pupal mass, and a trade-off between adult hemocyte concentration and adult life span was evident in parasitized female monarchs. Adult life span increased with phenoloxidase activity in some subsets of monarchs. Our results emphasize that food restriction can alter fitness and immunity across multiple life stages. Understanding the consequences of resource limitation for immune defense is therefore important for predicting how increasing constraints on wildlife resources will affect fitness and

  7. Ascaridia galli infection of pullets and intestinal viscosity: consequences for nutrient retention and gut morphology.

    PubMed

    Danicke, S; Moors, E; Beineke, A; Gauly, M

    2009-07-01

    1. Pullets were given a control diet or a diet supplemented with a non-starch-polysaccharide hydrolysing enzyme preparation (NSP-enzyme) from weeks 6 to 14 of age to induce differences in the viscosity of the small intestinal ingesta. Half of each feeding group (n = 25) was infected with 250 embryonated Ascaridia galli eggs at an age of 6 weeks. 2. At 14 weeks of age, before the pullets were slaughtered, a balance experiment was conducted, to sample ingesta for viscosity measurements. Also, tissue samples of jejunum and ileum were taken for morphometrical and histopathological studies. 3. An infection of pullets with A. galli reduced the viscosity of the jejunal ingesta at high initial levels of viscosity after feeding the NSP-enzyme unsupplemented diet. 4. The faecal A. galli egg output by the pullets expressed as eggs per g excrement (EpG) was significantly reduced in infected pullets given the NSP-enzyme supplemented diet. Also, the number and length of worms was less in these pullets. 5. The tunica muscularis of the jejunum was significantly thickened, this effect being more pronounced at a low intestinal viscosity. 6. NSP-enzyme addition resulted in an increased length of jejunal villus and was paralleled by a decrease in jejunal viscosity. 7. Histopathology of jejunal and ileal sections revealed no pathological alterations. 8. The apparent retention of organic matter was increased after enzyme addition while parasite infection exerted no effect.

  8. Post-treatment control of HIV infection

    DOE PAGES

    Conway, Jessica M.; Perelson, Alan S.

    2015-04-13

    Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies suggest that ART, initiated early during primary infection, may induce post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50 copies per mL. We investigate the hypothesis that ART initiated early during primary infection permits PTC by limiting the size of the latent reservoir, which, if small enough at treatment termination, may allow the adaptive immune response to prevent viral rebound (VR) and control infection. We use a mathematical model of within host HIV dynamics to capture interactions among target cells, productively infected cells, latently infectedmore » cells, virus, and cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL response strengths where a patient may show either VR or PTC, depending on the size of the latent reservoir at treatment termination. Below this range, patients will always rebound, whereas above this range, patients are predicted to behave like elite controllers. As a result, using data on latent reservoir sizes in patients treated during primary infection, we also predict population-level VR times for non-controllers consistent with observations.« less

  9. Causes and consequences of anti-infective drug stock-outs.

    PubMed

    Luans, C; Cardiet, I; Rogé, P; Baslé, B; Le Corre, P; Revest, M; Michelet, C; Tattevin, P

    2014-10-01

    Anti-infective drugs stock-outs are increasingly frequent, and this is unlikely to change. There are numerous causes for this, mostly related to parameters difficult to control: i) 60 to 80% of raw material or components are produced outside of Europe (compared to 20% 30 years ago), with subsequent loss of independence for their procurement; ii) the economic crisis drives the pharmaceutical companies to stop producing drugs of limited profitability (even among important drugs); iii) the enforcement of regulatory requirements and quality control procedures result in an increasing number of drugs being blocked during production. The therapeutic class most affected by drug stock-outs is that of anti-infective drugs, especially injectable ones, and many therapeutic dead ends have recently occurred. We provide an update on this issue, and suggest 2 major actions for improvement: i) to implement a group dedicated to anticipating drug stock-outs within the anti-infective committee in each health care center, with the objectives of organizing and coordinating the response whenever a drug stock-out is deemed at risk (i.e., contingency plans, substitution, communication to prescribers); ii) a national reflection lead by scientific societies, in collaboration with government agencies, upstream of the most problematic drug stock-outs, to elaborate and disseminate consensus guidelines for the management of these stock-outs.

  10. Control and relation: two foundational values and their consequences.

    PubMed

    Suchman, Anthony L

    2006-01-01

    This paper explores and contrasts personal philosophies based on two different core values, control and relation, with respect to expectations, social relationships, habits of perception and interpretation, and ways of feeling grounded in the world. The paradigm of control is widespread in medicine and certain other health professions, but because it fosters unrealistic expectations, evokes fear and shame, and inhibits effective partnerships, it can actually compromise health outcomes. The paradigm of relation calls attention to interpersonal process and fosters receptivity and adaptability, thus enhancing partnership. A mature clinical approach combines these two perspectives, respecting both the benefits and limitations of reductionistic science and making room for self-organization and emergence.

  11. Infection control in equine critical care settings.

    PubMed

    Burgess, Brandy A; Morley, Paul S

    2014-08-01

    There is a recognizable standard of practice for infection control in veterinary medicine. Effort must be given to control and prevention of infectious disease transmission within a facility and among animal populations. In the critical care setting, patients typically have a high degree of systemic illness and immune compromise, are commonly subjected to invasive procedures and placement of indwelling devices, and frequently receive antimicrobials and gastric protectants. Every equine critical care unit is distinctive in its physical and operational features and the types of patients that are managed. Infection control programs must therefore be tailored to each facility's needs. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Translational Control during Calicivirus Infection

    PubMed Central

    Royall, Elizabeth; Locker, Nicolas

    2016-01-01

    In this review, we provide an overview of the strategies developed by caliciviruses to subvert or regulate the host protein synthesis machinery to their advantage. As intracellular obligate parasites, viruses strictly depend on the host cell resources to produce viral proteins. Thus, many viruses have developed strategies that regulate the function of the host protein synthesis machinery, often leading to preferential translation of viral mRNAs. Caliciviruses lack a 5′ cap structure but instead have a virus-encoded VPg protein covalently linked to the 5′ end of their mRNAs. Furthermore, they encode 2–4 open reading frames within their genomic and subgenomic RNAs. Therefore, they use alternative mechanisms for translation whereby VPg interacts with eukaryotic initiation factors (eIFs) to act as a proteinaceous cap-substitute, and some structural proteins are produced by reinitiation of translation events. This review discusses our understanding of these key mechanisms during caliciviruses infection as well as recent insights into the global regulation of eIF4E activity. PMID:27104553

  13. Translational Control during Calicivirus Infection.

    PubMed

    Royall, Elizabeth; Locker, Nicolas

    2016-04-20

    In this review, we provide an overview of the strategies developed by caliciviruses to subvert or regulate the host protein synthesis machinery to their advantage. As intracellular obligate parasites, viruses strictly depend on the host cell resources to produce viral proteins. Thus, many viruses have developed strategies that regulate the function of the host protein synthesis machinery, often leading to preferential translation of viral mRNAs. Caliciviruses lack a 5' cap structure but instead have a virus-encoded VPg protein covalently linked to the 5' end of their mRNAs. Furthermore, they encode 2-4 open reading frames within their genomic and subgenomic RNAs. Therefore, they use alternative mechanisms for translation whereby VPg interacts with eukaryotic initiation factors (eIFs) to act as a proteinaceous cap-substitute, and some structural proteins are produced by reinitiation of translation events. This review discusses our understanding of these key mechanisms during caliciviruses infection as well as recent insights into the global regulation of eIF4E activity.

  14. Advancing infection control in dental care settings

    PubMed Central

    Cleveland, Jennifer L.; Bonito, Arthur J.; Corley, Tammy J.; Foster, Misty; Barker, Laurie; Brown, G. Gordon; Lenfestey, Nancy; Lux, Linda

    2015-01-01

    Background and Overview The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention’s Guidelines for Infection Control in Dental Health-Care Settings—2003. Methods In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists’ demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling. Results Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied. Conclusions Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education

  15. Infection prevention and control practitioners: improving engagement.

    PubMed

    Aziz, Ann-Marie

    Every healthcare worker plays a vital part in minimising the risk of cross infection. Infection prevention and control (IPC) practitioners have the skills and competencies to assist organisations in improving engagement among staff and play a vital part in achieving this. IPC practitioners have skills in clinical practice, education, research and leadership, and these skills ensure high-quality care for patients and support strategies for engaging staff. This article highlights how IPC practitioners' skills and competencies are required for preventing infection and improving staff engagement. Engaged staff generate positive outcomes for both patients and staff, which is a welcome result for all healthcare organisations.

  16. The infection control information system of the Hospital Infections Program, Centers for Disease Control and Prevention.

    PubMed

    Manangan, L P

    1996-12-01

    In December 1990 the Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention (CDC), developed the Hospital Infections Program infection control information system (HIP ICIS) to respond more efficiently to more than 200 public inquiries (telephone or written) that HIP receives daily. The HIP ICIS allows anyone with a Touch-Tone telephone, fax machine, or computer to access CDC information that answers the most commonly asked questions from infection control practitioners and other health care workers. The HIP ICIS has received approximately 56,608 inquiries; of these, 33% were about CDC guidelines on prevention and control of nosocomial infections, 25% about issues related to HIV, 16% about sterilization and disinfection of medical devices, 8% about methicillin-resistant Staphylococcus aureus, 3% about long-term care facilities, and 17% miscellaneous topics (e.g., nosocomial infection rates, infection control courses, and ventilation, construction, and renovation of hospitals). The HIP ICIS is an efficient method of providing infection control guidance to the infection control community. In this article, we a) review the history of the HIP ICIS, b) present data on HIP ICIS usage, c) summarize the current HIP ICIS contents, and d) present step-by-step instructions on how to access the HIP ICIS.

  17. Control of viruses infecting grapevine.

    PubMed

    Maliogka, Varvara I; Martelli, Giovanni P; Fuchs, Marc; Katis, Nikolaos I

    2015-01-01

    Grapevine is a high value vegetatively propagated fruit crop that suffers from numerous viruses, including some that seriously affect the profitability of vineyards. Nowadays, 64 viruses belonging to different genera and families have been reported in grapevines and new virus species will likely be described in the future. Three viral diseases namely leafroll, rugose wood, and infectious degeneration are of major economic importance worldwide. The viruses associated with these diseases are transmitted by mealybugs, scale and soft scale insects, or dagger nematodes. Here, we review control measures of the major grapevine viral diseases. More specifically, emphasis is laid on (i) approaches for the production of clean stocks and propagative material through effective sanitation, robust diagnosis, as well as local and regional certification efforts, (ii) the management of vectors of viruses using cultural, biological, and chemical methods, and (iii) the production of resistant grapevines mainly through the application of genetic engineering. The benefits and limitations of the different control measures are discussed with regard to accomplishments and future research directions.

  18. Snapshots: Chromatin Control of Viral Infection

    PubMed Central

    Knipe, David M.; Lieberman, Paul M.; Jung, Jae U.; McBride, Alison A.; Morris, Kevin V.; Ott, Melanie; Margolis, David; Nieto, Amelia; Nevels, Michael; Parks, Robin J.; Kristie, Thomas M.

    2012-01-01

    Like their cellular host counterparts, many invading viral pathogens must contend with, modulate, and utilize the host cell’s chromatin machinery to promote efficient lytic infection or control persistent-latent states. While not intended to be comprehensive, this review represents a compilation of conceptual snapshots of the dynamic interplay of viruses with the chromatin environment. Contributions focus on chromatin dynamics during infection, viral circumvention of cellular chromatin repression, chromatin organization of large DNA viruses, tethering and persistence, viral interactions with cellular chromatin modulation machinery, and control of viral latency-reactivation cycles. PMID:23217624

  19. 78 FR 6329 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices.... L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the following meeting for... of healthcare infection prevention and control; (2) strategies for surveillance, prevention,...

  20. Controls over fungal communities and consequences for nutrient cycling

    NASA Astrophysics Data System (ADS)

    Treseder, K. K.; Majumder, P.; Bent, E.; Borneman, J.; Allison, S. D.; Hanson, C. A.

    2007-12-01

    Soils harbor a high diversity of microbes-- as many as 100 species of fungi within a square meter. If different species target different components of litter, a more diverse community of fungi should lead to faster decomposition rates. We examined the hypotheses that variation in substrate use among fungal groups and variation in nitrogen availability are both important controls over the diversity of fungi in an Alaskan boreal forest. Nitrogen availability was considered because microbes are often N-limited, and because humans are altering N availability via anthropogenic N deposition and global warming. We used nucleotide analogs to link fungal groups with their role in decomposition in field samples. Leaf litter collected from the forest floor was supplemented with one of four N-containing compounds. Bromodeoxyuridine (BrdU, a thymidine analog) was also added. After 48 hours incubation, DNA was extracted. Most growing fungi should have assimilated the BrdU into new DNA. Their genetic identity was determined using oligonucleotide fingerprinting of rRNA genes (OFRG). OFRG is an rRNA gene profiling method that sorts genes into taxonomic groups with a high degree of resolution, and has a large capacity for sample processing. Fungal groups that proliferated following the addition of a given compound probably metabolized that compound. We found that fungal taxa varied in their responses to different substrates, indicating that they differed in substrate use. Specifically, community composition of fungi was significantly different among substrate treatments (P < 0.001). In addition, of the 15 dominant taxa, seven displayed significant preferences for one substrate over another. For instance, taxa within the Helotiales preferred glutamate (P = 0.001); Sporidiales, tannin-protein complexes (P = 0.014); Saccharomycetales, arginine (P = 0.042); and Polyporales, arginine and lignocellulose (P = 0.040). In a complementary experiment, we used BrdU labeling to characterize

  1. Planning strategies for nosocomial infection control.

    PubMed

    Lacanna, Giuseppe

    2014-01-01

    According to the American Centers for Disease Control and Prevention, 99,000 deaths per year in the United States are caused or impacted on by multiple hospital-acquired infections (HAIs), which are roughly estimated to be around 1.7 million cases. In Europe, there are 25,000 deaths per year from the same cause, 17.000 of which are linked to nosocomial infections. Patient safety is a core issue in today's health care settings. There is a growing consensus, supported by scientific investigation, that the role of the built environment is central towards minimizing and controlling the level of such infections. The contribution of architectural solutions and planning choices becomes crucial at this stage. This paper outlines the most common measures to adopt at the architectural and planning level, to combat HAI, focusing on the most critical areas of the hospital: wards, intensive care units and operating theatres.

  2. Infection control and biosecurity in equine disease control.

    PubMed

    Weese, J S

    2014-11-01

    Infectious diseases are an important cause of morbidity and mortality in horses, along with economic costs and broader impacts associated with the loss of members of a species that generates income, acts as a working animal and is a companion. Endemic diseases continue to challenge, emerging diseases are an ever-present threat and outbreaks can be both destructive and disruptive. While infectious diseases can never be completely prevented, measures can be introduced to restrict the entry of pathogens into a population or limit the implications of the presence of a pathogen. Objective research regarding infection control and biosecurity in horses is limited, yet a variety of practical infection prevention and control measures can be used. Unfortunately, infection control can be challenging, because of the nature of the equine industry (e.g. frequent horse movement) and endemic pathogens, but also because of lack of understanding or motivation to try to improve practices. Recognition of the basic concepts of infection control and biosecurity, and indeed the need for measures to control infectious diseases, is the foundation for successful infection prevention and control.

  3. Control of infection in hospital wards.

    PubMed

    Blowers, R

    1961-01-01

    Some of the problems of ward management are reviewed. Methods suggested for dealing with them are probably not the ideals that should ultimately be attained but minimum standards to serve as immediate objectives. They concern indications for and methods of isolation, control of infection from staff, environmental contamination, and a few technical procedures. A new type of dressing towel for wounds is described.

  4. Infections Control in North American Dental Schools.

    ERIC Educational Resources Information Center

    Sampson, Elise; Dhuru, Virendra B.

    1989-01-01

    Results from 1982 and 1987 surveys of dental schools concerning infection control issues found greater recent emphasis on instrument sterilization and barrier use, but some inconsistency and confusion concerning hepatitis B and HIV virus carrier patients and personnel. The information was used to develop guidelines for school policy formation.…

  5. 42 CFR 460.74 - Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Infection control. 460.74 Section 460.74 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE...

  6. Infections Control in North American Dental Schools.

    ERIC Educational Resources Information Center

    Sampson, Elise; Dhuru, Virendra B.

    1989-01-01

    Results from 1982 and 1987 surveys of dental schools concerning infection control issues found greater recent emphasis on instrument sterilization and barrier use, but some inconsistency and confusion concerning hepatitis B and HIV virus carrier patients and personnel. The information was used to develop guidelines for school policy formation.…

  7. [Changes in nosocomial infection control: new challenges and responsibilities for the infection control nurse].

    PubMed

    Freixas, Nuria; Sallés, Montserrat; García, Lola

    2009-05-01

    The complexity of surveillance, prevention, and control of nosocomial infections has increased over the last decades, owing to reductions in the length of hospital stay, health care practice outside of the hospital (home care, day hospital care, long-term care facilities, nursing homes), the increase in the number of elderly patients, new and emerging diseases, multidrug-resistant pathogens, and the administrative requirements for accreditation. In this setting, infection control nurses are progressively assuming new responsibilities in addition to infection control, such as ensuring the safety of the patient, guaranteeing health care quality, and other tasks. In the light of these changes, professional organizations of infection control personnel have voiced the opinion that staffing for infection control work should not be based solely on the number of hospital beds, but also on the complexity of the tasks involved, which should be defined according to standardized criteria and infection control indicators. In addition, the cost-benefit relationship of infection control programs should be demonstrated.

  8. Mixed-Strain Mycobacterium tuberculosis Infections and the Implications for Tuberculosis Treatment and Control

    PubMed Central

    van Helden, Paul D.; Wilson, Douglas; Colijn, Caroline; McLaughlin, Megan M.; Abubakar, Ibrahim; Warren, Robin M.

    2012-01-01

    Summary: Numerous studies have reported that individuals can simultaneously harbor multiple distinct strains of Mycobacterium tuberculosis. To date, there has been limited discussion of the consequences for the individual or the epidemiological importance of mixed infections. Here, we review studies that documented mixed infections, highlight challenges associated with the detection of mixed infections, and discuss possible implications of mixed infections for the diagnosis and treatment of patients and for the community impact of tuberculosis control strategies. We conclude by highlighting questions that should be resolved in order to improve our understanding of the importance of mixed-strain M. tuberculosis infections. PMID:23034327

  9. Psychosocial consequences of allocation to lung cancer screening: a randomised controlled trial

    PubMed Central

    Aggestrup, Louise Mosborg; Hestbech, Mie Sara; Siersma, Volkert; Pedersen, Jesper Holst

    2012-01-01

    Objective To examine the psychosocial consequences of being allocated to the control group as compared with the screen group in a randomised lung cancer screening trial. Method The Danish Lung Cancer Screening Trial, a randomised controlled trial, ran from 2004 to 2010 with the purpose of investigating the benefits and harms of lung cancer screening. The participants in Danish Lung Cancer Screening Trial were randomised to either the control group or the screen group and were asked to complete the questionnaires Consequences Of Screening and Consequences Of Screening in Lung Cancer (COS-LC). The Consequences Of Screening and the COS-LC were used to examine the psychosocial consequences of participating in the study, by comparing the control and the screen groups' responses at the prevalence and at the incidence round. Results There was no statistically significant difference in socio-demographic characteristics or smoking habits between the two groups. Responses to the COS-LC collected before the incidence round were statistically significantly different on the scales ‘anxiety’, ‘behaviour’, ‘dejection’, ‘self-blame’, ‘focus on airway symptoms’ and ‘introvert’, with the control group reporting higher negative psychosocial consequences. Furthermore, the participants in both the control and the screen groups exhibited a mean increase in negative psychosocial consequences when their responses from the prevalence round were compared with their responses from the first incidence round. Conclusions Participation in a randomised controlled trial on lung cancer screening has negative psychosocial consequences for the apparently healthy participants—both the participants in the screen group and the control group. This negative impact was greatest for the control group. PMID:22382119

  10. Obstetric infection control in a developing country.

    PubMed

    Cronin, W A; Quansah, M G; Larson, E

    1993-01-01

    In Ghana, infection has been identified as a major cause of birth-related mortality. Results of a 2-month observation of infection control practices among Ghanaian obstetric nurses and midwives indicated that most personnel did not practice basic rules of asepsis. Problems included frequent breaks in technique, inadequate sterilization and disinfection, and repeated exposure to large amounts of blood and vaginal secretions. Supplies were limited and, even when available, not always used appropriately. The situation in developing countries is different from that in the United States. Therefore, an observational needs assessment is essential to plan relevant and practical measures for change.

  11. [Sexually transmitted infections: epidemiology and control].

    PubMed

    Díez, M; Díaz, A

    2011-01-01

    Sexually transmitted infections (STI) include a group of diseases of diverse infectious etiology in which sexual transmission is relevant. The burden of disease that STI represent globally is unknown for several reasons. Firstly, asymptomatic infections are common in many STI; secondly, diagnostic techniques are not available in some of the most affected countries; finally, surveillance systems are inexistent or very deficient in many areas of the world. The Word Health Organization has estimated that in 1999 there were 340 million new cases of syphilis, gonorrhoea, chlamydia infection and trichomoniasis. An increasing trend in the incidence of gonorrhoea and syphilis has been noticed in the last years in the European Union, including Spain. Co-infection with other STI, especially HIV, should be ruled out in all STI patients. Chlamydia screening is also of particular importance since this is the most common STI in Europe and frequently goes unnoticed. STI prevention and control should be based on health education, early diagnosis and treatment, screening for asymptomatic infections, contact investigation and vaccination for those diseases for which a vaccine is available.

  12. Landscape features and helminth co-infection shape bank vole immunoheterogeneity, with consequences for Puumala virus epidemiology.

    PubMed

    Guivier, E; Galan, M; Henttonen, H; Cosson, J-F; Charbonnel, N

    2014-03-01

    Heterogeneity in environmental conditions helps to maintain genetic and phenotypic diversity in ecosystems. As such, it may explain why the capacity of animals to mount immune responses is highly variable. The quality of habitat patches, in terms of resources, parasitism, predation and habitat fragmentation may, for example, trigger trade-offs ultimately affecting the investment of individuals in various immunological pathways. We described spatial immunoheterogeneity in bank vole populations with respect to landscape features and co-infection. We focused on the consequences of this heterogeneity for the risk of Puumala hantavirus (PUUV) infection. We assessed the expression of the Tnf-α and Mx2 genes and demonstrated a negative correlation between PUUV load and the expression of these immune genes in bank voles. Habitat heterogeneity was partly associated with differences in the expression of these genes. Levels of Mx2 were lower in large forests than in fragmented forests, possibly due to differences in parasite communities. We previously highlighted the positive association between infection with Heligmosomum mixtum and infection with PUUV. We found that Tnf-α was more strongly expressed in voles infected with PUUV than in uninfected voles or in voles co-infected with the nematode H. mixtum and PUUV. H. mixtum may limit the capacity of the vole to develop proinflammatory responses. This effect may increase the risk of PUUV infection and replication in host cells. Overall, our results suggest that close interactions between landscape features, co-infection and immune gene expression may shape PUUV epidemiology.

  13. Landscape features and helminth co-infection shape bank vole immunoheterogeneity, with consequences for Puumala virus epidemiology

    PubMed Central

    Guivier, E; Galan, M; Henttonen, H; Cosson, J-F; Charbonnel, N

    2014-01-01

    Heterogeneity in environmental conditions helps to maintain genetic and phenotypic diversity in ecosystems. As such, it may explain why the capacity of animals to mount immune responses is highly variable. The quality of habitat patches, in terms of resources, parasitism, predation and habitat fragmentation may, for example, trigger trade-offs ultimately affecting the investment of individuals in various immunological pathways. We described spatial immunoheterogeneity in bank vole populations with respect to landscape features and co-infection. We focused on the consequences of this heterogeneity for the risk of Puumala hantavirus (PUUV) infection. We assessed the expression of the Tnf-α and Mx2 genes and demonstrated a negative correlation between PUUV load and the expression of these immune genes in bank voles. Habitat heterogeneity was partly associated with differences in the expression of these genes. Levels of Mx2 were lower in large forests than in fragmented forests, possibly due to differences in parasite communities. We previously highlighted the positive association between infection with Heligmosomum mixtum and infection with PUUV. We found that Tnf-α was more strongly expressed in voles infected with PUUV than in uninfected voles or in voles co-infected with the nematode H. mixtum and PUUV. H. mixtum may limit the capacity of the vole to develop proinflammatory responses. This effect may increase the risk of PUUV infection and replication in host cells. Overall, our results suggest that close interactions between landscape features, co-infection and immune gene expression may shape PUUV epidemiology. PMID:24149655

  14. Evolving concepts of the clinical and serologic consequences of hepatitis B virus infection.

    PubMed

    Seeff, L B; Koff, R S

    1986-02-01

    Measurement of conventional markers has provided a general understanding of HBV infection, and conceptual advances in knowledge of the clinical and serologic events associated with persistent HBV infection have resulted from the development and application of new methodologies. These studies suggest that persistent HBV infection is a dynamic process, with replicative and nonreplicative phases, that nonreplicative infection may be the precursor of PHC, and that the natural history of persistent infection can be modified by a variety of factors, including viral reactivation and viral superinfections. Further understanding of these phenomena may lead to the development of new therapeutic approaches.

  15. [Role of university hospitals in regional infection control network].

    PubMed

    Kayaba, Hiroyuki; Saito, Norihiro; Yamamoto, Ayako; Tsutaya, Shoji; Akimoto, Hiroyuki; Kimura, Masahiko; Inoue, Fumio; Kondo, Jun; Akahira, Emi; Tachibana, Naoki; Okamura, Yuji; Takahashi, Shiori; Kojima, Keiya; Tamazawa, Naoki; Hayakari, Makoto

    2013-08-01

    Activities and the understanding of infection control in healthcare facilities have improved in the past decade since a certification system for medical personnel, such as infection control nurse and infection control doctor, were introduced in Japan. These specialists are distributed among tertiary general hospitals, while many small and mid-scale hospitals have no infection control specialists. In 2012, the Japanese Ministry of Health, Labour and Welfare launched a new strategy for further improvement of infection control by supporting a regional network of infection control activities. Through the infection control network, small or mid-scaled hospitals can utilize infection control specialists in tertiary general hospitals, enter educational programs on infection control and consult in cases of nosocomial infection outbreaks. As part of the regional infection control network, we established an information network system, named ReNICS, to share the bacteriological test results of the hospitals in Akita prefecture. ReNICS offers epidemiological data on bacteria identified in the region. We can identify the spread of multi-drug resistant bacteria and can roughly estimate the quality of infection control activities in each facility. As a similar information network is being prepared in Hirosaki University Hospital Infection Control Center in Aomori, a prefecture neighboring Akita, we discussed the roles of university hospitals for a regional infection control network.

  16. Hospital design for better infection control.

    PubMed

    Lateef, Fatimah

    2009-09-01

    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.

  17. Hospital design for better infection control

    PubMed Central

    Lateef, Fatimah

    2009-01-01

    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 PMID:20009307

  18. Quality, equipment hold keys to infection control.

    PubMed

    2006-02-01

    EDs that are the most successful at infection control are the ones that look for new ways to improve on proven strategies and techniques. Follow and observe staff during hand-washing, and make them repeat steps that were omitted or performed improperly. Increase the percentage of isolation rooms in your department to help improve surge capacity. Have all cleaning supplies readily at hand to improve flow.

  19. Control of infection in hospital wards

    PubMed Central

    Blowers, Robert

    1961-01-01

    Some of the problems of ward management are reviewed. Methods suggested for dealing with them are probably not the ideals that should ultimately be attained but minimum standards to serve as immediate objectives. They concern indications for and methods of isolation, control of infection from staff, environmental contamination, and a few technical procedures. A new type of dressing towel for wounds is described. Images PMID:16810967

  20. Control of Mycoplasma hyopneumoniae infections in pigs.

    PubMed

    Maes, D; Segales, J; Meyns, T; Sibila, M; Pieters, M; Haesebrouck, F

    2008-01-25

    Mycoplasma hyopneumoniae, the primary pathogen of enzootic pneumonia, occurs worldwide and causes major economic losses to the pig industry. The organism adheres to and damages the ciliated epithelium of the respiratory tract. Affected pigs show chronic coughing, are more susceptible to other respiratory infections and have a reduced performance. Control of the disease can be accomplished in a number of ways. First, management practices and housing conditions in the herd should be optimized. These include all-in/all-out production, limiting factors that may destabilize herd immunity, maintaining optimal stocking densities, prevention of other respiratory diseases, and optimal housing and climatic conditions. Strategic medication with antimicrobials active against M. hyopneumoniae and, preferably, also against major secondary bacteria may be useful during periods when the pigs are at risk for respiratory disease. Finally, commercial bacterins are widely used to control M. hyopneumoniae infections. The main effects of vaccination include less clinical symptoms, lung lesions and medication use, and improved performance. However, bacterins provide only partial protection and do not prevent colonization of the organism. Different vaccination strategies (timing of vaccination, vaccination of sows, vaccination combined with antimicrobial medication) can be used, depending on the type of herd, the production system and management practices, the infection pattern and the preferences of the pig producer. Research on new vaccines is actively occurring, including aerosol and feed-based vaccines as well as subunit and DNA vaccines. Eradication of the infection at herd level based on age-segregation and medication is possible, but there is a permanent risk for re-infections.

  1. Toxoplasmosis can be a sexually transmitted infection with serious clinical consequences. Not all routes of infection are created equal.

    PubMed

    Flegr, J; Klapilová, K; Kaňková, S

    2014-09-01

    Toxoplasma gondii infects about 30% of the human population. Common sources of infection are oocysts in cat faeces contaminating drinking water or unwashed vegetables, undercooked meat containing tissue cysts, and organ transplants from infected donors containing tissue cysts. However, very often, it is not possible to identify any potential source of infection in mothers of children with congenital toxoplasmosis. Here we present a hypothesis suggesting that toxoplasmosis is transmitted from infected men to noninfected women during unprotected sexual intercourse, which can result in the most serious form of disease, congenital toxoplasmosis. Arguments for the hypothesis: (1) Toxoplasma tachyzoites are present in the seminal fluid and tissue of the testes of various animals including humans. In some species infection of females by artificial insemination with semen from infected males has been observed. (2) Up to two thirds of Toxoplasma infections in pregnant women cannot be explained by the known risk factors. (3) Prevalence of toxoplasmosis in women in child-bearing age covaries with the incidence of sexually transmitted diseases in particular countries. (4) In some countries, an increased incidence of toxoplasmosis has been reported in women (but not men) aged 25-35 years. This second peak of infection could be associated with women having regular unprotected sex after marriage. (5) Toxoplasmosis triggers schizophrenia in predisposed subjects. Onset of schizophrenia is about 2-3 years earlier in men than in women. However, this difference in the onset can be found only between Toxoplasma-infected patients. The increased onset of schizophrenia in infected women could be associated with the already mentioned second peak of toxoplasmosis incidence. (6) The prevalence of toxoplasmosis decreases in developed countries in last 20 years. This trend could be a result of decrease in promiscuity and increase in safe sex practices, both associated with the AIDS pandemics

  2. Infection Control: MedlinePlus Health Topic

    MedlinePlus

    ... infections when visiting (Medical Encyclopedia) Also in Spanish Staph infections - hospital (Medical Encyclopedia) Also in Spanish Topic Image ... precautions Personal protective equipment Preventing infections when visiting Staph infections - hospital Related Health Topics Hepatitis HIV/AIDS MRSA ...

  3. Quinolone-resistant Campylobacter Infections: Risk Factors and Clinical Consequences1

    PubMed Central

    Neimann, Jakob; Nielsen, Eva Møller; Aarestrup, Frank Møller; Fussing, Vivian

    2004-01-01

    We integrated data on quinolone and macrolide susceptibility patterns with epidemiologic and typing data from Campylobacter jejuni and C. coli infections in two Danish counties. The mean duration of illness was longer for 86 patients with quinolone-resistant C. jejuni infections (median 13.2 days) than for 381 patients with quinolone-sensitive C. jejuni infections (median 10.3 days, p = 0.001). Foreign travel, eating fresh poultry other than chicken and turkey, and swimming were associated with increased risk for quinolone-resistant C. jejuni infection. Eating fresh chicken (of presumably Danish origin) was associated with a decreased risk. Typing data showed an association between strains from retail food products and broiler chickens and quinolone-sensitive domestically acquired C. jejuni infections. An association between treatment with a fluoroquinolone before stool-specimen collection and having a quinolone-resistant C. jejuni infection was not observed. PMID:15207057

  4. Neurologic consequences of HTLV-II infection in injection-drug users.

    PubMed

    Dooneief, G; Marlink, R; Bell, K; Marder, K; Renjifo, B; Stern, Y; Mayeux, R

    1996-06-01

    Several case reports have suggested an association between human T-cell lymphotropic virus type II (HTLV-II) infection and chronic neurologic disease. We performed serial neurologic examinations in injection-drug users (IDU), a group known to be at increased risk for HTLV-II infection. At baseline, those infected with HTLV-II alone, human immunodeficiency virus (HIV) alone, or both were significantly more likely to have neurologic disability than uninfected subjects. Longitudinally, HTLV-II infection was independently associated with the development of global neurologic disability and neuropathy, suggesting that HTLV-II causes neurologic disease.

  5. 42 CFR 418.60 - Condition of participation: Infection control.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of Participation: Patient Care § 418.60 Condition of participation: Infection control. The hospice must maintain and document an effective infection control program that protects patients, families, visitors, and...

  6. Nosocomial pneumonia: epidemiology and infection control.

    PubMed

    Craven, D E; Steger, K A; Barat, L M; Duncan, R A

    1992-01-01

    Elderly, debilitated, or critically ill patients are at high risk for hospital acquired or nosocomial respiratory tract infection. Gram-negative bacilli, Staphyloccoccus aureus, and anaerobes colonizing the oropharynx are the most frequent etiologic agents. Colonization of the oropharynx may be related to the patient's age, underlying disease, nutritional status, prior exposure to antibiotics, supine position, and gastric colonization. Nosocomial pathogens may also be acquired from the hands of hospital personnel, contaminated equipment or fluids. The absence of sensitive and specific methods for accurate diagnosis remain a concern. Despite treatment with appropriate antimicrobial therapy, there is a high mortality and morbidity. Measures for the prevention of nosocomial pneumonia should include compliance with infection control principles, appropriate use of antibiotics, proper patient position, and removal of potential sources of cross colonization.

  7. Prevention and control of health care-associated waterborne infections in health care facilities.

    PubMed

    Exner, M; Kramer, A; Lajoie, L; Gebel, J; Engelhart, S; Hartemann, P

    2005-06-01

    The current article is a review of the public health risks attributable to waterborne pathogens in health care. The consequences of health care-associated infections (HAIs) are discussed. Not only are Legionella spp involved in HAIs, but also Pseudomonas aeruginosa, other gram-negative microorganisms, fungi, and amoeba-associated bacteria. This is particularly noteworthy among immunocompromised patients. New prevention strategies and control measures brought about through advanced planning, facility remodelling and reconstruction, disinfection, and filtration have resulted in a significant reduction of the incidence of waterborne HAIs. The positive consequences of a comprehensive multibarrier approach including prevention and control programs in health care facilities are discussed. Environmental cultures are now integrated within the infection control program of some European countries. In high-risk areas, the application of disposable sterile point-of-use filters for faucets and shower heads appears to be the practice of choice to efficiently control waterborne pathogens and to prevent infections.

  8. 42 CFR 494.30 - Condition: Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition: Infection control. 494.30 Section 494.30... Patient Safety § 494.30 Condition: Infection control. The dialysis facility must provide and monitor a... adjacent hospital or other public areas. (a) Standard: Procedures for infection control. The facility...

  9. 42 CFR 494.30 - Condition: Infection control.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition: Infection control. 494.30 Section 494.30... Patient Safety § 494.30 Condition: Infection control. The dialysis facility must provide and monitor a... adjacent hospital or other public areas. (a) Standard: Procedures for infection control. The facility...

  10. Multi-resistant infections in repatriated patients after natural disasters: lessons learned from the 2004 tsunami for hospital infection control.

    PubMed

    Uçkay, I; Sax, H; Harbarth, S; Bernard, L; Pittet, D

    2008-01-01

    Infections are a frequent consequence of natural disasters. Repatriated victims may require hospital care due to multiple fractures, pneumonia or wound infections caused by multi-resistant pathogens that require specific infection control measures. To address potential pitfalls of infection control and clinical care in repatriated patients, we sought to provide microbiological insight into the possible origins of multi-drug antibiotic resistance in survivors of natural disasters. A review of the medical literature was performed from 1986 to 2006 with an emphasis on the 2004 tsunami disaster in the Indian Ocean. After natural disasters, polymicrobial infections may occur following heavy inoculation during trauma. Multi-resistant Gram-negative pathogens are more prevalent than Gram-positive bacteria. A high incidence of extended spectrum beta-lactamase-producing bacteria and difficult-to-treat fungal infections in otherwise immunocompetent hosts may challenge routine hospital care. We recommend that survivors of natural disasters should be kept in pre-emptive contact isolation during air transport and hospitalisation until the results of all microbiological cultures become available. A meticulous diagnostic work-up is necessary upon admission and empiric antibiotic treatment should be avoided. Infections may also become manifest after several weeks of hospitalisation. In case of life-threatening infection, antibiotic therapy should cover non-fermenting pathogens.

  11. Psychosocial consequences in the Danish randomised controlled lung cancer screening trial (DLCST).

    PubMed

    Rasmussen, Jakob F; Siersma, V; Pedersen, J H; Brodersen, J

    2015-01-01

    To measure the psychosocial consequences in the Danish lung cancer screening trial (DLCST) and compare those between the computed tomography (CT) group and the control group. This study was a single centre randomised controlled trial with five annual screening rounds. Healthy current or former heavy smokers aged 50-70 years (men and women) were randomised 1:1 to a CT group and a control group. Heavy smokers were defined by having smoked ≥20 pack years and former smokers by being abstinent ≤10 years. Both groups were invited annually to the screening clinic to complete the validated lung-cancer-specific questionnaire consequences of screening lung cancer (COS-LC). The CT group was also offered a low dose CT scan of the lungs. The COS-LC measures nine scales with psychosocial properties: Anxiety, Behaviour, Dejection, Negative impact on sleep, Self-blame, Focus on Airway Symptoms, Stigmatisation, Introvert, and Harm of Smoking. 4104 participants were randomised to the DLCST and the COS-LC completion rates for the CT group and the control group were 95.5% and 73.6%, respectively. There was a significant increase in negative psychosocial consequences from baseline through rounds 2-5 for both the CT group and the control group (mean increase >0, p<.0001 for 3 of 4 possible scales). During rounds 2-5 the control group experienced significantly more negative psychosocial consequences in seven of nine scales compared with the CT group (mean Δ score >0 and p<.033). Lung cancer CT-screening trials induced more negative psychosocial reactions in both the CT group and the control group compared with the baseline psychosocial profile. The CT group experienced less negative psychosocial consequences compared with the control group, which might be explained by reassurance among those with normal screening results. ClinicalTrials.gov: NCT00496977. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Fuzzy Modeling and Control of HIV Infection

    PubMed Central

    Zarei, Hassan; Kamyad, Ali Vahidian; Heydari, Ali Akbar

    2012-01-01

    The present study proposes a fuzzy mathematical model of HIV infection consisting of a linear fuzzy differential equations (FDEs) system describing the ambiguous immune cells level and the viral load which are due to the intrinsic fuzziness of the immune system's strength in HIV-infected patients. The immune cells in question are considered CD4+ T-cells and cytotoxic T-lymphocytes (CTLs). The dynamic behavior of the immune cells level and the viral load within the three groups of patients with weak, moderate, and strong immune systems are analyzed and compared. Moreover, the approximate explicit solutions of the proposed model are derived using a fitting-based method. In particular, a fuzzy control function indicating the drug dosage is incorporated into the proposed model and a fuzzy optimal control problem (FOCP) minimizing both the viral load and the drug costs is constructed. An optimality condition is achieved as a fuzzy boundary value problem (FBVP). In addition, the optimal fuzzy control function is completely characterized and a numerical solution for the optimality system is computed. PMID:22536298

  13. Photodynamic Antimicrobial Polymers for Infection Control

    PubMed Central

    McCoy, Colin P.; O’Neil, Edward J.; Cowley, John F.; Carson, Louise; De Baróid, Áine T.; Gdowski, Greg T.; Gorman, Sean P.; Jones, David S.

    2014-01-01

    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/cm2 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. PMID:25250740

  14. Assessing Environmental Controls and Biogeochemical Consequences of Virus-Host Interactions in Marine Eukaryotic Picophytoplankton

    NASA Astrophysics Data System (ADS)

    Zimmerman, A. E.; Worden, A. Z.

    2014-12-01

    Viruses are the most abundant biological entities in marine systems and propagate through lysis of their prokaryotic or eukaryotic hosts. Viruses infecting marine phytoplankton can be significant agents of mortality and disrupt the canonical flow of carbon and nutrients through the microbial loop via the "viral shunt." A large proportion of the ocean's primary production is contributed by photosynthetic eukaryotes, which are important members of the picophytoplankton size class. The smallest picoeukaryote Ostreococcus represents a diverse and widely distributed genus. While the genomes of several viruses infecting the coastal species Ostreococcus lucimarinus have been sequenced, the dependence of viral infection dynamics on environmental parameters such as light and nutrient availability has not been characterized. Therefore, the goal of this study is to determine how light synchronization and nutrient availability modulate the infection of three O. lucimarinus viruses. Viruses were introduced to mid-exponentially-growing O. lucimarinus cultures at different points during a 14:10h light:dark cycle and the infections were followed through a lysis event. Additionally, viral infection dynamics were quantified for cultures of O. lucimarinus under either nutrient-replete or nutrient-deplete conditions. Preliminary results suggest that both light and nutrient availability influence viral infection dynamics, and that low nutrient availability may dampen the severity of infection. This work provides insight to the role of light and nutrient availability in controlling viral replication in an ecologically important picophytoplankton. Considering virus-host interactions is therefore critical for understanding marine plankton-driven biogeochemical processes.

  15. Organization of infection control in European hospitals.

    PubMed

    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 < 0.001), but not by countries' healthcare expenditure. There is great variance in IC staffing and policies across Europe. Some areas of practice, such as hand hygiene, seem to receive considerably more attention than others that are equally important, such as antibiotic stewardship. Programmes in IC suffer from deficiencies in human resources and local policies, ubiquitous factors that negatively impact on IC effectiveness. Strengthening of IC policies in European hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices.... L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the following meeting for... Control of Infectious Diseases (NCPDCID), regarding: (1) The practice of hospital infection control;...

  17. Evaluation of the epidemiological and economic consequences of control scenarios for bovine viral diarrhea virus in dairy herds.

    PubMed

    Santman-Berends, I M G A; Mars, M H; van Duijn, L; van Schaik, G

    2015-11-01

    Bovine viral diarrhea virus (BVDV) is an important endemic infection. However, no information was available on whether it would be economically beneficial to implement a national control program in the Netherlands. Therefore, a stochastic simulation model was developed in which control scenarios were added to compare the epidemiological and economic consequences of BVDV control in Dutch dairy herds in the next 10 yr. In the epidemiological part of the model, herds could be classified as susceptible, infectious, recovered, or vaccinated. The outputs of the epidemiological module served as input for the economic module. Net costs that could be attributed to bovine viral diarrhea consisted of production losses, costs for testing, and culling persistently infected cattle in the present voluntary Dutch BVDV control program and costs for vaccination. Four different control scenarios were simulated, involving testing and culling of persistently infected (based on serum or ear-notch testing), and monitoring BVDV statuses and vaccination and were derived from BVDV control programs that are currently executed in Europe. The costs and benefits of BVDV control in the current situation and in each of the simulated control scenarios were evaluated assuming an annual discount rate of 2%. The model estimated a mean BVDV herd prevalence of 18.0% in 2014 and showed a slightly decreasing prevalence over time. The outputs seemed realistic for the present situation in the Netherlands when compared with actual survey data. The average annual net costs associated with bovine viral diarrhea were estimated at €27.8 million for the dairy industry. Two control scenarios were beneficial in controlling BVDV during the study period (between 2015 and 2025). In the scenario where tracing and removing of PI animals and monitoring of the subsequent status was obligatory, the benefit to cost (B/C) ratio was 1.5 (€1.5 benefit for each invested euro). In the scenario in which the BVDV status of

  18. Of Mice and Monkeys: Can Animal Models Be Utilized to Study Neurological Consequences of Pediatric HIV-1 Infection?

    PubMed Central

    Carryl, Heather; Swang, Melanie; Lawrence, Jerome; Curtis, Kimberly; Kamboj, Herman; Van Rompay, Koen K. A.; De Paris, Kristina; Burke, Mark W.

    2015-01-01

    Pediatric human immunodeficiency virus (HIV-1) infection remains a global health crisis. Children are much more susceptible to HIV-1 neurological impairments than adults, which can be exacerbated by coinfections. Neurological characteristics of pediatric HIV-1 infection suggest dysfunction in the frontal cortex as well as the hippocampus; limited MRI data indicate global cerebral atrophy, and pathological data suggest accelerated neuronal apoptosis in the cortex. An obstacle to pediatric HIV-1 research is a human representative model system. Host-species specificity of HIV-1 limits the ability to model neurological consequences of pediatric HIV-1 infection in animals. Several models have been proposed including neonatal intracranial injections of HIV-1 viral proteins in rats and perinatal simian immunodeficiency virus (SIV) infection of infant macaques. Nonhuman primate models recapitulate the complexity of pediatric HIV-1, neuropathogenesis while rodent models are able to elucidate the role specific viral proteins exert on neurodevelopment. Nonhuman primate models show similar behavioral and neuropathological characteristics to pediatric HIV-1 infection and offer a stage to investigate early viral mechanisms, latency reservoirs, and therapeutic interventions. Here we review the relative strengths and limitations of pediatric HIV-1 model systems. PMID:26034832

  19. 76 FR 29756 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-23

    ... the aforementioned committee: Times and Dates: 9 a.m.-5 p.m., June 16, 2011. 9 a.m.-12 p.m., June 17... surveillance, prevention, and control of infections (e.g., nosocomial infections), antimicrobial resistance... intensive care units (NICU); draft guidelines for infection control in healthcare personnel;...

  20. Strategies for Coping with Educational and Social Consequences of Chronic Ear Infections in Rural Communities.

    ERIC Educational Resources Information Center

    Pillai, Patrick

    2000-01-01

    Children with chronic ear infections experience a lag time in understanding speech, which inhibits classroom participation and the ability to make friends, and ultimately reduces self-esteem. Difficulty in hearing affects speech and vocabulary development, reading and writing proficiency, and academic performance, and could lead to placement in…

  1. Strategies for Coping with Educational and Social Consequences of Chronic Ear Infections in Rural Communities.

    ERIC Educational Resources Information Center

    Pillai, Patrick

    2000-01-01

    Children with chronic ear infections experience a lag time in understanding speech, which inhibits classroom participation and the ability to make friends, and ultimately reduces self-esteem. Difficulty in hearing affects speech and vocabulary development, reading and writing proficiency, and academic performance, and could lead to placement in…

  2. Hospital infection control in hematopoietic stem cell transplant recipients.

    PubMed Central

    Dykewicz, C. A.

    2001-01-01

    Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients contains a section on hospital infection control including evidence-based recommendations regarding ventilation, construction, equipment, plants, play areas and toys, health-care workers, visitors, patient skin and oral care, catheter-related infections, drug-resistant organisms, and specific nosocomial infections. These guidelines are intended to reduce the number and severity of hospital infections in hematopoietic stem cell transplant recipients. PMID:11294720

  3. 75 FR 22816 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices.... L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the following meeting of...), regarding the practice of hospital infection control and strategies for surveillance, prevention,...

  4. 75 FR 29772 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices.... L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the following meeting for... Zoonotic Infectious Diseases (NCEZID) regarding (1) The practice of healthcare infection control;...

  5. 75 FR 50770 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-17

    ... surveillance, prevention, and control of infections (e.g., nosocomial infections), antimicrobial resistance.... Materials for the call will be available on the HICPAC Web site, http://www.cdc.gov/hicpac , no later than...

  6. [Medical technologist as a member of infection control team].

    PubMed

    Okuzumi, Katsuko; Ieiri, Tamio

    2005-11-01

    For the prevention of infection at institutions, an Anti-nosocomial Infection Committee or an Infection Control Team (ICT) is organized at each institution according to its scale. We report the present status of the ICT managed mainly by medical technologists engaged in microbiological examination (certified medical microbiological technologists) at Dokkyo University School of Medicine. Since this hospital is an educational hospital, the department of clinical laboratory medicine cooperates with the microbiological laboratory of the clinical laboratory in infection control education of medical workers (such as medical students, nursing students, physicians and nurses) in infection diagnosis, infection control/infection management. Since infection control is achieved by improvement in hygiene knowledge and its practice in all citizens, we also attached importance to publicity activities associated with microbiology for patients, their families, and all medical workers.

  7. Emotional consequences of wheel running in mice: which is the appropriate control?

    PubMed

    Dubreucq, Sarah; Marsicano, Giovanni; Chaouloff, Francis

    2011-03-01

    An overview of the literature on the emotional impacts of wheel running reveals contradictory findings. Among the hypotheses underlying such a discrepancy, that related to the different housing conditions of the controls, i.e., standard housing without any object or housing with blocked running wheels, merits attention. We addressed this point in C57Bl/6N mice by examining the consequences of chronic wheel running on anxiety, context fear recall, and behavioral despair compared either to standard control housing or to housing with blocked wheels. Compared to standard housing, wheel running proved anxiolytic while facilitating fear memory. On the other hand, wheel running increased behavioral despair but influenced neither anxiety nor fear memory when compared to housing with blocked wheels. This study suggests that investigations aimed at measuring the emotional consequences of wheel running should take into consideration the housing conditions of the controls to which are compared the runners.

  8. Resources to aid further learning about infection control.

    PubMed

    Last year, the National Audit Office published a report outlining progress since its initial analysis of hospital-acquired infection in 2000 (National Audit Office, 2004). It identified that up to 300,000 patients picked up a hospital-acquired infection every year. Contributing factors included: patchy implementation of good infection control practice; a lack of resources for infection control teams; increasing antibiotic resistance; poor isolation facilities; and a lack of data on the extent and cost of hospital-acquired infections. It also identified that a range of approaches was needed to change staff behaviour to reduce the risk of a hospital-acquired infection

  9. Biological and pathological consequences of feline infectious peritonitis virus infection in the cheetah.

    PubMed

    Evermann, J F; Heeney, J L; Roelke, M E; McKeirnan, A J; O'Brien, S J

    1988-01-01

    An epizootic of feline infectious peritonitis in a captive cheetah population during 1982-1983 served to focus attention on the susceptibility of the cheetah (Acinoyx jubatus) to infectious disease. Subsequent observations based upon seroepidemiological surveys and electron microscopy of fecal material verified that cheetahs were indeed capable of being infected by coronaviruses, which were antigenically related to coronaviruses affecting domestic cats, i.e. feline infectious peritonitis virus/feline enteric coronavirus. Coincident with the apparent increased susceptibility of the cheetah to infectious diseases, were observations that the cheetah was genetically unusual insofar as large amounts of enzyme-encoding loci were monomorphic, and that unrelated cheetahs were capable of accepting allogenic skin grafts. These data provided the basis for a hypothesis that the cheetah, through intensive inbreeding, had become more susceptible to viral infections as a result of genetic homogeneity.

  10. Parity and Longevity of Aedes aegypti According to Temperatures in Controlled Conditions and Consequences on Dengue Transmission Risks

    PubMed Central

    Goindin, Daniella; Delannay, Christelle; Ramdini, Cédric; Gustave, Joël; Fouque, Florence

    2015-01-01

    Background In Guadeloupe, Aedes aegypti mosquitoes are the only vectors of dengue and chikungunya viruses. For both diseases, vector control is the only tool for preventing epidemics since no vaccine or specific treatment is available. However, to efficiently implement control of mosquitoes vectors, a reliable estimation of the transmission risks is necessary. To become infective an Ae. aegypti female must ingest the virus during a blood meal and will not be able to transmit the virus during another blood-meal until the extrinsic incubation period is completed. Consequently the aged females will carry more infectious risks. The objectives of the present study were to estimate under controlled conditions the expectation of infective life for females and thus the transmission risks in relation with their reproductive cycle and parity status. Methodology/Principal Findings Larvae of Ae. aegypti were collected in central Guadeloupe and breed under laboratory conditions until adult emergence. The experiments were performed at constant temperatures (± 1.5°C) of 24°C, 27°C and 30°C on adults females from first generation (F1). Females were kept and fed individually and records of blood-feeding, egg-laying and survival were done daily. Some females were dissected at different physiological stages to observe the ovaries development. The data were analyzed to follow the evolution of parity rates, the number of gonotrophic cycles, the fecundity and to study the mean expectation of life and the mean expectation of infective life for Ae. aegypti females according to temperatures. The expectation of life varies with the parity rates and according to the temperatures, with durations from about 10 days at low parity rates at the higher temperature to an optimal duration of about 35 days when 70% of females are parous at 27°C. Infective life expectancy was found highly variable in the lower parous rates and again the optimal durations were found when more than 50% of females

  11. Desialylation of Spermatozoa and Epithelial Cell Glycocalyx Is a Consequence of Bacterial Infection of the Epididymis*

    PubMed Central

    Khosravi, Farhad; Michel, Vera; Galuska, Christina E.; Bhushan, Sudhanshu; Christian, Philipp; Schuppe, Hans-Christian; Pilatz, Adrian; Galuska, Sebastian P.; Meinhardt, Andreas

    2016-01-01

    Urinary tract infections caused by uropathogenic Escherichia coli (UPEC) pathovars belong to the most frequent infections in humans. In men, pathogens can also spread to the genital tract via the continuous ductal system, eliciting bacterial prostatitis and/or epididymo-orchitis. Antibiotic treatment usually clears pathogens in acute epididymitis; however, the fertility of patients can be permanently impaired. Because a premature acrosome reaction was observed in an UPEC epididymitis mouse model, and sialidases on the sperm surface are considered to be activated via proteases of the acrosome, we aimed to investigate whether alterations of the sialome of epididymal spermatozoa and surrounding epithelial cells occur during UPEC infection. In UPEC-elicited acute epididymitis in mice, a substantial loss of N-acetylneuraminic acid residues was detected in epididymal spermatozoa and epithelial cells using combined laser microdissection/HPLC-ESI-MS analysis. In support, a substantial reduction of sialic acid residues bound to the surface of spermatozoa was documented in men with a recent history of E. coli-associated epididymitis. In vitro, such an UPEC induced N-acetylneuraminic acid release from human spermatozoa was effectively counteracted by a sialidase inhibitor. These findings strongly suggest a substantial remodeling of the glycocalyx of spermatozoa and epididymal epithelial cells by endogenous sialidases after a premature acrosome reaction during acute epididymitis. PMID:27339898

  12. An expert system for culture-based infection control surveillance.

    PubMed Central

    Kahn, M. G.; Steib, S. A.; Fraser, V. J.; Dunagan, W. C.

    1993-01-01

    Hospital-acquired infections represent a significant cause of prolonged inpatient days and additional hospital charges. We describe an expert system, called GERMWATCHER, which applies the Centers for Disease Control's National Nosocomial Infection Surveillance culture-based criteria for detecting nosocomial infections. GERMWATCHER has been deployed at Barnes Hospital, a large tertiary-care teaching hospital, since February 1993. We describe the Barnes Hospital infection control environment, the expert system design, and a predeployment performance evaluation. We then compare our system to other efforts in computer-based infection control. PMID:8130456

  13. De novo Generation of Cells within Human Nurse Macrophages and Consequences following HIV-1 Infection

    PubMed Central

    Gartner, Suzanne

    2012-01-01

    Nurse cells are defined as those that provide for the development of other cells. We report here, that in vitro, human monocyte-derived macrophages can behave as nurse cells with functional capabilities that include de novo generation of CD4+ T-lymphocytes and a previously unknown small cell with monocytoid characteristics. We named these novel cells “self-renewing monocytoid cells” (SRMC), because they could develop into nurse macrophages that produced another generation of SRMC. SRMC were not detectable in blood. Their transition to nurse behavior was characterized by expression of CD10, a marker of thymic epithelium and bone marrow stroma, typically absent on macrophages. Bromodeoxyuridine labeling and immunostaining for cdc6 expression confirmed DNA synthesis within nurse macrophages. T-cell excision circles were detected in macrophages, along with expression of pre-T-cell receptor alpha and recombination activating gene 1, suggesting that genetic recombination events associated with generation of the T-cell receptor were occurring in these cells. SRMC expressed CCR5, the coreceptor for R5 HIV-1 isolates, and were highly susceptible to HIV-1 entry leading to productive infection. While expressing HIV-1, SRMC could differentiate into nurse macrophages that produced another generation of HIV-1-expressing SRMC. The infected nurse macrophage/SRMC cycle could continue in vitro for multiple generations, suggesting it might represent a mechanism whereby HIV-1 can maintain persistence in vivo. HIV-1 infection of nurse macrophages led to a decline in CD4+ T-cell production. There was severe, preferential loss of the CCR5+ CD4+ T-cell subpopulation. Confocal microscopy revealed individual HIV-1-expressing nurse macrophages simultaneously producing both HIV-1-expressing SRMC and non-expressing CD3+ cells, suggesting that nurse macrophages might be a source of latently infected CD4+ T-cells. Real-time PCR experiments confirmed this by demonstrating 10-fold more HIV-1

  14. Control of Salmonella infections in animals and prevention of human foodborne Salmonella infections. WHO Consultation.

    PubMed Central

    1994-01-01

    In many countries the incidence of human salmonella infections has markedly increased in recent years. To discuss recent developments and current understanding on the control of salmonella infections in animals, WHO organized a Consultation on the Control of Salmonella Infections in Animals: Prevention of Foodborne Salmonella Infections in Humans, held in Jena, Germany, on 21-26 November 1993. The present article summarizes the recommendations made by the participants on the pathoimmunogenesis, diagnosis, epidemiology, and control of salmonella infections and contaminations in animal production. PMID:7867127

  15. Severity of infection following the introduction of new infection control measures for medical abortion

    PubMed Central

    Fjerstad, Mary; Trussell, James; Lichtenberg, E Steve; Sivin, Irving; Cullins, Vanessa

    2013-01-01

    Background In response to concerns about serious infections following medical abortion, in early 2006 Planned Parenthood changed the route of misoprostol administration from vaginal to buccal and required either routine antibiotic coverage or universal screening and treatment for chlamydia; in July 2007, Planned Parenthood began requiring routine antibiotic coverage for all medical abortions. We previously reported a pronounced drop in the rate of serious infection following the adoption of these new infection control measures. Our objective here is to assess whether the degree of severity of the serious infections differed in the three infection-control groups (vaginal misoprostol and no antibiotics, buccal misoprostol and screen-and-treat, buccal misoprostol and routine antibiotics) or, equivalently, to assess whether the declines in rates of serious infections after the adoption of new infection control measures differed across degree of severity categories. Of particular importance is whether the new infection control measures selectively reduced the least severe serious infections but did not diminish the rate of the most severe infections. Methods We performed a retrospective analysis assessing the degree of severity of infections before infection controls were implemented and after each of the two new measures was adopted: buccal administration of antibiotics with either screen-and-treat or routine antibiotic coverage. We ranked the severity of infection from 1 (when treatment occurred in an emergency department) to 4 (when death occurred). We compared the distribution of the severity of serious infections in the three infection control groups (none, buccal misoprostol and screen-and-treat, buccal misoprostol and routine antibiotics), or, equivalently, assessed whether the declines in rates of serious infections after the adoption of new infection control measures differed across degree of severity categories using the Jonckheere-Terpstra test for a doubly

  16. Flaviviruses in Europe: Complex Circulation Patterns and Their Consequences for the Diagnosis and Control of West Nile Disease

    PubMed Central

    Beck, Cécile; Jimenez-Clavero, Miguel Angel; Leblond, Agnès; Durand, Benoît; Nowotny, Norbert; Leparc-Goffart, Isabelle; Zientara, Stéphan; Jourdain, Elsa; Lecollinet, Sylvie

    2013-01-01

    In Europe, many flaviviruses are endemic (West Nile, Usutu, tick-borne encephalitis viruses) or occasionally imported (dengue, yellow fever viruses). Due to the temporal and geographical co-circulation of flaviviruses in Europe, flavivirus differentiation by diagnostic tests is crucial in the adaptation of surveillance and control efforts. Serological diagnosis of flavivirus infections is complicated by the antigenic similarities among the Flavivirus genus. Indeed, most flavivirus antibodies are directed against the highly immunogenic envelope protein, which contains both flavivirus cross-reactive and virus-specific epitopes. Serological assay results should thus be interpreted with care and confirmed by comparative neutralization tests using a panel of viruses known to circulate in Europe. However, antibody cross-reactivity could be advantageous in efforts to control emerging flaviviruses because it ensures partial cross-protection. In contrast, it might also facilitate subsequent diseases, through a phenomenon called antibody-dependent enhancement mainly described for dengue virus infections. Here, we review the serological methods commonly used in WNV diagnosis and surveillance in Europe. By examining past and current epidemiological situations in different European countries, we present the challenges involved in interpreting flavivirus serological tests and setting up appropriate surveillance programs; we also address the consequences of flavivirus circulation and vaccination for host immunity. PMID:24225644

  17. Using a Novel Lysin To Help Control Clostridium difficile Infections

    PubMed Central

    Wang, Qiong; Euler, Chad W.; Delaune, Aurelia

    2015-01-01

    As a consequence of excessive antibiotic therapies in hospitalized patients, Clostridium difficile, a Gram-positive anaerobic spore-forming intestinal pathogen, is the leading cause of hospital-acquired diarrhea and colitis. Drug treatments for these diseases are often complicated by antibiotic-resistant strains and a high frequency of treatment failures and relapse; therefore, novel nonantibiotic approaches may prove to be more effective. In this study, we recombinantly expressed a prophage lysin identified from a C. difficile strain, CD630, which we named PlyCD. PlyCD was found to have lytic activity against specific C. difficile strains. However, the recombinantly expressed catalytic domain of this protein, PlyCD1–174, displayed significantly greater lytic activity (>4-log kill) and a broader lytic spectrum against C. difficile strains while still retaining a high degree of specificity toward C. difficile versus commensal clostridia and other bacterial species. Our data also indicated that noneffective doses of vancomycin and PlyCD1–174 when combined in vitro could be significantly more bactericidal against C. difficile. In an ex vivo treatment model of mouse colon infection, we found that PlyCD1–174 functioned in the presence of intestinal contents, significantly decreasing colonizing C. difficile compared to controls. Together, these data suggest that PlyCD1–174 has potential as a novel therapeutic for clinical application against C. difficile infection, either alone or in combination with other preexisting treatments to improve their efficacy. PMID:26392484

  18. Tuberculosis: infection control in hospital and at home.

    PubMed

    Jarvis, Miles

    This article examines infection control issues relating to tuberculosis (TB) in acute and community settings. Background information on TB is discussed briefly along with key challenges to global and national control. A programme to prevent infection composed of specific hierarchical levels is outlined, using national and international guidance, and suggestions are made for infection control in the community. The article will be useful for nurses involved in the care of patients with confirmed or suspected TB.

  19. The status and consequences of Mansonella perstans infection in Calabar, Nigeria.

    PubMed

    Useh, M F; Ejezie, G C

    1995-02-01

    Two aetiological studies on filariasis were conducted from January to June, 1993. In the first study, 690 blood samples clinically diagnosed of filariasis were examined. In the other, 150 blood samples and 150 skin snips collected from the same group of eye clinic Patients clinically diagnosed of filariasis were investigated. Of the 690 subjects, 108 (15.64%) had filariasis with M. perstans and Loa loa accounting for 98.15 and 1.85% of positive cases respectively. Among the eye clinic patients, 16% had M. perstans while O. volvulus was seen in 4% of patients. There was no concurrent infection with these two agents. A statistically significant association existed in the frequency of M. perstans in the different ages treated (p > 0.01) while non existed by sex (p > 0.01). The possible involvement of M. perstans in ocular filariasis and its treatment are discussed.

  20. [Economic consequences of an infection with the bovine diarrhea virus (BVD virus) in 15 dairy farms].

    PubMed

    Wentink, G H; Dijkhuizen, A A

    1990-11-15

    In outbreaks of disease with the bovine virus diarrhoea virus (BVD virus), the economic loss to fourteen dairy farms was determined on the basis of the amount of loss per dairy cow. The patients included cases of abortion, stillbirths, delivery of calves showing lesions, lesions of the feet, mucosal disease and animals persistently infected with BVD virus. BVD virus was isolated from several cases of disease on all farms. It was not possible, however, directly to examine all individuals for the presence of the virus. The amount of loss caused by BVD virus was Dfl. 136,- per average dairy cow. The amount varied between individual farms from Dfl. 42,- to Dfl. 285,- per dairy cow.

  1. [Living conditions of prostitutes: consequences for the prevention of HIV infection].

    PubMed

    Serre, A; Schutz-Samson, M; Cabral, C; Martin, F; Hardy, R; DeAquino, O; Vinsonneau, P; Arnaudies, M; Fierro, F; Mathieu, L; Pryen, S; Welzer-Lang, D; DeVincenzi, I

    1996-10-01

    Since 1990, several community-based interventions have been set up for populations of prostitutes in France with the principal objective of preventing HIV infection in prostitutes and their sexual partners. Field workers have suggested that extremely precarious living conditions are a major obstacle for the diffusion of prevention messages. A multidisciplinary working group thus set up a study in order to determine which living conditions could affect the adoption of behaviour at low risk for HIV infection. In May 1995, six of the seven teams conducting prevention actions among prostitutes in France used a short standardised questionnaire to collect information including type of housing, health insurance cover, physical aggressions, drug use. It was planned to collect data from all persons attending the drop-in centres. A total of 355 questionnaires were completed (sampling was exhaustive for 3 of the 6 teams). The population comprised women, men and transvestites. The median age was 28 years. Only 39% (135/348) of the subjects had access to health insurance. Approximately 50% (160/324) of the persons lived in precarious accommodation (hotel or no fixed address) and 33% (119/355) had been victims of physical aggressions during the 5 months preceding the study. Transvestites and young people had the most precarious living conditions. Despite the limits of this study due to the difficulty in carrying out a survey in this very marginalised population, the unique information collected may enable community health action strategies to be suitably adapted. In particular, it is important to improve partnership between field workers and existing social and health services, to improve access to better accommodation, health care and physical security while disseminating prevention messages and distributing condoms.

  2. [Jaundice and urinary tract infection in neonates: simple coincidence or real consequence?].

    PubMed

    Abourazzak, S; Bouharrou, A; Hida, M

    2013-09-01

    In neonates, jaundice may be one of the initial symptoms related to urinary tract infection (UTI). The routine testing of the urine in jaundiced neonates is controversial. This study aimed to evaluate the related factors of neonatal infants with the initial presentation of hyperbilirubinemia and the final diagnosis of UTI by evaluating data that help diagnose UTI early in apparently healthy newborns with jaundice. We retrospectively investigated the medical records of neonates who had been admitted for management of jaundice (n=26) and compared with neonates with jaundice but without UTI (n=26). There was a significant difference between the two groups in male gender and maternal conditions (prolonged rupture of membranes, maternal UTI). There was also a significant difference between the two groups in their age at the time jaundice started (4 ± 3 days vs 2 ± 1 days) in the UTI and non-UTI groups, respectively (P>0.05). The cases in the UTI group had significantly lower total bilirubin levels (183 ± 71 mg/l) vs (227 ± 40 mg/l) in the non-UTI group, but a higher indirect bilirubin rate than the non-UTI group (P<0.05). Type B blood group was more common in neonates with UTI (P<0.01). In the cases presented herein, none of the jaundiced infants with UTI presented conjugated hyperbilirubinemia. Therefore, urinary tests for UTI should not be absolutely excluded or neglected in neonates in the early stage with unconjugated hyperbilirubinemia. Performing urinary tests to exclude the possibility of coincidental UTI may be necessary for admitted jaundiced infants younger than if they have a high level of indirect bilirubin, especially in male newborns with group B blood and in the presence of maternal urinary infection. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. 42 CFR 482.42 - Condition of participation: Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... sanitary environment to avoid sources and transmission of infections and communicable diseases. There must... diseases. (a) Standard: Organization and policies. A person or persons must be designated as infection... communicable diseases. (1) The infection control officer or officers must develop a system for identifying...

  4. Hospital Epidemiology and Infection Control in Acute-Care Settings

    PubMed Central

    Sydnor, Emily R. M.; Perl, Trish M.

    2011-01-01

    Summary: Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program. PMID:21233510

  5. HIV-1 elite controllers: beware of super-infections.

    PubMed

    Clerc, Olivier; Colombo, Sara; Yerly, Sabine; Telenti, Amalio; Cavassini, Matthias

    2010-04-01

    Super- and co-infection with HIV-1 are generally associated with accelerated disease progression. We report on the outcome of super-infection in two HIV-1 infected individuals previously known as elite controllers. Both presented an acute retroviral syndrome following super-infection and showed an immuno-virological progression thereafter. Host genotyping failed to reveal any of the currently recognized protective factors associated with slow disease progression. This report indicates that elite controllers should be informed of the risk of super-infection, and illustrates the complexity of mounting broad anti-HIV immunity.

  6. Follow-up of nosocomial infections on nursing units: an approach to infection control.

    PubMed

    Loss, S L; Goodloe, S

    1986-07-01

    The infection control department at Niagara Falls Memorial Medical Center in Niagara Falls, New York, has developed an innovative approach to decreasing nosocomial infections. By following up on the infections that occur on nursing units, nurses actively work to prevent their occurrence. The approach utilizes nursing accountability, continuing staff education, and documentation, with positive results.

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

    DTIC Science & Technology

    2011-08-01

    REVIEW ARTICLE Infection Prevention and Control in Deployed Military Medical Treatment Facilities Duane R. Hospenthal, MD, PhD, FACP, FIDSA, Andrew D...Heather C. Yun, MD, FACP, Clinton K. Murray, MD, FACP, FIDSA, and the Prevention of Combat-Related Infections Guidelines Panel Abstract: Infections have...survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of

  8. World Wide Web resources on control of nosocomial infections.

    PubMed

    Siempos, Ilias I; Fragoulis, Konstantinos N; Falagas, Matthew E

    2007-01-01

    Nosocomial infections are a major worldwide cause of death and disability, infection control programs are effective in limiting these infections, especially those acquired in the intensive care unit. The development of the world wide web has provided health care professionals with immediate access to continuously updated information in the field of infection control. We sought to identify websites that contain information on nosocomial infection control by using popular internet search engines, such as Google, Yahoo and AltaVista, and by reviewing relevant publications identified in the PubMed and Current Contents databases. Only those sites that were English language, open access, and developed by a government, academic institution, or national or international scientific association were eligible for inclusion. From a vast number of internet sites initially identified, we selected 49 that provide information on infection control for inclusion in our list of practical and relevant internet resources. Several sites provide general information on infection control practices, whereas others focus on one or a few specific infection(s). We provide health care professionals with a timely and succinct list of open access internet resources that contain information regarding the prevention and control of nosocomial infections in order to help in the dissemination of relevant information and so contribute to the limitation of such hazards.

  9. An unintended consequence of CPOE implementation: shifts in power, control, and autonomy.

    PubMed

    Ash, Joan S; Sittig, Dean F; Campbell, Emily; Guappone, Kenneth; Dykstra, Richard H

    2006-01-01

    Having found that an unintended consequence of computerized provider order entry (CPOE) implementation is "changes in the power structure" of the organization, we sought a deeper understanding of what was happening and why. If such consequences can be anticipated, they can be better managed. Using qualitative methods to study five successful CPOE sites, a multidisciplinary team found that CPOE enables shifts in power related to work redistribution and safety initiatives and causes a perceived loss of control and autonomy by clinicians. With recognition of the extent of these shifts, clinicians can anticipate them and will no longer be surprised by them. Greater provider involvement in planning, quality initiatives, and the work of clinical information coalitions/committees can benefit the organization and provide a different kind of power and satisfaction to clinicians.

  10. Atypical variants of bovine spongiform encephalopathy: rare diseases with consequences for BSE surveillance and control.

    PubMed

    Boujon, C; Serra, F; Seuberlich, T

    2016-03-01

    Occurring for the first time in 1986 in the United Kingdom, bovine spongiform encephalopathy (BSE), the so-called "mad-cow disease", has had unprecedented consequences in veterinary public health. The implementation of drastic measures, including the ban of meat-and-bone-meal from livestock feed and the removal of specified risk materials from the food chain has eventually resulted in a significant decline of the epidemic. The disease was long thought to be caused by a single agent, but since the introduction of immunochemical diagnostic techniques, evidence of a phenotypic variation of BSE has emerged. Reviewing the literature available on the subject, this paper briefly summarizes the current knowledge about these atypical forms of BSE and discusses the consequences of their occurrence for disease control measures.

  11. Vancomycin-Resistant Enterococci: Epidemiology, Infection Prevention, and Control.

    PubMed

    Reyes, Katherine; Bardossy, Ana Cecilia; Zervos, Marcus

    2016-12-01

    Vancomycin-resistant enterococci (VRE) infections have acquired prominence as a leading cause of health care-associated infections. Understanding VRE epidemiology, transmission modes in health care settings, risk factors for colonization, and infection is essential to prevention and control of VRE infections. Infection control strategies are pivotal in management of VRE infections and should be based on patient characteristics, hospital needs, and available resources. Hand hygiene is basic to decrease acquisition of VRE. The effectiveness of surveillance and contact precautions is variable and controversial in endemic settings, but important during VRE outbreak investigations and control. Environmental cleaning, chlorhexidine bathing, and antimicrobial stewardship are vital in VRE prevention and control. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Infection control practice in countries with limited resources.

    PubMed

    Alp, Emine; Leblebicioglu, Hakan; Doganay, Mehmet; Voss, Andreas

    2011-10-22

    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. © 2011 Alp et al; licensee BioMed Central Ltd.

  13. Infection control practice in countries with limited resources

    PubMed Central

    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 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. PMID:22018286

  14. Clinically Significant Pocket Hematoma Increases Long-Term Risk of Device Infection: BRUISE CONTROL INFECTION Study.

    PubMed

    Essebag, Vidal; Verma, Atul; Healey, Jeff S; Krahn, Andrew D; Kalfon, Eli; Coutu, Benoit; Ayala-Paredes, Felix; Tang, Anthony S; Sapp, John; Sturmer, Marcio; Keren, Arieh; Wells, George A; Birnie, David H

    2016-03-22

    The BRUISE CONTROL trial (Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial) demonstrated that a strategy of continued warfarin during cardiac implantable electronic device surgery was safe and reduced the incidence of clinically significant pocket hematoma (CSH). CSH was defined as a post-procedure hematoma requiring further surgery and/or resulting in prolongation of hospitalization of at least 24 h, and/or requiring interruption of anticoagulation. Previous studies have inconsistently associated hematoma with the subsequent development of device infection; reasons include the retrospective nature of many studies, lack of endpoint adjudication, and differing subjective definitions of hematoma. The BRUISE CONTROL INFECTION (Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial Extended Follow-Up for Infection) prospectively examined the association between CSH and subsequent device infection. The study included 659 patients with a primary outcome of device-related infection requiring hospitalization, defined as 1 or more of the following: pocket infection; endocarditis; and bloodstream infection. Outcomes were verified by a blinded adjudication committee. Multivariable analysis was performed to identify predictors of infection. The overall 1-year device-related infection rate was 2.4% (16 of 659). Infection occurred in 11% of patients (7 of 66) with previous CSH and in 1.5% (9 of 593) without CSH. CSH was the only independent predictor and was associated with a >7-fold increased risk of infection (hazard ratio: 7.7; 95% confidence interval: 2.9 to 20.5; p < 0.0001). Empiric antibiotics upon development of hematoma did not reduce long-term infection risk. CSH is associated with a significantly increased risk of infection requiring hospitalization within 1 year following cardiac implantable electronic device surgery. Strategies aimed at reducing hematomas may decrease the long-term risk of infection. (Bridge or Continue

  15. 77 FR 4820 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ...., February 17, 2012. Place: CDC, Global Communications Center, Building 19, Auditorium B3, 1600 Clifton Road... control; (2) strategies for surveillance, prevention, and control of infections (e.g.,...

  16. 77 FR 28392 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ...., June 15, 2012. Place: CDC, Global Communications Center, Building 19, Auditorium B3, 1600 Clifton Road... control; 2) strategies for surveillance, prevention, and control of infections (e.g.,...

  17. 76 FR 63622 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Prevention (CDC) announces the following meeting for the aforementioned committee: Times and Dates: 9 a.m.-5 p.m., November 3, 2011. 9 a.m.-12 p.m., November 4, 2011. Place: Embassy Suites-Washington, DC... healthcare infection control; (2) strategies for surveillance, prevention, and control of infections...

  18. 42 CFR 418.60 - Condition of participation: Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of Participation: Patient Care § 418.60 Condition of participation: Infection control. The hospice must maintain and document an effective infection control program that protects patients, families, visitors, and hospice personnel by...

  19. 78 FR 28221 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... definitions for catheter-associated urinary tract infections. Agenda items are subject to change as priorities... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... Director, CDC, the Secretary, Health and Human Services regarding (1) the practice of healthcare...

  20. Severe anaemia associated with Plasmodium falciparum infection in children: consequences for additional blood sampling for research.

    PubMed

    Kuijpers, Laura Maria Francisca; Maltha, Jessica; Guiraud, Issa; Kaboré, Bérenger; Lompo, Palpouguini; Devlieger, Hugo; Van Geet, Chris; Tinto, Halidou; Jacobs, Jan

    2016-06-02

    Plasmodium falciparum infection may cause severe anaemia, particularly in children. When planning a diagnostic study on children suspected of severe malaria in sub-Saharan Africa, it was questioned how much blood could be safely sampled; intended blood volumes (blood cultures and EDTA blood) were 6 mL (children aged <6 years) and 10 mL (6-12 years). A previous review [Bull World Health Organ. 89: 46-53. 2011] recommended not to exceed 3.8 % of total blood volume (TBV). In a simulation exercise using data of children previously enrolled in a study about severe malaria and bacteraemia in Burkina Faso, the impact of this 3.8 % safety guideline was evaluated. For a total of 666 children aged >2 months to <12 years, data of age, weight and haemoglobin value (Hb) were available. For each child, the estimated TBV (TBVe) (mL) was calculated by multiplying the body weight (kg) by the factor 80 (ml/kg). Next, TBVe was corrected for the degree of anaemia to obtain the functional TBV (TBVf). The correction factor consisted of the rate 'Hb of the child divided by the reference Hb'; both the lowest ('best case') and highest ('worst case') reference Hb values were used. Next, the exact volume that a 3.8 % proportion of this TBVf would present was calculated and this volume was compared to the blood volumes that were intended to be sampled. When applied to the Burkina Faso cohort, the simulation exercise pointed out that in 5.3 % (best case) and 11.4 % (worst case) of children the blood volume intended to be sampled would exceed the volume as defined by the 3.8 % safety guideline. Highest proportions would be in the age groups 2-6 months (19.0 %; worst scenario) and 6 months-2 years (15.7 %; worst case scenario). A positive rapid diagnostic test for P. falciparum was associated with an increased risk of violating the safety guideline in the worst case scenario (p = 0.016). Blood sampling in children for research in P. falciparum endemic settings may easily violate

  1. Modern trends in infection control practices in intensive care units.

    PubMed

    Gandra, Sumanth; Ellison, Richard T

    2014-01-01

    Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection.

  2. General medicine and surgery for dental practitioners: part 4. Infections and infection control.

    PubMed

    Jakubovics, N; Greenwood, M; Meechan, J G

    2014-07-01

    Infection control and knowledge of common infectious agents is a cornerstone of safe dental practice. This paper summarises the measures that need to be taken to control cross infection and discusses some of the infectious agents of concern to dental practitioners.

  3. A brief history of infection control - past and present.

    PubMed

    Forder, A A

    2007-11-01

    The scientific study of hospital or nosocomial cross-infection began during the first half of the 18th century, and from that time until the start of the 'Bacteriological Era' many of the most notable contributions originated in Scotland. However it was only 100 years later in 1858 that Florence Nightingale promoted the case for hospital reform. The real understanding of hospital infection followed upon the discoveries of Pasteur, Koch and Lister and the beginning of the 'Bacteriological Era'. The close of the 19th century saw the triumphs of hospital reform and asepsis and seemed to herald the final victory over hospital cross-infection. However, the victory was short-lived. It was soon realised that infections occurred not only in obstetric and surgical patients, but in medical patients as well, and that air could also be a source of infection. Streptococcal, staphylococcal and then Gram-negative bacilli as a cause of hospital infection became a focus of attention, as did antibiotic-resistant organisms. This paper looks briefly at the establishment of the control of infection doctor, infection control committee and infection control nurse as well as summarising the changes, problems and advances in infection control up to the present time.

  4. [Role of medical technologists in the infection control team].

    PubMed

    Abe, Yuko; Ohisa, Yoshiharu; Yoshida, Katsumi; Kaku, Mitsuo

    2006-08-01

    The infection control team (ICT) plays important roles in many different aspects of infection control. They include (1) surveillance for hospital-acquired infection, (2) developing the infection control manual, (3) checking that the manual is followed correctly, (4) giving information about the isolation of microorganisms in the hospital, (5) educating and instructing medical staff, etc. Many data have been accumulated on a database in the microbiology laboratory. Bacterial samples are also examined in the microbiological laboratory therefore medical technologists will be the first to notice hospital-acquired infection. Offering prompt information, obtained by surveillance or routine work, greatly contributes to infection control. Furthermore, a 24hr system for the microbiological laboratory may prevent occupational infection of health care workers. The role of the medical technologist in ICT is thus important. To prevent outbreaks of infection, the regional network is also important for the collection of information about the pathogen and the susceptibility of antimicrobial agents in the region. The medical technologist should participate in and communicate with this network. As mentioned above, the inclusion of medical technologists in infection control practice is essential. To participate in the ICT, medical technologists need to have communication skills, and be recognized by other team members as an essential member.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    Grundmann, H; 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 emerged that provides solid and testable hypotheses and opens the road to a quantitative assessment of the main obstructions that undermine current efforts to control the spread of health-care-associated infections in hospitals and communities. We aim to explain to a broader audience of professionals in health care, infection control, and health systems administration some of these models that can improve the understanding of the hidden dynamics of health-care-associated infections. We also appraise their usefulness and limitations as an innovative research and decision tool for control purposes.

  8. Putting it into practice: Infection control professionals' perspectives on early career nursing graduates' microbiology and infection control knowledge and practice.

    PubMed

    Cox, Jennifer L; Simpson, Maree Donna; Letts, Will; Cavanagh, Heather M A

    2014-01-01

    The microbiology component of Australian undergraduate nursing programmes varies considerably. Any actual or potential impact of this variation on infection control practice, as a nursing graduate, is relatively unknown. The aim of this study was to explore infection control professionals' perceptions of the importance of microbiology and infection control training in undergraduate nursing curricula and the perceived retention of that knowledge and its transferability to practice. Semi-structured interviews were conducted with eight infection control professionals from a range of hospital settings in Australia. Four main themes emerged: Theory versus practice, importance of role modelling, disjunction between university curricula and 'the real world,' and learning in context. As the underpinning element of infection control practice, the role of microbiology education and training in nursing education will benefit from review. Further discussions about the nature and timing of theoretical microbiology content and assessment of undergraduate students' microbiology knowledge to ensure retention and appropriate application of that knowledge in practice are urgently needed.

  9. Plant virus infections control stomatal development

    PubMed Central

    Murray, Rose R.; Emblow, Mark S. M.; Hetherington, Alistair M.; Foster, Gary D.

    2016-01-01

    Stomata are important regulators of carbon dioxide uptake and transpirational water loss. They also represent points of vulnerability as bacterial and fungal pathogens utilise this natural opening as an entry portal, and thus have an increasingly complex relationship. Unlike the situation with bacterial and fungal pathogens, we know very little about the role of stomata in viral infection. Here we report findings showing that viral infection influences stomatal development in two susceptible host systems (Nicotiana tabacum with TMV (Tobacco mosaic virus), and Arabidopsis thaliana with TVCV (Turnip vein-clearing virus)), but not in resistant host systems (Nicotiana glutinosa and Chenopodium quinoa with TMV). Virus infected plants had significantly lower stomatal indices in systemic leaves of susceptible systems; N. tabacum 9.8% reduction and A. thaliana 12.3% reduction, but not in the resistant hosts. Stomatal density in systemic leaves was also significantly reduced in virus infected A. thaliana by 19.6% but not in N. tabacum or the resistant systems. In addition, transpiration rate was significantly reduced in TMV infected N. tabacum. PMID:27687773

  10. Plant virus infections control stomatal development.

    PubMed

    Murray, Rose R; Emblow, Mark S M; Hetherington, Alistair M; Foster, Gary D

    2016-09-30

    Stomata are important regulators of carbon dioxide uptake and transpirational water loss. They also represent points of vulnerability as bacterial and fungal pathogens utilise this natural opening as an entry portal, and thus have an increasingly complex relationship. Unlike the situation with bacterial and fungal pathogens, we know very little about the role of stomata in viral infection. Here we report findings showing that viral infection influences stomatal development in two susceptible host systems (Nicotiana tabacum with TMV (Tobacco mosaic virus), and Arabidopsis thaliana with TVCV (Turnip vein-clearing virus)), but not in resistant host systems (Nicotiana glutinosa and Chenopodium quinoa with TMV). Virus infected plants had significantly lower stomatal indices in systemic leaves of susceptible systems; N. tabacum 9.8% reduction and A. thaliana 12.3% reduction, but not in the resistant hosts. Stomatal density in systemic leaves was also significantly reduced in virus infected A. thaliana by 19.6% but not in N. tabacum or the resistant systems. In addition, transpiration rate was significantly reduced in TMV infected N. tabacum.

  11. Plant virus infections control stomatal development

    NASA Astrophysics Data System (ADS)

    Murray, Rose R.; Emblow, Mark S. M.; Hetherington, Alistair M.; Foster, Gary D.

    2016-09-01

    Stomata are important regulators of carbon dioxide uptake and transpirational water loss. They also represent points of vulnerability as bacterial and fungal pathogens utilise this natural opening as an entry portal, and thus have an increasingly complex relationship. Unlike the situation with bacterial and fungal pathogens, we know very little about the role of stomata in viral infection. Here we report findings showing that viral infection influences stomatal development in two susceptible host systems (Nicotiana tabacum with TMV (Tobacco mosaic virus), and Arabidopsis thaliana with TVCV (Turnip vein-clearing virus)), but not in resistant host systems (Nicotiana glutinosa and Chenopodium quinoa with TMV). Virus infected plants had significantly lower stomatal indices in systemic leaves of susceptible systems; N. tabacum 9.8% reduction and A. thaliana 12.3% reduction, but not in the resistant hosts. Stomatal density in systemic leaves was also significantly reduced in virus infected A. thaliana by 19.6% but not in N. tabacum or the resistant systems. In addition, transpiration rate was significantly reduced in TMV infected N. tabacum.

  12. The funding and organization of infection control in NHS hospital trusts: a study of infection control professionals' views.

    PubMed

    Croxson, B; Allen, P; Roberts, J A; Archibald, K; Crawshaw, S; Taylor, L

    2003-05-01

    The problems associated with hospital-acquired infection have been causing increasing concern in England in recent years. This paper reports the results of a nationwide survey of hospital infection control professionals' views concerning the organizational structures used to manage and obtain funding for control of infection. A complex picture with significant variation between hospitals emerges. Although government policy dictates that specific funding for hospital infection control is formally made available, it is not always the case that infection control professionals have adequate resources to undertake their roles. In some cases this reflects the failure of hospitals' infection control budgetary mechanisms; in others it reflects the effects of decentralizing budgets to directorate or ward level. Some use was made of informal mechanisms either to supplement or to substitute for the formal ones. But almost all infection control professionals still believed they were constrained in their ability to protect the hospital population from the risk of infectious disease. It is clear that recent government announcements that increased effort will be made to support local structures and thereby improve the control of hospital acquired infection are to be welcomed.

  13. Infection control and prevention: a review of hospital-acquired infections and the economic implications.

    PubMed

    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 has proposed changes to the Hospital Inpatient Prospective Payment System and Fiscal Year Rates: Proposed Rule CMS 1488-P-Healthcare-associated infection. Payment will be linked to performance. Under the new rule, payment will be withheld from hospitals for care associated with treating certain catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery. Infection-prevention strategies are essential. In the healthcare setting, the infection control department is categorized as non-revenue-producing. Funds dedicated to resources such as staff, educational programs, and prevention measures are vastly limited. Hospital leaders will need to balance the upfront cost needed to prevent hospital-related infections with the non-reimbursed expense accrued secondary to potentially preventable infections. The purpose of this paper is to present case studies and cost analysis of hospital-acquired infections and present strategies that reduce infections and cost.

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

    PubMed Central

    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 has proposed changes to the Hospital Inpatient Prospective Payment System and Fiscal Year Rates: Proposed Rule CMS 1488-P-Healthcare-associated infection. Payment will be linked to performance. Under the new rule, payment will be withheld from hospitals for care associated with treating certain catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery. Infection-prevention strategies are essential. In the healthcare setting, the infection control department is categorized as non-revenue-producing. Funds dedicated to resources such as staff, educational programs, and prevention measures are vastly limited. Hospital leaders will need to balance the upfront cost needed to prevent hospital-related infections with the non-reimbursed expense accrued secondary to potentially preventable infections. The purpose of this paper is to present case studies and cost analysis of hospital-acquired infections and present strategies that reduce infections and cost. PMID:21603406

  15. 77 FR 58397 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices.... L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the following meeting for... Services (HHS); the Director, Centers for Disease Control and Prevention (CDC); the Deputy Director,...

  16. 78 FR 62636 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices.... L. 92-463), the Centers for Disease Control and Prevention (CDC) announce the following meeting for... p.m., November 7, 2013. Place: Centers for Disease Control and Prevention, Global...

  17. Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy.

    PubMed

    Roberts, Andrew W; Farley, Joel F; Holmes, G Mark; Oramasionwu, Christine U; Ringwalt, Chris; Sleath, Betsy; Skinner, Asheley C

    2016-10-01

    Controlled substance lock-in programs are garnering increased attention from payers and policy makers seeking to combat the epidemic of opioid misuse. These programs require high-risk patients to visit a single prescriber and pharmacy for coverage of controlled substance medication services. Despite high prevalence of the programs in Medicaid, we know little about their effects on patients' behavior and outcomes aside from reducing controlled substance-related claims. Our study was the first rigorous investigation of lock-in programs' effects on out-of-pocket controlled substance prescription fills, which circumvent the programs' restrictions and mitigate their potential public health benefits. We linked claims data and prescription drug monitoring program data for the period 2009-12 for 1,647 enrollees in North Carolina Medicaid's lock-in program and found that enrollment was associated with a roughly fourfold increase in the likelihood and frequency of out-of-pocket controlled substance prescription fills. This finding illuminates weaknesses of lock-in programs and highlights the need for further scrutiny of the appropriate role, optimal design, and potential unintended consequences of the programs as tools to prevent opioid abuse. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Photodynamic therapy controls of Staphylococcus aureus intradermal infection in mice.

    PubMed

    Almeida, Palloma Porto; Pereira, Ítalo Sousa; Rodrigues, Karine Bitencourt; Leal, Lorena Santos; Marques, Andressa Souza; Rosa, Luciano Pereira; da Silva, Francine Cristina; da Silva, Robson Amaro Augusto

    2017-08-01

    Infections caused by Staphylococcus aureus lead to skin infections, as well as soft tissues and bone infections. Given the communal resistance to antibiotics developed by strains of this bacterium, photodynamic therapy emerges as a promising alternative treatment to control and cure infections. Females of the Balb/C mice were infected with 10(8) CFU of methicillin-resistant S. aureus (MRSA) and divided into four distinct groups: P-L- (negative control group), P+L- (group exposed only to curcumin), P-L+ (group exposed only to LED incidence of 450 nm, 75 mW/cm(2), and 54 J/cm(2) for 10 min), and P+L+ (group exposed to curcumin followed by 10 min of LED irradiation) (n = 24). The mice were euthanized 48 and 72 h after infection, and biologic materials were collected for analysis of the bacterial load, peripheral blood leukocyte counts, and draining lymph nodes cell counts. The normalization of data was checked and the ANOVA test was applied. The bacterial load in the draining lymph node of P+L+ group was lower when compared to the control groups 72 h post infection (p < 0.0001), indicating that the LED incidence associated with curcumin controls of the staphylococci intradermal infection. The number of the total lymph node cells shows to be lower than control groups in the two availed times (p < 0.01). The histological analysis and the counting of white blood cells did not show differences among cells in the blood and in the tissue of infection. This is the first report showing that photodynamic therapy may be effective against MRSA infection in a murine model of intradermal infection.

  19. Infection control in the pulmonary function test laboratory

    PubMed Central

    Rasam, Shweta Amol; Apte, Komalkirti Keshavkiran; Salvi, Sundeep Santosh

    2015-01-01

    Pulmonary function testing plays a crucial role in the diagnostic evaluation of patients with lung diseases. Cases of cross infection acquired from the pulmonary function laboratory, although rare, have been reported from various countries. It is therefore imperative to identify the risks and potential organisms implicated in cross infections in a pulmonary function test (PFT) laboratory and implement better and more effective infection control procedures, which will help in preventing cross infections. The infrastructure, the daily patient flow, and the prevalent disinfection techniques used in a PFT laboratory, all play a significant role in transmission of infections. Simple measures to tackle the cross infection potential in a PFT laboratory can help reduce this risk to a bare minimum. Use of specialized techniques and equipment can also be of much use in a set up that has a high turnover of patients. This review aims at creating awareness about the possible pathogens and situations commonly encountered in a PFT laboratory. We have attempted to suggest some relevant and useful infection control measures with regard to disinfection, sterilization, and patient planning and segregation to help minimize the risk of cross infections in a PFT laboratory. The review also highlights the lacuna in the current scenario of PFT laboratories in India and the need to develop newer and better methods of infection control, which will be more user-friendly and cost effective. Further studies to study the possible pathogens in a PFT laboratory and evaluate the prevalent infection control strategies will be needed to enable us to draw more precious conclusions, which can lead to more relevant, contextual recommendations for cross infections control in PFT lab in India. PMID:26180386

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

    PubMed

    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.

  1. Infection control: maintaining the personal hygiene of patients and staff.

    PubMed

    Parker, Lynn

    This article concentrates on the importance of personal hygiene for staff and patients in reducing the risk of healthcare-associated infections for patients. It provides an historical context to the associated risks of "basic nursing care" and how these can be counteracted. With the introduction of modern matrons and directors of infection control, emphasis is again focused on these practices.

  2. 42 CFR 418.60 - Condition of participation: Infection control.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... infectious and communicable diseases that— (1) Is an integral part of the hospice's quality assessment and... and controlling infections and communicable diseases. (a) Standard: Prevention. The hospice must follow accepted standards of practice to prevent the transmission of infections and communicable diseases...

  3. A definition of normovolaemia and consequences for cardiovascular control during orthostatic and environmental stress.

    PubMed

    Truijen, Jasper; Bundgaard-Nielsen, Morten; van Lieshout, Johannes J

    2010-05-01

    The Frank-Starling mechanism describes the relationship between stroke volume and preload to the heart, or the volume of blood that is available to the heart--the central blood volume. Understanding the role of the central blood volume for cardiovascular control has been complicated by the fact that a given central blood volume may be associated with markedly different central vascular pressures. The central blood volume varies with posture and, consequently, stroke volume and cardiac output (Q) are affected, but with the increased central blood volume during head-down tilt, stroke volume and Q do not increase further indicating that in the supine resting position the heart operates on the plateau of the Frank-Starling curve which, therefore, may be taken as a functional definition of normovolaemia. Since the capacity of the vascular system surpasses the blood volume, orthostatic and environmental stress including bed rest/microgravity, exercise and training, thermal loading, illness, and trauma/haemorrhage is likely to restrict venous return and Q. Consequently the cardiovascular responses are determined primarily by their effect on the central blood volume. Thus during environmental stress, flow redistribution becomes dependent on sympathetic activation affecting not only skin and splanchnic blood flow, but also flow to skeletal muscles and the brain. This review addresses the hypothesis that deviations from normovolaemia significantly influence these cardiovascular responses.

  4. Harmonizing and supporting infection control training in Europe.

    PubMed

    Brusaferro, S; Arnoldo, L; Cattani, G; Fabbro, E; Cookson, B; Gallagher, R; Hartemann, P; Holt, J; Kalenic, S; Popp, W; Privitera, G; Prikazsky, V; Velasco, C; Suetens, C; Varela Santos, C

    2015-04-01

    Healthcare-associated infection (HCAI), patient safety, and the harmonization of related policies and programmes are the focus of increasing attention and activity in Europe. Infection control training for healthcare workers (HCWs) is a cornerstone of all patient safety and HCAI prevention and control programmes. In 2009 the European Centre for Disease Prevention and Control (ECDC) commissioned an assessment of needs for training in infection control in Europe (TRICE), which showed a substantial increase in commitment to HCAI prevention. On the other hand, it also identified obstacles to the harmonization and promotion of training in infection control and hospital hygiene (IC/HH), mostly due to differences between countries in: (i) the required qualifications of HCWs, particularly nurses; (ii) the available resources; and (iii) the sustainability of IC/HH programmes. In 2013, ECDC published core competencies for infection control and hospital hygiene professionals in the European Union and a new project was launched ['Implementation of a training strategy for infection control in the European Union' (TRICE-IS)] that aimed to: define an agreed methodology and standards for the evaluation of IC/HH courses and training programmes; develop a flexible IC/HH taxonomy; and implement an easily accessible web tool in 'Wiki' format for IC/HH professionals. This paper reviews several aspects of the TRICE and the TRICE-IS projects.

  5. Prioritization of reactor control components susceptible to fire damage as a consequence of aging

    SciTech Connect

    Lowry, W.; Vigil, R.; Nowlen, S.

    1994-01-01

    The Fire Vulnerability of Aged Electrical Components Test Program is to identify and assess issues of plant aging that could lead to an increase in nuclear power plant risk because of fires. Historical component data and prior analyses are used to prioritize a list of components with respect to aging and fire vulnerability and the consequences of their failure on plant safety systems. The component list emphasizes safety system control components, but excludes cables, large equipment, and devices encompassed in the Equipment Qualification (EQ) program. The test program selected components identified in a utility survey and developed test and fire conditions necessary to maximize the effectiveness of the test program. Fire damage considerations were limited to purely thermal effects.

  6. Power and motivation: important concepts for infection control practitioners.

    PubMed

    Campbell, B

    1991-02-01

    Organizations are composed of people vying with one another for power. Failure to acquire it may result in a limited ability to have an impact on organizational politics, and ultimately can lessen the success of motivating personnel. Therefore, using the power sources described to acquire power and developing strategies to motivate others are essential in attaining the goals of an infection control program. In summary, infection control practitioners have tended to focus on the technical aspects of their roles and may have neglected the development of influencing and motivational strategies that well could have an impact on improving compliance to infection control. Knowledge of key concepts, such as power and motivation, should be as important as any component of an infection control practitioner's training.

  7. The control of bovine viral diarrhoea virus infection.

    PubMed

    Harkness, J W

    1987-01-01

    In this paper, current ideas concerning the epidemiology of BVD virus infection are reviewed briefly, together with its possible economic implications. The different types of control strategies are considered. Problems associated with vaccination are discussed.

  8. The consequences of juvenile detention reform for mental health and sexually transmitted infection screening among detained youth.

    PubMed

    Aalsma, Matthew C; Gudonis, Lauren C; Jarjoura, G Roger; Blythe, Margaret J; Tong, Yan; Harezlak, Jaroslaw; Rosenman, Marc B

    2012-04-01

    To understand how diversion of low-risk youth from juvenile detention affected screening practices for detained youth. In a 22-month cross-sectional study of 2,532 detainees (age, 13-18 years), mental health and sexually transmitted infection (STI) screening data were compared before and after the beginning of diversion efforts through implementation of a Risk Assessment Instrument (RAI). Detention diversion resulted in a 30% census reduction. In a logistic regression, younger age (odds ratio [OR] = 1.10 for a 1-year increase; confidence interval [CI]: 1.03, 1.17), Hispanic versus white race/ethnicity (OR = .53; CI: .35, .82), and less severe crime (OR = .90 per 1 point; CI: .89, .91) predicted reduced likelihood of detention. Mental health and STI screening increased significantly after implementation of the RAI. Additionally, the rate of positive STI tests increased among detained males (9% pre-RAI to 14% after implementation of the RAI, p = .01). However, implementation of the RAI did not result in a significant increase in the number of positive mental health screens. Universal mental health and STI screening are increasingly common public health practices in detention centers. The results of this study indicate that juvenile justice diversion programming affects public health screening rates among detained youth in our population. Future study of the possible unintended consequences of criminal justice initiatives on public health outcomes is recommended. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Corticalization of motor control in humans is a consequence of brain scaling in primate evolution.

    PubMed

    Herculano-Houzel, Suzana; Kaas, Jon H; de Oliveira-Souza, Ricardo

    2016-02-15

    Control over spinal and brainstem somatomotor neurons is exerted by two sets of descending fibers, corticospinal/pyramidal and extrapyramidal. Although in nonhuman primates the effect of bilateral pyramidal lesions is mostly limited to an impairment of the independent use of digits in skilled manual actions, similar injuries in humans result in the locked-in syndrome, a state of mutism and quadriplegia in which communication can be established only by residual vertical eye movements. This behavioral contrast makes humans appear to be outliers compared with other primates because of our almost total dependence on the corticospinal/pyramidal system for the effectuation of movement. Here we propose, instead, that an increasing preponderance of the corticospinal/pyramidal system over motor control is an expected consequence of increasing brain size in primates because of the faster scaling of the number of neurons in the primary motor cortex over the brainstem and spinal cord motor neuron pools, explaining the apparent uniqueness of the corticalization of motor control in humans.

  10. Infection control practices related to Clostridium difficile infection in acute care hospitals in Canada.

    PubMed

    Gravel, Denise; Gardam, Michael; Taylor, Geoffrey; Miller, Mark; Simor, Andrew; McGeer, Allison; Hutchinson, James; Moore, Dorothy; Kelly, Sharon; Mulvey, Michael

    2009-02-01

    We carried out a survey to identify the infection prevention and control practices in place in Canadian hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP). An infection prevention and control practices survey was sent to CNISP hospitals at the beginning of November 2004, the same time that CNISP started a 6-month prospective surveillance for Clostridium difficile infection (CDI) to evaluate their infection prevention and control measures and laboratory methods for C difficile. A total of 33 hospitals completed and returned the survey. Infection control precautions were initiated in 18 hospitals (55%) due to the presence of a symptomatic patient before the C difficile laboratory tests were available. All of the hospitals used gloves and gowns as additional precautions. Twenty-three hospitals (70%) tested liquid stools based on a clinician's order, and 8 (24%) tested all liquid stools submitted whether of not C difficile testing was requested. The hospitals used 1 of 3 different products as a standard hospital-wide disinfectant; 24 (73%) used a quaternary ammonium compound, 8 (24%) used accelerated hydrogen peroxide, and 1 (3%) used a hypochlorite solution (1:10 bleach solution). Although the hospitals used contact precautions quite uniformly, considerable variation was seen among hospitals in terms of testing strategies, cleaning and disinfection protocols and products, and isolation practices. The timing for the initiation of infection control precautions is important to prevent secondary transmission of CDI. Most of the hospitals implemented precautions while waiting for the toxin assay results.

  11. Implementing GermWatcher, an enterprise infection control application.

    PubMed

    Doherty, Joshua; Noirot, Laura A; Mayfield, Jennie; Ramiah, Sridhar; Huang, Christine; Dunagan, Wm Claiborne; Bailey, Thomas C

    2006-01-01

    Automated surveillance tools can provide significant advantages to infection control practitioners. When stored in a relational database, the data collected can also be used to support numerous research and quality improvement opportunities. A previously described electronic infection control surveillance system was remodeled to provide multi-hospital support, an XML based rule set, and interoperability with an enterprise terminology server. This paper describes the new architecture being used at hospitals across BJC HealthCare.

  12. Identifying controlling variables for math computation fluency through experimental analysis: the interaction of stimulus control and reinforcing consequences.

    PubMed

    Hofstadter-Duke, Kristi L; Daly, Edward J

    2015-03-01

    This study investigated a method for conducting experimental analyses of academic responding. In the experimental analyses, academic responding (math computation), rather than problem behavior, was reinforced across conditions. Two separate experimental analyses (one with fluent math computation problems and one with non-fluent math computation problems) were conducted with three elementary school children using identical contingencies while math computation rate was measured. Results indicate that the experimental analysis with non-fluent problems produced undifferentiated responding across participants; however, differentiated responding was achieved for all participants in the experimental analysis with fluent problems. A subsequent comparison of the single-most effective condition from the experimental analyses replicated the findings with novel computation problems. Results are discussed in terms of the critical role of stimulus control in identifying controlling consequences for academic deficits, and recommendations for future research refining and extending experimental analysis to academic responding are made. © The Author(s) 2014.

  13. [Significance of infection control in dentistry: a review].

    PubMed

    Györfi, Adrienne; Fazekas, Arpad

    2007-08-01

    Dental care is a field of high priority regarding the risk of infections. Since many carriers are not aware of their infection, it may happen that the dentist meets a patient, in whom an earlier infection can be proven by serology, but the patient is not aware of it and the clinical signs and symptoms are missing, as well. For this reason, the dentist has to consider every patient potentially infected. On the other hand, health-care workers are not only susceptible persons to infections but they can also be sources of infections. In order to prevent the nosocomial infections the dentist has to ensure the hygienic protection of both the patients and the health-care workers. All the health-occupational measures have to be known and have to be kept by the dental personnel. The health personnel has to be informed on the risk and how to prevent infections. The essential importance of hygiene, the role of protective equipment and all the duties connected with should be emphasized. Furthermore, the continuing education of health-care workers is indispensable regarding the infectious diseases. In order to reduce the risk of nosocomial infections the authors summarize the state-of-the-art knowledge of infection control.

  14. Immunologic and infectious consequences of immediate versus delayed umbilical cord clamping in premature infants: a prospective, randomized, controlled study.

    PubMed

    Kugelman, Amir; Borenstein-Levin, Liron; Kessel, Aharon; Riskin, Arieh; Toubi, Elias; Bader, David

    2009-01-01

    To evaluate the immunologic and infectious consequences of delayed versus immediate cord clamping in premature infants (<35 weeks) during the neonatal period. This was a prospective, masked, randomized, controlled, single-center study. Prior to delivery 35 infants were randomly assigned to immediate cord clamping (ICC) at 5-10 s and 30 infants to delayed cord clamping (DCC), at 30-45 s (14 and 15 infants in each group were <1500 g, respectively). Neonatal characteristics of the ICC and DCC groups were comparable. There was no significant difference between the ICC and DCC groups in the complement or in the immunoglobulin levels. All were within the normal range for age. All infectious parameters (events of sepsis or "rule-out sepsis", days of antibiotic therapy, and number of antibiotic courses during hospitalization and infections within the first month of life in cases of earlier discharge) were comparable in both groups. Similar results were found in the subgroup of infants <1500 g. Gender analysis showed only modest differences. Delayed compared to immediate cord clamping did not affect the immunologic or the infectious status of infants born at <35 weeks during the neonatal period.

  15. Innate immune control and regulation of influenza virus infections

    PubMed Central

    McGill, Jodi; Heusel, Jonathan W.; Legge, Kevin L.

    2009-01-01

    Adaptive immune responses are critical for the control and clearance of influenza A virus (IAV) infection. However, in recent years, it has become increasingly apparent that innate immune cells, including natural killer cells, alveolar macrophages (aMφ), and dendritic cells (DC) are essential following IAV infection in the direct control of viral replication or in the induction and regulation of virus-specific adaptive immune responses. This review will discuss the role of these innate immune cells following IAV infection, with a particular focus on DC and their ability to induce and regulate the adaptive IAV-specific immune response. PMID:19643736

  16. Prion diseases: risks, characteristics, and infection control considerations in dentistry.

    PubMed

    Bali, Zarina; Bali, Rishi K; Nagrath, Saurabh

    2011-11-01

    Prion diseases are a group of fatal neurodegenerative diseases that are rapidly progressive and fatal, with no definite cure. There are no reported cases of prion disease transmission arising from dental procedures. Nevertheless, there is a theoretical but real risk of transmission of prion disease from dental instruments. A review was made of studies up to 2008 to provide an update of the characteristics, risk of transmission, and the infection-control implications of prions in the field of dentistry. As the prions are resistant to conventional sterilization methods, highly-specific, cross-infection control measures are required when managing patients infected with these.

  17. Control of Mycobacterium avium subsp. paratuberculosis infection in agricultural species.

    PubMed

    Kennedy, D J; Benedictus, G

    2001-04-01

    Paratuberculosis or Johne's disease is a chronic intestinal disease caused by Mycobacterium avium subsp. paratuberculosis, which continues to spread in agricultural species. Control of paratuberculosis is challenging and should not be underestimated. Due to the long incubation period of the infection, disease is largely subclinical in domesticated livestock. Hence, direct effects on animal productivity and welfare are often masked and may appear insufficient to justify large investments in control programmes by individual farmers, livestock industries or governments. Furthermore, in some countries the main effects of the disease are indirect, resulting from the impact of market discrimination against herds and flocks known to be infected, or from the control measures enforced to reduce transmission. In such circumstances, producers may be unwilling to co-operate with surveillance that may detect infection in herds or flocks. As control programmes are rarely successful in eliminating the infection from a herd or flock in the short term without an aggressive and costly programme, financial and community support assists producers to deal with the challenge. Successful prevention and control depends on animal health authorities and livestock industries acquiring a good understanding of the nature and epidemiology of infection, and of the application of tools for diagnosis and control. Building support for control programmes under the leadership of the affected livestock industries is critical, as programmes are unlikely to be successful without ongoing political will, supported by funding for research, surveillance and control.

  18. Probiotics: a new frontier for infection control.

    PubMed

    Seale, J V; Millar, M

    2013-05-01

    Probiotics are live micro-organisms administered to provide health benefits. Probiotics are being increasingly used in healthcare contexts both in research studies and routine practice, for example in neonatal intensive care. Currently there is a paucity of guidelines or regulations governing the mitigation of infection risks associated with the use of probiotics in clinical practice. We propose a number of recommendations to mitigate risks. These include the communication of probiotic use to appropriate stakeholders, ensuring that routine laboratories can identify and test the susceptibility of probiotic strains, assuring standards for preparation and administration, and ensuring surveillance designed to capture adverse events.

  19. Neurological Complications in Controlled HIV Infection.

    PubMed

    Crossley, Kate M; Brew, Bruce J

    2013-12-01

    In recent years, there have been great advances in therapies for human immunodeficiency virus (HIV) that have allowed suppression of the virus and its effects on the body. Despite this progress, neurological complications persist in HIV-infected individuals. In this review we consider the possible ways that HIV might cause neurotoxicity and neuroinflammation. We discuss the spectrum of neurological disorders caused by HIV and its treatment, with a particular focus on both HIV-associated neurocognitive disorders and peripheral neuropathies. Since there has been a shift to HIV being a chronic illness, we also review the increasing prevalence of cerebrovascular disease and neurodegenerative disorders.

  20. [Healthcare-Associated Infection Control with Awareness of Patient Safety].

    PubMed

    Murakami, Nobuo

    2016-03-01

    In order to provide safe and secure medical care for patients, health care-associated infections (HAI) must not occur. HAI should be considered as incidents, and countermeasures should be viewed as a patient safety management itself. Healthcare-associated infection control (HAIC) is practiced by the infection control team (ICT), which is based on multidisciplinary cooperation. Team members have to recognize that it is the most important to make use of the expertise of each discipline. In addition, all members must try to respond quickly, to help the clinic staff. Visualized rapid information provision and sharing, environmental improvement, outbreak factor analysis, hand hygiene compliance rate improvement, proper antibiotic use (Antimicrobial Stewardship Program: ASP), and regional cooperation & leadership comprise the role of the ICT in the flagship hospital. Regarding this role, we present our hospital's efforts and the outcomes. In conclusion, for medical practice quality improvement, healthcare-associated infection control should be conducted thoroughly along with an awareness of patient safety.

  1. A clinical data repository enhances hospital infection control.

    PubMed Central

    Samore, M.; Lichtenberg, D.; Saubermann, L.; Kawachi, C.; Carmeli, Y.

    1997-01-01

    We describe the benefits of a relational database of hospital clinical data (Clinical Data Repository; CDR) for an infection control program. The CDR consists of > 40 Sybase tables, and is directly accessible for ad hoc queries by members of the infection control unit who have been granted privileges for access by the Information Systems Department. The data elements and functional requirements most useful for surveillance of nosocomial infections, antibiotic use, and resistant organisms are characterized. Specific applications of the CDR are presented, including the use of automated definitions of nosocomial infection, graphical monitoring of resistant organisms with quality control limits, and prospective detection of inappropriate antibiotic use. Hospital surveillance and quality improvement activities are significantly benefited by the availability of a querable set of tables containing diverse clinical data. PMID:9357588

  2. Evasion of tumours from the control of the immune system: consequences of brief encounters.

    PubMed

    Al-Tameemi, Mohannad; Chaplain, Mark; d'Onofrio, Alberto

    2012-09-25

    In this work a mathematical model describing the growth of a solid tumour in the presence of an immune system response is presented. Specifically, attention is focused on the interactions between cytotoxic T-lymphocytes (CTLs) and tumour cells in a small, avascular multicellular tumour. At this stage of the disease the CTLs and the tumour cells are considered to be in a state of dynamic equilibrium or cancer dormancy. The precise biochemical and cellular mechanisms by which CTLs can control a cancer and keep it in a dormant state are still not completely understood from a biological and immunological point of view. The mathematical model focuses on the spatio-temporal dynamics of tumour cells, immune cells, chemokines and "chemorepellents" in an immunogenic tumour. The CTLs and tumour cells are assumed to migrate and interact with each other in such a way that lymphocyte-tumour cell complexes are formed. These complexes result in either the death of the tumour cells (the normal situation) or the inactivation of the lymphocytes and consequently the survival of the tumour cells. In the latter case, we assume that each tumour cell that survives its "brief encounter" with the CTLs undergoes certain beneficial phenotypic changes. We explore the dynamics of the model under these assumptions and show that the process of immuno-evasion can arise as a consequence of these encounters. We show that the proposed mechanism not only shape the dynamics of the total number of tumor cells and of CTLs, but also the dynamics of their spatial distribution. We also briefly discuss the evolutionary features of our model, by framing them in the recent quasi-Lamarckian theories. Our findings might have some interesting implication of interest for clinical practice. Indeed, immuno-editing process can be seen as an "involuntary" antagonistic process acting against immunotherapies, which aim at maintaining a tumor in a dormant state, or at suppressing it.

  3. The psychosocial consequences of child sexual abuse in Ethiopia: a case-control comparative analysis.

    PubMed

    Wondie, Yemataw; Zemene, Workie; Tafesse, Biruk; Reschke, Konrad; Schröder, Harry

    2011-07-01

    Child sexual abuse (CSA) continues to be a pressing public health concern around the globe. Few existing reports, however, indicate the alarming rate at which the problem is increasing in sub-Saharan Africa. The present study is designed to investigate the psychosocial consequences of sexual abuse among child survivors in Ethiopia who were abused mainly through early marriage, rape, and child prostitution. Data are collected from 318 such CSA survivors-and 318 matched, non-sexually abused, normal controls- using the Children's Impact of Traumatic Events Scale-Revised and the Rosenberg Self-Esteem Scale. The results reveal the CSA survivors to be significantly more symptomatic than the control group: They demonstrated a lower degree of social support, a lower degree of empowerment, as well as a higher degree of guilt and increased likelihood of viewing the world as dangerous. Finally, these CSA survivors show a lower degree of positive self-worth than their non-sexually abused counterparts. These findings have important implications for the formulation of appropriate preventions and interventions to be undertaken by various stakeholders ranging from family to policy makers.

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

    PubMed

    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.

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

    PubMed

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

    2017-09-18

    Controlled Human Malaria Infection (CHMI) entails deliberate infection with malaria parasites either by mosquito bite or direct injection of sporozoites or parasitised erythrocytes. When required, the resulting blood-stage infection is curtailed by the administration of anti-malarial 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 malaria-endemic areas. Controlled infections have also been used to immunise 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 P. falciparum isolates. Recent advances have included cryopreservation of sporozoites, the manufacture of well characterised and genetically distinct cultured malaria cell banks for blood-stage infection, and P. 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.

  6. Insights into acinetobacter war-wound infections, biofilms, and control.

    PubMed

    Dallo, Shatha F; Weitao, Tao

    2010-04-01

    Multidrug-resistant Acinetobacter baumannii is associated with a wide spectrum of infectious diseases ranging from nosocomial, community-acquired infections to those acquired following war or natural disaster. Especially to military personnel with war wounds, Acinetobacter infection is a formidable threat. The treatment has become exceedingly difficult, not only because the bacterium can develop extensive antimicrobial resistance but because it also forms biofilms that are resistant to host defense and antimicrobial treatment. Such causative factors as biofilm formation and resistance are highly likely to lead to nonhealing wounds. This review, although focused on A baumannii infections, aims to summarize what is known about immunization protection against wound biofilm infections and to apply such understanding in exploring the unknown area of war-wound infection protection. Publications were searched and selected through http://www.pubmed.gov by using the key words Acinetobacter baumannii, bacteria, war wounds, burn wounds, wound infections, biofilms, vaccines, and immunization. The literature selected was categorized according to the subheadings within this article. It is imperative to develop such effective measures as active and passive immunization to control multidrug-resistant and tenacious A baumannii infections and to prevent nonhealing wounds. The authors' understanding in immunization against burn wound-related infections by the model bacteria will facilitate research progress in the poorly explored area of immunization against war-wound biofilm infections.

  7. Infection control practices and infectious complications in dermatological surgery.

    PubMed

    Rogues, A M; Lasheras, A; Amici, J M; Guillot, P; Beylot, C; Taïeb, A; Gachie, J P

    2007-03-01

    The aim of this study was to assess infection control practices and their impact upon infectious complications in skin surgery conducted by private dermatologists. A prospective study was carried out by 73 volunteers belonging to the Surgical Group of the Société Française de Dermatologie over a period of three months. Data were collected for surgical procedures performed during this period, including the excision of all benign or malignant tumours, but excluding sebaceous cysts and pyodermas. A total of 3491 dermatological surgical procedures were included in the survey. Post-operative infections occurred in 67 patients (1.9%), with superficial suppuration accounting for 92.5% of surgical site infections. The incidence was higher in the excision group with a reconstructive procedure (4.3%) than in excisions alone (1.6%). Infection control precautions varied according to the site of procedure; multivariate analysis showed that haemorrhagic complications were an independent factor for infection in both types of surgical procedure. The male gender, immunosuppressive therapy and not wearing sterile gloves were independent factors for infections occurring following excisions with reconstruction. Not all of the procedures needed the use of a hospital theatre. It is clear that for excisions with a reconstructive procedure or for certain anatomical sites, such as the nose, there should be more emphasis upon infection control precautions. Further studies are needed to establish optimal guidelines for this kind of surgery.

  8. Immunological control of gastrointestinal nematode infections.

    PubMed

    Klei, T R

    1997-11-01

    Control of nematode parasitism by an active manipulation of the host immune response has been a goal of veterinary and medical parasitologists for decades. The reality of achieving this goal has been questioned vigorously and demonstrations of the feasibility of using immunological control under field conditions are minimal. Nevertheless, with the rapid growth of modern biotechnology and the identification of novel parasite molecules as vaccine targets, the potential for success in this area has recently generated considerable excitement. The induction and regulation of the ruminant immune response against nematode parasites can be controlled either by management programs which include anthelmintic treatment or by vaccination. Both approaches will be discussed in this session.

  9. Investigating the Consequences of Interference between Multiple CD8+ T Cell Escape Mutations in Early HIV Infection

    PubMed Central

    Garcia, Victor; Feldman, Marcus W.; Regoes, Roland R.

    2016-01-01

    During early human immunodeficiency virus (HIV) infection multiple CD8+ T cell responses are elicited almost simultaneously. These responses exert strong selective pressures on different parts of HIV’s genome, and select for mutations that escape recognition and are thus beneficial to the virus. Some studies reveal that the later these escape mutations emerge, the more slowly they go to fixation. This pattern of escape rate decrease(ERD) can arise by distinct mechanisms. In particular, in large populations with high beneficial mutation rates interference among different escape strains –an effect that can emerge in evolution with asexual reproduction and results in delayed fixation times of beneficial mutations compared to sexual reproduction– could significantly impact the escape rates of mutations. In this paper, we investigated how interference between these concurrent escape mutations affects their escape rates in systems with multiple epitopes, and whether it could be a source of the ERD pattern. To address these issues, we developed a multilocus Wright-Fisher model of HIV dynamics with selection, mutation and recombination, serving as a null-model for interference. We also derived an interference-free null model assuming initial neutral evolution before immune response elicitation. We found that interference between several equally selectively advantageous mutations can generate the observed ERD pattern. We also found that the number of loci, as well as recombination rates substantially affect ERD. These effects can be explained by the underexponential decline of escape rates over time. Lastly, we found that the observed ERD pattern in HIV infected individuals is consistent with both independent, interference-free mutations as well as interference effects. Our results confirm that interference effects should be considered when analyzing HIV escape mutations. The challenge in estimating escape rates and mutation-associated selective coefficients posed by

  10. Disruptions of Host Immunity and Inflammation by Giardia Duodenalis: Potential Consequences for Co-Infections in the Gastro-Intestinal Tract

    PubMed Central

    Cotton, James A.; Amat, Christina B.; Buret, Andre G.

    2015-01-01

    Giardia duodenalis (syn. G. intestinalis, or G. lamblia) is a leading cause of waterborne diarrheal disease that infects hundreds of millions of people annually. Research on Giardia has greatly expanded within the last few years, and our understanding of the pathophysiology and immunology on this parasite is ever increasing. At peak infection, Giardia trophozoites induce pathophysiological responses that culminate in the development of diarrheal disease. However, human data has suggested that the intestinal mucosa of Giardia-infected individuals is devoid of signs of overt intestinal inflammation, an observation that is reproduced in animal models. Thus, our understanding of host inflammatory responses to the parasite remain incompletely understood and human studies and experimental data have produced conflicting results. It is now also apparent that certain Giardia infections contain mechanisms capable of modulating their host’s immune responses. As the oral route of Giardia infection is shared with many other gastrointestinal (GI) pathogens, co-infections may often occur, especially in places with poor sanitation and/or improper treatment of drinking water. Moreover, Giardia infections may modulate host immune responses and have been found to protect against the development of diarrheal disease in developing countries. The following review summarizes our current understanding of the immunomodulatory mechanisms of Giardia infections and their consequences for the host, and highlights areas for future research. Potential implications of these immunomodulatory effects during GI co-infection are also discussed. PMID:26569316

  11. A systematic audit of economic evidence linking nosocomial infections and infection control interventions: 1990-2000.

    PubMed

    Stone, Patricia W; Larson, Elaine; Kawar, Lina Najib

    2002-05-01

    Nosocomial infections (NIs) are a serious patient safety issue. Infection control personnel are responsible for implementing interventions to reduce this risk. The purpose of this systematic review was to audit the published economic evidence of the attributable cost of NIs and interventions conducted by infection control professionals and to evaluate the methods used. Economic evaluation methodology and recommendations for standardization are reviewed. A search of MEDLINE and HealthSTAR with medical subject headings or text words "nosocomial infections," "infection control," or "hospital acquired infections" cross-referenced with "costs," "cost analysis," "economics," or "cost-effectiveness analysis" was conducted. Published review articles were also searched. Inclusion criteria included articles published between 1990 and 2000 that contained an abstract and original cost estimate and were written in English. Results were standardized into a common currency. Fifty-five studies were eligible. Approximately one quarter examined NIs in intensive care patients (n = 13). Most studies were conducted from the hospital perspective (n = 48). The costs attributable to bloodstream (mean = $38,703) and methicillin-resistant Staphylococcus aureus infections (mean = $35,367) were the largest. Increased standardization and rigor are needed. Clinicians should partner with economists and policy analysts to expand and improve the economic evidence available to reduce hospital complications such as NI and other adverse patient/staff outcomes.

  12. Staffing and structure of infection prevention and control programs

    PubMed Central

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

    2009-01-01

    Background The nature of infection prevention and control is changing; however, little is known about current staffing and structure of infection prevention and control programs. Methods 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. Results 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 < .001). Median staffing was 1 IP per 167 beds. Forty-seven percent of IPs were certified, and 24 percent had less than 2 years of experience. Most directors or 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. Conclusion 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. PMID:19201510

  13. Designing Hospital for better Infection Control: an Experience.

    PubMed

    Rao, Skm

    2004-01-01

    The physical design of hospital is an essential component of a hospital's infection control strategy, incorporating infection control issues to minimise the risk of infection transmission. Hospital design therefore, needs to consider the separation of dirty and clean areas, adequate ventilation, lighting and storage facilities and design of patient accommodation areas, including adequate number of wash hand basins and single bed facilities. A 250 bed general hospital was planned keeping in view structural and design elements necessary for success of a good infection control programme. Various National and International Standards like BSI recommendations, JCAHO, IC Standards, DHSS, ASHRAE, AIA and OSHA were studied and compared with our planning parameters. Planning of ward unit, ICU, Operation theatre and Isolation wards were especially reviewed in the light of recent knowledge available in the field of hospital acquired infection and modifications were carried out. Need for effective identification of potential infections, risks in the design of a hospital were stressed. Engineering controls required to reduce the concentration of infectious droplet nuclei in the air and prevention of transmission of disease were highlighted.

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

    PubMed

    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 < .001). Median staffing was 1 IP per 167 beds. Forty-seven percent of IPs were certified, and 24 percent had less than 2 years of experience. Most directors or 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.

  15. Regulation of phagocyte triglyceride by a STAT-ATG2 pathway controls mycobacterial infection

    PubMed Central

    Péan, Claire B.; Schiebler, Mark; Tan, Sharon W. S.; Sharrock, Jessica A.; Kierdorf, Katrin; Brown, Karen P.; Maserumule, M. Charlotte; Menezes, Shinelle; Pilátová, Martina; Bronda, Kévin; Guermonprez, Pierre; Stramer, Brian M.; Andres Floto, R.; Dionne, Marc S.

    2017-01-01

    Mycobacterium tuberculosis remains a global threat to human health, yet the molecular mechanisms regulating immunity remain poorly understood. Cytokines can promote or inhibit mycobacterial survival inside macrophages and the underlying mechanisms represent potential targets for host-directed therapies. Here we show that cytokine-STAT signalling promotes mycobacterial survival within macrophages by deregulating lipid droplets via ATG2 repression. In Drosophila infected with Mycobacterium marinum, mycobacterium-induced STAT activity triggered by unpaired-family cytokines reduces Atg2 expression, permitting deregulation of lipid droplets. Increased Atg2 expression or reduced macrophage triglyceride biosynthesis, normalizes lipid deposition in infected phagocytes and reduces numbers of viable intracellular mycobacteria. In human macrophages, addition of IL-6 promotes mycobacterial survival and BCG-induced lipid accumulation by a similar, but probably not identical, mechanism. Our results reveal Atg2 regulation as a mechanism by which cytokines can control lipid droplet homeostasis and consequently resistance to mycobacterial infection in Drosophila. PMID:28262681

  16. Pyrimidinergic Receptor Activation Controls Toxoplasma gondii Infection in Macrophages

    PubMed Central

    Moreira-Souza, Aline Cristina Abreu; Marinho, Ygor; Correa, Gladys; Santoro, Giani França; Coutinho, Claudia Mara Lara Melo; Vommaro, Rossiane Claudia; Coutinho-Silva, Robson

    2015-01-01

    Infection by the protozoan parasite Toxoplasma gondii is highly prevalent worldwide and may have serious clinical manifestations in immunocompromised patients. T. gondii is an obligate intracellular parasite that infects almost any cell type in mammalian hosts, including immune cells. The immune cells express purinergic P2 receptors in their membrane – subdivided into P2Y and P2X subfamilies - whose activation is important for infection control. Here, we examined the effect of treatment with UTP and UDP in mouse peritoneal macrophages infected with T. gondii tachyzoites. Treatment with these nucleotides reduced parasitic load by 90%, but did not increase the levels of the inflammatory mediators NO and ROS, nor did it modulate host cell death by apoptosis or necrosis. On the other hand, UTP and UDP treatments induced early egress of tachyzoites from infected macrophages, in a Ca2+-dependent manner, as shown by scanning electron microscopy analysis, and videomicroscopy. In subsequent infections, prematurely egressed parasites had reduced infectivity, and could neither replicate nor inhibit the fusion of lysosomes to the parasitophorous vacuole. The use of selective agonists and antagonists of the receptor subtypes P2Y2 and P2Y4 and P2Y6 showed that premature parasite egress may be mediated by the activation of these receptor subtypes. Our results suggest that the activity of P2Y host cell receptors controls T. gondii infection in macrophages, highlighting the importance of pyrimidinergic signaling for innate immune system response against infection. Finally the P2Y receptors should be considered as new target for the development of drugs against T. gondii infection. PMID:26192447

  17. Pyrimidinergic Receptor Activation Controls Toxoplasma gondii Infection in Macrophages.

    PubMed

    Moreira-Souza, Aline Cristina Abreu; Marinho, Ygor; Correa, Gladys; Santoro, Giani França; Coutinho, Claudia Mara Lara Melo; Vommaro, Rossiane Claudia; Coutinho-Silva, Robson

    2015-01-01

    Infection by the protozoan parasite Toxoplasma gondii is highly prevalent worldwide and may have serious clinical manifestations in immunocompromised patients. T. gondii is an obligate intracellular parasite that infects almost any cell type in mammalian hosts, including immune cells. The immune cells express purinergic P2 receptors in their membrane--subdivided into P2Y and P2X subfamilies--whose activation is important for infection control. Here, we examined the effect of treatment with UTP and UDP in mouse peritoneal macrophages infected with T. gondii tachyzoites. Treatment with these nucleotides reduced parasitic load by 90%, but did not increase the levels of the inflammatory mediators NO and ROS, nor did it modulate host cell death by apoptosis or necrosis. On the other hand, UTP and UDP treatments induced early egress of tachyzoites from infected macrophages, in a Ca2+-dependent manner, as shown by scanning electron microscopy analysis, and videomicroscopy. In subsequent infections, prematurely egressed parasites had reduced infectivity, and could neither replicate nor inhibit the fusion of lysosomes to the parasitophorous vacuole. The use of selective agonists and antagonists of the receptor subtypes P2Y2 and P2Y4 and P2Y6 showed that premature parasite egress may be mediated by the activation of these receptor subtypes. Our results suggest that the activity of P2Y host cell receptors controls T. gondii infection in macrophages, highlighting the importance of pyrimidinergic signaling for innate immune system response against infection. Finally the P2Y receptors should be considered as new target for the development of drugs against T. gondii infection.

  18. Computer-Assisted Instruction in AIDS Infection Control for Physicians.

    ERIC Educational Resources Information Center

    Garrett, T. J.; And Others

    1990-01-01

    A microcomputer program to provide health care workers with instruction in Acquired Immune Deficiency Syndrome (AIDS) infection control was assessed by medical residents. The experimental group (n=24) acquired more knowledge than controls (n=33). Response to the method was positive, and computer-assisted instruction is seen as useful for AIDS…

  19. Transmission and Institutional Infection Control of Tuberculosis.

    PubMed

    Nardell, Edward A

    2015-08-20

    Tuberculosis (TB) transmission control in institutions is evolving with increased awareness of the rapid impact of treatment on transmission, the importance of the unsuspected, untreated case of transmission, and the advent of rapid molecular diagnostics. With active case finding based on cough surveillance and rapid drug susceptibility testing, in theory, it is possible to be reasonably sure that no patient enters a facility with undiagnosed TB or drug resistance. Droplet nuclei transmission of TB is reviewed with an emphasis on risk factors relevant to control. Among environmental controls, natural ventilation and upper-room ultraviolet germicidal ultraviolet air disinfection are the most cost-effective choices, although high-volume mechanical ventilation can also be used. Room air cleaners are generally not recommended. Maintenance is required for all engineering solutions. Finally, personal protection with fit-tested respirators is used in many situations where administrative and engineering methods cannot assure protection.

  20. IL-10 Signaling Blockade Controls Murine West Nile Virus Infection

    PubMed Central

    Bai, Fengwei; Wang, Penghua; Kamanaka, Masahito; Connolly, Tarah M.; Gate, David; Montgomery, Ruth R.; Flavell, Richard A.; Fikrig, Erol

    2009-01-01

    West Nile virus (WNV), a mosquito-borne single-stranded RNA flavivirus, can cause significant human morbidity and mortality. Our data show that interleukin-10 (IL-10) is dramatically elevated both in vitro and in vivo following WNV infection. Consistent with an etiologic role of IL-10 in WNV pathogenesis, we find that WNV infection is markedly diminished in IL-10 deficient (IL-10−/−) mice, and pharmacologic blockade of IL-10 signaling by IL-10 neutralizing antibody increases survival of WNV-infected mice. Increased production of antiviral cytokines in IL-10−/− mice is associated with more efficient control of WNV infection. Moreover, CD4+ T cells produce copious amounts of IL-10, and may be an important cellular source of IL-10 during WNV infection in vivo. In conclusion, IL-10 signaling plays a negative role in immunity against WNV infection, and blockade of IL-10 signaling by genetic or pharmacologic means helps to control viral infection, suggesting a novel anti-WNV therapeutic strategy. PMID:19816558

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

    PubMed

    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.

  2. Implementing basic infection control practices in disaster situations.

    PubMed

    Vane, Elizabeth A P; Winthrop, Thomas G; Martinez, Leonardo M

    2010-06-01

    Infections, troublesome in even optimal health care environments, can be a source of serious and persistent concern for local populations and health care workers during a disaster, and in austere environments such as those found in Iraq and Afghanistan. For these scenarios, it is vital to have standard infection control practices in place and to have them used consistently. Only then will healthcare workers be able to contain the potential spread of disease and improve conditions for those affected.

  3. Thermoregulatory consequences of long-term microwave exposure at controlled ambient temperatures. Final report

    SciTech Connect

    Adair, E.R.; Spiers, D.E.; Rawson, R.O.; Adams, B.W.; Sheldon, D.K.

    1984-08-01

    The study was designed to identify and measure changes in thermoregulatory response systems, both behavioral and physiological, that may occur when squirrel monkeys are exposed to 2450-MHz CW microwaves 40 hours/week for 15 weeks. Microwave power densities explored were 1 and 5 mW/sq. cm. (SAR = 0.16 W/kg per mW/sq. cm.) and were presented at controlled environmental temperatures of 25, 30, and 35 C. Standardized tests, conducted periodically, assessed changes in thermoregulatory responses. Dependent variables measured included body mass, certain blood properties, metabolic heat production, sweating, skin temperatures, deep body temperature, and behavioral responses by which the monkeys selected a preferred environmental temperature. Results showed no alteration of metabolic rate, internal body temperature, or thermoregulatory behavior by microwave exposure although the ambient temperature prevailing during chronic exposure could exert an effect. An increase in sweating rate occurred in the 35 C environment, not enhanced significantly by microwave exposure. Skin temperature, reflecting vasomotor state, was reliably influenced by both ambient temperature and microwaves. The most robust consequence of microwave exposure was a reduction in body mass which appeared to be a function of microwave power density.

  4. Controls on and consequences of specific leaf area variation with permafrost depth in a boreal forest

    NASA Astrophysics Data System (ADS)

    Anderson, C.; Bond-Lamberty, B. P.; Huang, M.; Xu, Y.; Stegen, J.

    2016-12-01

    Specific leaf area (SLA, leaf area per unit dry mass) is an index of plant carbon captured by photosynthesis and an important input into many terrestrial process models. However, the controls on and consequences of SLA variation are poorly understood, especially in high latitude, climatically-sensitive permafrost regions. To address this, we measured SLA along with soil and topographic properties across a boreal forest permafrost transition, in which forest composition changed as permafrost deepened from 54 to >150 cm. Using replicated transects, we characterized both linear and threshold relationships between topographic and edaphic variables and SLA, and evaluated and expanded upon a conceptual model of environmental factors and vegetation patterns. We found that the depth of the soil active layer above permafrost (ALD) was highly correlated with SLA, for both coniferous and deciduous boreal tree species. Across a permafrost transition, intraspecific SLA variation was associated with a fivefold increase in NPP, suggesting that changes in ALD due to permafrost thaw could heavily influence ecosystem carbon accumulation. High levels of intraspecific trait variation suggest the need for flexible trait representation across plant functional types in Earth System Models. We thus incorporated our empirical environment-SLA relationships into spatially explicit spin-ups of the Community Land Model (CLM v4.5) in an effort to constrain model uncertainty. Dynamic representation of plant traits can improve our representation of intraspecific trait variability and its functional relationship with environmental gradients in models predicting ecosystem responses to ongoing climate change.

  5. Glycerin-Based Hydrogel for Infection Control

    PubMed Central

    Stout, Edward I.; McKessor, Angie

    2012-01-01

    Problem 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. Solution 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 New Technology 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

  6. Glycerin-Based Hydrogel for Infection Control.

    PubMed

    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

  7. Evasion of tumours from the control of the immune system: consequences of brief encounters

    PubMed Central

    2012-01-01

    Background In this work a mathematical model describing the growth of a solid tumour in the presence of an immune system response is presented. Specifically, attention is focused on the interactions between cytotoxic T-lymphocytes (CTLs) and tumour cells in a small, avascular multicellular tumour. At this stage of the disease the CTLs and the tumour cells are considered to be in a state of dynamic equilibrium or cancer dormancy. The precise biochemical and cellular mechanisms by which CTLs can control a cancer and keep it in a dormant state are still not completely understood from a biological and immunological point of view. The mathematical model focuses on the spatio-temporal dynamics of tumour cells, immune cells, chemokines and “chemorepellents” in an immunogenic tumour. The CTLs and tumour cells are assumed to migrate and interact with each other in such a way that lymphocyte-tumour cell complexes are formed. These complexes result in either the death of the tumour cells (the normal situation) or the inactivation of the lymphocytes and consequently the survival of the tumour cells. In the latter case, we assume that each tumour cell that survives its “brief encounter” with the CTLs undergoes certain beneficial phenotypic changes. Results We explore the dynamics of the model under these assumptions and show that the process of immuno-evasion can arise as a consequence of these encounters. We show that the proposed mechanism not only shape the dynamics of the total number of tumor cells and of CTLs, but also the dynamics of their spatial distribution. We also briefly discuss the evolutionary features of our model, by framing them in the recent quasi-Lamarckian theories. Conclusions Our findings might have some interesting implication of interest for clinical practice. Indeed, immuno-editing process can be seen as an “involuntary” antagonistic process acting against immunotherapies, which aim at maintaining a tumor in a dormant state, or at

  8. Helicobacter pylori infection in non-ulcer dyspeptic and ulcer patients. Determinants and consequences in 'real life'.

    PubMed

    Thürmer, H L; Flaaten, B; Erichsen, K E; Lid, N O; Solheim, S B

    1996-08-01

    Infection rates are high in patients with ulcer disease, but even non-ulcer dyspepsia (NUD) patients have Helicobacter pylori infection. The Notodden Helicobacter study is an 'outcome study' of clinical practice in a local hospital. The study may identify factors associated with infection and evaluate whether H. pylori infection predicts symptoms in both ulcer disease and NUD. Base-line results on infection, symptoms, endoscopy, and treatment were registered in 587 ulcer and NUD patients. H. pylori status was assessed with a rapid urease test. Questionnaire data (5-43 months after treatment) give information about symptoms. Regression models to identify H. pylori status were developed. Ulcer patients (H. pylori +/-) were similar to infected NUD patients. In contrast, uninfected NUD patients were younger, had less severe symptoms, and used less medication than other patients. In NUD, infection rate increased with epigastric pain, male sex, and age. From a local hospital's point of view, H. pylori-infected NUD patients are like ulcer patients with regard to symptoms and demographics. The results suggest that H. pylori infection may give dyspeptic symptoms through other mechanisms than ulcer. We propose a division of the NUD group into HINUD (Helicobacter-infected NUD) and NINUD (non-infected NUD).

  9. Bioengineered probiotics, a strategic approach to control enteric infections.

    PubMed

    Amalaradjou, Mary Anne Roshni; Bhunia, Arun K

    2013-01-01

    Enteric infections account for high morbidity and mortality and are considered to be the fifth leading cause of death at all ages worldwide. Seventy percent of all enteric infections are foodborne. Thus significant efforts have been directed toward the detection, control and prevention of foodborne diseases. Many antimicrobials including antibiotics have been used for their control and prevention. However, probiotics offer a potential alternative intervention strategy owing to their general health beneficial properties and inhibitory effects against foodborne pathogens. Often, antimicrobial probiotic action is non-specific and non-discriminatory or may be ineffective. In such cases, bioengineered probiotics expressing foreign gene products to achieve specific function is highly desirable. In this review we summarize the strategic development of recombinant bioengineered probiotics to control enteric infections, and to examine how scientific advancements in the human microbiome and their immunomodulatory effects help develop such novel and safe bioengineered probiotics.

  10. Bioengineered probiotics, a strategic approach to control enteric infections

    PubMed Central

    Amalaradjou, Mary Anne Roshni; Bhunia, Arun K

    2013-01-01

    Enteric infections account for high morbidity and mortality and are considered to be the fifth leading cause of death at all ages worldwide. Seventy percent of all enteric infections are foodborne. Thus significant efforts have been directed toward the detection, control and prevention of foodborne diseases. Many antimicrobials including antibiotics have been used for their control and prevention. However, probiotics offer a potential alternative intervention strategy owing to their general health beneficial properties and inhibitory effects against foodborne pathogens. Often, antimicrobial probiotic action is non-specific and non-discriminatory or may be ineffective. In such cases, bioengineered probiotics expressing foreign gene products to achieve specific function is highly desirable. In this review we summarize the strategic development of recombinant bioengineered probiotics to control enteric infections, and to examine how scientific advancements in the human microbiome and their immunomodulatory effects help develop such novel and safe bioengineered probiotics. PMID:23327986

  11. The potential role of Wolbachia in controlling the transmission of emerging human arboviral infections

    PubMed Central

    Kamtchum-Tatuene, Joseph; Makepeace, Benjamin L.; Benjamin, Laura; Baylis, Matthew; Solomon, Tom

    2017-01-01

    Purpose of review Wolbachia is a genus of Gram-negative intracellular bacteria that is naturally found in more than half of all arthropod species. These bacteria cannot only reduce the fitness and the reproductive capacities of arthropod vectors, but also increase their resistance to arthropod-borne viruses (arboviruses). This article reviews the evidence supporting a Wolbachia-based strategy for controlling the transmission of dengue and other arboviral infections. Recent findings Studies conducted 1 year after the field release of Wolbachia-infected mosquitoes in Australia have demonstrated the suppression of dengue virus (DENV) replication in and dissemination by mosquitoes. Recent mathematical models show that this strategy could reduce the transmission of DENV by 70%. Consequently, the WHO is encouraging countries to boost the development and implementation of Wolbachia-based prevention strategies against other arboviral infections. However, the evidence regarding the efficacy of Wolbachia to prevent the transmission of other arboviral infections is still limited to an experimental framework with conflicting results in some cases. There is a need to demonstrate the efficacy of such strategies in the field under various climatic conditions, to select the Wolbachia strain that has the best pathogen interference/spread trade-off, and to continue to build community acceptance. Summary Wolbachia represents a promising tool for controlling the transmission of arboviral infections that needs to be developed further. Long-term environmental monitoring will be necessary for timely detection of potential changes in Wolbachia/vector/virus interactions. PMID:27849636

  12. Impact of Salivary Gland Hypertrophy Virus Infection on the Mating Success of Male Glossina pallidipes: Consequences for the Sterile Insect Technique

    PubMed Central

    Mutika, Gratian N.; Marin, Carmen; Parker, Andrew G.; Boucias, Drion G.; Vreysen, Marc J. B.; Abd-Alla, Adly M. M.

    2012-01-01

    Many species of tsetse flies are infected by a virus (GpSGHV) that causes salivary gland hypertrophy (SGH). Female Glossina pallidipes (Austen) with SGH symptoms (SGH+) have reduced fecundity and SGH+ male G. pallidipes are unable to inseminate female flies. Consequently, G. pallidipes laboratory colonies with a high prevalence of SGH have been difficult to maintain and have collapsed on several occasions. To assess the potential impact of the release of SGH+ sterile male G. pallidipes on the efficacy of an integrated control programme with a sterile insect technique (SIT) component, we examined the mating efficiency and behaviour of male G. pallidipes in field cages in relation to SGH prevalence. The results showed in a field cage setting a significantly reduced mating frequency of 19% for a male G. pallidipes population with a high prevalence of SGH (83%) compared to 38% for a male population with a low prevalence of SGH (7%). Premating period and mating duration did not vary significantly with SGH status. A high percentage (>80%) of females that had mated with SGH+ males had empty spermathecae. The remating frequency of female G. pallidipes was very low irrespective of the SGH status of the males in the first mating. These results indicate that a high prevalence of SGH+ in G. pallidipes not only affects colony stability and performance but, in view of their reduced mating propensity and competitiveness, releasing SGH+ sterile male G. pallidipes will reduce the efficiency of a sterile male release programme. PMID:22912687

  13. Evidence that hepatitis C virus genome partly controls infection outcome

    PubMed Central

    Hartfield, Matthew; Bull, Rowena; White, Peter A; Lloyd, Andrew; Luciani, Fabio; Alizon, Samuel

    2014-01-01

    Infection by hepatitis C virus (HCV) leads to one of two outcomes; either the infection resolves within approximately 6 months or the virus can persist indefinitely. Host genetics are known to affect the likelihood of clearance or persistence. By contrast, the importance of the virus genotype in determining infection outcome is unknown, as quantifying this effect traditionally requires well-characterized transmission networks, which are rare. Extending phylogenetic approaches previously developed to estimate the virus control over set-point viral load in HIV-1 infections, we simulate inheritance of a binary trait along a phylogenetic tree, use this data to quantify how infection outcomes cluster and ascertain the effect of virus genotype on these. We apply our method to the Hepatitis C Incidence and Transmission Study in prisons (HITS-p) data set from Australia, as this cohort prospectively identified incident cases including viraemic subjects who ultimately clear the virus, thus providing us with a unique collection of sequences from clearing infections. We detect significant correlations between infection outcome and virus distance in the phylogeny for viruses of Genotype 1, with estimates lying at around 67%. No statistically significant estimates were obtained for viruses of Genotype 3a. PMID:24944567

  14. [The community health team: roles and responsibilities in infection control].

    PubMed

    Fu, Yu-Chen; Chen, Mei-Yen; Feng, Huang-Chih

    2011-08-01

    Over the past three decades, chronic disease has replaced communicable disease as the leading collective cause of death in Taiwan. As a result, medical and public healthcare manpower and budgets dedicated to communicable diseases have been reduced. The 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) changed government epidemic prevention policies and marked a renewed focus on preventing and controlling communicable diseases. This study introduces Taiwan's communicable disease control system and reforms, the domestic status of communicable diseases, the infection control policies of Japanese colonial authorities in the early 20th century, and national / community-level communicable disease control mechanisms in place before and after 2003. This paper further examines the actual health management conditions in a county in southern Taiwan to show how the public health system is rooted in communities, how infection control strategies are promoted, and how social organizations influence community life and mores.

  15. Carboxymethylcellulose film for bacterial wound infection control and healing.

    PubMed

    Wong, Tin Wui; Ramli, Nor Amlizan

    2014-11-04

    Infection control and wound healing profiles of sodium carboxymethylcellulose (SCMC) films were investigated as a function of their anti-bacterial action, physical structures, polymer molecular weights and carboxymethyl substitution degrees. The films were prepared with in vitro polymer/film and in vivo microbe-colonized wound healing/systemic infection profiles examined. Adhesive high carboxymethyl substituted SCMC films aided healing via attaching to microbes and removing them from wound. Pseudomonas aeruginosa was removed via encapsulating in gelling low molecular weight SCMC film, whereas Staphylococcus aureus was trapped in tight folds of high molecular weight SCMC film. Incomplete microbe removal from wound did not necessary translate to inability to heal as microbe remnant at wound induced fibroblast migration and aided tissue reconstruction. Using no film nonetheless will cause systemic blood infection. SCMC films negate infection and promote wound healing via specific polymer-microbe adhesion, and removal of S. aureus and P. aeruginosa requires films of different polymer characteristics.

  16. Infection prevention and control in pediatric ambulatory settings.

    PubMed

    2007-09-01

    Since the American Academy of Pediatrics published a statement titled "Infection Control in Physicians' Offices" (Pediatrics. 2000;105[6]:1361-1369), 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 transmission of infectious agents. Policies for infection prevention and control should be written, readily available, updated annually, and enforced. The standard precautions for hospitalized patients from the Centers for Disease Control and Prevention, with a modification from the American Academy of Pediatrics exempting the use of gloves for routine diaper changes and wiping a well child's nose or tears, are appropriate for most patient encounters. As employers, pediatricians are required by the Occupational Safety and Health Administration to take precautions to identify and protect employees who are likely to be exposed to blood or other potentially infectious materials while on the job. Key principles of standard precautions include hand hygiene (ie, use of alcohol-based hand rub or hand-washing with soap [plain or antimicrobial] and water) before and after every patient contact; implementation of respiratory hygiene and cough-etiquette strategies for patients with suspected influenza or infection with another respiratory tract pathogen to the extent feasible; separation of infected, contagious children from uninfected children when feasible; safe handling and disposal of needles and other sharp medical devices and evaluation and implementation of needle-safety devices; appropriate use of personal protective equipment such as gloves, gowns, masks, and eye protection; and appropriate sterilization

  17. 42 CFR 416.51 - Conditions for coverage-Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Conditions for coverage-Infection control. 416.51... Coverage § 416.51 Conditions for coverage—Infection control. The ASC must maintain an infection control... adhering to professionally acceptable standards of practice. (b) Standard: Infection control program....

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

    PubMed

    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 = 100 beds to 6.5 FTE ICPs 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

  19. Construction: a model program for infection control compliance.

    PubMed

    Kidd, Francine; Buttner, Clark; Kressel, Amy B

    2007-06-01

    In the 21st century, one of the most challenging tasks for the infection control practitioner (ICP) is establishing collegiality and trust with contractors, architects, maintenance and engineering personnel. We describe how an urban teaching hospital's infection control program cooperated with contractors during a large demolition, construction, and renovation project in order to protect its large population of immunosuppressed patients. Most contractors are not accustomed to taking special precautions during demolition. Because of a previous Aspergillus outbreak in our heart transplant population, we already had an established infection control (IC) training program for contractors. We expanded and codified it in response to a major hospital renovation. The IC, in-house Design and Construction, and outside contractors meet before the initiation of all major renovation projects to anticipate IC concerns and proactively plan for infection control interventions. Now, all contractors and maintenance staff are required to receive IC training at the time of their employment. A hospital identification badge with attached sticker that indicates the IC training date is required. Infection Control Risk Assessments (ICRA) are initiated by project managers and completed jointly with IC. The ICPs make rounds on all projects at least weekly and large projects are visited daily. We established a team comprised of ICP, project manager, construction manager, and area nurse manager to monitor and make recommendations for improvement continually during the project. Staff are educated about construction so they can help monitor airflow and cleanliness. Our contractors are more compliant with our IC specifications since they now understand why we insist on them. Through the years of major construction, the workers have jumped on the bandwagon. It is not unusual for construction or maintenance staff to contact IC for advice. There were four years of extensive construction without any

  20. Indirect fitness consequences of mate choice in sticklebacks: offspring of brighter males grow slowly but resist parasitic infections.

    PubMed Central

    Barber, I; Arnott, S A; Braithwaite, V A; Andrew, J; Huntingford, F A

    2001-01-01

    'Good genes' models of sexual selection suggest that elaborate male sexual ornaments have evolved as reliable signals of male quality because only males of high genetic viability are able to develop and maintain them. Females benefit from choosing such individuals if quality is heritable. A key prediction is that the offspring of males with elaborate mating displays will perform better than those of less elaborate males, but it has proved difficult to demonstrate such an effect independently of the effects of differences in parental investment. We tested for 'good genes' linked to male ornamentation in the three-spined stickleback Gasterosteus aculeatus using in vitro fertilization to generate maternal half-siblings, which were raised without parental care. Maternal half-siblings sired by brightly coloured males grew less quickly than half-siblings sired by dull males but were more resistant to a controlled disease challenge. Among the offspring that became infected, those with brighter fathers had higher white blood cell counts. This suggests that highly ornamented males confer disease resistance on their offspring. The association with reduced growth suggests a mechanism for the maintenance of heritable variation in both disease resistance and male sexual coloration. PMID:12123300

  1. Prevention and Control of Antimicrobial Resistant Healthcare-Associated Infections: The Microbiology Laboratory Rocks!

    PubMed

    Simões, Alexandra S; Couto, Isabel; Toscano, Cristina; Gonçalves, Elsa; Póvoa, Pedro; Viveiros, Miguel; Lapão, Luís V

    2016-01-01

    In Europe, each year, more than four milion patients acquire a healthcare-associated infection (HAI) and almost 40 thousand die as a direct consequence of it. Regardless of many stategies to prevent and control HAIs, they remain an important cause of morbidity and mortality worldwide with a significant economic impact: a recent estimate places it at the ten billion dollars/year. The control of HAIs requires a prompt and efficient identification of the etiological agent and a rapid communication with the clinician. The Microbiology Laboratory has a significant role in the prevention and control of these infections and is a key element of any Infection Control Program. The work of the Microbiology Laboratory covers microbial isolation and identification, determination of antimicrobial susceptibility patterns, epidemiological surveillance and outbreak detection, education, and report of quality assured results. In this paper we address the role and importance of the Microbiology Laboratory in the prevention and control of HAI and in Antibiotic Stewardship Programs and how it can be leveraged when combined with the use of information systems. Additionally, we critically review some challenges that the Microbiology Laboratory has to deal with, including the selection of analytic methods and the proper use of communication channels with other healthcare services.

  2. Prevention and Control of Antimicrobial Resistant Healthcare-Associated Infections: The Microbiology Laboratory Rocks!

    PubMed Central

    Simões, Alexandra S.; Couto, Isabel; Toscano, Cristina; Gonçalves, Elsa; Póvoa, Pedro; Viveiros, Miguel; Lapão, Luís V.

    2016-01-01

    In Europe, each year, more than four milion patients acquire a healthcare-associated infection (HAI) and almost 40 thousand die as a direct consequence of it. Regardless of many stategies to prevent and control HAIs, they remain an important cause of morbidity and mortality worldwide with a significant economic impact: a recent estimate places it at the ten billion dollars/year. The control of HAIs requires a prompt and efficient identification of the etiological agent and a rapid communication with the clinician. The Microbiology Laboratory has a significant role in the prevention and control of these infections and is a key element of any Infection Control Program. The work of the Microbiology Laboratory covers microbial isolation and identification, determination of antimicrobial susceptibility patterns, epidemiological surveillance and outbreak detection, education, and report of quality assured results. In this paper we address the role and importance of the Microbiology Laboratory in the prevention and control of HAI and in Antibiotic Stewardship Programs and how it can be leveraged when combined with the use of information systems. Additionally, we critically review some challenges that the Microbiology Laboratory has to deal with, including the selection of analytic methods and the proper use of communication channels with other healthcare services. PMID:27375577

  3. Infection control in the new age of genomic epidemiology.

    PubMed

    Tang, Patrick; Croxen, Matthew A; Hasan, Mohammad R; Hsiao, William W L; Hoang, Linda M

    2017-02-01

    With the growing importance of infectious diseases in health care and communicable disease outbreaks garnering increasing attention, new technologies are playing a greater role in helping us prevent health care-associated infections and provide optimal public health. The microbiology laboratory has always played a large role in infection control by providing tools to identify, characterize, and track pathogens. Recently, advances in DNA sequencing technology have ushered in a new era of genomic epidemiology, where traditional molecular diagnostics and genotyping methods are being enhanced and even replaced by genomics-based methods to aid epidemiologic investigations of communicable diseases. The ability to analyze and compare entire pathogen genomes has allowed for unprecedented resolution into how and why infectious diseases spread. As these genomics-based methods continue to improve in speed, cost, and accuracy, they will be increasingly used to inform and guide infection control and public health practices.

  4. A framework for infection control surveillance using association rules.

    PubMed

    Ma, Lili; Tsui, Fu-Chiang; Hogan, William R; Wagner, Michael M; Ma, Haobo

    2003-01-01

    Surveillance of antibiotic resistance and nosocomial infections is one of the most important functions of a hospital infection control program. We employed the association rule method for automatically identifying new, unexpected, and potentially interesting patterns in hospital infection control. We hypothesized that mining for low-support, low-confidence rules would detect unexpected outbreaks caused by a small number of cases. To build a framework, we preprocessed the data and added new templates to eliminate uninteresting patterns. We applied our method to the culture data collected over 3 months from 10 hospitals in the UPMC Health System. We found that the new process and system are efficient and effective in identifying new, unexpected, and potentially interesting patterns in surveillance data. The clinical relevance and utility of this process await the results of prospective studies.

  5. Controlling healthcare-associated infections in the NHS.

    PubMed

    Duerden, Brian

    2008-04-01

    The prevention and control of healthcare-associated infection (HCAI) is a priority for the NHS. The delivery of national targets for reducing methicillin resistant Staphylococcus aureus bacteraemias and Clostridium difficile infection are supported by enhanced mandatory surveillance through the Health Protection Agency and a Department of Health improvement programme that promotes policies and protocols for enhancing clinical procedures and places infection prevention and control at the centre of clinical and corporate governance. The Health Act 2006 Code of Practice makes such policies and protocols a legal requirement and compliance will be assessed by the Healthcare Commission. Clinicians must recognise their responsibilities for patient safety and take a lead role in ensuring good practice to reduce HCAI.

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

    PubMed

    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.

  7. Central line infections - hospitals

    MedlinePlus

    ... infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired infection - central line infection; Patient safety - central ...

  8. Transcriptional Regulation of CXCL5 in HIV-1-Infected Macrophages and Its Functional Consequences on CNS Pathology.

    PubMed

    Guha, Debjani; Klamar, Cynthia R; Reinhart, Todd; Ayyavoo, Velpandi

    2015-05-01

    Human immunodeficiency virus-1 (HIV-1)-infected monocytes/macrophages and microglia release increased levels of proinflammatory cytokines and chemokines, including ELR+ (containing glutamic acid-leucine-arginine motif) chemokines. To investigate the role of HIV-1 infection on chemokine regulation, monocyte-derived macrophages (MDMs) from normal donors were infected with HIV-1 and the expression of chemokines and their downstream biological functions were evaluated. Among the tested chemokines, CXCL5 was upregulated significantly both at the mRNA and protein level in the HIV-1-infected MDMs compared with mock-infected cultures. Upregulation of CXCL5 in the HIV-1-infected MDMs is, in part, regulated by increased interleukin-1β (IL-1β) production and phosphorylation of ERK1/2. Functional analyses indicate that HIV-1-induced overexpression of CXCL5 has enhanced the ability to attract neutrophils, as observed by chemotaxis assay. However, exposure of NT2, SH-SY5Y cells, and primary neurons to HIV-1-infected MDM supernatants resulted in cell death that was not rescued by anti-CXCL5 antibody suggesting that CXCL5 does not have direct effect on neuronal death. Together, these results suggest that the increased level of CXCL5 in tissue compartments, including the central nervous system of HIV-1-infected individuals might alter the inflammatory response through the infiltration of neutrophils into tissue compartment, thus causing secondary effects on resident cells.

  9. Nursing activity recognition using an inexpensive game controller: An application to infection control.

    PubMed

    Momen, Kaveh; Fernie, Geoff R

    2010-01-01

    It is estimated that 10% of the patients admitted to North American hospitals die of hospital acquired infections. Approximately half of these are thought to be a consequence of poor hand hygiene practices by the hospital staff. Electronic hand washing reminders that prompt caregivers to wash their hands before and after the patient/patient's environment contact may help to increase the hand hygiene compliance rate. However, the current systems fail to identify the nursing procedures happening around the patient to issue proper hand hygiene prompt. In this research we used the hardware of a low-cost wireless Sony game controller, which included a 3-axis accelerometer, to identify six nursing activities happening around a patient. We attached five sensors to eight nurses' left and right wrists, left and right upper arms, and the backs. Each nurse performed 10 trials of each nursing activity in sequence, followed by a combined nursing activities trial. We extracted mean, standard deviation, energy, and correlation among axes per sensor and compared the results of 1-Nearest Neighbour (1-NN), Decision Tree (J48), and Naïve Bayes classifiers. 1-NN classifier had the best performance and on average regardless of the sensor locations, we achieved 84% ± 2% accuracy.

  10. Poverty and infection in the developing world: healthcare-related infections and infection control in the tropics.

    PubMed

    Shears, P

    2007-11-01

    In many hospitals serving the poorest communities of Africa and other parts of the developing world, infection control activities are limited by poor infrastructure, overcrowding, inadequate hygiene and water supply, poorly functioning laboratory services and a shortage of trained staff. Hospital transmission of communicable diseases, a high prevalence of human immunodeficiency virus and multidrug-resistant tuberculosis, lack of resources for isolation and disinfection, and widespread antimicrobial resistance create major risks for healthcare-related infections. Few data exist on the prevalence or impact of these infections in such environments. There is a need for interventions to reduce the burden of healthcare-related infections in the tropics and to set up effective surveillance programmes to determine their impact. Both the Global (G8) International Development Summit of 2005 and the United Nations Millennium Development Goals (MDGs) have committed major resources to alleviating poverty and poor health in the developing world over the next decade. Targeting resources specifically to infection control in low-resource settings must be a part of this effort, if the wider aims of the MDGs to improve healthcare are to be achieved.

  11. 42 CFR 494.30 - Condition: Infection control.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES... of Infections Among Chronic Hemodialysis Patients,” developed by the Centers for Disease Control and.../code_of_regulations/ibr_locations.html. (3) Patient isolation procedures to minimize the spread of...

  12. 42 CFR 418.60 - Condition of participation: Infection control.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... investigation of infectious and communicable diseases that— (1) Is an integral part of the hospice's quality... infectious and communicable disease problems; and (ii) A plan for implementing the appropriate actions that... personnel by preventing and controlling infections and communicable diseases. (a) Standard: Prevention. The...

  13. 42 CFR 418.60 - Condition of participation: Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... investigation of infectious and communicable diseases that— (1) Is an integral part of the hospice's quality... infectious and communicable disease problems; and (ii) A plan for implementing the appropriate actions that... personnel by preventing and controlling infections and communicable diseases. (a) Standard: Prevention. The...

  14. Uniform-related infection control practices of dental students

    PubMed Central

    Aljohani, Yazan; Almutadares, Mohammed; Alfaifi, Khalid; El Madhoun, Mona; Albahiti, Maysoon H; Al-Hazmi, Nadia

    2017-01-01

    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. PMID:28490894

  15. 42 CFR 482.42 - Condition of participation: Infection control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Hospital Functions § 482.42 Condition of participation: Infection control. The hospital must provide a...) Standard: Responsibilities of chief executive officer, medical staff, and director of nursing services. The chief executive officer, the medical staff, and the director of nursing services must— (1) Ensure...

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

    USDA-ARS?s Scientific Manuscript database

    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 ...

  17. 42 CFR 494.30 - Condition: Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Infection control. 494.30 Section 494.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE...

  18. 42 CFR 494.30 - Condition: Infection control.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition: Infection control. 494.30 Section 494.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE...

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

    PubMed

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

    2015-12-01

    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 heterogeneity in training opportunities and IPC qualifications. The European Union promotes the harmonization of IPC strategies among member states. The European Centre for Disease Prevention and Control (ECDC)-commissioned Training in Infection Control in Europe project sets the stage for harmonization of IPC activities in Europe by issuing a list of core competencies for IPC professionals. European certification of IPC training and professionals would be the next logical step, which must be achieved by close collaboration between different stakeholders in Europe such as the ECDC, the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the European Union of Medical Specialities, and the national IPC societies. Therefore, the ESCMID has launched the new European Committee on Infection Control to take the lead in the implementation of a European (board) certificate for IPC professionals. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  20. Infection

    MedlinePlus

    ... or articles contaminated by them is an important component of infection control and isolation precautions. To help protect exposure to infectious materials, wash your hands: Wear gloves: In addition to ...

  1. Sexually Transmitted Infections in Youth With Controlled and Uncontrolled Human Immunodeficiency Virus Infection.

    PubMed

    Camacho-Gonzalez, Andres F; Chernoff, Miriam C; Williams, Paige L; Chahroudi, Ann; Oleske, James M; Traite, Shirley; Chakraborty, Rana; Purswani, Murli U; Abzug, Mark J

    2016-07-20

    Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), disproportionately affect adolescents and young adults (AYAs) ages 13-24 years. Sexually transmitted infections likewise are a risk factor for HIV acquisition and transmission; however, there is a lack of data on STI acquisition in HIV-infected AYAs. We determined the incidence of STIs in HIV-infected AYAs 12.5 <25 years of age in the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1074 observational cohort study. Univariate and multivariable logistic regression models were used to evaluate the association of HIV control (mean viral load <500 copies/mL and CD4(+) T cells >500 cells/mm(3) in the year preceding STI diagnosis) and other risk factors with STI occurrence. Of 1201 enrolled subjects, 1042 participants met age criteria and were included (49% male, 61% black, 88% perinatally infected; mean age 18.3 years). One hundred twenty participants had at least 1 STI on study, of whom 93 had their first lifetime STI (incidence rate = 2.8/100 person-years). For individual STI categories, 155 incident category-specific events were reported; human papillomavirus (HPV) and chlamydial infections were the most common. In the multivariable model, having an STI was associated with older age (adjusted odds ratio [aOR] = 1.13; 95% confidence interval [CI], 1.05-1.22), female sex (aOR = 2.65; 95% CI, 1.67-4.21), nonperinatal HIV acquisition (aOR = 2.33; 95% CI, 1.29-4.22), and uncontrolled HIV infection (aOR = 2.05; 95% CI, 1.29-3.25). Sexually transmitted infection acquisition in HIV-infected AYAs is associated with older age, female sex, nonperinatal HIV acquisition, and poorly controlled HIV infection. Substantial rates of STIs among HIV-infected AYAs support enhanced preventive interventions, including safe-sex practices and HPV vaccination, and antiretroviral adherence strategies. © The Author 2016. Published by Oxford University Press on behalf of the

  2. Mammalian antimicrobial peptide influences control of cutaneous Leishmania infection

    PubMed Central

    Kulkarni, Manjusha M.; Barbi, Joseph; McMaster, W. Robert; Gallo, Richard L.; Satoskar, Abhay R.; McGwire, Bradford S.

    2011-01-01

    Summary Cathelicidin-type antimicrobial peptides (CAMP) are important mediators of innate immunity against microbial pathogens acting through direct interaction with and disruption of microbial membranes and indirectly through modulation of host cell migration and activation. Using a mouse knock-out model in CAMP we studied the role of this host peptide in control of dissemination of cutaneous infection by the parasitic protozoan Leishmania. The presence of pronounced host inflammatory infiltration in lesions and lymph nodes of infected animals was CAMP-dependent. Lack of CAMP expression was associated with higher levels of IL-10 receptor expression in bone marrow, splenic and lymph node macrophages as well as higher anti-inflammatory IL-10 production by bone marrow macrophages and spleen cells but reduced production of the pro-inflammatory cytokines IL-12 and IFN-γ by lymph nodes. Unlike wild-type mice, local lesions were exacerbated and parasites were found largely disseminated in CAMP knockouts. Infection of CAMP knockouts with parasite mutants lacking the surface metalloprotease virulence determinant resulted in more robust disseminated infection than in control animals suggesting that CAMP activity is negatively regulated by parasite surface proteolytic activity. This correlated with the ability of the pro-tease to degrade CAMP in vitro and co-localization of CAMP with parasites within macrophages. Our results highlight the interplay of antimicrobial peptides and Leishmania that influence the host immune response and the outcome of infection. PMID:21501359

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

    PubMed

    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 (P<0.001). The incidence of drug-resistant bacteria was significantly lower after implementation of the programme (79% vs 12%; P<0.001), and remained low one year later. In this neonatal unit, 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

  4. MULTI-SCALE CONTROLS ON AND CONSEQUENCES OF AEOLIAN PROCESSES IN LANDSCAPE CHANGE IN ARID AND SEMI-ARID ENVIRONMENTS

    EPA Science Inventory

    This paper reviews the controls on aeolian processes and their consequences at plant-interspace, patch-landscape, and regional-global scales. Based on this review, we define the requirements for a cross-scale model of wind erosion in structurally complex arid and semiarid ecosyst...

  5. MULTI-SCALE CONTROLS ON AND CONSEQUENCES OF AEOLIAN PROCESSES IN LANDSCAPE CHANGE IN ARID AND SEMI-ARID ENVIRONMENTS

    EPA Science Inventory

    This paper reviews the controls on aeolian processes and their consequences at plant-interspace, patch-landscape, and regional-global scales. Based on this review, we define the requirements for a cross-scale model of wind erosion in structurally complex arid and semiarid ecosyst...

  6. Artificial-intelligence-based hospital-acquired infection control.

    PubMed

    Adlassnig, Klaus-Peter; Blacky, Alexander; Koller, Walter

    2009-01-01

    Nosocomial or hospital-acquired infections (NIs) are a frequent complication in hospitalized patients. The growing availability of computerized patient records in hospitals permits automated identification and extended monitoring for signs of NIs. A fuzzy- and knowledge-based system to identify and monitor NIs at intensive care units (ICUs) according to the European Surveillance System HELICS (NI definitions derived from the Centers of Disease Control and Prevention (CDC) criteria) was developed and put into operation at the Vienna General Hospital. This system, named Moni, for monitoring of nosocomial infections contains medical knowledge packages (MKPs) to identify and monitor various infections of the bloodstream, pneumonia, urinary tract infections, and central venous catheter-associated infections. The MKPs consist of medical logic modules (MLMs) in Arden syntax, a medical knowledge representation scheme, whose definition is part of the HL7 standards. These MLM packages together with the Arden software are well suited to be incorporated in medical information systems such as hospital information or intensive-care patient data management systems, or in web-based applications. In terms of method, Moni contains an extended data-to-symbol conversion with several layers of abstraction, until the top level defining NIs according to HELICS is reached. All included medical concepts such as "normal", "increased", "decreased", or similar ones are formally modeled by fuzzy sets, and fuzzy logic is used to process the interpretations of the clinically observed and measured patient data through an inference network. The currently implemented cockpit surveillance connects 96 ICU beds with Moni and offers the hospital's infection control department a hitherto unparalleled NI infection survey.

  7. Gamma interferon controls mouse polyomavirus infection in vivo.

    PubMed

    Wilson, Jarad J; Lin, Eugene; Pack, Christopher D; Frost, Elizabeth L; Hadley, Annette; Swimm, Alyson I; Wang, Jun; Dong, Ying; Breeden, Cynthia P; Kalman, Daniel; Newell, Kenneth A; Lukacher, Aron E

    2011-10-01

    Human polyomaviruses are associated with substantial morbidity in immunocompromised patients, including those with HIV/AIDS, recipients of bone marrow and kidney transplants, and individuals receiving immunomodulatory agents for autoimmune and inflammatory diseases. No effective antipolyomavirus agents are currently available, and no host determinants have been identified to predict susceptibility to polyomavirus-associated diseases. Using the mouse polyomavirus (MPyV) infection model, we recently demonstrated that perforin-granzyme exocytosis, tumor necrosis factor alpha (TNF-α), and Fas did not contribute to control of infection or virus-induced tumors. Gamma interferon (IFN-γ) was recently shown to inhibit replication by human BK polyomavirus in primary cultures of renal tubular epithelial cells. In this study, we provide evidence that IFN-γ is an important component of the host defense against MPyV infection and tumorigenesis. In immortalized and primary cells, IFN-γ reduces expression of MPyV proteins and impairs viral replication. Mice deficient for the IFN-γ receptor (IFN-γR(-/-)) maintain higher viral loads during MPyV infection and are susceptible to MPyV-induced tumors; this increased viral load is not associated with a defective MPyV-specific CD8(+) T cell response. Using an acute MPyV infection kidney transplant model, we further show that IFN-γR(-/-) donor kidneys harbor higher MPyV levels than donor kidneys from wild-type mice. Finally, administration of IFN-γ to persistently infected mice significantly reduces MPyV levels in multiple organs, including the kidney, a major reservoir for persistent mouse and human polyomavirus infections. These findings demonstrate that IFN-γ is an antiviral effector molecule for MPyV infection.

  8. Daptomycin and Its Immunomodulatory Effect: Consequences for Antibiotic Treatment of Methicillin-Resistant Staphylococcus aureus Wound Infections after Heart Surgery

    PubMed Central

    Tirilomis, Theodor

    2014-01-01

    Infections by methicillin-resistant Staphylococcus aureus (MRSA) play an increasing role in the postoperative course. Although wound infections after cardiac surgery are rare, the outcome is limited by the prolonged treatment with high mortality. Not only surgical debridement is crucial, but also antibiotic support. Next to vancomycin and linezolid, daptomycin gains increasing importance. Although clinical evidence is limited, daptomycin has immunomodulatory properties, resulting in the suppression of cytokine expression after host immune response stimulation by MRSA. Experimental studies showed an improved efficacy of daptomycin in combination with administration of vitamin E before infecting wounds by MRSA. PMID:24653723

  9. A simple infection-control protocol to reduce serious cardiac device infections.

    PubMed

    Ahsan, Syed Y; Saberwal, Bunny; Lambiase, Pier D; Koo, Chieh Y; Lee, Simon; Gopalamurugan, Aerokondal B; Rogers, Dominic P; Lowe, Martin D; Chow, Anthony W C

    2014-10-01

    Device infection is a serious complication and is considered procedure-related if occurring within 12 months of an intervention. We analysed the effectiveness of a simple infection-control protocol (ICP) at reducing cardiac device infections (CDIs) in a tertiary referral centre. Prior to the introduction of a new ICP, we retrospectively analysed all simple and complex device implants, related procedures, and infections over a 3-year period. A new protocol was implemented from November 2007, including antibiotic prophylaxis determined by risk stratification, improved glycaemic control, specific skin preparation, and closure techniques, as well as different diathermy settings. Follow-up data for all patients were collected. Risk factors for infection were compared between pre- and post-intervention groups to ensure that the populations were comparable. A cost analysis of CDI and a review of the commonly identified micro-organisms were also undertaken. One thousand seven hundred and ninety-eight procedures were performed between November 2004 and November 2007 and 981 procedures between November 2007 and May 2009. There were no significant differences in the risk factors for infection between the two groups. Following the introduction of the ICP, there was a 54% reduction in the incidence of CDI from 1.3 to 0.6% (P < 0.03; CI 0.25, 1.36). Most patients with CDI had negative blood cultures or grew Staphylococcus sp. The average cost was £30 958.40 per infection incident and the cost of the new ICP was minimal. A significant reduction in CDI can be achieved with the introduction of a simple ICP with substantial cost savings. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  10. Knowledge of norovirus prevention and control among infection preventionists.

    PubMed

    Kosa, Katherine M; Cates, Sheryl C; Hall, Aron J; Brophy, Jenna E; Frasier, Angela

    2014-06-01

    A Web-based survey was administered to infection preventionists (IPs) (N = 941) to characterize awareness and knowledge of norovirus (NoV). Only 44% of respondents correctly identified NoV as one of the 3 most common foodborne pathogens in the United States, and 5% correctly identified the 3 most common settings for NoV outbreaks. Several gaps in IPs' knowledge of NoV were identified; specifically, IPs could benefit from learning more about the natural history of NoV, modes of transmission, and cleaning and disinfection processes. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  11. The Consequences of Being Overweight: A Controlled Study of Gender Differences.

    ERIC Educational Resources Information Center

    Stake, Jayne; Lauer, Monica L.

    1987-01-01

    Consequences of body weight were explored in sample of women and men. Average weight subjects showed preference for thin women but not for thin men; women are more negatively affected by body size in opposite-sex relationships; being overweight negatively affected self-attitudes of all subjects, but particularly those of women; and women are…

  12. Clarifying Functional Analysis Outcomes for Disruptive Behaviors by Controlling Consequence Delivery for Stereotypy

    ERIC Educational Resources Information Center

    Asmus, Jennifer M.; Franzese, Julie C.; Conroy, Maureen A.; Dozier, Claudia L.

    2003-01-01

    Although individuals may engage in several topographies of aberrant behavior, each with different functions, it is not uncommon for researchers to conduct one functional analysis. We conducted two functional analyses for a child with autism, one with and one without consequences for stereotypic vocalizations. Only the analysis without consequences…

  13. Infection control. 1: A practical guide to glove usage.

    PubMed

    Parker, L J

    With increased demands from the general public for healthcare professionals to be accountable for their actions, many are becoming familiar with clinical governance and other initiatives to improve clinical practice. Good infection control is central to nursing practice. To achieve higher standards of clinical practice, especially when thinking about how to reduce the risk of cross-infection, it is necessary to not only do the right thing, but also do the thing right. Safe practice should be uppermost in the minds of healthcare professionals when caring for patients. This new series of articles attempts to look at the practical aspects of infection control, highlighting the requirements for risk assessment and applying the principles of infection control to a variety of patient care situations. This article investigates the use of protective clothing and gloves. It looks at the types of gloves available for use, the importance of choosing the correct glove for the task to be undertaken, and the modern day problems of allergies to latex.

  14. 42 CFR 416.51 - Conditions for coverage-Infection control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Conditions for coverage-Infection control. 416.51....51 Conditions for coverage—Infection control. The ASC must maintain an infection control program that seeks to minimize infections and communicable diseases. (a) Standard: Sanitary environment. The ASC must...

  15. Antimicrobial Resistance and Reduced Susceptibility in Clostridium difficile: Potential Consequences for Induction, Treatment, and Recurrence of C. difficile Infection

    PubMed Central

    Baines, Simon D.; Wilcox, Mark H.

    2015-01-01

    Clostridium difficile infection (CDI) remains a substantial burden on healthcare systems and is likely to remain so given our reliance on antimicrobial therapies to treat bacterial infections, especially in an aging population in whom multiple co-morbidities are common. Antimicrobial agents are a key component in the aetiology of CDI, both in the establishment of the infection and also in its treatment. The purpose of this review is to summarise the role of antimicrobial agents in primary and recurrent CDI; assessing why certain antimicrobial classes may predispose to the induction of CDI according to a balance between antimicrobial activity against the gut microflora and C. difficile. Considering these aspects of CDI is important in both the prevention of the infection and in the development of new antimicrobial treatments. PMID:27025625

  16. [Antibacterial drug resistance in Latin America: consequences for infectious disease control].

    PubMed

    Casellas, José María

    2011-12-01

    Antibacterial drug resistance is a particularly significant issue in Latin America. This article explores antimicrobial resistance in three classes of clinically important bacteria: gram-positive bacteria, enterobacteria, and nonfermenting gram-negative bacilli. The gram-positive bacteria frequently responsible for infections in humans are for the most part cocci: staphylococci, streptococci (including pneumococci), and enterococci, in both community and hospital settings. This situation is no different in the Region of the Americas. Among the gram-positive bacteria, the causative agents of bacteremia are most commonly strains of coagulase-negative Staphylococcus, followed by enterococci. This report explores the resistance of these species to different antimicrobial drugs, resistance mechanisms in community and hospital strains, and new drugs for treating infections caused by these bacteria. In Latin America, antimicrobial resistance in Enterococcus strains is still a minor problem compared to the situation in the United States. The strains of the genus Streptococcus isolated from respiratory infections are still sensitive to penicillin. Furthermore, the resistance of enterobacteria is extremely important in the Region, particularly because of the broad dissemination of CTX-M extended-spectrum beta-lactamases (ESBL), some of which originated in Latin America. This article analyzes the resistance of Streptococcus pneumoniae, beta-hemolytic streptococci, and viridans group streptococci. Among the nonfermenting gram-negative bacilli, while Pseudomonas aeruginosa strains remain the leading cause of bacteremia, infections caused by strains of Acinetobacter spp. have proliferated extensively in some areas. With regard to antibiotics, several options are available for treating gram-positive bacterial infections. The same cannot be said for infections caused by enterobacteria and nonfermenting gram-negative bacilli, where options for the effective treatment of patients

  17. Clinical and economic consequences of first-year urinary tract infections, sepsis, and pneumonia in contemporary kidney transplantation practice.

    PubMed

    Naik, Abhijit S; Dharnidharka, Vikas R; Schnitzler, Mark A; Brennan, Daniel C; Segev, Dorry L; Axelrod, David; Xiao, Huiling; Kucirka, Lauren; Chen, Jiajing; Lentine, Krista L

    2016-02-01

    We examined United States Renal Data System registry records for Medicare-insured kidney transplant recipients in 2000-2011 to study the clinical and cost impacts of urinary tract infections (UTI), pneumonia, and sepsis in the first year post-transplant among a contemporary, national cohort. Infections were identified by billing diagnostic codes. Among 60 702 recipients, 45% experienced at least one study infection in the first year post-transplant, including UTI in 32%, pneumonia in 13%, and sepsis in 12%. Older recipient age, female sex, diabetic kidney failure, nonstandard criteria organs, sirolimus-based immunosuppression, and steroids at discharge were associated with increased risk of first-year infections. By time-varying, multivariate Cox regression, all study infections predicted increased first-year mortality, ranging from 41% (aHR 1.41, 95% CI 1.25-1.56) for UTI alone, 6- to 12-fold risk for pneumonia or sepsis alone, to 34-fold risk (aHR 34.38, 95% CI 30.35-38.95) for those with all three infections. Infections also significantly increased first-year costs, from $17 691 (standard error (SE) $591) marginal cost increase for UTI alone, to approximately $40 000-$50 000 (SE $1054-1238) for pneumonia or sepsis alone, to $134 773 (SE $1876) for those with UTI, pneumonia, and sepsis. Clinical and economic impacts persisted in years 2-3 post-transplant. Early infections reflect important targets for management protocols to improve post-transplant outcomes and reduce costs of care. © 2015 Steunstichting ESOT.

  18. Clinical and Economic Consequences of First-Year Urinary Tract Infections, Sepsis and Pneumonia in Contemporary Kidney Transplantation Practice

    PubMed Central

    Naik, Abhijit S.; Dharnidharka, Vikas R.; Schnitzler, Mark A.; Brennan, Daniel C.; Segev, Dorry L.; Axelrod, David; Xiao, Huiling; Kucirka, Lauren; Chen, Jiajing; Lentine, Krista L.

    2015-01-01

    We examined United States Renal Data System registry records for Medicare-insured kidney transplant recipients in 2000–2011 to study the clinical and cost impacts of urinary tract infections (UTI), pneumonia, and sepsis in the first year post-transplant among a contemporary, national cohort. Infections were identified by billing diagnostic codes. Among 60,702 recipients, 45% experienced at least one study infection in the first year post-transplant, including UTI in 32%, pneumonia in 13%, and sepsis in 12%. Older recipient age, female sex, diabetic kidney failure, non-standard criteria organs, sirolimus-based immunosuppression and steroids at discharge were associated with increased risk of first-year infections. By time-varying, multivariate Cox regression, all study infections predicted increased first-year mortality, ranging from 41% (aHR 1.41, 95%CI 1.25–1.56) for UTI alone, 6-to-12-fold risk for pneumonia or sepsis alone, to 34-fold risk (aHR 34.38, 95%CI 30.35–38.95) for those with all three infections. Infections also significantly increased first-year costs, from $17,691 (standard error (SE) $591) marginal cost increase for UTI alone, to approximately $40,000–$50,000 (SE $1054–1238) for pneumonia or sepsis alone, to $134,773 (SE $1876) for those with UTI, pneumonia and sepsis. Clinical and economic impacts persisted in years 2–3 post-transplant. Early infections reflect important targets for management protocols to improve post-transplant outcomes and reduce costs of care. PMID:26563524

  19. Human gastrointestinal nematode infections: are new control methods required?

    PubMed Central

    Stepek, Gillian; Buttle, David J; Duce, Ian R; Behnke, Jerzy M

    2006-01-01

    Gastrointestinal (GI) nematode infections affect 50% of the human population worldwide, and cause great morbidity as well as hundreds of thousands of deaths. Despite modern medical practices, the proportion of the population infected with GI nematodes is not falling. This is due to a number of factors, the most important being the lack of good healthcare, sanitation and health education in many developing countries. A relatively new problem is the development of resistance to the small number of drugs available to treat GI nematode infections. Here we review the most important parasitic GI nematodes and the methods available to control them. In addition, we discuss the current status of new anthelmintic treatments, particularly the plant cysteine proteinases from various sources of latex-bearing plants and fruits. PMID:16965561

  20. T Cell Responses during Influenza Infection: Getting and Keeping Control

    PubMed Central

    Kim, Taeg S.; Sun, Jie; Braciale, Thomas J.

    2011-01-01

    The 2009 influenza pandemic highlights the threat that type A influenza poses to human health. Thus there is an urgency to understand the pathobiology of influenza infection and the contribution of the host immune response to both virus elimination and the development of lung injury. This review focuses on the T cell arm of the adaptive host immune response to influenza and assesses recent developments in our understanding of the induction of primary influenza virus-specific T cell responses by antigen-presenting cells, the interaction of activated effector T cells with antigen-bearing cells in the infected lungs, and the contribution of influenza-specific effector T cells to the development and control of lung injury and inflammation during infection. PMID:21435950

  1. Unexpected consequences of control: competitive vs. predator release in a four-species assemblage of invasive mammals.

    PubMed

    Ruscoe, Wendy A; Ramsey, David S L; Pech, Roger P; Sweetapple, Peter J; Yockney, Ivor; Barron, Mandy C; Perry, Mike; Nugent, Graham; Carran, Roger; Warne, Rodney; Brausch, Chris; Duncan, Richard P

    2011-10-01

    Invasive species are frequently the target of eradication or control programmes to mitigate their impacts. However, manipulating single species in isolation can lead to unexpected consequences for other species, with outcomes such as mesopredator release demonstrated both theoretically and empirically in vertebrate assemblages with at least two trophic levels. Less is known about the consequences of species removal in more complex assemblages where a greater number of interacting invaders increases the potential for selective species removal to result in unexpected changes in community structure. Using a replicated Before-After Control-Impact field experiment with a four-species assemblage of invasive mammals we show that species interactions in the community are dominated by competition rather than predation. There was no measurable response of two mesopredators (rats and mice) following control of the top predator (stoats), but there was competitive release of rats following removal of a herbivore (possums), and competitive release of mice following removal of rats.

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

    PubMed

    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.

  3. Organization of nosocomial infection control measures and local networks for infectious disease control in middle-scale hospitals in Japan.

    PubMed

    Mori-Yoshikawa, Namiko; Ohmagari, Norio; Kirikae, Teruo

    2014-01-01

    The aims of this study were to assess nosocomial infection control measures at middle-scale hospitals throughout Japan. Of the 823 hospitals participating in this questionnaire-based survey, more than half of the middle-scale hospitals have implemented nosocomial infection control measures, including infection surveillance or infection control rounds, while acknowledging a shortage of infection control staff. These hospitals most frequently consulted public health centers to obtain information and advice. Improved nosocomial infection control in middle-scale hospitals requires sufficient staffing and a local network, with active participation by public health centers.

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

    PubMed

    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

  5. Compliance with infection-control procedures among Illinois orthodontists.

    PubMed

    Davis, D; BeGole, E A

    1998-06-01

    The authors of previous studies have reported an increasing percentage of orthodontists complying with infection-control procedures in their offices, yet compliance was found to be less than ideal. In this study we surveyed Illinois orthodontists to evaluate their compliance with the infection-control guidelines established by the American Dental Association and the Centers for Disease Control and Prevention. This study is an addition to a small number of studies in the field of orthodontics on infection-control procedures. The study population was taken from the World Directory of Orthodontists, which contains 374 listings for the state of Illinois. Responses were received from 140 orthodontists, for a response rate of 37%. Thirty-two percent of the responding orthodontists stated that they always wear masks; 13% said they never do. Almost 97% of the orthodontists said they always wear gloves, and no orthodontist reported never wearing gloves. Nearly 64% of the orthodontists reported always using eyewear, and 34% said they wear gowns, whereas only 5% do not wear eye protection and 35% never wear gowns. With regard to instruments and pliers, most of the orthodontists reported using dry-heat ovens (72% and 80%, respectively), whereas nearly 58% said they use chemical disinfection to some extent on instruments and 39% said they use chemical disinfection on pliers. Only 51% of the orthodontists surveyed in our study reported using a steam autoclave to sterilize handpieces, whereas 27% said they use dry-heat ovens, 11% reported using chemical vapor, and 37% said they use chemical disinfection. In conclusion, compliance with infection control procedures among orthodontists has improved from recent studies but is still less than full compliance.

  6. Methicillin-resistant Staphylococcus aureus. A continuing infection control challenge.

    PubMed

    Molinari, John A

    2012-04-01

    The ability of MRSA and other staphylococci to colonize, persist, and adapt to multiple environmental and tissue conditions has allowed for these bacteria to be virtually ubiquitous in their distribution. The effectiveness of commonly used antibiotics, such as penicillin, has continued to decline against infections caused by MRSA and increasingly resistant strains. The challenge for both dental and medical health professionals is to routinely apply proven, evidence-based infection control precautions. As mentioned earlier in this discussion, when compliance with effective aseptic technique practices improves, the patients and environments. Ensure that reusable equipment is not used for the care of another patient until it has been appropriately cleaned and reprocessed and that single-use items are properly discarded. Clean and disinfect clinical contact surfaces that are not barrier-protected by using an environmental protection agency-registered hospital disinfectant with a low- (ie, HIV and HBV label claims) to intermediate-level (ie, tuberculocidal claim) activity after each patient. When the surface is visibly contaminated with blood, an intermediate-incidence of detectable infections can be reduced. Microorganisms will continue to evolve and adapt in order to survive and thrive, sometimes at the expense of susceptible human hosts. The struggle is to constantly remain aware of impending infectious threats which may challenge current precautions, and maintain and improve the quality of infection control to minimize the potential for disease.

  7. Compliance with infection control practices by Veterinarians in Nigeria.

    PubMed

    Makinde, G I; Ana, G R E E; Emikpe, B O; Fawole, O I

    2015-03-01

    There is a global increase in morbidity and mortality due to zoonotic diseases hence there is a need to identify possible sources of infections to human population. This study assessed veterinarians' compliance with standard infection control practices (ICPs) for prevention of zoonosis in Nigeria. A cross sectional survey of 320 veterinarians participating in the National Annual Conference of the Nigerian Veterinary Me ic Association was done in November, 2011 Characteristics related to compliance with standard infection control practices were assessed. Chi-square and logistic regression tests were done at 0.05 significant levels. More veterinarians (51.1% and 61.2%) did not comply with appropriate ICPs while carrying out medical procedures of necropsy and assisting in parturition. Those with longer years of practice (OR=0.42,95% CI=0.23-0.75) and with long working hours (OR=0.52, 95% CI=0.28-0.97) were less likely to comply with ICPS. Private practice veterinarians' were less likely than public practitioners to comply (OR=0.67, 95% CI = 0.15-0.69). Also veterinarians who had workplace IC policy were more likely than those without to be compliant with ICPs (OR=3.71, 95% CI = 1.87-7.37). Future conferences can be used to advise veterinarians on the importance of implementing appropriate IC measures. Also infection prevention practices laws and policies should be enacted to encourage compliance by veterinarians.

  8. T cells home to the thymus and control infection

    PubMed Central

    Nobrega, Claudia; Nunes-Alves, Cláudio; Cerqueira-Rodrigues, Bruno; Roque, Susana; Barreira-Silva, Palmira; Behar, Samuel M.; Correia-Neves, Margarida

    2012-01-01

    The thymus is a target of multiple pathogens. How the immune system responds to thymic infection is largely unknown. Despite being considered an immune privileged organ, we detect a mycobacteria-specific T cell response in the thymus following dissemination of Mycobacterium avium or Mycobacterium tuberculosis. This response includes pro-inflammatory cytokine production by mycobacteria-specific CD4+ and CD8+ T cells, which stimulates infected cells and controls bacterial growth in the thymus. Importantly, the responding T cells are mature peripheral T cells that recirculate back to the thymus. The recruitment of these cells is associated with an increased expression of Th1 chemokines and an enrichment of CXCR3+ mycobacteria-specific T cells in the thymus. Finally, we demonstrate it is the mature T cells that home to the thymus that most efficiently control mycobacterial infection. Although the presence of mature T cells in the thymus has been recognized for some time, these data are the first to show that T cell recirculation from the periphery to the thymus is a mechanism that allows the immune system to respond to thymic infection. Maintaining a functional thymic environment is essential to maintain T cell differentiation and prevent the emergence of central tolerance to the invading pathogens. PMID:23315077

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

    PubMed

    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.

  10. Acute infection with the intestinal parasite Trichuris muris has long-term consequences on mucosal mast cell homeostasis and epithelial integrity.

    PubMed

    Sorobetea, Daniel; Holm, Jacob Bak; Henningsson, Henrietta; Kristiansen, Karsten; Svensson-Frej, Marcus

    2017-02-01

    A hallmark of parasite infection is the accumulation of innate immune cells, notably granulocytes and mast cells, at the site of infection. While this is typically viewed as a transient response, with the tissue returning to steady state once the infection is cleared, we found that mast cells accumulated in the large-intestinal epithelium following infection with the nematode Trichuris muris and persisted at this site for several months after worm expulsion. Mast cell accumulation in the epithelium was associated with the induction of type-2 immunity and appeared to be driven by increased maturation of local progenitors in the intestinal lamina propria. Furthermore, we also detected increased local and systemic levels of the mucosal mast cell protease MCPt-1, which correlated highly with the persistent epithelial mast cell population. Finally, the mast cells appeared to have striking consequences on epithelial barrier integrity, by regulation of gut permeability long after worm expulsion. These findings highlight the importance of mast cells not only in the early phases of infection but also at later stages, which has functional implications on the mucosal tissue. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Differential expression of genes in fetal brain as a consequence of maternal protein deficiency and nematode infection.

    PubMed

    Haque, Manjurul; Starr, Lisa M; Koski, Kristine G; Scott, Marilyn E

    2017-09-10

    Maternal dietary protein deficiency and gastrointestinal nematode infection during early pregnancy have negative impacts on both maternal placental gene expression and fetal growth in the mouse. Here we used next-generation RNA sequencing to test our hypothesis that maternal protein deficiency and/or nematode infection also alter the expression of genes in the developing fetal brain. Outbred pregnant CD1 mice were used in a 2×2 design with two levels of dietary protein (24% versus 6%) and two levels of infection (repeated sham versus Heligmosomoides bakeri beginning at gestation day 5). Pregnant dams were euthanized on gestation day 18 to harvest the whole fetal brain. Four fetal brains from each treatment group were analyzed using RNA Hi-Seq sequencing and the differential expression of genes was determined by the edgeR package using NetworkAnalyst. In response to maternal H. bakeri infection, 96 genes (88 up-regulated and eight down-regulated) were differentially expressed in the fetal brain. Differentially expressed genes were involved in metabolic processes, developmental processes and the immune system according to the PANTHER classification system. Among the important biological functions identified, several up-regulated genes have known neurological functions including neuro-development (Gdf15, Ing4), neural differentiation (miRNA let-7), synaptic plasticity (via suppression of NF-κβ), neuro-inflammation (S100A8, S100A9) and glucose metabolism (Tnnt1, Atf3). However, in response to maternal protein deficiency, brain-specific serine protease (Prss22) was the only up-regulated gene and only one gene (Dynlt1a) responded to the interaction of maternal nematode infection and protein deficiency. In conclusion, maternal exposure to GI nematode infection from day 5 to 18 of pregnancy may influence developmental programming of the fetal brain. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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

    PubMed

    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.

  13. Clinical governance and infection control in the United Kingdom.

    PubMed

    Masterson, R G; Teare, E L

    2001-01-01

    The recent organizational changes in the NHS have at their core the concept of clinical governance. Although initially poorly defined and understood this term has now taken on a clear identity, placing quality alongside fiscal probity and corporate governance at the top of NHS priorities. Integral to clinical governance are the basic elements of clear national standards for services and treatments that are to be locally delivered through assured, monitored, high quality healthcare. It is within this framework that workers in infection control must develop their own methods of applying clinical governance. This review explores the implications that the strategy of clinical governance holds for the speciality of infection control, emphasizing the benefits its active adoption can bring and highlighting the key relevance of clinical risk management in this setting. It illustrates clinical governance as a tool to engage colleagues on a multi-disciplinary front, most particularly the crucial link to senior Trust management.

  14. Infection control and hazards management. Economics of regulatory compliance.

    PubMed

    Runnells, R R

    1991-04-01

    Dentistry has become subject to rapid change in office safety, including infection control and hazards management. This change includes increasingly diverse governmental regulations and compliance with such regulations, influencing the very basics of dental practice. As all practitioners are moving toward compliance, costs are increasing substantially. Various sources estimate such increases at between 12.5% and 19%, and it is doubtful whether third-party reimbursement will offset these additional costs. As practitioners plan methods for offsetting the costs of office safety, consideration should be given to providing patients oral and printed information to preclude misinterpretation of the reasons for fee escalation caused by implementation of chemical hazards communication, infection control, and waste disposal programs mandated by OSHA, EPA, and state or other regulatory authorities. The decade of the 1990s may well become the period of meeting the formidable microbiological and regulatory challenges of the 1980s.

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

    PubMed

    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.

  16. Controlled human malaria infection trials: How tandems of trust and control construct scientific knowledge.

    PubMed

    Bijker, Else M; Sauerwein, Robert W; Bijker, Wiebe E

    2016-02-01

    Controlled human malaria infections are clinical trials in which healthy volunteers are deliberately infected with malaria under controlled conditions. Controlled human malaria infections are complex clinical trials: many different groups and institutions are involved, and several complex technologies are required to function together. This functioning together of technologies, people, and institutions is under special pressure because of potential risks to the volunteers. In this article, the authors use controlled human malaria infections as a strategic research site to study the use of control, the role of trust, and the interactions between trust and control in the construction of scientific knowledge. The authors argue that tandems of trust and control play a central role in the successful execution of clinical trials and the construction of scientific knowledge. More specifically, two aspects of tandems of trust and control will be highlighted: tandems are sites where trust and control coproduce each other, and tandems link the personal, the technical, and the institutional domains. Understanding tandems of trust and control results in setting some agendas for both clinical trial research and science and technology studies.

  17. Vaccine to Control the Viral Infection of Fish.

    DOEpatents

    Leong, JoAnn Ching

    1994-10-11

    Subunit vaccines and their use for immunizing fish against infection by viruses are disclosed. In particular, plasmid pG8 is constructed by joining, with the plasmid pUC8, DNA which encodes the glycoprotein of infectious hematopoietic necrosis virus (IHNV). E. coli cells are transformed by pG8, whereby pure viral antigen is produced to provide a vaccine for the control of IHNV in fish. 10 figs.

  18. Vaccine to control the viral infection of fish

    DOEpatents

    Leong, Jo-Ann C.

    1994-10-11

    Subunit vaccines and their use for immunizing fish against infection by viruses are disclosed. In particular, plasmid pG8 is constructed by joining, with the plasmid pUC8, DNA which encodes the glycoprotein of infectious hematopoietic necrosis virus (IHNV). E. coli cells are transformed by pG8, whereby pure viral antigen is produced to provide a vaccine for the control of IHNV in fish.

  19. Synthetic Peptide Vaccines for the Control of Arenavirus Infections.

    DTIC Science & Technology

    1983-09-01

    as a model system for work on other arenaviruses (Machupo, Junin, Lassa ). The experimental approach involves transcribing arenavirus RNA segments into...the technology developed here, on LCMV and using RNA from Machupo, Junin and Lassa Fever viruses provided by inves- tigators at Fort Detrick, we will be...able to develop similar reagents for the control of Machupo, Junin and Lassa Fever virus infections. Specific peptide vaccines developed from these

  20. Infection control among dentists in private practice in Durban.

    PubMed

    Yengopal, V; Naidoo, S; Chikte, U M

    2001-12-01

    The general fear, superstition and alarm surrounding HIV/AIDS warrant that the highest standards of care be available to our patients. A survey on infection control was undertaken in Durban to assess the current state of infection control procedures among dentists in private practice. A self-administered 44-item questionnaire was hand-delivered to a random sample of 75 dentists (31.3%)--see comments in Methods--in private practice. The response rate was 90.7% (68 dentists). The routine use of gloves, masks, and protective eyewear was reported by 97.1%, 82.4% and 52.9% of dentists respectively. Although 89.7% of dentists had autoclaves in their practices, only 45.2% autoclaved their high speed handpieces and 39.7% their slow handpieces. Almost 60% of dentists did not use rubber dam at all whilst 46.3% did not disinfect impressions before sending them to the laboratory. Approximately 6% of respondents reported re-using local anaesthetic cartridges and 1.5% re-used needles. Needlestick injuries in the previous six months were reported by 13.8% of dentists but two thirds of them did not follow any specific protocol after injury. Almost 90 per cent of dentists were immunised against Hepatitis B but more than 60% of their staff were not. The results of the study showed that adherence to universally accepted guidelines for infection control remain low amid a climate of an ever-increasing HIV pandemic.

  1. Taenia ovis infection and its control: a Canadian perspective.

    PubMed

    De Wolf, B D; Peregrine, A S; Jones-Bitton, A; Jansen, J T; Menzies, P I

    2014-01-01

    Distributed worldwide, Taenia ovis infection is responsible for the condemnation of sheep carcasses in many countries. This review highlights the programme used in New Zealand to successfully control T. ovis in sheep, and discusses how similar approaches may be modified for use in Canada, given what is currently known about the epidemiology of T. ovis. The lifecycle of the parasite is well known, involving dogs as the definitive host and sheep or goats as the intermediate host. An effective vaccine does exist, although it is not presently commercially available. In New Zealand an industry-based, non-regulatory programme was created to educate producers about T. ovis and necessary control strategies, including the need to treat farm dogs with cestocides regularly. This programme resulted in a substantial decrease in the prevalence of T. ovis infections between 1991 and 2012. Historically, T. ovis was not a concern for the Canadian sheep industry, but more recently the percentage of lamb condemnations due to T. ovis has increased from 1.5% in 2006 to 55% in 2012. It has been suggested that coyotes may be transmitting T. ovis, but this has not been confirmed. Recommendation are made for the Canadian sheep industry to adopt a control programme similar to that used in New Zealand in order to reduce the prevalence of T. ovis infection.

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

    PubMed

    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

  3. 76 FR 9577 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... (Pub. L. 92-463) of October 6, 1972, that the Healthcare Infection Control Practices Advisory Committee... information, contact Jeffrey Hageman, M.H.S., Executive Secretary, Healthcare Infection Control...

  4. 78 FR 6328 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... (Pub. L. 92-463) of October 6, 1972, that the Healthcare Infection Control Practices Advisory Committee... information, contact Jeffrey Hageman, M.H.S., Executive Secretary, Healthcare Infection Control...

  5. Survey of infection control programs in a large national healthcare system.

    PubMed

    Talbot, Thomas R; Tejedor, Sheri Chernetsky; Greevy, Robert A; Burgess, Hayley; Williams, Mark V; Deshpande, Jayant K; McFadden, Patsy; Weinger, Matthew B; Englebright, Jane; Dittus, Robert S; Speroff, Theodore

    2007-12-01

    In light of consumers' and regulators' increasing focus on infection prevention, infection control practices and resources were surveyed at 134 hospitals owned by the Hospital Corporation of America. Infection control practices and resources varied substantially among hospitals, and many facilities reported difficulty acquiring the data they needed to report infection rates.

  6. Gene Regulation and Quality Control in Murine Polyomavirus Infection

    PubMed Central

    Carmichael, Gordon G.

    2016-01-01

    Murine polyomavirus (MPyV) infects mouse cells and is highly oncogenic in immunocompromised hosts and in other rodents. Its genome is a small, circular DNA molecule of just over 5000 base pairs and it encodes only seven polypeptides. While seemingly simply organized, this virus has adopted an unusual genome structure and some unusual uses of cellular quality control pathways that, together, allow an amazingly complex and varied pattern of gene regulation. In this review we discuss how MPyV leverages these various pathways to control its life cycle. PMID:27763514

  7. Multidrug-Resistant Gram-Negative Bacilli: Infection Control Implications.

    PubMed

    Adler, Amos; Friedman, N Deborah; Marchaim, Dror

    2016-12-01

    Antimicrobial resistance is a common iatrogenic complication of both modern life and medical care. Certain multidrug resistant and extensively drug resistant Gram-negative organisms pose the biggest challenges to health care today, predominantly owing to a lack of therapeutic options. Containing the spread of these organisms is challenging, and in reality, the application of multiple control measures during an evolving outbreak makes it difficult to measure the relative impact of each measure. This article reviews the usefulness of various infection control measures in containing the spread of multidrug-resistant Gram-negative bacilli. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Multicenter study in Colombia: Impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on central line-associated bloodstream infection rates.

    PubMed

    Álvarez-Moreno, Carlos A; Valderrama-Beltrán, Sandra L; Rosenthal, Víctor D; Mojica-Carreño, Beatriz E; Valderrama-Márquez, Ismael A; Matta-Cortés, Lorena; Gualtero-Trujillo, Sandra M; Rodríguez-Peña, Jazmín; Linares-Miranda, Claudia J; Gonzalez-Rubio, Ángela P; Vega-Galvis, María C; Riaño-Forero, Iván; Ariza-Ayala, Beatriz E; García-Laverde, Germán; Susmann, Otto; Mancera-Páez, Oscar; Olarte, Narda; Rendón-Campo, Luis F; Astudillo, Yamileth; Trullo-Escobar, María Del Socorro; Orellano, Pablo W

    2016-11-01

    The objective of this study was to analyze the impact of a multidimensional infection control approach and the use of the International Nosocomial Infection Control Consortium (INICC) Surveillance Online System on central line-associated bloodstream infection (CLABSI) rates from June 2003-April 2010. We conducted a prospective, before-after surveillance study of 2,564 patients hospitalized in 4 adult intensive care units (ICUs) and 424 patients in 2 pediatric ICUs of 4 hospitals in 2 cities of Colombia. During baseline, we performed outcome surveillance of CLABSI applying the Centers for Disease Control and Prevention's National Healthcare Safety Network definitions. During intervention, we implemented the INICC multidimensional approach and the ISOS, which included a bundle of infection prevention practice interventions, education, outcome surveillance, process surveillance, feedback on CLABSI rates and consequences, and performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate. The baseline rate of 12.9 CLABSIs per 1,000 central line (CL) days, with 3,032 CL days and 39 CLABSIs, was reduced to 3.5 CLABSIs per 1,000 CL days, with 3,686 CL days and 13 CLABSIs, accounting for a 73% CLABSI rate reduction (relative risk, 0.27; 95% confidence interval, 0.14-0.52; P=.002). Implementing the INICC multidimensional infection control approach for CLABSI prevention was associated with a significant reduction in the CLABSI rate of ICUs of Colombia. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    Balasingam, Shobana; Wilder-Smith, Annelies

    2016-08-01

    Controlled human infection, the intentional infection of healthy volunteers, allows disease pathogenesis to be studied and vaccines and therapeutic interventions to be evaluated in a controlled setting. A systematic review of randomized controlled trials of countermeasures for influenza that used the experimental human infection platform was performed. The primary objective was to document the scope of trials performed to date and the main efficacy outcome in the trials. The secondary objective was to assess safety and identify serious adverse events. The PubMed database was searched for randomized controlled influenza human challenge studies with predetermined search terms. Review papers, papers without outcomes, community-acquired infections, duplicated data, pathogenesis studies, and observational studies were excluded. Twenty-six randomized controlled trials published between 1947 and 2014 fit the study inclusion criteria. Two-thirds of these trials investigated antivirals and one-third investigated influenza vaccines. Among 2462 subjects inoculated with influenza virus, the incidence of serious adverse events was low (0.04%). These challenge studies helped to down-select three antivirals and one vaccine that were subsequently approved by the US Food and Drug Administration (FDA). 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. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Indoor environmental control of tuberculosis and other airborne infections.

    PubMed

    Nardell, E A

    2016-02-01

    Tuberculosis (TB) remains the airborne infection of global importance, although many environmental interventions to control TB apply to influenza and other infections with airborne potential. This review focuses on the global problem and the current state of available environmental interventions. TB transmission is facilitated in overcrowded, poorly ventilated congregate settings, such as hospitals, clinics, prisons, jails, and refugee camps. The best means of TB transmission control is source control- to identify unsuspected infectious cases and to promptly begin effective therapy. However, even with active case finding and rapid diagnostics, not every unsuspected case will be identified, and environmental control measures remain the next intervention of choice. Natural ventilation is the main means of air disinfection and has the advantage of wide availability, low cost, and high efficacy-under optimal conditions. It is usually not applicable all year in colder climates and may not be effective when windows are closed on cold nights in warm climates, for security, and for pest control. In warm climates, windows may be closed when air conditioning is installed for thermal comfort. Although mechanical ventilation, if properly installed and maintained, can provide adequate air disinfection, it is expensive to install, maintain, and operate. The most cost-effective way to achieve high levels of air disinfection is upper room germicidal irradiation. The safe and effective application of this poorly defined intervention is now well understood, and recently published evidence-based application guidelines will make implementation easier.

  11. Gelsolin activity controls efficient early HIV-1 infection

    PubMed Central

    2013-01-01

    Background HIV-1 entry into target lymphocytes requires the activity of actin adaptors that stabilize and reorganize cortical F-actin, like moesin and filamin-A. These alterations are necessary for the redistribution of CD4-CXCR4/CCR5 to one pole of the cell, a process that increases the probability of HIV-1 Envelope (Env)-CD4/co-receptor interactions and that generates the tension at the plasma membrane necessary to potentiate fusion pore formation, thereby favouring early HIV-1 infection. However, it remains unclear whether the dynamic processing of F-actin and the amount of cortical actin available during the initial virus-cell contact are required to such events. Results Here we show that gelsolin restructures cortical F-actin during HIV-1 Env-gp120-mediated signalling, without affecting cell-surface expression of receptors or viral co-receptor signalling. Remarkably, efficient HIV-1 Env-mediated membrane fusion and infection of permissive lymphocytes were impaired when gelsolin was either overexpressed or silenced, which led to a loss or gain of cortical actin, respectively. Indeed, HIV-1 Env-gp120-induced F-actin reorganization and viral receptor capping were impaired under these experimental conditions. Moreover, gelsolin knockdown promoted HIV-1 Env-gp120-mediated aberrant pseudopodia formation. These perturbed-actin events are responsible for the inhibition of early HIV-1 infection. Conclusions For the first time we provide evidence that through its severing of cortical actin, and by controlling the amount of actin available for reorganization during HIV-1 Env-mediated viral fusion, entry and infection, gelsolin can constitute a barrier that restricts HIV-1 infection of CD4+ lymphocytes in a pre-fusion step. These findings provide important insights into the complex molecular and actin-associated dynamics events that underlie early viral infection. Thus, we propose that gelsolin is a new factor that can limit HIV-1 infection acting at a pre-fusion step

  12. Genetic Control of Weight Loss During Pneumonic Burkholderia pseudomallei Infection

    PubMed Central

    Emery, Felicia D.; Parvathareddy, Jyothi; Pandey, Ashutosh K.; Cui, Yan; Williams, Robert W.; Miller, Mark A.

    2014-01-01

    Burkholderia pseudomallei (Bp) is the causal agent of a high morbidity/mortality disease syndrome known as melioidosis. This syndrome can range from acute fulminate disease to chronic, local, and disseminated infections that are often difficult to treat because Bp exhibits resistance to many antibiotics. Bp is a prime candidate for use in biological warfare/terrorism and is classified as a Tier-1 Select Agent by HHS and APHIS. It is known that inbred mouse strains display a range of susceptibility to Bp and that the murine infection model is ideal for studying acute melioidosis. Here we exploit a powerful mouse genetics resource that consists of a large family of BXD type recombinant inbred strains, to perform genome-wide linkage analysis of the weight loss phenotype following pneumonic infection with Bp. We infected parental mice and 32 BXD strains with 50-100 CFU of Bp (strain 1026b) and monitored weight retention each day over an eleven-day time course. Using the computational tools in GeneNetwork, we performed genome-wide linkage analysis to identify an interval on chromosome 12 that appears to control the weight retention trait. We then analysed and ranked positional candidate genes in this interval, several of which have intriguing connections with innate immunity, calcium homeostasis, lipid transport, host cell growth and development, and autophagy. PMID:24687986

  13. Infection control programs and nursing experts for hospital hygiene

    PubMed Central

    Bühler, Margrith

    2007-01-01

    From the data he had collected, Ignaz Phillip Semmelweis drew the right conclusions and began using disinfectants for handwashing. And this at a time when it was not at all known that infections were caused by bacteria. While ridiculed by colleagues, the results achieved impressively attested to just how correct were his views: there was a demonstrable reduction in mortality rates among puerperae from some 20% to 3%, which was very low for that time. In the course of the 20th century “Surveillance” was introduced, entailing systematic recording, analysis and interpretation of nosocomial infection data, in several countries throughout the world. This helps identify infection problems and take appropriate preventive measures. But the ongoing trend of emergent infectious diseases and the development of antibiotic-resistant bacteria continue to pose new challenges for us: the microorganisms appear to be always one step ahead of us. During the 20th century the prevailing belief was that hand disinfection was the easiest, least expensive and most effective preventive measure to prevent the spread of microorganisms. In the 21st century compliance is the main focus of attention. We must devise novel motivational systems, tailored to the present day setting, to inculcate a sense of responsibility and ensure observance of hand hygiene regimens. Here, the infection control nurse plays a pivotal role. PMID:20200682

  14. Antimicrobial resistance among enterobacteriaceae causing uncomplicated urinary tract infections in Mauritius: consequences of past misuse of antibiotics.

    PubMed

    Issack, M I; Yee Kin Tet, H Y; Morlat, P

    2007-04-01

    A study was conducted to determine the nature and antimicrobial susceptibility of uropathogens in Mauritius in order to provide guidance on the empirical treatment of uncomplicated urinary tract infections. The study was based on urine samples sent for bacteriological investigation at the Central Health Laboratory from unhospitalized patients over a 3-month period. Information on organisms isolated in pure growth and their antibiotic susceptibility was collected and analyzed. Entero - bacteriaceae accounted for over 80% of the 260 isolates obtained during the study period, and showed high rates of resistance to ampicillin (80%), co-trimoxazole (50%), nalidixic acid (34%) and ciprofloxacin (26%). Resistance to mecillinam and fosfomycin were only 2% and 0% respectively. The high rate of antimicrobial resistance in Enterobacteriaceae in urine is cause for concern. Fluoroquinolones may not be very reliable for empirical treatment of urinary tract infections in Mauritius. Alternatives such as pivmecillinam and fosfomycin should be considered.

  15. Bovine viral diarrhea virus infections: manifestations of infection and recent advances in understanding pathogenesis and control.

    PubMed

    Brodersen, B W

    2014-03-01

    Bovine viral diarrhea virus (BVDV) continues to be of economic significance to the livestock industry in terms of acute disease and fetal loss. Many of the lesions relating to BVDV infection have been well described previously. The virus is perpetuated in herds through the presence of calves that are persistently infected. Relationships between various species and biotypes of BVDV and host defenses are increasingly understood. Understanding of the host defense mechanisms of innate immunity and adaptive immunity continues to improve, and the effects of the virus on these immune mechanisms are being used to explain how persistent infection develops. The noncytopathic biotype of BVDV plays the major role in its effects on the host defenses by inhibiting various aspects of the innate immune system and creation of immunotolerance in the fetus during early gestation. Recent advances have allowed for development of affordable test strategies to identify and remove persistently infected animals. With these improved tests and removal strategies, the livestock industry can begin more widespread effective control programs.

  16. Survey of infection control practices in hemodialysis units: preventing vascular access-associated bloodstream infections.

    PubMed

    Trépanier, Pascale; Quach, Caroline; Gonzales, Milagros; Fortin, Elise; Kaouache, Mohammed; Desmeules, Simon; Rocher, Isabelle; Ngenda-Muadi, Muleka; Frenette, Charles; Tremblay, Claude

    2014-07-01

    Despite surveillance, the Quebec Healthcare-Associated Infections Surveillance Program saw no improvement in vascular access-associated bloodstream infections in hemodialysis (HD). We aimed to determine the infection control measures recommended and implemented in Quebec's HD units, compliance of local protocols to infection control practice guidelines, and reasons behind the low prevalence of arteriovenous fistulas. An online survey was elaborated on the basis of the Centers for Disease Control and Prevention (CDC) and National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines. The questionnaire was validated (construct, content, face validity, and reliability) and sent to all HD units in Quebec (n = 40). Results were analyzed using descriptive statistics, linear regression, and Poisson regression. Thirty-seven (93%) of 40 HD units participated. Thirty (94%) of the 32 centers where central catheters are inserted have written insertion protocols. Compliance with practice guidelines is good, except for full-body draping during catheter insertion (79%) and ointment use at insertion site (3%). Prevention measures for catheter maintenance are in accordance with guidelines, except for skin disinfection with at least 0.5% chlorhexidine and 70% alcohol (67% compliance) and regular antiseptic ointment use at the insertion site (3%). Before fistula cannulation, skin preparation is suboptimal; forearm hygiene is performed in only 61% of cases. Several factors explain the low rate of fistulas, including patient preference (69%) and lack of surgical resources (39%; P = .01). Improvement in standardization of care according to practice guidelines is necessary. Fistula rate could be increased by improving access to surgical resources and patient education. Strategies are now being elaborated to address these findings.

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

    PubMed

    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.

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

    PubMed

    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.

  19. The potential for a controlled human infection platform in Singapore

    PubMed Central

    Balasingam, Shobana; Horby, Peter; Wilder-Smith, Annelies

    2014-01-01

    For over 100 years, controlled human infection (CHI) studies have been performed to advance the understanding of the pathogenesis, treatment and prevention of infectious diseases. This methodology has seen a resurgence, as it offers an efficient model for selecting the most promising agents for further development from available candidates. CHI studies are utilised to bridge safety and immunogenicity testing and phase II/III efficacy studies. However, as this platform is not currently utilised in Asia, opportunities to study therapeutics and vaccines for infections that are important in Asia are missed. This review examines the regulatory differences for CHI studies between countries and summarises other regulatory differences in clinical trials as a whole. We found that the regulations that would apply to CHI studies in Singapore closely mirror those in the United Kingdom, and conclude that the regulatory and ethical guidelines in Singapore are compatible with the conduct of CHI studies. PMID:25273928

  20. Controlling bacterial infections by inhibiting proton-dependent processes.

    PubMed

    Kaneti, Galoz; Meir, Ohad; Mor, Amram

    2016-05-01

    Bacterial resistance to antibiotics is recognized as one of the greatest threats in modern healthcare, taking a staggering toll worldwide. New approaches for controlling bacterial infections must be designed, eventually combining multiple strategies for complimentary therapies. This review explores an old/new paradigm for multi-targeted antibacterial therapy, focused at disturbing bacterial cytoplasmic membrane functions at sub minimal inhibitory concentrations, namely through superficial physical alterations of the bilayer, thereby perturbing transmembrane signals transduction. Such a paradigm may have the advantage of fighting the infection while avoiding many of the known resistance mechanisms. This article is part of a Special Issue entitled: Antimicrobial peptides edited by Karl Lohner and Kai Hilpert. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. The environmental, economic and societal consequences of inadequate nitrogen pollution controls.

    PubMed

    Randall, C W

    2004-01-01

    Because adequate nutrient controls were not established in the USA and other countries when there were past opportunities to do so, nutrient pollution of estuaries and coastal waters has resulted in the impairment of ecosystems and major reductions or collapse of fisheries at numerous sites around the world, resulting in major economic and societal impacts. The root problem is that political policies and processes have permitted municipalities, developers, industries and farmers to expand and operate without paying the full cost of their activities. Their expanded activities have occurred at the expense and displacement of those who rely on the productivity and recreational value of our estuarine and coastal waters. Some governments have developed remedial nutrient control programs, but most of them have been poorly conceived, under funded and inadequately enforced, resulting in small increments of progress that tend to be lost because of inadequate land use and immigration controls. It is proposed that establishment of comprehensive nutrient controls is needed throughout the world to preserve and protect estuarine and coastal waters, and to protect or re-establish fisheries, for both economic and societal stability. Nitrogen is the key nutrient for the establishment of control strategies. It is recommended that nutrient recovery from wastewaters and controlled reuse of both water and nutrients be widely implemented as a part of nutrient control strategies.

  2. Comprehensive control of human papillomavirus infections and related diseases.

    PubMed

    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

    2013-12-29

    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

  3. Comprehensive Control of Human Papillomavirus Infections and Related Diseases

    PubMed Central

    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. Comprehensive control of human papillomavirus infections and related diseases.

    PubMed

    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

    2013-12-31

    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

  5. Comprehensive control of human papillomavirus infections and related diseases.

    PubMed

    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

    2013-12-30

    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

  6. Comprehensive control of human papillomavirus infections and related diseases.

    PubMed

    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

    2013-11-22

    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

  7. Epidemiology, surveillance and control of Nipah virus infections in Malaysia.

    PubMed

    Chua, K B

    2010-12-01

    The outbreak of Nipah virus, affecting pigs and pig-farm workers, was first noted in September 1998 in the north-western part of peninsular Malaysia. By March 1999, the outbreak had spread to other pig-farming areas of the country, inclusive of the neighbouring country, Singapore. A total of 283 human cases of viral encephalitis with 109 deaths were recorded in Malaysia from 29 September 1998 to December 1999. During the outbreak period, a number of surveillances under three broad groups; Surveillance in Human Health Sector, Surveillance in Animal Health Sector, and Surveillance for the Reservoir Hosts, were carried out to determine the prevalence, risk of virus infections and transmission in human and swine populations as well as the source and reservoir hosts of Nipah virus. Surveillance data showed that the virus spread rapidly among pigs within infected farms and transmission was attributed to direct contact with infective excretions and secretions. The spread of the virus among pig farms within and between states of peninsular Malaysia was due to movement of pigs. The transmission of the virus to humans was through close contact with infected pigs. Human to human transmission was considered a rare event though the Nipah virus could be isolated from saliva, urine, nasal and pharyngeal secretions of patients. Field investigations identified fruitbats of the Pteropid species as the natural reservoir hosts of the viruses. The outbreak was effectively brought under control following the discovery of the virus and institution of correct control measures through a combined effort of multi-ministerial and multidisciplinary teams working in close co-operation and collaboration with other international agencies.

  8. Heightened infection-control practices are associated with significantly lower infection rates in office-based Mohs surgery.

    PubMed

    Martin, Julie E; Speyer, Lark-Aeryn; Schmults, Chrysalyne D

    2010-10-01

    Reported infection rates for Mohs micrographic surgery (MMS) range from less than 1% to 3.5%. To determine whether lower infection rates are possible for MMS with a consistently applied infection-control regimen. A series of 832 consecutive patients with 950 tumors undergoing MMS formed the cohort for a retrospective study of infections before and after a program of heightened infection-control practices at a single-surgeon academic Mohs practice. The sterility upgrade included jewelry restrictions, alcohol hand scrub before stages and reconstruction, sterile gloves and (during reconstruction) sterile gowns for staff, and sterile towels and dressings for patients during Mohs stages. Infection rate was 2.5% (9 infections/365 tumors) before the sterility upgrade and 0.9% (5 infections/585 tumors) after, a statistically significant difference (p=.04). MMS already has low rates of infection, but this study shows that rigorous infection-control practices can significantly affect infection rates. The authors have indicated no significant interest with commercial supporters. © 2010 by the American Society for Dermatologic Surgery, Inc.

  9. A matter of timing: early, not chronic phase intestinal nematode infection restrains control of a concurrent enteric protozoan infection.

    PubMed

    Rausch, Sebastian; Held, Josephin; Stange, Joerg; Lendner, Matthias; Hepworth, Matthew R; Klotz, Christian; Lucius, Richard; Pogonka, Thomas; Hartmann, Susanne

    2010-10-01

    Infections with parasitic worms are often long lasting and associated with modulated immune responses. We analyzed the influence of the nematode Heligmosomoides polygyrus bakeri dwelling in the small intestine on concurrent protozoan infection with Eimeria falciformis residing in the cecum. To dissect the effects of a nematode infection in the early versus chronic phase, we infected animals with E. falciformis 6 or 28 days post H. p. bakeri infection. Only a concurrent early nematode infection led to an increased replication of the protozoan parasite, whereas a chronic worm infection had no influence on the control of E. falciformis. Increased protozoan replication correlated with the reduced production of IFN-γ, IL-12/23, CCL4, CXCL9 and CXCL10, reduced migration of T cells and increased expression of Foxp3 at the site of protozoan infection. This was accompanied by a stronger nematode-specific Th2 response in gut-draining LN. Protection of mice against challenge infections with the protozoan parasite was not altered. Hence, the detrimental effect of a nematode infection on the control of a concurrent protozoan infection is transient and occurs only in the narrow time window of the early phase of infection.

  10. Gastrointestinal nematode infections in adult dairy cattle: impact on production, diagnosis and control.

    PubMed

    Charlier, Johannes; Höglund, Johan; von Samson-Himmelstjerna, Georg; Dorny, Pierre; Vercruysse, Jozef

    2009-09-16

    Due to the intensification of dairy herds and the recognition of subclinical infections with a negative impact on production as disease, control of gastrointestinal (GI) nematodes in adult cows is becoming established in an increasing number of dairy herds. The objectives of this paper are to review the aspects related to the impact on production, diagnosis and control of GI nematodes in adult dairy cattle. During the last decade substantial evidence has been generated that GI nematodes can have a negative impact on the performance of adult animals. The milk-yield response to anthelmintic treatment in recent studies in pastured dairy herds was observed to be around 1kg/cow per day, whereas effects on reproductive performance remain equivocal. GI-nematode infections can be monitored based on Ostertagia ostertagi-specific antibody measurement, which provides information on the level of larval exposure and an indication of the associated production losses. Other diagnostic parameters are considered of limited use in adult cattle. Control relies on anthelmintic treatment and grazing management, which can be used complementary to each other. There are three critical points that need to be considered when developing anthelmintic control recommendations in adult cows: the unpredictability of the treatment response, the timing of treatment and the risk for developing anthelmintic resistance. As a consequence, monitoring of GI-nematode infections is desirable in order to focus anthelmintic treatments on those herds with a high larval challenge and associated production losses. For the future, more studies are needed to evaluate the effects of different control approaches in terms of financial benefits for the farmer and sustainability on the long term.

  11. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection.

    PubMed

    Goldberg, Brittany E; Mongodin, Emmanuel F; Jones, Cheron E; Chung, Michelle; Fraser, Claire M; Tate, Anupama; Zeichner, Steven L

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi's sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better

  12. The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection

    PubMed Central

    Goldberg, Brittany E.; Mongodin, Emmanuel F.; Jones, Cheron E.; Chung, Michelle; Fraser, Claire M.; Tate, Anupama; Zeichner, Steven L.

    2015-01-01

    The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi’s sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better

  13. Continuing Progress in Infection Control in U.S. Dental Schools.

    ERIC Educational Resources Information Center

    Merchant, Virginia A.; Molinari, John A.

    1990-01-01

    Results of a 1988 survey of dental school deans concerning infection control instruction and protocols found increased attention to infection control and application of recommended protocols. Findings are contrasted with those of earlier studies, and remaining obstacles to implementation of infection control programs are discussed. (Author/MSE)

  14. Bacteraemic urinary tract infections may mimic respiratory infections: a nested case-control study.

    PubMed

    Denis, E; Martis, N; Guillouet-de Salvador, F; Demonchy, E; Degand, N; Carles, K; Roger, P-M

    2016-10-01

    Daily practice suggests that respiratory signs may be observed in bacteraemic urinary infections (BUI). Our objective was to search for an association between the presence of respiratory symptoms and the bacteraemic nature of urinary tract infections (UTI). A nested case-control study was carried out based on our computerised dashboard from January 2011 to June 2015. Cases were defined as patients with a BUI due to Enterobacteriaceae species, identified in blood and urine cultures. Controls had fever and a positive urinary sample but sterile blood cultures (NBUI) and a final diagnosis of urinary infection. Patients from the BUI group were 1:1 matched to the NBUI group according to four parameters: age, gender, cardiovascular and pulmonary comorbid conditions. Subjects with cognitive impairment limiting clinical accuracy and those with healthcare-associated infections were excluded. We compared systematically recorded respiratory and urinary symptoms between groups: signs on auscultation, dyspnoea, chest pain, cough and sputum, dysuria with burning, pollakiuria, flank or costovertebral angle tenderness and ischuria. One hundred BUI were compared to 100 NBUI, both groups exhibiting a similar rate for all considered comorbid conditions. In the BUI group, 58 % showed at least one respiratory sign vs. 20 % in the NBUI group, p < 0.001, while urinary signs were less frequent: 54 % vs. 71 %, p = 0.013. In the multivariate analysis, BUI was associated with the presence of abnormal pulmonary auscultation [adjusted odds ratio (AOR), 5.91; p < 0.001] and a trend towards less urinary symptoms (AOR, 1.58; p = 0.058). Patients with BUI presented with significantly more respiratory signs, which overshadowed urinary symptoms, compared to those with non-bacteraemic UTI. Such observations impact clinical decision-making.

  15. Economic consequences of paratuberculosis control in dairy cattle: A stochastic modeling study.

    PubMed

    Smith, R L; Al-Mamun, M A; Gröhn, Y T

    2017-03-01

    The cost of paratuberculosis to dairy herds, through decreased milk production, early culling, and poor reproductive performance, has been well-studied. The benefit of control programs, however, has been debated. A recent stochastic compartmental model for paratuberculosis transmission in US dairy herds was modified to predict herd net present value (NPV) over 25 years in herds of 100 and 1000 dairy cattle with endemic paratuberculosis at initial prevalence of 10% and 20%. Control programs were designed by combining 5 tests (none, fecal culture, ELISA, PCR, or calf testing), 3 test-related culling strategies (all test-positive, high-positive, or repeated positive), 2 test frequencies (annual and biannual), 3 hygiene levels (standard, moderate, or improved), and 2 cessation decisions (testing ceased after 5 negative whole-herd tests or testing continued). Stochastic dominance was determined for each herd scenario; no control program was fully dominant for maximizing herd NPV in any scenario. Use of the ELISA test was generally preferred in all scenarios, but no paratuberculosis control was highly preferred for the small herd with 10% initial prevalence and was frequently preferred in other herd scenarios. Based on their effect on paratuberculosis alone, hygiene improvements were not found to be as cost-effective as test-and-cull strategies in most circumstances. Global sensitivity analysis found that economic parameters, such as the price of milk, had more influence on NPV than control program-related parameters. We conclude that paratuberculosis control can be cost effective, and multiple control programs can be applied for equivalent economic results. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Infection Control Programs and Antibiotic Control Programs to Limit Transmission of Multi-Drug Resistant Acinetobacter baumannii Infections: Evolution of Old Problems and New Challenges for Institutes.

    PubMed

    Chen, Chang-Hua; Lin, Li-Chen; Chang, Yu-Jun; Chen, Yu-Min; Chang, Chin-Yen; Huang, Chieh-Chen

    2015-07-30

    Acinetobacter baumannii complex (A. baumannii) has been isolated worldwide. The rapid spread of multidrug-resistant A. baumannii complex (MDRAB) in clinical settings has made choosing an appropriate antibiotic to treat these infections and executing contact precautions difficult for clinicians. Although controlling the transmission of MDRAB is a high priority for institutions, there is little information about MDRAB control. Therefore, this study evaluated infection control measures for A. baumannii infections, clusters and outbreaks in the literature. We performed a review of OVID Medline (from 1980 to 2015), and analyzed the literature. We propose that both infection control programs and antibiotic control programs are essential for control of MDRAB. The first, effective control of MDRAB infections, requires compliance with a series of infection control methods including strict environmental cleaning, effective sterilization of reusable medical equipment, concentration on proper hand hygiene practices, and use of contact precautions, together with appropriate administrative guidance. The second strategy, effective antibiotic control programs to decrease A. baumannii, is also of paramount importance. We believe that both infection control programs and antibiotics stewardship programs are essential for control of MDRAB infections.

  17. Dental infection control and occupational safety in the Russian Federation.

    PubMed

    Budnyak, Marina A; Gurevich, Konstantin G; Fabrikant, Kate G; Miller, Kierste; Puttaiah, Raghunath

    2012-09-01

    In the recent past, the Russian Federation has seen a considerable increase in HIV caseload. A high level committee was formed to assess the status of dental infection control and safety (IC&S) in Russia. This article is one of the outcomes to assess the status of IC&S and is the research of a doctoral student (PhD) in public health. To assess needs in Dental Infection Control and Occupational Safety in the Moscow Metropolitan Region of the Russian Federation. A survey with variables assessing knowledge, attitude and practice of IC&S was administered to dentists practicing and or teaching in Moscow city and suburban areas on a convenience sample of dental practitioners. The total number of completed questionnaires were 303. Over 67% had up to three significant exposures to blood and potentially infectious materials (OPIM), but less than 30% got tested for HIV in the previous 3 months. Use of personal protective equipment was not based on anticipated exposure. Less than 10% had an understanding of Spaulding's classification with respect to sanitization, disinfection and sterilization. Only about 34% stated that there was a potential for infectious disease transmission through a percutaneous route and about 61% double gloved while treating patients with infectious diseases. Only about 61% disinfected impressions and most (83%) used alcohol for disinfection purposes. While 34% still used glass-bead sterilizers, about 13% did not sterilize handpieces between patients. Results from this study indicated a disparity in the practice of infection control and safety procedures requiring formulation of nationwide dental safety standards. Further, there is a need in implementation of a standardized dental safety curriculum for dental schools and continuing dental education requirements in dental safety for practicing dentists in the Russian Federation.

  18. Undesirable Consequences of Insecticide Resistance following Aedes aegypti Control Activities Due to a Dengue Outbreak

    PubMed Central

    Maciel-de-Freitas, Rafael; Avendanho, Fernando Campos; Santos, Rosangela; Sylvestre, Gabriel; Araújo, Simone Costa; Lima, José Bento Pereira; Martins, Ademir Jesus; Coelho, Giovanini Evelim; Valle, Denise

    2014-01-01

    Background During a dengue outbreak with co-circulation of DENV-1 and -2 in the city of Boa Vista, one patient was diagnosed with DENV-4, a serotype supposed absent from Brazil for almost 30 years. The re-emergence of DENV-4 triggered the intensification of mechanical and chemical Aedes aegypti control activities in order to reduce vector density and avoid DENV-4 dissemination throughout the country. Methods/Principal Findings Vector control activities consisted of (a) source reduction, (b) application of diflubenzuron against larvae and (c) vehicle-mounted space spraying of 2% deltamethrin to eliminate adults. Control activity efficacy was monitored by comparing the infestation levels and the number of eggs collected in ovitraps before and after interventions, performed in 22 Boa Vista districts, covering an area of ∼80% of the city and encompassing 56,837 dwellings. A total of 94,325 containers were eliminated or treated with diflubenzuron. The most frequently positive containers were small miscellaneous receptacles, which corresponded to 59% of all positive breeding sites. Insecticide resistance to deltamethrin was assessed before, during and after interventions by dose-response bioassays adopting WHO-based protocols. The intense use of the pyrethroid increased fourfold the resistance ratio of the local Ae. aegypti population only six months after the beginning of vector control. Curiously, this trend was also observed in the districts in which no deltamethrin was applied by the public health services. On the other hand, changes in the resistance ratio to the organophosphate temephos seemed less influenced by insecticide in Boa Vista. Conclusions Despite the intense effort, mosquito infestation levels were only slightly reduced. Besides, the median number of eggs in ovitraps remained unaltered after control activity intensification. The great and rapid increase in pyrethroid resistance levels of natural Ae. aegypti populations is discussed in the context of

  19. Infection control practice across Europe: results of the EPD.

    PubMed

    De Vos, J Y; Elseviers, M; Harrington, M; Zampieron, A; Vlaminck, H; Ormandy, P; Kafkia, T

    2006-01-01

    The European Practice Database (EPD) project, developed by the EDTNA/ERCA Research Board, collects data on renal practice at centre level in different European countries. Results presented in this paper focus on infection control practice in haemodialysis centres from 8 different European countries or regions following data collection from 2002 up to 2004. The prevalence of hepatitis B (HBV), hepatitis C (HCV), human immune deficiency (HIV) and methicillin-resistant staphylococcus Aureus (MRSA) was studied as well as the use of screening and preventive actions. These results will enable international comparison in practice and will stimulate further research and the development of new practice recommendations.

  20. Social marketing: a behavior change technology for infection control.

    PubMed

    Mah, Manuel W; Deshpande, Sameer; Rothschild, Michael L

    2006-09-01

    Changing health care worker behaviors is a core function of infection control programs. The social change technologies of education and institutional policy are limited in their capacity to achieve desired behaviors on a sustained basis because they do not address the importance of opportunity and ability in practice enhancement. Social marketing addresses the health care worker's lack of opportunity and ability by offering a bundle of benefits at low cost with high accessibility and by doing this better than the behavioral status quo. This article introduces some social marketing concepts and explicates them in the context of hand hygiene promotion.

  1. Root cause analysis to support infection control in healthcare premises.

    PubMed

    Venier, A-G

    2015-04-01

    Infection control teams (ICTs) seek to prevent healthcare-associated infections (HCAIs). They undertake surveillance and prevention, promote safety and quality of care, and evaluate and manage risk. Root cause analysis (RCA) can support this work but is not widely used by ICTs. This paper describes how ICTs can use RCA to enhance their day-to-day work. Many different tools and methods exist for RCA. Its primary aim is to identify the factors that have led to HCAI, but RCA can also be used for near-misses. A team effort and multidisciplinary work are usually required. Published accounts and personal experience in the field indicate that an ICT that correctly uses RCA implements more effective prevention measures, improves practice and collaborative working, enhances teamwork, and reduces the risk of HCAI. RCA should be promoted among ICTs because it adds value to their work and helps to develop a hospital culture that anticipates and pre-empts problems. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. Anthocyanins control neuroinflammation and consequent memory dysfunction in mice exposed to lipopolysaccharide.

    PubMed

    Carvalho, Fabiano B; Gutierres, Jessié M; Bueno, Andressa; Agostinho, Paula; Zago, Adriana M; Vieira, Juliano; Frühauf, Pâmela; Cechella, José L; Nogueira, Cristina Wayne; Oliveira, Sara M; Rizzi, Caroline; Spanevello, Roselia M; Duarte, Marta M F; Duarte, Thiago; Dellagostin, Odir A; Andrade, Cinthia M

    2017-07-01

    Peripheral inflammatory stimuli may activate a brain neuroinflammatory processes with consequences in brain function. The present study investigated if anthocyanins (ANT) consumption was able to prevent the memory loss, the neuronal damage, and the neuroinflammatory processes triggered by the intraperitoneal lipopolysaccharide (LPS) administration. C57BL6 male mice were treated with ANT (30-100 mg/kg by gavage). With a single dose or during 10 days, before be challenged with LPS (250 μg/kg intraperitoneally single administration), a classical inductor of inflammation. The data obtained showed that ANT was able to confer protection against the memory impairment after 10 days of ANT treatment (100 mg/kg). This phytonutrient also prevented the hypothermia episode induced by LPS. Moreover, ANT prevented the increase in protein carbonyl, NOx, and MDA levels in the hippocampus and cerebral cortex (4 and 24 h) in animal challenged with LPS. ANT showed a protective effect on the increase in the pro-inflammatory cytokines content, especially Interleukin (IL)-1β, tumoral necrosis factor-α and on the reduction of IL-10 induced by LPS. ANT 100 mg/kg prevented the infiltration of peripheral immune cells in the hippocampus at 24 h post-LPS administration. In parallel, LPS increased the activity of myeloperoxidase in cortex and hippocampus, and ANT prevented this effect, also reducing microglia (Iba-1) and astrocyte (GFAP) immunoreactivity. Thus, our data support that ANT are a promising therapeutic component against brain disorders associated with process of neuroinflammation. Graphical Abstract ᅟ.

  3. Applications and consequences of bacteriocins to control Campylobacter spp. in poultry production

    USDA-ARS?s Scientific Manuscript database

    The unacceptably high frequency of Campylobacter jejuni transmission from poultry to humans encourages scientists to consider and create alternative intervention strategies to control the pathogen in poultry production. Extremely high numbers of Campylobacter (often >108 cfu/g of poultry intestinal...

  4. Developmental Comparisons of the Consequences for Memory of Spontaneous vs. Controlled Imaginal Elaborations.

    ERIC Educational Resources Information Center

    Foley, Mary Ann; And Others

    Two studies compared the effects of spontaneous and controlled imagery on reality monitoring decisions. Reality monitoring refers to the decision processes involved in discriminating perceptual memories from imaginal ones. In Experiment 1, 6-year-olds and adults were shown pictures and words and they responded to one of two questions: (1)…

  5. Clustering of vector control interventions has important consequences for their effectiveness: a modelling study.

    PubMed

    Lutambi, Angelina Mageni; Chitnis, Nakul; Briët, Olivier J T; Smith, Thomas A; Penny, Melissa A

    2014-01-01

    Vector control interventions have resulted in considerable reductions in malaria morbidity and mortality. When universal coverage cannot be achieved for financial or logistical reasons, the spatial arrangement of vector control is potentially important for optimizing benefits. This study investigated the effect of spatial clustering of vector control interventions on reducing the population of biting mosquitoes. A discrete-space continuous-time mathematical model of mosquito population dynamics and dispersal was extended to incorporate vector control interventions of insecticide treated bednets (ITNs), Indoor residual Spraying (IRS), and larviciding. Simulations were run at varying levels of coverage and degree of spatial clustering. At medium to high coverage levels of each of the interventions or in combination was more effective to spatially spread these interventions than to cluster them. Suggesting that when financial resources are limited, unclustered distribution of these interventions is more effective. Although it is often stated that locally high coverage is needed to achieve a community effect of ITNs or IRS, our results suggest that if the coverage of ITNs or IRS are insufficient to achieve universal coverage, and there is no targeting of high risk areas, the overall effects on mosquito densities are much greater if they are distributed in an unclustered way, rather than clustered in specific localities. Also, given that interventions are often delivered preferentially to accessible areas, and are therefore clustered, our model results show this may be inefficient. This study provides evidence that the effectiveness of an intervention can be highly dependent on its spatial distribution. Vector control plans should consider the spatial arrangement of any intervention package to ensure effectiveness is maximized.

  6. Clustering of Vector Control Interventions Has Important Consequences for Their Effectiveness: A Modelling Study

    PubMed Central

    Lutambi, Angelina Mageni; Chitnis, Nakul; Briët, Olivier J. T.; Smith, Thomas A.; Penny, Melissa A.

    2014-01-01

    Vector control interventions have resulted in considerable reductions in malaria morbidity and mortality. When universal coverage cannot be achieved for financial or logistical reasons, the spatial arrangement of vector control is potentially important for optimizing benefits. This study investigated the effect of spatial clustering of vector control interventions on reducing the population of biting mosquitoes. A discrete-space continuous-time mathematical model of mosquito population dynamics and dispersal was extended to incorporate vector control interventions of insecticide treated bednets (ITNs), Indoor residual Spraying (IRS), and larviciding. Simulations were run at varying levels of coverage and degree of spatial clustering. At medium to high coverage levels of each of the interventions or in combination was more effective to spatially spread these interventions than to cluster them. Suggesting that when financial resources are limited, unclustered distribution of these interventions is more effective. Although it is often stated that locally high coverage is needed to achieve a community effect of ITNs or IRS, our results suggest that if the coverage of ITNs or IRS are insufficient to achieve universal coverage, and there is no targeting of high risk areas, the overall effects on mosquito densities are much greater if they are distributed in an unclustered way, rather than clustered in specific localities. Also, given that interventions are often delivered preferentially to accessible areas, and are therefore clustered, our model results show this may be inefficient. This study provides evidence that the effectiveness of an intervention can be highly dependent on its spatial distribution. Vector control plans should consider the spatial arrangement of any intervention package to ensure effectiveness is maximized. PMID:24823656

  7. [Predictive values of the usual biologic tests for the detection of human immunodeficiency virus infection. Consequences for screening].

    PubMed

    Grémy, F; Salmi, L R

    1995-02-01

    This paper tries to review what is scientifically known about the predictive values of biological tests of HIV infection. The epidemiological situation for that infection is characterized by two facts: the very high values of sensitivity and specificity which are close to unity; the prevalence of seropositivity which is on average--at least in western countries--, very low (except for some small specific groups). Under those conditions, Negative Predictive Values are always very close to unity, and the percentage of false negative tests is extremely low. Things are quite different for Positive Predictive Value, which varies very rapidly with very small shifts or uncertainties about specificity and prevalence. In the case when prevalence is very low (general population screening) and at the same time specificity is not excellent (that means < 0.99 or even < 0.995), Positive Predictive Value is very poor and the proportion of false positive tests rather important. Indeed the analysis of scientific literature, using the method of "best synthesis evidence", reveals numerous discrepancies as to the value of specificity among different tests. Figures vary a lot from one study to another. It is not obvious which screening strategies are concerned by the results, which finally entail a strong statistical uncertainty. Finally, the figures published in the literature are given by high standard laboratories. One may fear the tests realized in routine laboratories are less reliable. As a conclusion, let us say that despite their very good quality, the biological tests, when used separately, should not be trusted without strong previous criticism when applied to samples of the general population. Any biological screening should be preceded by a clinical examination, including a precise inquiry, in order to detect people at risk, that means with a high prior probability. Clinical dialogue has moreover another great interest: it allows health consulting and education, and calls

  8. Infection control by antibody disruption of bacterial quorum sensing signaling.

    PubMed

    Park, Junguk; Jagasia, Reshma; Kaufmann, Gunnar F; Mathison, John C; Ruiz, Diana I; Moss, Jason A; Meijler, Michael M; Ulevitch, Richard J; Janda, Kim D

    2007-10-01

    Quorum sensing (QS) is the process through which bacteria communicate utilizing small diffusible molecules termed autoinducers. It has been demonstrated that QS controls a plethora of microbial processes including the expression of virulence factors. Here we report an immunopharmacotherapeutic approach for the attenuation of QS in the Gram-positive human pathogen Staphylococcus aureus. An anti-autoinducer monoclonal antibody, AP4-24H11, was elicited against a rationally designed hapten, and efficiently inhibited QS in vitro through the sequestration of the autoinducing peptide (AIP)-4 produced by S. aureus RN4850. Importantly, AP4-24H11 suppressed S. aureus pathogenicity in an abscess formation mouse model in vivo and provided complete protection against a lethal S. aureus challenge. These findings provide a strong foundation for further investigations of immunopharmacotherapy for the treatment of bacterial infections in which QS controls the expression of virulence factors.

  9. The importance of infection prevention and control in medical ultrasound

    PubMed Central

    Moshkanbaryans, Lia; Meyers, Craig; Ngu, Andrew

    2015-01-01

    Abstract Infection control and prevention is critical to delivering safe and high‐quality care to patients undergoing sonographic procedures. In Australia comprehensive standards for reprocessing of ultrasound probes are based on the AS/NZS, TGA and ASUM recommendations. These standards align with the US Centers for Disease Control and Prevention recommendations. However compliance to these guidelines is not ideal and there exists an unmet need for refinement of the guidelines relating to specific factors in clinical sonography. Significant microbiological evidence exists reflecting the increased risk of infection transmission specifically through inadequately reprocessed ultrasound probes. Studies have reported > 80% of transvaginal ultrasound probe handles are contaminated with disease causing pathogens since handle disinfection is omitted from standard reprocessing protocols. Significantly, it was recently discovered that widely‐used high level disinfectants referred to in guidelines are unable to kill HPV while it is becoming increasingly apparent that attention must be paid to the clinical sonography environment as a potential source of nosocomial pathogens. Ultrasound probe reprocessing guidelines and standards are comprehensive however the challenge is in general awareness and effective implementation into practice. As future research in this area is performed, guidelines will need to be amenable to revision to provide patients with the best standard of care. PMID:28191249

  10. Controlled alternate partial root-zone irrigation: its physiological consequences and impact on water use efficiency.

    PubMed

    Kang, Shaozhong; Zhang, Jianhua

    2004-11-01

    Controlled alternate partial root-zone irrigation (CAPRI), also called partial root-zone drying (PRD) in other literature, is a new irrigation technique and may improve the water use efficiency of crop production without significant yield reduction. It involves part of the root system being exposed to drying soil while the remaining part is irrigated normally. The wetted and dried sides of the root system are alternated with a frequency according to soil drying rate and crop water requirement. The irrigation system is developed on the basis of two theoretical backgrounds. (i) Fully irrigated plants usually have widely opened stomata. A small narrowing of the stomatal opening may reduce water loss substantially with little effect on photosynthesis. (ii) Part of the root system in drying soil can respond to the drying by sending a root-sourced signal to the shoots where stomata may be inhibited so that water loss is reduced. In the field, however, the prediction that reduced stomatal opening may reduce water consumption may not materialize because stomatal control only constitutes part of the total transpirational resistance. The boundary resistance from the leaf surface to the outside of the canopy may be so substantial that reduction in stomatal conductance is small and may be partially compensated by the increase in leaf temperature. It is likely that densely populated field crops, such as wheat and maize, may have a different stomatal control over transpiration from that of fruit trees which are more sparsely separated. It was discussed how long the stomata can keep 'partially' closed when a prolonged and repeated 'partial' soil drying is applied and what role the rewatering-stimulated new root growth may play in sensing the repeated soil drying. The physiological and morphological alternation of plants under partial root-zone irrigation may bring more benefits to crops than improved water use efficiency where carbon redistribution among organs is crucial to the

  11. Modeling activities in air traffic control systems: antecedents and consequences of a mid-air collision.

    PubMed

    de Carvalho, Paulo Victor R; Ferreira, Bemildo

    2012-01-01

    In this article we present a model of some functions and activities of the Brazilian Air traffic Control System (ATS) in the period in which occurred a mid-air collision between flight GLO1907, a commercial aircraft Boeing 737-800, and flight N600XL, an executive jet EMBRAER E-145, to investigate key resilience characteristics of the ATM. Modeling in some detail activities during the collision and related them to overall behavior and antecedents that stress the organization uncover some drift into failure mechanisms that erode safety defenses provided by the Air Navigation Service Provider (ANSP), enabling a mid-air collision to be happen.

  12. Control of Chromatin Structure by Spt6: Different Consequences in Coding and Regulatory Regions▿ †

    PubMed Central

    Ivanovska, Iva; Jacques, Pierre-Étienne; Rando, Oliver J.; Robert, François; Winston, Fred

    2011-01-01

    Spt6 is a highly conserved factor required for normal transcription and chromatin structure. To gain new insights into the roles of Spt6, we measured nucleosome occupancy along Saccharomyces cerevisiae chromosome III in an spt6 mutant. We found that the level of nucleosomes is greatly reduced across some, but not all, coding regions in an spt6 mutant, with nucleosome loss preferentially occurring over highly transcribed genes. This result provides strong support for recent studies that have suggested that transcription at low levels does not displace nucleosomes, while transcription at high levels does, and adds the idea that Spt6 is required for restoration of nucleosomes at the highly transcribed genes. Unexpectedly, our studies have also suggested that the spt6 effects on nucleosome levels across coding regions do not cause the spt6 effects on mRNA levels, suggesting that the role of Spt6 across coding regions is separate from its role in transcriptional regulation. In the case of the CHA1 gene, regulation by Spt6 likely occurs by controlling the position of the +1 nucleosome. These results, along with previous studies, suggest that Spt6 regulates transcription by controlling chromatin structure over regulatory regions, and its effects on nucleosome levels over coding regions likely serve an independent function. PMID:21098123

  13. Control of chromatin structure by spt6: different consequences in coding and regulatory regions.

    PubMed

    Ivanovska, Iva; Jacques, Pierre-Étienne; Rando, Oliver J; Robert, François; Winston, Fred

    2011-02-01

    Spt6 is a highly conserved factor required for normal transcription and chromatin structure. To gain new insights into the roles of Spt6, we measured nucleosome occupancy along Saccharomyces cerevisiae chromosome III in an spt6 mutant. We found that the level of nucleosomes is greatly reduced across some, but not all, coding regions in an spt6 mutant, with nucleosome loss preferentially occurring over highly transcribed genes. This result provides strong support for recent studies that have suggested that transcription at low levels does not displace nucleosomes, while transcription at high levels does, and adds the idea that Spt6 is required for restoration of nucleosomes at the highly transcribed genes. Unexpectedly, our studies have also suggested that the spt6 effects on nucleosome levels across coding regions do not cause the spt6 effects on mRNA levels, suggesting that the role of Spt6 across coding regions is separate from its role in transcriptional regulation. In the case of the CHA1 gene, regulation by Spt6 likely occurs by controlling the position of the +1 nucleosome. These results, along with previous studies, suggest that Spt6 regulates transcription by controlling chromatin structure over regulatory regions, and its effects on nucleosome levels over coding regions likely serve an independent function.

  14. Endocannabinoid control of glutamate NMDA receptors: the therapeutic potential and consequences of dysfunction

    PubMed Central

    Rodríguez-Muñoz, María; Sánchez-Blázquez, Pilar; Merlos, Manuel; Garzón-Niño, Javier

    2016-01-01

    Glutamate is probably the most important excitatory neurotransmitter in the brain. The glutamate N-methyl-D-aspartate receptor (NMDAR) is a calcium-gated channel that coordinates with G protein-coupled receptors (GPCRs) to establish the efficiency of the synaptic transmission. Cross-regulation between these receptors requires the concerted activity of the histidine triad nucleotide-binding protein 1 (HINT1) and of the sigma receptor type 1 (σ1R). Essential brain functions like learning, memory formation and consolidation, mood and behavioral responses to exogenous stimuli depend on the activity of NMDARs. In this biological context, endocannabinoids are released to retain NMDAR activity within physiological limits. The efficacy of such control depends on HINT1/σ1R assisting in the physical coupling between cannabinoid type 1 receptors (CB1Rs) and NMDARs to dampen their activity. Subsequently, the calcium-regulated HINT1/σ1R protein tandem uncouples CB1Rs to prevent NMDAR hypofunction. Thus, early recruitment or a disproportionate cannabinoid induced response can bring about excess dampening of NMDAR activity, impeding its adequate integration with GPCR signaling. Alternatively, this control circuit can apparently be overridden in situations where bursts of NMDAR overactivity provoke convulsive syndromes. In this review we will discuss the possible relevance of the HINT1/σ1R tandem and its use by endocannabinoids to diminish NMDAR activity and their implications in psychosis/schizophrenia, as well as in NMDAR-mediated convulsive episodes. PMID:27323834

  15. Variation in infectivity and aggressiveness in space and time in wild host-pathogen systems – causes and consequences

    PubMed Central

    Tack, Ayco JM; Thrall, Peter H; Barrett, Luke G; Burdon, Jeremy J; Laine, Anna-Liisa

    2012-01-01

    Variation in host resistance and in the ability of pathogens to infect and grow (i.e. pathogenicity) is important as it provides the raw material for antagonistic (co)evolution, and therefore underlies risks of disease spread, disease evolution, and host shifts. Moreover, the distribution of this variation in space and time may inform us about the mode of coevolutionary selection (arms race vs. fluctuating selection dynamics) and the relative roles of GxG interactions, gene flow, selection and genetic drift in shaping coevolutionary processes. While variation in host resistance has recently been reviewed, little is known about overall patterns in the frequency and scale of variation in pathogenicity, particularly in natural systems. Using 48 studies from 30 distinct host-pathogen systems, this review demonstrates that variation in pathogenicity is ubiquitous across multiple spatial and temporal scales. Quantitative analysis of a subset of extensively studied plant-pathogen systemsshows that the magnitude of within-population variation in pathogenicity is large relative to among-population variation, and that the distribution of pathogenicity partly mirrors the distribution of host resistance. At least part of the variation in pathogenicity found at a given spatial scale is adaptive, as evidenced by studies that have examined local adaptation at scales ranging from single hosts through metapopulations to entire continents, and – to a lesser extent - by comparisons of pathogenicity with neutral genetic variation. Together these results support coevolutionary selection through fluctuating selection dynamics. We end by outlining several promising directions for future research. PMID:22905782

  16. Consequences of following the new American Academy of Pediatrics guidelines for imaging children with urinary tract infection.

    PubMed

    Ristola, Marko Tapani; Hurme, Timo

    2015-01-01

    Urinary tract infections (UTIs) and vesicoureteral reflux (VUR) are assumed to predispose children to renal damage. Awareness of the significance of VUR and the possibility of reducing UTI recurrence and renal damage has warranted guidelines on which patients should undergo imaging after UTI. An authoritative guideline has been issued by the American Academy of Pediatrics (AAP). This study assessed the applicability of the AAP guidelines to a subpopulation of patients with UTI, 2-24-month-old children with febrile UTI. The records of 394 children aged 2-24 months with their first UTI were reviewed. Data were recorded on the indications for renal and bladder ultrasonography (RBUS) and voiding cystourethrography (VCUG) according to the AAP guidelines, RBUS results, VCUG results, use of antimicrobial prophylaxis, antireflux procedures and other urological treatment, and UTI recurrence. An indication for RBUS was seen in 344 patients. RBUS results were abnormal in 87, including 53 with urinary tract dilatation. An unnecessary RBUS would have been avoided in 43 patients. Seven patients with an abnormal RBUS would not have undergone RBUS. An indication for VCUG was seen in 126 patients. VCUG was performed in 206 patients; VUR was found in 72 patients, including 36 with high-grade VUR. An unnecessary VCUG would have been avoided in 82 patients. High-grade VUR would have been missed in six patients. Five patients would not have undergone surgery. The AAP guidelines for imaging studies in children aged 2-24 months with febrile UTI seem applicable to clinical practice.

  17. Estimation of the clinical and economic consequences of non-compliance with antimicrobial treatment of canine skin infections.

    PubMed

    Van Vlaenderen, Ilse; Nautrup, Barbara Poulsen; Gasper, Sabina M

    2011-05-01

    The goal of this study was to estimate the health and economic consequences of non-compliance with oral antimicrobial treatment in dogs with superficial pyoderma, wounds or abscesses in the US. A mathematical model (Markov model) which simulated treatment with long-term injectable cefovecin versus oral amoxicillin/clavulanic acid was developed and accounted for the effect of non-compliance on clinical outcomes and mean total treatment costs per patient. Efficacy parameters considered in the model were derived from clinical studies. Treatment failure due to oral antimicrobial treatment non-compliance was approximated from published data at 13.6%. US cost data for 2009 were derived from public sources. When non-compliance was considered as a cause of treatment failure with oral medication, the long-term injectable antibiotic was more effective than oral comparator (162 versus 158 days without clinical signs). Mean total treatment costs were lower with cefovecin (USD 376.74) versus amoxicillin/clavulanic acid (USD 382.34) in dogs of 25 kg; and cefovecin remained cost-saving up to a body weight of 31 kg. In large dogs, cefovecin was more costly; however, total therapy costs were less than 6% greater than with amoxicillin/clavulanic acid. Accordingly the higher drug and administration costs of the long-term injectable antibiotic were totally or substantially offset when non-compliance was considered as reason for treatment failure with oral medication. The model also allowed for the estimation of the impact of various non-compliance scenarios. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Cultures of control: A historical analysis of the development of infection control nursing in Ireland.

    PubMed

    McNamra, Martin S; Fealy, Gerard M; Geraghty, Ruth

    2013-01-01

    Responses to the rise of antimicrobial resistance in Europe and North America included establishment of special hospital infection control teams of a microbiologist and a nurse. Based on the testimonies of seven infection control nurses in Irish hospitals appointed during 1979-1990, this article examines the early development and expressions of their disciplinary practice. Fairman's model of collaborative practice was used to examine the context in which the role emerged, the places practice was negotiated and mutually constructed, and exemplars of collaborative practice. Aspects of the relationship between theory and method in Wengraf's biographical narrative interpretive method (BNIM) used to generate the nurses' accounts of their early experiences in the role are highlighted. Practice was contingent on effective negotiation of places of practice, and disciplinary practice bore hallmarks of collaborative practice. The infection control nurse transitioned from conspicuous outsider and object of suspicion to valued resource for patients and staff. Infection control nursing came to be a prototype for new specialist nursing roles in hospitals.

  19. [Control of Opisthorchis viverrini infection for cholangiocarcinoma prevention].

    PubMed

    Buisson, Y

    2017-02-01

    The International Agency for Research on Cancer (IARC) has classified two liver flukes as carcinogenic to humans (Group 1): Opisthorchis viverrini in 1994 and Clonorchis sinensis in 2009. This review is focused on O. viverrini, the most studied of these two trematodes, which infects nearly 10 million people in Southeast Asia. The life cycle involves two intermediate hosts living in fresh water: a snail of the genus Bithynia and a ciprinid fish. The definitive hosts (human, cat, dog) become infected by ingesting raw fish containing metacercariae, the infective stage of the parasite. Adult flukes attach to the epithelium of the bile ducts where they feed for as long as 10 to 30 years, resulting in chronic inflammation, epithelial hyperplasia, periductal fibrosis and formation of granuloma. For a long asymptomatic, the distomatosis is revealed by a chronic cholangitis when the parasite load becomes high. Complications can occur with time: gallstones, cholangitis, liver abscess, pancreatitis and, after a few decades, cholangiocarcinoma (CCA). The epidemiological correlation between the prevalence of O. viverrini infection and the incidence of CCA has been demonstrated in the northeast of Thailand. Specifically, the Khon Kaen province has the highest incidence rate in the world. The CCA can develop asymptomatically for a long time, especially in intrahepatic locations. It is often discovered at a late stage, unresectable. Its prognosis is dreadful with a survival rate less than 5% at 5 years. The phenomenon of carcinogenesis induced by O. viverrini is multifactorial. It has been specially studied using experimental infection on the Syrian golden hamster. Three intricated mechanisms are involved: (i) the direct damage caused by adult worms on the bile duct epithelium, (ii) the immunopathologic processes related to chronic inflammation (oxidative stress) and (iii) the mitogenic and anti-apoptotic effects of the proteins secreted by the parasite. Exogenous cofactors are

  20. Predictors and consequences of anaemia among antiretroviral-naïve HIV-infected and HIV-uninfected children in Tanzania

    PubMed Central

    Chatterjee, Anirban; Bosch, Ronald J; Kupka, Roland; Hunter, David J; Msamanga, Gernard I; Fawzi, Wafaie W

    2013-01-01

    Objective Predictors and consequences of childhood anaemia in settings with high HIV prevalence are not well known. The aims of the present study were to identify maternal and child predictors of anaemia among children born to HIV-infected women and to study the association between childhood anaemia and mortality. Design Prospective cohort study. Maternal characteristics during pregnancy and Hb measurements at 3-month intervals from birth were available for children. Information was also collected on malaria and HIV infection in the children, who were followed up for survival status until 24 months after birth. Setting Dar es Salaam, Tanzania. Subjects The study sample consisted of 829 children born to HIV-positive women. Results Advanced maternal clinical HIV disease (relative risk (RR) for stage ≥2 v. stage 1: 1.31, 95% CI 1.14, 1.51) and low CD4 cell counts during pregnancy (RR for <350 cells/mm3 v. ≥350 cells/mm3: 1.58, 95% CI 1.05, 2.37) were associated with increased risk of anaemia among children. Birth weight <2500 g, preterm birth (<34 weeks), malaria parasitaemia and HIV infection in the children also increased the risk of anaemia. Fe-deficiency anaemia in children was an independent predictor of mortality in the first two years of life (hazard ratio 1.99, 95 % CI 1.06, 3.72). Conclusions Comprehensive care including highly active antiretroviral therapy to eligible HIV-infected women during pregnancy could reduce the burden of anaemia in children. Programmes for the prevention of mother-to-child transmission of HIV and antimalarial treatment to children could improve child survival in settings with high HIV prevalence. PMID:19650963

  1. Predictors and consequences of anaemia among antiretroviral-naïve HIV-infected and HIV-uninfected children in Tanzania.

    PubMed

    Chatterjee, Anirban; Bosch, Ronald J; Kupka, Roland; Hunter, David J; Msamanga, Gernard I; Fawzi, Wafaie W

    2010-02-01

    Predictors and consequences of childhood anaemia in settings with high HIV prevalence are not well known. The aims of the present study were to identify maternal and child predictors of anaemia among children born to HIV-infected women and to study the association between childhood anaemia and mortality. Prospective cohort study. Maternal characteristics during pregnancy and Hb measurements at 3-month intervals from birth were available for children. Information was also collected on malaria and HIV infection in the children, who were followed up for survival status until 24 months after birth. Dar es Salaam, Tanzania. The study sample consisted of 829 children born to HIV-positive women. Advanced maternal clinical HIV disease (relative risk (RR) for stage > or =2 v. stage 1: 1.31, 95 % CI 1.14, 1.51) and low CD4 cell counts during pregnancy (RR for <350 cells/mm3 v. > or =350 cells/mm3: 1.58, 95 % CI 1.05, 2.37) were associated with increased risk of anaemia among children. Birth weight <2500 g, preterm birth (<34 weeks), malaria parasitaemia and HIV infection in the children also increased the risk of anaemia. Fe-deficiency anaemia in children was an independent predictor of mortality in the first two years of life (hazard ratio 1.99, 95 % CI 1.06, 3.72). Comprehensive care including highly active antiretroviral therapy to eligible HIV-infected women during pregnancy could reduce the burden of anaemia in children. Programmes for the prevention of mother-to-child transmission of HIV and antimalarial treatment to children could improve child survival in settings with high HIV prevalence.

  2. Vertical stability, high elongation, and the consequences of loss of vertical control on DIII-D

    SciTech Connect

    Kellman, A.G.; Ferron, J.R.; Jensen, T.H.; Lao, L.L.; Luxon, J.L.; Skinner, D.G.; Strait, E.J.; Reis, E.; Taylor, T.S.; Turnbull, A.D. ); Lazarus, E.A. ); Lister, J.B. )

    1990-09-01

    Recent modifications to the vertical control system for DIII-D has enabled operation of discharges with vertical elongation {kappa}, up to 2.5. When vertical stability is lost, a disruption follows and a large vertical force on the vacuum vessel is observed. The loss of plasma energy begins when the edge safety factor q is 2 but the current decay does not begin until q {approximately}1.3. Current flow on the open field lines in the plasma scrapeoff layer has been measured and the magnitude and distribution of these currents can explain the observed force on the vessel. Equilibrium calculations and simulation of this vertical displacement episode are presented. 7 refs., 4 figs.

  3. Consequences of excessive use of Amlarasa (sour taste): A case-control study.

    PubMed

    Panara, Kalpesh B; Acharya, Rabinarayan

    2014-04-01

    Palatability is an important factor for choice of food by an individual. Amlarasa (sour taste) is one of the main organoleptic entities in foods of present day, which always tempts the consumer to take it now and then. According to classical Ayurvedic texts, balanced intake of Amlarasa in diet helps to maintain physiological health, but its excessive intake produces some signs and symptoms such as dentine hypersensitivity, stomatitis, halitosis, heartburn, urticaria, papule and joint inflammation. To establish the relationship between excessive use of sour predominant diets and signs/symptoms produced by it. A case-control survey study was designed wherein total of 178 volunteers were interviewed personally. Subjects with particular symptoms consider as a cases while healthy volunteers as controls. To measure the excessive intake of Amlarasa, quantity and frequency of common food articles such as mango, tomato, lime, butter milk, tamarind, curd, fermented items etc., are taken into consideration. Data was arranged in to 2 × 2 table and odd ratio was calculated for each symptom. Odds ratio for dentine hypersensitivity, stomatitis, halitosis, heartburn, urticaria, papule and joint inflammation with 95% confidence interval were found 1.95 (0.97-3.93), 2.45 (1.12-5.40), 2.76 (0.96-7.98), 2.21 (1.09-4.53), 0.86 (0.32-2.32), 2.28 (1.02-5.05) and 4.85 (1.09-10.24) respectively. Study reveals that Amlarasa is a risk factor for joint inflammation, dentine hypersensitivity, stomatitis, halitosis, heartburn and papules. Study supports the Ayurvedic classical claim regarding Atiyoga of Amlarasa.

  4. Investigating the dosimetric and tumor control consequences of prostate seed loss and migration

    SciTech Connect

    Knaup, Courtney; Mavroidis, Panayiotis; Esquivel, Carlos; Stathakis, Sotirios; Swanson, Gregory; Baltas, Dimos; Papanikolaou, Nikos

    2012-06-15

    Purpose: Low dose-rate brachytherapy is commonly used to treat prostate cancer. However, once implanted, the seeds are vulnerable to loss and movement. The goal of this work is to investigate the dosimetric and radiobiological effects of the types of seed loss and migration commonly seen in prostate brachytherapy. Methods: Five patients were used in this study. For each patient three treatment plans were created using Iodine-125, Palladium-103, and Cesium-131 seeds. The three seeds that were closest to the urethra were identified and modeled as the seeds lost through the urethra. The three seeds closest to the exterior of prostatic capsule were identified and modeled as those lost from the prostate periphery. The seed locations and organ contours were exported from Prowess and used by in-house software to perform the dosimetric and radiobiological evaluation. Seed loss was simulated by simultaneously removing 1, 2, or 3 seeds near the urethra 0, 2, or 4 days after the implant or removing seeds near the exterior of the prostate 14, 21, or 28 days after the implant. Results: Loss of one, two or three seeds through the urethra results in a D{sub 90} reduction of 2%, 5%, and 7% loss, respectively. Due to delayed loss of peripheral seeds, the dosimetric effects are less severe than for loss through the urethra. However, while the dose reduction is modest for multiple lost seeds, the reduction in tumor control probability was minimal. Conclusions: The goal of this work was to investigate the dosimetric and radiobiological effects of the types of seed loss and migration commonly seen in prostate brachytherapy. The results presented show that loss of multiple seeds can cause a substantial reduction of D{sub 90} coverage. However, for the patients in this study the dose reduction was not seen to reduce tumor control probability.

  5. Phage therapy as an alternative or complementary strategy to prevent and control biofilm-related infections.

    PubMed

    Pires, D P; Melo, Ldr; Vilas Boas, D; Sillankorva, S; Azeredo, J

    2017-09-28

    The complex heterogeneous structure of biofilms confers to bacteria an important survival strategy. Biofilms are frequently involved in many chronic infections in consequence of their low susceptibility to antibiotics as well as resistance to host defences. The increasing need of novel and effective treatments to target these complex structures has led to a growing interest on bacteriophages (phages) as a strategy for biofilm control and prevention. Phages can be used alone, as a cocktail to broaden the spectra of activity, or in combination with other antimicrobials to improve their efficacy. Here, we summarize the studies involving the use of phages for the treatment or prevention of bacterial biofilms, highlighting the biofilm features that can be tackled with phages or combined therapy approaches. Copyright © 2017. Published by Elsevier Ltd.

  6. 42 CFR 416.51 - Conditions for coverage-Infection control.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... seeks to minimize infections and communicable diseases. (a) Standard: Sanitary environment. The ASC must... an ongoing program designed to prevent, control, and investigate infections and communicable diseases. In addition, the infection control and prevention program must include documentation that the ASC...

  7. Hepatitis C virus transmission in hemodialysis units: importance of infection control practices and aseptic technique.

    PubMed

    Thompson, Nicola D; Novak, Ryan T; Datta, Deblina; Cotter, Susanne; Arduino, Matthew J; Patel, Priti R; Williams, Ian T; Bialek, Stephanie R

    2009-09-01

    We investigated 4 hepatitis C virus (HCV) infection outbreaks at hemodialysis units to identify practices associated with transmission. Apparent failures to follow recommended infection control precautions resulted in patient-to-patient HCV transmission, through cross-contamination of the environment or intravenous medication vials. Fastidious attention to aseptic technique and infection control precautions are essential to prevent HCV transmission.

  8. Determinants of Vaccination Coverage and Consequences for Rabies Control in Bali, Indonesia.

    PubMed

    Arief, Riana A; Hampson, Katie; Jatikusumah, Andri; Widyastuti, Maria D W; Sunandar; Basri, Chaerul; Putra, Anak A G; Willyanto, Iwan; Estoepangestie, Agnes T S; Mardiana, I W; Kesuma, I K G N; Sumantra, I P; Doherty, Paul F; Salman, M D; Gilbert, Jeff; Unger, Fred

    2016-01-01

    Maintaining high vaccination coverage is key to successful rabies control, but mass dog vaccination can be challenging and population turnover erodes coverage. Declines in rabies incidence following successive island-wide vaccination campaigns in Bali suggest that prospects for controlling and ultimately eliminating rabies are good. Rabies, however, has continued to circulate at low levels. In the push to eliminate rabies from Bali, high coverage needs to be maintained across all areas of the island. We carried out door-to-door (DTD) questionnaire surveys (n = 10,352 dog-owning households) and photographic mark-recapture surveys (536 line transects, 2,597 observations of free-roaming dogs) in 2011-2012 to estimate dog population sizes and assess rabies vaccination coverage and dog demographic characteristics in Bali, Indonesia. The median number of dogs per subvillage unit (banjar) was 43 (range 0-307) for owned dogs estimated from the DTD survey and 17 (range 0-83) for unconfined dogs (including both owned and unowned) from transects. Vaccination coverage of owned dogs was significantly higher in adults (91.4%) compared to juveniles (<1 year, 43.9%), likely due to insufficient targeting of pups and from puppies born subsequent to vaccination campaigns. Juveniles had a 10-70 times greater risk of not being vaccinated in urban, suburban, and rural areas [combined odds ratios (ORs): 9.9-71.1, 95% CI: 8.6-96.0]. Free-roaming owned dogs were also 2-3 times more likely to be not vaccinated compared to those confined (combined Ors: 1.9-3.6, 95% CI: 1.4-5.4), with more dogs being confined in urban (71.2%) than in suburban (16.1%) and rural areas (8.0%). Vaccination coverage estimates from transects were also much lower (30.9%) than household surveys (83.6%), possibly due to loss of collars used to identify the vaccination status of free-roaming dogs, but these unconfined dogs may also include dogs that were unowned or more difficult to vaccinate. Overall, coverage

  9. Determinants of Vaccination Coverage and Consequences for Rabies Control in Bali, Indonesia

    PubMed Central

    Arief, Riana A.; Hampson, Katie; Jatikusumah, Andri; Widyastuti, Maria D. W.; Sunandar; Basri, Chaerul; Putra, Anak A. G.; Willyanto, Iwan; Estoepangestie, Agnes T. S.; Mardiana, I. W.; Kesuma, I. K. G. N.; Sumantra, I. P.; Doherty, Paul F.; Salman, M. D.; Gilbert, Jeff; Unger, Fred

    2017-01-01

    Maintaining high vaccination coverage is key to successful rabies control, but mass dog vaccination can be challenging and population turnover erodes coverage. Declines in rabies incidence following successive island-wide vaccination campaigns in Bali suggest that prospects for controlling and ultimately eliminating rabies are good. Rabies, however, has continued to circulate at low levels. In the push to eliminate rabies from Bali, high coverage needs to be maintained across all areas of the island. We carried out door-to-door (DTD) questionnaire surveys (n = 10,352 dog-owning households) and photographic mark–recapture surveys (536 line transects, 2,597 observations of free-roaming dogs) in 2011–2012 to estimate dog population sizes and assess rabies vaccination coverage and dog demographic characteristics in Bali, Indonesia. The median number of dogs per subvillage unit (banjar) was 43 (range 0–307) for owned dogs estimated from the DTD survey and 17 (range 0–83) for unconfined dogs (including both owned and unowned) from transects. Vaccination coverage of owned dogs was significantly higher in adults (91.4%) compared to juveniles (<1 year, 43.9%), likely due to insufficient targeting of pups and from puppies born subsequent to vaccination campaigns. Juveniles had a 10–70 times greater risk of not being vaccinated in urban, suburban, and rural areas [combined odds ratios (ORs): 9.9–71.1, 95% CI: 8.6–96.0]. Free-roaming owned dogs were also 2–3 times more likely to be not vaccinated compared to those confined (combined Ors: 1.9–3.6, 95% CI: 1.4–5.4), with more dogs being confined in urban (71.2%) than in suburban (16.1%) and rural areas (8.0%). Vaccination coverage estimates from transects were also much lower (30.9%) than household surveys (83.6%), possibly due to loss of collars used to identify the vaccination status of free-roaming dogs, but these unconfined dogs may also include dogs that were unowned or more difficult to vaccinate

  10. Mantle Control of the Geodynamo: Consequences of Top-Down Regulation

    NASA Astrophysics Data System (ADS)

    Olson, P.

    2015-12-01

    The mantle global circulation, including plate motions, deep subduction, and lower mantle superplumes exerts first-order controls on the evolution of the core, the history of the geodynamo, and the structure of the geomagnetic field. Mantle global circulation models that include deep subduction and compositional heterogeneity similar to the observed large low seismic velocity provinces in the lower mantle predict that the present-day global average heat flux at the core-mantle boundary exceeds 90 mW.m-2. This is sufficient to drive the present-day geodynamo by thermochemical convection and implies a very young inner core, with inner core nucleation between 400 and 1000 Ma, plus heterogeneous heat flux at the core-mantle boundary (CMB) with peak-to-peak lateral variations exceeding 100 mW.m-2. Extreme lateral variations in CMB heat flux indicate that the liquid outer core is thermally unstable beneath the high seismic velocity regions in the lower mantle and thermally stable beneath the large low seismic velocity provinces. Numerical dynamo simulations show how this pattern of boundary heat flux affects the flow in the outer core below the CMB, tends to align the time average geomagnetic dipole axis with the rotation axis, while promoting polarity reversals. It also contributes to longitudinal variations in the solidification rate on the inner core boundary, a possible cause of the hemispherical pattern of seismic heterogeneity observed in the inner core.

  11. [Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial].

    PubMed

    Cebrià I Iranzo, Maria Dels Àngels; Tortosa-Chuliá, M Ángeles; Igual-Camacho, Celedonia; Sancho, Patricia; Galiana, Laura; Tomás, José Manuel

    2014-01-01

    The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  12. [Outcomes of Infection Control Team Inspections at the Dental Hospital, Tokyo Medical and Dental University].

    PubMed

    Sunakawa, Mitsuhiro; Matsumoto, Hiroyuki; Okihata, Rie; Tsuruoka, Hiromi; Yamada, Yuichi; Adachi, Toshiko; Izumi, Yuichi

    2015-07-01

    In the Dental Hospital, Tokyo Medical and Dental University, an infection control team (ICT) has been formed to inspect each diagnosis department of clinics and wards in order to identify problems regarding nosocomial infection control. In this study, we analyzed the inspection reports and highlighted the following serious problems: 1) inadequate hygienic hand-washing for out- and in-patient treatment, 2) incomplete wearing of personal protective equipment (PPE) by dental health care workers, 3) necessity of environmental improvement in the clinics, and 4) cross-infection risk induced by. the continuous use of treatment devices without appropriate disinfection. The ICT provided feedback to the inspected departments, suggesting solutions to problems regarding nosocomial infection control. In order to enhance infection control in our hospital, dental healthcare practitioners must make further efforts on nosocomial infection control and prevention, and act according to their position by continuously educating students and enlightening hospital staff about the importance of infection control.

  13. Middle East Respiratory Syndrome Infection Control and Prevention Guideline for Healthcare Facilities

    PubMed Central

    Kim, Jin Yong; Song, Joon Young; Yoon, Young Kyung; Choi, Seong-Ho; Song, Young Goo; Kim, Sung-Ran; Son, Hee-Jung; Jeong, Sun-Young; Choi, Jung-Hwa; Kim, Kyung Mi; Yoon, Hee Jung; Choi, Jun Yong; Kim, Tae Hyong; Choi, Young Hwa; Kim, Hong Bin; Yoon, Ji Hyun; Lee, Jacob; Eom, Joong Sik; Lee, Sang-Oh; Oh, Won Sup; Choi, Jung-Hyun; Yoo, Jin-Hong; Kim, Woo Joo

    2015-01-01

    Middle East Respiratory Syndrome (MERS) is an acute viral respiratory illness with high mortality caused by a new strain of betacoronavirus (MERS-CoV). Since the report of the first patient in Saudi Arabia in 2012, large-scale outbreaks through hospital-acquired infection and inter-hospital transmission have been reported. Most of the patients reported in South Korea were also infected in hospital settings. Therefore, to eliminate the spread of MERS-CoV, infection prevention and control measures should be implemented with rigor. The present guideline has been drafted on the basis of the experiences of infection control in the South Korean hospitals involved in the recent MERS outbreak and on domestic and international infection prevention and control guidelines. To ensure efficient MERS-CoV infection prevention and control, care should be taken to provide comprehensive infection control measures including contact control, hand hygiene, personal protective equipment, disinfection, and environmental cleaning. PMID:26788414

  14. Middle East Respiratory Syndrome Infection Control and Prevention Guideline for Healthcare Facilities.

    PubMed

    Kim, Jin Yong; Song, Joon Young; Yoon, Young Kyung; Choi, Seong-Ho; Song, Young Goo; Kim, Sung-Ran; Son, Hee-Jung; Jeong, Sun-Young; Choi, Jung-Hwa; Kim, Kyung Mi; Yoon, Hee Jung; Choi, Jun Yong; Kim, Tae Hyong; Choi, Young Hwa; Kim, Hong Bin; Yoon, Ji Hyun; Lee, Jacob; Eom, Joong Sik; Lee, Sang-Oh; Oh, Won Sup; Choi, Jung-Hyun; Yoo, Jin-Hong; Kim, Woo Joo; Cheong, Hee Jin

    2015-12-01

    Middle East Respiratory Syndrome (MERS) is an acute viral respiratory illness with high mortality caused by a new strain of betacoronavirus (MERS-CoV). Since the report of the first patient in Saudi Arabia in 2012, large-scale outbreaks through hospital-acquired infection and inter-hospital transmission have been reported. Most of the patients reported in South Korea were also infected in hospital settings. Therefore, to eliminate the spread of MERS-CoV, infection prevention and control measures should be implemented with rigor. The present guideline has been drafted on the basis of the experiences of infection control in the South Korean hospitals involved in the recent MERS outbreak and on domestic and international infection prevention and control guidelines. To ensure efficient MERS-CoV infection prevention and control, care should be taken to provide comprehensive infection control measures including contact control, hand hygiene, personal protective equipment, disinfection, and environmental cleaning.

  15. Unintended consequences of invasive predator control in an Australian forest: overabundant wallabies and vegetation change.

    PubMed

    Dexter, Nick; Hudson, Matt; James, Stuart; Macgregor, Christopher; Lindenmayer, David B

    2013-01-01

    Over-abundance of native herbivores is a problem in many forests worldwide. The abundance of native macropod wallabies is extremely high at Booderee National Park (BNP) in south-eastern Australia. This has occurred because of the reduction of exotic predators through an intensive baiting program, coupled with the absence of other predators. The high density of wallabies at BNP may be inhibiting the recruitment of many plant species following fire-induced recruitment events. We experimentally examined the post-fire response of a range of plant species to browsing by wallabies in a forest heavily infested with the invasive species, bitou bush Chrysanthemoides monilifera. We recorded the abundance and size of a range of plant species in 18 unfenced (browsed) and 16 fenced (unbrowsed) plots. We found the abundance and size of bitou bush was suppressed in browsed plots compared to unbrowsed plots. Regenerating seedlings of the canopy or middle storey tree species Eucalyptus pilularis, Acacia implexa, Allocasuarina littoralis, Breynia oblongifolia and Banksia integrifolia were either smaller or fewer in number in grazed plots than treatment plots as were the vines Kennedia rubicunda, Glycine tabacina and Glycine clandestina. In contrast, the understorey fern, Pteridium esculentum increased in abundance in the browsed plots relative to unbrowsed plots probably because of reduced competition with more palatable angiosperms. Twelve months after plots were installed the community structure of the browsed and unbrowsed plots was significantly different (P = 0.023, Global R = 0.091). The relative abundance of C. monilifera and P. esculentum contributed most to the differences. We discuss the possible development of a low diversity bracken fern parkland in Booderee National Park through a trophic cascade, similar to that caused by overabundant deer in the northern hemisphere. We also discuss its implications for broad scale fox control in southern Australian forests.

  16. Unintended Consequences of Invasive Predator Control in an Australian Forest: Overabundant Wallabies and Vegetation Change

    PubMed Central

    Dexter, Nick; Hudson, Matt; James, Stuart; MacGregor, Christopher; Lindenmayer, David B.

    2013-01-01

    Over-abundance of native herbivores is a problem in many forests worldwide. The abundance of native macropod wallabies is extremely high at Booderee National Park (BNP) in south-eastern Australia. This has occurred because of the reduction of exotic predators through an intensive baiting program, coupled with the absence of other predators. The high density of wallabies at BNP may be inhibiting the recruitment of many plant species following fire-induced recruitment events. We experimentally examined the post-fire response of a range of plant species to browsing by wallabies in a forest heavily infested with the invasive species, bitou bush Chrysanthemoides monilifera. We recorded the abundance and size of a range of plant species in 18 unfenced (browsed) and 16 fenced (unbrowsed) plots. We found the abundance and size of bitou bush was suppressed in browsed plots compared to unbrowsed plots. Regenerating seedlings of the canopy or middle storey tree species Eucalyptus pilularis, Acacia implexa, Allocasuarina littoralis, Breynia oblongifolia and Banksia integrifolia were either smaller or fewer in number in grazed plots than treatment plots as were the vines Kennedia rubicunda, Glycine tabacina and Glycine clandestina. In contrast, the understorey fern, Pteridium esculentum increased in abundance in the browsed plots relative to unbrowsed plots probably because of reduced competition with more palatable angiosperms. Twelve months after plots were installed the community structure of the browsed and unbrowsed plots was significantly different (P = 0.023, Global R = 0.091). The relative abundance of C. monilifera and P. esculentum contributed most to the differences. We discuss the possible development of a low diversity bracken fern parkland in Booderee National Park through a trophic cascade, similar to that caused by overabundant deer in the northern hemisphere. We also discuss its implications for broad scale fox control in southern Australian forests

  17. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital.

    PubMed

    Jenks, P J; Laurent, M; McQuarry, S; Watkins, R

    2014-01-01

    Although surgical site infections (SSIs) are known to be associated with increased length of stay (LOS) and additional cost, their impact on the profitability of surgical procedures is unknown. To determine the clinical and economic burden of SSI over a two-year period and to predict the financial consequences of their elimination. SSI surveillance and Patient Level Information and Costing System (PLICS) datasets for patients who underwent major surgical procedures at Plymouth Hospitals NHS Trust between April 2010 and March 2012 were consolidated. The main outcome measures were the attributable postoperative length of stay (LOS), cost, and impact on the margin differential (profitability) of SSI. A secondary outcome was the predicted financial consequence of eliminating all SSIs. The median additional LOS attributable to SSI was 10 days [95% confidence interval (CI): 7-13 days] and a total of 4694 bed-days were lost over the two-year period. The median additional cost attributable to SSI was £5,239 (95% CI: 4,622-6,719) and the aggregate extra cost over the study period was £2,491,424. After calculating the opportunity cost of eliminating all SSIs that had occurred in the two-year period, the combined overall predicted financial benefit of doing so would have been only £694,007. For seven surgical categories, the hospital would have been financially worse off if it had successfully eliminated all SSIs. SSI causes significant clinical and economic burden. Nevertheless the current system of reimbursement provided a financial disincentive to their reduction. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Risk factors for Propionibacterium acnes infection after neurosurgery: A case-control study.

    PubMed

    Haruki, Yuto; Hagiya, Hideharu; Takahashi, Yu; Yoshida, Hideyuki; Kobayashi, Kazuki; Yukiue, Tadato; Tsuboi, Nobushige; Sugiyama, Tetsuhiro

    2017-04-01

    Propionibacterium acnes is increasingly known as a causative organism for post-neurosurgical infection; however, no clinical studies have examined the risk factors associated with P. acnes infections. Clinical data obtained from 14 cases of P. acnes infection and 28 controls infected with other pathogens were analyzed. Craniotomy, malignancy, and prolonged duration of operation were significantly associated with the onset of P. acnes infection. No fatal cases were reported.

  19. Interactions of air quality and climate: Consequences of US emission controls

    NASA Astrophysics Data System (ADS)

    Leibensperger, Eric Michael

    2011-12-01

    This thesis applies global chemical transport (CTM) and general circulation models (GCM), along with chemical and meteorological observations, to investigate the interactions between US air quality and climate. The frequency of summertime mid-latitude cyclones tracking across eastern North America at 40--50°N is shown to be a strong predictor of ozone pollution days in the eastern US. Analyses of weather maps, assimilated meteorology, and NASA Goddard Institute for Space Studies (GISS) GCM simulations show a long-term decline in the number of summertime cyclones in this track starting in 1980. Using observed correlations between ozone pollution days and cyclone frequency, it is shown that this trend has offset by half the ozone air quality gains expected in the northeastern US from reductions in anthropogenic emissions. Without this trend in cyclones the northeastern US would have been largely compliant with the ozone standard by 2001. Aerosol distributions derived from the GEOS-Chem CTM using historical and projected emissions are used with the NASA GISS GCM to estimate the climate effects of US anthropogenic aerosols. Aerosol forcing in the eastern US peaked in 1970--1990 (direct effect: -2.0 W m-2; indirect effects: -2.0 W m-2) and has strongly declined since due to air quality regulation. This regional radiative forcing elicits a strong regional climate response, cooling the central and eastern US by 0.5--1.0°C on average during 1970--1990. Observations over the eastern US show a lack of warming in 1960--1980 followed by rapid warming, which is attributed here to trends in US anthropogenic aerosols. It is shown that current US aerosol concentrations are sufficiently low that projected air quality regulations will cause little further warming. Most of the potential warming from US aerosol source controls has thus been realized. In an additional study, it is shown that anthropogenic emissions of nitrogen oxides (NOx ≡NO + NO2) and carbon monoxide (CO) affect

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

    PubMed

    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

  1. Infection control preparedness for human infection with influenza A H7N9 in Hong Kong.

    PubMed

    Cheng, Vincent C C; Tai, Josepha W M; Lee, W M; Chan, W M; Wong, Sally C Y; Chen, Jonathan H K; Poon, Rosana W S; To, Kelvin K W; Chan, Jasper F W; Ho, P L; Chan, K H; Yuen, K Y

    2015-01-01

    OBJECTIVE To assess the effectiveness of infection control preparedness for human infection with influenza A H7N9 in Hong Kong. DESIGN A descriptive study of responses to the emergence of influenza A H7N9. SETTING A university-affiliated teaching hospital. PARTICIPANTS Healthcare workers (HCWs) with unprotected exposure (not wearing N95 respirator during aerosol-generating procedure) to a patient with influenza A H7N9. METHODS A bundle approach including active and enhanced surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and extensive contact tracing for HCWs with unprotected exposure was implemented. Seventy HCWs with unprotected exposure to an index case were interviewed especially regarding their patient care activities. RESULTS From April 1, 2013, through May 31, 2014, a total of 126 (0.08%) of 163,456 admitted patients were tested for the H7 gene by reverse transcription-polymerase chain reaction per protocol. Two confirmed cases were identified. Seventy (53.8%) of 130 HCWs had unprotected exposure to an index case, whereas 41 (58.6%) and 58 (82.9%) of 70 HCWs wore surgical masks and practiced hand hygiene after patient care, respectively. Sixteen (22.9%) of 70 HCWs were involved in high-risk patient contacts. More HCWs with high-risk patient contacts received oseltamivir prophylaxis (P=0.088) and significantly more had paired sera collected for H7 antibody testing (P<0.001). Ten (14.3%) of 70 HCWs developed influenza-like illness during medical surveillance, but none had positive results by reverse transcription-polymerase chain reaction. Paired sera was available from 33 of 70 HCWs with unprotected exposure, and none showed seroconversion against H7N9. CONCLUSIONS Despite the delay in airborne precautions implementation, no patient-to-HCW transmission of influenza A H7N9 was demonstrated.

  2. Multiple Immune Factors Are Involved in Controlling Acute and Chronic Chikungunya Virus Infection

    PubMed Central

    Poo, Yee Suan; Rudd, Penny A.; Gardner, Joy; Wilson, Jane A. C.; Larcher, Thibaut; Colle, Marie-Anne; Le, Thuy T.; Nakaya, Helder I.; Warrilow, David; Allcock, Richard; Bielefeldt-Ohmann, Helle; Schroder, Wayne A.; Khromykh, Alexander A.; Lopez, José A.; Suhrbier, Andreas

    2014-01-01

    The recent epidemic of the arthritogenic alphavirus, chikungunya virus (CHIKV) has prompted a quest to understand the correlates of protection against virus and disease in order to inform development of new interventions. Herein we highlight the propensity of CHIKV infections to persist long term, both as persistent, steady-state, viraemias in multiple B cell deficient mouse strains, and as persistent RNA (including negative-strand RNA) in wild-type mice. The knockout mouse studies provided evidence for a role for T cells (but not NK cells) in viraemia suppression, and confirmed the role of T cells in arthritis promotion, with vaccine-induced T cells also shown to be arthritogenic in the absence of antibody responses. However, MHC class II-restricted T cells were not required for production of anti-viral IgG2c responses post CHIKV infection. The anti-viral cytokines, TNF and IFNγ, were persistently elevated in persistently infected B and T cell deficient mice, with adoptive transfer of anti-CHIKV antibodies unable to clear permanently the viraemia from these, or B cell deficient, mice. The NOD background increased viraemia and promoted arthritis, with B, T and NK deficient NOD mice showing high-levels of persistent viraemia and ultimately succumbing to encephalitic disease. In wild-type mice persistent CHIKV RNA and negative strand RNA (detected for up to 100 days post infection) was associated with persistence of cellular infiltrates, CHIKV antigen and stimulation of IFNα/β and T cell responses. These studies highlight that, secondary to antibodies, several factors are involved in virus control, and suggest that chronic arthritic disease is a consequence of persistent, replicating and transcriptionally active CHIKV RNA. PMID:25474568

  3. The control of Corynebacterium pseudotuberculosis infection in sheep flocks: a mathematical model of the impact of vaccination, serological testing, clinical examination and lancing of abscesses.

    PubMed

    O'Reilly, K M; Medley, G F; Green, L E

    2010-06-01

    A mathematical model of Corynebacterium pseudotuberculosis infection in sheep flocks was used to evaluate strategies for control and elimination of caseous lymphadenitis (CLA). Control strategies tested were vaccination, serological testing and removal of seropositives, clinical examination and removal of sheep with abscesses, lancing abscesses, and appropriate combinations. Three different infection rates with and without replacement of culled ewes were used to evaluate the control options. Controls were either implemented immediately after infection was detected in a flock or once CLA was at endemic equilibrium, and with different frequencies of examination or testing. Elimination of infection was defined as 99% confidence that no sheep were infected with C. pseudotuberculosis. The control strategies were evaluated by estimating the reduction in infection or probability of elimination and the number of ewes culled from the flock. Lancing abscesses reduced the prevalence of infection when the initial prevalence was <0.60, but elimination was unlikely. A vaccine efficacy of 0.79 or more led to elimination of infection from the flock, provided that the endemic prevalence of infection was <0.60. A combination of vaccination and clinical examination reduced the prevalence of infection at a faster rate than using clinical examination or vaccination alone where five rounds of clinical examination were done. Serological testing led to elimination of infection after five tests, but was highly dependent upon the diagnostic test sensitivity and specificity and management options used: a test sensitivity of 0.90 always resulted in elimination. A test specificity greater than 0.90 prevented removal of many false positive ewes and consequently prevented a large reduction in lamb production. Elimination was most likely using a serological test with sensitivity and specificity >0.90, but vaccination combined with clinical examination reduced infection rapidly with little impact

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

    NASA Astrophysics Data System (ADS)

    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

  5. Clinical and Economic Consequences of Failure of Initial Antibiotic Therapy for Patients with Community-Onset Complicated Intra-Abdominal Infections

    PubMed Central

    Chong, Yong Pil; Bae, In-Gyu; Lee, Sang-Rok; Chung, Jin-Won; Jun, Jae-Bum; Choo, Eun Ju; Moon, Soo-youn; Lee, Mi Suk; Jeon, Min Hyok; Song, Eun Hee; Lee, Eun Jung; Park, Seong Yeon; Kim, Yang Soo

    2015-01-01

    Objectives Complicated intra-abdominal infection (cIAI) is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI. Methods A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week. Results A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14%) had health care-associated infection, and 48 (9%) experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred $3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13. Conclusions To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed. PMID:25910171

  6. Infection control best practices in clinical research in resource-limited settings.

    PubMed

    Godfrey, Catherine; Schouten, Jeffrey T

    2014-01-01

    Infection control activities in the international research setting include the development of meaningful and effective policies on specific topics such as hand and respiratory hygiene. Prevention of infection in health care workers and management of occupational exposure to transmissible agents are important aspects of the role of an infection control practitioner. Hand hygiene reduces health care associated infections and practices may be implemented in the research setting.

  7. Reengineering and infection control programs: commentary and a case study.

    PubMed

    Jackson, M; Massanari, R M

    2000-02-01

    Transformation of the health care system has been an ongoing process for generations, but many changes in the past 2 decades have focused on reducing costs in concert with rapidly changing technologies and demands for high quality care. Many cost-containment efforts in the 1990s are characterized by attempts to apply the business model for "reengineering the corporation" to health care systems. This commentary reviews principles of reengineering and how strategies to reduce costs through market forces, competition, and downsizing can result in substantial problems for bureaucratic organizations unaccustomed to rapid change and innovation. A case study drawn from experiences of a large metropolitan academic health care system is presented, with specific focus on lessons that will be helpful to infection control professionals (ICPs) confronted with similar situations.

  8. Infection control considerations during construction activities: land excavation and demolition.

    PubMed

    Cheng, S M; Streifel, A J

    2001-10-01

    Because current trends in hospital restructuring in North America, amalgamations and mergers, and the aging of health care facilities, the need to restructure physical buildings has become greater. Hospital construction carries with it risks to patients. One key concern is the risk of aspergillosis associated with hospital construction. Infection control practitioners must consider some key factors when addressing land excavation and building demolition, which differ in some ways from construction that occurs within a health care facility. The key factors to consider are project concept, risk assessment of patients, procedures and environment, air quality, routes of entry and egress, soil management, conducting inspections, contingency planning, housekeeping, and lines of cooperation and communication with various stakeholders. Considering these areas will help ensure that health care facility personnel and the workers have exercised diligence in patient care.

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

    PubMed

    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.

  10. Roles of infection control nurses in regional hospitals.

    PubMed

    Kananitaya, Thamolwan; Senarat, Wilawan; Moongtui, Wanchai; Tantisiriwat, Warapot; Danchaivijitr, Somwang

    2005-12-01

    To evaluate the roles of infection control nurses (ICNs) in regional hospitals and to detect problems, obstacles in practice and needs for support. A descriptive study by interview and questionnaire survey of 16 ICNs from regional hospitals appling for HA. From February to April 2002, a study by interview and questionnaires was done in 16 ICNs from 10 regional hospitals applying for HA. Most of the ICNs practised IC roles according to HA criteria except for hospital employee health, NI surveillance and research. The major problems and obstacles included the lack of IC positions, inadequate ICNs, lack of support from hospital administrative personnel, too heavy work load, lack of: IC experts, budget for IC, equipment, IC research data and education material. The present study suggested that roles of ICNs in hospital employee health, NI surveillance and research were inadequate because of the lack of full time ICNs, too heavy a work load, lack of: IC consultants supply and administrative support.

  11. Gut microbiota promote hematopoiesis to control bacterial infection.

    PubMed

    Khosravi, Arya; Yáñez, Alberto; Price, Jeremy G; Chow, Andrew; Merad, Miriam; Goodridge, Helen S; Mazmanian, Sarkis K

    2014-03-12

    The commensal microbiota impacts specific immune cell populations and their functions at peripheral sites, such as gut mucosal tissues. However, it remains unknown whether gut microbiota control immunity through regulation of hematopoiesis at primary immune sites. We reveal that germ-free mice display reduced proportions and differentiation potential of specific myeloid cell progenitors of both yolk sac and bone marrow origin. Homeostatic innate immune defects may lead to impaired early responses to pathogens. Indeed, following systemic infection with Listeria monocytogenes, germ-free and oral-antibiotic-treated mice display increased pathogen burden and acute death. Recolonization of germ-free mice with a complex microbiota restores defects in myelopoiesis and resistance to Listeria. These findings reveal that gut bacteria direct innate immune cell development via promoting hematopoiesis, contributing to our appreciation of the deep evolutionary connection between mammals and their microbiota.

  12. Experimental system for the control of surgically induced infections

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The results are presented of the development tests performed on the experimental system for the control of surgically induced infections. Tests were performed on the portable clean room to demonstrate assembly, collapsability, portability and storage. Collapsing, relocating and storing within the surgery room can be accomplished in 12 minutes. The storage envelope dimensions are 1.64 m x 4.24 m x 2.62 m high. The disassembly transfer to another room, and reassembly were demonstrated. The laminar air flow velocity profile within the enclosure was measured. In the undisturbed area of the enclosure the air flow met the Federal Standard 209a requirements of 27.45 meters per minute + or - 6.10 meters per minute. Smoke tests with simulated surgery equipment and personnel in the enclosure did not indicate any detrimental air flow patterns. It is concluded that the system as designed will perform the functions required for its intended use.

  13. Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial

    PubMed Central

    Bolbol-Haghighi, Nahid; Masoumi, Seyedeh Zahra

    2016-01-01

    Introduction Childbirth experience is a process throughout women’s life and the most important consequence of labour. Support is the key factor to have a positive experience of childbirth. In order to improve and reduce the stress and anxiety levels in women during labour and cope with the childbirth pain, the emotional, physical and educational support of doulas can be used. Aim This study was aimed to evaluate the effect of continued support of midwifery students in labour on the childbirth and labour consequences. Materials and Methods The present study was conducted using a randomized controlled clinical trial design on 100 pregnant women referred to the maternity ward at Fatemieh Hospital, Shahroud, Iran. The participants were assigned to the supportive or non-supportive group based on allocation sequence using a randomized block design and table of computer-generated random numbers prior to beginning the study. Supportive care was provided by the trained midwifery students. Childbirth and labour consequences were analysed by chi-square test, Fisher-exact test, independent t-test, Mann-Whitney U-test using SPSS-21 software. Results The results showed a significantly lower duration of the first stage of labour in the supportive group, as compared to that in the non-supportive group (p <0.001). Moreover, Apgar scores in the supportive group, compared to those in the non-supportive group, significantly increased at minutes 1 and 5 (p <0.001 and p = 0.04, respectively). Conclusion The findings of this study showed that the supportive care provided by the midwifery students shortens duration of the first stage of labour and improves the Apgar scores in the first and fifth minutes. PMID:27790526

  14. Effect of Consultation and Educating in Preparation Classes for Delivery on Pregnancy Consequences: A Randomized Controlled Clinical Trial

    PubMed Central

    Karimi, Simin; Kazemi, Farideh; Masoumi, Seyedeh Zahra; Shobeiri, Fatemeh; Roshanaei, Ghodratollah

    2016-01-01

    Background Care during pregnancy and performing consultation for delivery preparation play an important role in improving pregnant women’s knowledge. Objective The purpose of this study was to investigate the effect of consultation and instruction in the preparation classes for delivery on pregnancy consequences, including choosing the type of delivery, the performed type of delivery, and infant’s weight. Methods This study was conducted in 2015 on 170 pregnant women who had been referred to the prenatal clinic in Hamedan. The participants were randomly divided into intervention and control groups. Eight sessions of consultation for delivery preparation were held for the women in 20 to 36 weeks of pregnancy. The control group received only the routine care. After 37 weeks of pregnancy, the participants answered a questionnaire. The infant’s weight was measured after birth. Data were analyzed Using SPSS-21 and McNemar–Bowker Test, independent t-test, chi-square test, and Fisher exact test. Results Results showed a significant statistical difference between the two groups concerning their selective and performed delivery (p<0.001). The weight of infants in the intervention group was significantly higher than that of those in the control group (p<0.001). Conclusion The findings of this study showed that the consultation for delivery preparation had a positive effect on some pregnancy consequences such as selecting the type of delivery performed and infant’s weight. Trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCTID: IRCT2015012513405N9. Funding The authors received no financial support for the research, authorship, and/or publication of this article. PMID:28070250

  15. Surgical site infections in breast surgery: case-control study.

    PubMed

    Vilar-Compte, Diana; Jacquemin, Benedicte; Robles-Vidal, Carlos; Volkow, Patricia

    2004-03-01

    The purpose of this study was to estimate the frequency of surgical site infections (SSIs) and identify associated risk factors for each type of breast surgery at a cancer hospital. We used a nested case-control design. Between February 1, 2000 and July 31, 2000, all breast surgeries performed were recorded on a daily basis. After hospital discharge, we evaluated patients simultaneously with surgeons three times a week for 30 days or longer. The odds ratio (OR) was estimated using logistic regression analysis. The study followed 280 patients (298 wounds). Altogether, 77 SSIs were detected, for an overall SSI rate of 25.8% (77/298). For excisions, conservative surgery, and radical mastectomies the SSI rates were 1.4%, 18.0%, and 38.3%, respectively. Excisions were excluded ( n = 68) for risk factor analysis. After multivariate analysis, risk factors associated with SSIs were obesity [OR 2.5, 95% confidence interval (CI) 1.2-4.3], concomitant chemotherapy and radiation (OR 2.3, 95% CI 1.2-4.3), radical surgery (OR 3.1, 95% CI 1.1-8.6), insertion of a second drain during the late postoperative period (OR 3.7, 95% CI 1.8-7.8), and drainage duration > or = 19 days (OR 2.9, 95% CI 1.5-5.6). The bacteria most frequently isolated were Pseudomonas aeruginosa ( n = 18 ), Serratia sp. ( n = 18), Staphylococcus aureus ( n = 10), and Staphylococcus epidermidis ( n = 10). Poor compliance with infection control practices and wound management was detected throughout the study period. The overall frequency of SSIs for mastectomies was higher than the reported rates, which was principally related to the more radical surgery required for advanced-stage disease, preoperative irradiation, and inadequate wound and drain care.

  16. Airborne infection control in India: Baseline assessment of health facilities

    PubMed Central

    Parmar, Malik M.; Sachdeva, K.S.; Rade, Kiran; Ghedia, Mayank; Bansal, Avi; Nagaraja, Sharath Burugina; Willis, Matthew D.; Misquitta, Dyson P.; Nair, Sreenivas A.; Moonan, Patrick K.; Dewan, Puneet K.

    2016-01-01

    Background Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year. Method A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines. Result Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice. Conclusion A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice. PMID:26970461

  17. Improved tuberculosis infection control practices in Maryland acute care hospitals.

    PubMed

    Fuss, E P; Israel, E; Baruch, N; Roghmann, M C

    2000-04-01

    In 1992 and 1993, the Maryland Hospital Association and the Maryland Department of Health and Mental Hygiene conducted 2 surveys of tuberculosis prevention practices in Maryland hospitals that showed poor compliance with the 1990 Centers for Disease Control and Prevention's guidelines for preventing transmission of tuberculosis in health care facilities. The objective of this study was to assess compliance in 1997 with the Centers for Disease Control and Prevention's guidelines in Maryland acute care hospitals. A written questionnaire with 3 components-Infection Control, Employee Health, and Microbiology Laboratory-was mailed to 56 Maryland acute care hospitals. Seventy-three percent of the surveys were returned. One hundred percent of responding hospitals with tuberculosis isolation rooms reported negative pressure ventilation, 6 air exchanges per hour, and air exhausted to the outside or through high-efficiency particulate air filters. One hundred percent of the responding hospitals reported providing National Institute for Occupational Safety and Health-approved respiratory protection for health care workers; this compared with 24% in 1992 (P <.01). One hundred percent of the responding hospitals reported performing at least annual tuberculin skin testing; this compared with 50% in 1992 (P <. 01). The survey results demonstrate excellent compliance with the 1994 Centers for Disease Control and Prevention recommendations for tuberculosis control in Maryland acute care hospitals, even in those facilities determined to be at minimal to low risk for tuberculosis exposure. The proposed Occupational Safety and Health Administration regulations are unlikely to further reduce the risk of tuberculosis exposure to health care workers in Maryland acute care hospitals.

  18. The implications of viral reservoirs on the elite control of HIV-1 infection.

    PubMed

    Buckheit, Robert W; Salgado, Maria; Martins, Karen O; Blankson, Joel N

    2013-03-01

    The mechanisms by which a small percentage of HIV-1 infected individuals known as elite suppressors or controllers are able to control viral replication are not fully understood. Early cases of viremic control were attributed to infection with defective virus, but subsequent work has demonstrated that infection with a defective virus is not the exclusive cause of control. Replication-competent virus has been isolated from patients who control viral replication, and studies have demonstrated that evolution occurs in plasma virus but not in virus isolates from the latent reservoir. Additionally, transmission pair studies have demonstrated that patients infected with similar viruses can have dramatically different outcomes of infection. An increased understanding of the viral factors associated with control is important to understand the interplay between viral replication and host control, and has implications for the design of an effective therapeutic vaccine that can lead to a functional cure of HIV-1 infection.

  19. Consequent effects of the great cormorant (Phalacrocorax carbo sinensis) predation on parasite infection and body condition of common carp (Cyprinus carpio).

    PubMed

    Ondračková, Markéta; Valová, Zdenka; Kortan, Jiří; Vojtek, Libor; Adámek, Zdeněk

    2012-04-01

    Lesions ranging from surface wounds to deep tissue wounds caused by cormorant predation were observed on several species of the farmed fish in Pohořelice, Czech Republic. Two-year-old stocked common carp Cyprinus carpio harvested in late March were examined for ectoparasites and endoparasites, injuries extent, and lysozyme concentration in skin mucus. Additionally, three body condition indices were measured. Endoparasite infection occurred only scarcely. Wounded fish were more susceptible to the ectoparasites Gyrodactylus spp. and Dactylogyrus spp. (Monogenea), and Ichthyophthirius multifiliis (Ciliophora). The intensity of infection of other ectoparasites Eudiplozoon nipponicum (Monogenea), Argulus spp. (Branchiura) and trichodinids (Ciliophora) did not significantly differ between wounded and control groups of fish. Lysozyme concentration in fish mucus was significantly higher in wounded fish and was positively associated with both the extent of damaged epithelium and Gyrodactylus spp. abundance. There were no differences in Fulton's condition factor and lipid content in muscle and liver tissues between wounded and non-wounded fish. Higher values of spleen-somatic index in wounded fish corresponded to increased intensity of parasite infection, most likely reflecting changes in immune system of infected fish. Although our results did not show any significant effect of cormorant attacks on fish condition, the wounded fish had significantly higher parasite numbers which could impact the growth or survival of the fish throughout the production season.

  20. Risky business. Organizations tackle infection control during construction.

    PubMed

    Burmhal, Beth

    2003-06-01

    Construction projects, no matter how minor, can be dangerous for patients who are especially sensitive to infection. Guidelines from three prominent organizations are finally helping hospitals understand how to prevent infections during those projects.

  1. Developing a model to assess optimum infection control workforce in acute care settings.

    PubMed

    Powell, Tom; Wigglesworth, Neil; Drey, Nick; Gould, Dinah

    2014-11-01

    Little research has been completed to assess the numbers of infection prevention and control personnel employed or optimal size and composition of infection control teams. Acute national health hospital organizations in England were requested to provide information about the numbers of infection prevention and control personnel employed and weekly hours contributed by each occupational group under the United Kingdom's Freedom of Information legislation. The relationship between capacity of the infection prevention and control workforce, size of the inpatient population, and routinely collected surveillance data for health care-associated infection were explored. There were 137 (85%) National Health Service (NHS) hospital organizations that responded. The number of infection prevention and control nurses ranged from 1-16 per organization. A total of 46 (33.6%) reported that they received no clinical microbiology sessions, and for 11 (8%) input was inadequate. An antibiotic pharmacist was reported to be employed in 107 (78.1%) organizations. Few infection prevention and control teams reported receiving the following: 1. managerial support, 2. being represented on committees where decisions about resource allocation were made, or 3. assistance with administration. Despite the priority that infection prevention and control have received in the United Kingdom over the last 10 years, many infection prevention and control teams appear underresourced. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Infections

    MedlinePlus

    ... Eye Infections Pinkeye (Conjunctivitis) Styes Fungal Infections (Ringworm, Yeast, etc.) Diaper Rash Infections That Pets Carry Oral ... Pneumonia Tinea (Ringworm, Jock Itch, Athlete's Foot) Vaginal Yeast Infections Immunizations Do My Kids Need Vaccines Before ...

  3. Relationship of Antimicrobial Control Policies and Hospital and Infection Control Characteristics to Antimicrobial Resistance Rates

    PubMed Central

    Larson, Elaine L.; Quiros, Dave; Giblin, Tara; Lin, Susan

    2007-01-01

    Background Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals. Objectives To assess the extent to which resistance is monitored in infection control programs and to correlate resistance rates with characteristics of antimicrobial control policies, provider attitudes and practices, and systems-level indicators of implementation of the hand hygiene guideline of the Centers for Disease Control and Prevention. Methods An on-site survey of intensive care unit staff and infection control directors of 33 hospitals in the United States was conducted. The following data were collected: antimicrobial control policies; rates during the previous 12 months of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and ceftazidime-resistant Klebsiella pneumoniae; an implementation score of systems-level efforts to implement the guideline; staff attitudes toward practice guidelines; and observations of staff hand hygiene. Variables associated with resistance rates were examined for independent effects by using logistic regression. Results Resistance rates for S aureus, enterococci, and K pneumoniae were 52.5%, 18.2%, and 16.0%, respectively. Ten (30.3%) hospitals had an antibiotic control policy. No statistically significant correlation was observed between staff attitudes toward practice guidelines, observed hand hygiene behavior, or having an antibiotic use policy and resistance rates. In logistic regression analysis, higher scores on measures of systems-level efforts to implement the guideline were associated with lower rates of resistant S aureus and enterococci (P=.046). Conclusions Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance. PMID:17322010

  4. Performance consequences of alternating directional control-response compatibility: Evidence from a coal mine shuttle car simulator

    SciTech Connect

    Zupanc, C.M.; Burgess-Limerick, R.J.; Wallis, G.

    2007-08-15

    This experiment examines the performance of 48 novice participants in a virtual analogy of an underground coal mine shuttle car. Participants were randomly assigned to a compatible condition, an incompatible condition, an alternating condition in which compatibility alternated within and between hands, or an alternating condition in which compatibility alternated between hands. Participants made fewer steering direction errors and made correct steering responses more quickly in the compatible condition. Error rate decreased over time in the incompatible condition. A compatibility effect for both errors and reaction time was also found when the control-response relationship alternated; however, performance improvements over time were not consistent. Isolating compatibility to a hand resulted in reduced error rate and faster reaction time than when compatibility alternated within and between hands. Thus consequences of alternating control-response relationships are higher error rates and slower responses, at least in the early stages of learning. This research highlights the importance of ensuring consistently compatible human-machine directional control-response relationships.

  5. REVIEW OF CONTROL OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN NIGERIA.

    PubMed

    Dami, N; Shehu, N Y; Dami, S; Iroezindu, M O

    2015-01-01

    The global scourge of human immunodeficiency virus (HIV) infection is inundating, especially in sub-Saharan Africa and in particular Nigeria which is home to 10% of the world's HIV-infected persons. The target of the millennium development goal 6 is to halt and reverse the spread of HIV/AIDS by 2015. HIV control in Nigeria was initially shrouded in denial and apathy. Subsequently, a more pragmatic approach was launched during the tenure of President Olusegun Obasanjo. Several policies were formulated. The national prevalence of HIV witnessed some progressive decline and is currently 4.1%. There is now improvement in both HIV awareness and counselling and testing. Greater access to antiretroviral therapy and other support services have also been witnessed with over 300,000 persons currently on drugs. Notable achievements have been recorded in prevention of mother to child transmission (PMTC). However, with increased access to antiretroviral therapy, antiretroviral drug resistance has become inevitable. Acquired drug resistance is high-82% and transmitted drug resistance ranges between 0.7 and 4.5%. The achievements were largely facilitated by international partnerships which have become more streamlined in recent years. A sustained shift to indigenously sourced financial and manpower resource has become imperative. It is also important to integrate HIV facilities with other existing health care facilities for sustainability and cost-effectiveness. In an attempt to strengthen the national response, President Goodluck Ebele Jonathan launched the President's Comprehensive Response Plan for HIV/AIDS in Nigeria. It is hoped that this well-articulated policy would be well implemented to significantly reverse the epidemic.

  6. Control of HPV infection and related cancer through vaccination.

    PubMed

    Tran, Nam Phuong; Hung, Chien-Fu; Roden, Richard; Wu, T-C

    2014-01-01

    Human papillomavirus (HPV), the most common sexually transmitted virus, and its associated diseases continue to cause significant morbidity and mortality in over 600 million infected individuals. Major progress has been made with preventative vaccines, and clinical data have emerged regarding the efficacy and cross-reactivity of the two FDA approved L1 virus like particle (VLP)-based vaccines. However, the cost of the approved vaccines currently limits their widespread use in developing countries which carry the greatest burden of HPV-associated diseases. Furthermore, the licensed preventive HPV vaccines only contain two high-risk types of HPV (HPV-16 and HPV-18) which can protect only up to 75 % of all cervical cancers. Thus, second generation preventative vaccine candidates hope to address the issues of cost and broaden protection through the use of more multivalent L1-VLPs, vaccine formulations, or alternative antigens such as L1 capsomers, L2 capsid proteins, and chimeric VLPs. Preventative vaccines are crucial to controlling the transmission of HPV, but there are already hundreds of millions of infected individuals who have HPV-associated lesions that are silently progressing toward malignancy. This raises the need for therapeutic HPV vaccines that can trigger T cell killing of established HPV lesions, including HPV-transformed tumor cells. In order to stimulate such antitumor immune responses, therapeutic vaccine candidates deliver HPV antigens in vivo by employing various bacterial, viral, protein, peptide, dendritic cell, and DNA-based vectors. This book chapter will review the commercially available preventive vaccines, present second generation candidates, and discuss the progress of developing therapeutic HPV vaccines.

  7. [Advances in research on harm and control of Enterobius vermicularis infection in children].

    PubMed

    An, Yao-Wu; Pang, Xin-Li; Liu, Jie-Bing; Huang, Shao-Yu

    2012-10-01

    In China, the infection rate of Enterobius vermicularis in children is still relatively high. Because the development and spread of worm eggs is fast, it is easy to treat but difficult to control the disease, and the control effect is also difficult to be consolidated. The long-term repeated Enterobius vermicularis infection may cause the damage on children's body and mind in different degrees. This paper offers an overview on the current status, harm and prevention and control of Enterobius vermicularis infection.

  8. A short-term, multicomponent infection control program in nursing homes: a cluster randomized controlled trial.

    PubMed

    Chami, Kathleen; Gavazzi, Gaëtan; Bar-Hen, Avner; Carrat, Fabrice; de Wazières, Benoît; Lejeune, Benoist; Armand, Nathalie; Rainfray, Muriel; Hajjar, Joseph; Piette, François; Rothan Tondeur, Monique

    2012-07-01

    To assess the impact of a hygiene-encouragement program on reducing infection rates (primary end point) by 5%. A cluster randomized study was carried out over a 5-month period. Fifty nursing homes (NHs) with 4345 beds in France were randomly assigned by stratified-block randomization to either a multicomponent intervention (25 NHs) or an assessment only (25 NHs). The multicomponent intervention was targeted to caregivers and consisted of implementing a bundle of infection prevention consensual measures. Interactive educational meetings using a slideshow were organized at the intervention NHs. The NHs were also provided with color posters emphasizing hand hygiene and a kit that included hygienic products such as alcoholic-based hand sanitizers. Knowledge surveys were performed periodically and served as reminders. The primary end point was the total infection rate (urinary, respiratory, and gastrointestinal infections) in those infection cases classified either as definite or probable. Analyses corresponded to the underlying design and were performed according to the intention-to-treat principle. This study was registered (#NCT01069497). Forty-seven NHs (4515 residents) were included and followed. The incidence rate of the first episode of infection was 2.11 per 1000 resident-days in the interventional group and 2.15 per 1000 resident-days in the control group; however, the difference between the groups did not reach statistical significance in either the unadjusted (Hazard Ratio [HR] = 1.00 [95% confidence interval (CI) 0.89-1.13]; P = .93]) or the adjusted (HR = 0.99 [95% CI 0.87-1.12]; P = .86]) analysis. Disentangling the impact of this type of intervention involving behavioral change in routine practice in caregivers from the prevailing environmental and contextual determinants is often complicated and confusing to interpret the results. Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2016-09-01

    "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.

  10. Qualitative evaluation and economic estimates of an infection control champions program.

    PubMed

    Lloyd-Smith, Elisa; Curtin, Jim; Gilbart, Wayne; Romney, Marc G

    2014-12-01

    In many North American hospitals, conventional infection control operational models often struggle to provide sufficient support to frontline health care workers. The objective of this study was to describe a sustainable infection control champion (ICC) program based on findings from focus groups. A distributed model of infection control was established by placing infection prevention and control-trained ICCs in 3 Canadian hospitals for a period of 12 months. Subsequently, semistructured focus groups were conducted to describe overall feasibility and impeding and critical factors affecting sustainability. An economic estimate of the ICC program compared with the cost of hiring a new infection control practitioner was also calculated. Focus group participants considered the program feasible. Barriers included lack of time and staff turnover. Themes critical for the successful implementation of an ICC program included defined ICC roles and goals, adequate support and resources for the ICC, engagement with all levels of staff, flexible structure, and program evaluation. The cost per bed of the ICC program was less than the cost per bed of hiring a new infection control practitioner. A distributed model of providing infection prevention and control services may have benefit when hospital infection control teams are underresourced, as is often the case. Several key factors are needed for the successful implementation of an ICC program. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

    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 a multicentre surveillance executed June and July 2012. Methods The IRIS includes two patient outcome-variables, i.e. the prevalence of healthcare associated infections (HAI) and rectal carriage of Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (ESBL-E); two patient-related risk factors, i.e. use of medical devices, and antimicrobial therapy; and three ward-related risk factors, i.e. environmental contamination, availability of local guidelines, and shortcomings in infection prevention preconditions. Results were categorised as low-, intermediate- and high risk, presented in an easy-to-read graphic risk spider-plot. This plot was given as feedback to management and healthcare workers of the NH. Results Large differences were found among most the variables in the different NH. Common shortcomings were the availability of infection control guidelines and the level of environmental cleaning. Most striking differences were observed in the prevalence of ESBL carriage, ranged from zero to 20.6% (p < 0.001). Conclusions The IRIS provided a rapid and easy to understand assessment of the infection control situation of the participating NH. The results can be used to improve the quality of infection control based on the specific needs of a NH but needs further validation in future studies. Repeated measurement can determine the effectiveness of the interventions. This makes the IRIS a useful tool for quality systems. PMID:25243067

  12. Knowledge and Practice of Nursing Staff towards Infection Control Measures in the Palestinian Hospitals

    ERIC Educational Resources Information Center

    Fashafsheh, Imad; Ayed, Ahmad; Eqtait, Faeda; Harazneh, Lubna

    2015-01-01

    Health care professionals are constantly exposed to microorganisms. Many of which can cause serious or even lethal infections. Nurses in particular are often exposed to various infections during the course of carrying out their nursing activities. Therefore nurses should have sound knowledge and strict adherence to infection control practice. Aim…

  13. Neurological Consequences of Cytomegalovirus Infection

    MedlinePlus

    ... such as the lungs (pneumonia) or intestinal gract (gastritis, enteritis, or colitis). In addition, transplant recipients may ... such as the lungs (pneumonia) or intestinal gract (gastritis, enteritis, or colitis). In addition, transplant recipients may ...

  14. Optimal control analysis of malaria-schistosomiasis co-infection dynamics.

    PubMed

    Okosun, Kazeem Oare; Smith, Robert

    2017-04-01

    This paper presents a mathematical model for malaria--schistosomiasis co-infection in order to investigate their synergistic relationship in the presence of treatment. We first analyse the single infection steady states, then investigate the existence and stability of equilibria and then calculate the basic reproduction numbers. Both the single-infection models and the co-infection model exhibit backward bifurcations. We carrying out a sensitivity analysis of the co-infection model and show that schistosomiasis infection may not be associated with an increased risk of malaria. Conversely, malaria infection may be associated with an increased risk of schistosomiasis. Furthermore, we found that effective treatment and prevention of schistosomiasis infection would also assist in the effective control and eradication of malaria. Finally, we apply Pontryagin's Maximum Principle to the model in order to determine optimal strategies for control of both diseases.

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

    PubMed

    Kohio, Hinissan P; Adamson, Amy L

    2013-09-01

    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.

  16. Significant reduction of endemic MRSA acquisition and infection in cardiothoracic patients by means of an enhanced targeted infection control programme.

    PubMed

    Schelenz, S; Tucker, D; Georgeu, C; Daly, S; Hill, M; Roxburgh, J; French, G L

    2005-06-01

    Due to increasing methicillin-resistant Staphylococcus aureus (MRSA) infection in cardiothoracic patients at St Thomas' Hospital, an enhanced infection control programme was introduced in September 2000. It was based on UK national guidelines on the control of MRSA and targeted additional identified risk factors for surgical site infection (SSI). It included recognition of the problem by senior staff and their taking responsibility for it; intensive support, education and advice from the infection control team; improved ward and theatre hygiene; pre-admission, admission and weekly MRSA screening; isolation and clearance treatment; nursing care pathways for MRSA colonized patients; and teicoplanin plus gentamicin surgical prophylaxis. The effectiveness of the programme was assessed by retrospective analysis of computerized patient data for the 16 months before and after the introduction of the programme. There was no significant change in the number of operations or the proportion of patients admitted with MRSA, although nine patients were cleared of carriage before admission. However, there were significant falls in the proportion of patients acquiring MRSA on the ward [38/1036 to 14/921, P=0.003, RR 2.4 (95%CI 1.32-4.42)] and in the rate of bloodstream MRSA infections [12/1075 to 2/956, P=0.014, RR 5.34 (95%CI 1.20-23.78)]. Sternal and leg wound infections both halved (from 28/1075 to 13/956 and 16/1075 to 7/956, respectively) but this did not reach statistical significance. These results demonstrate that an enhanced, targeted infection control programme based on the UK national guidelines, SSI prevention guidelines and local risk assessment can reduce the incidence of nosocomial MRSA acquisition and invasive infection in cardiothoracic patients in the face of continuing endemic risk.

  17. External Source of Infection and Nutritional Efficiency Control Chaos in a Predator-Prey Model with Disease in the Predator

    NASA Astrophysics Data System (ADS)

    Pada Das, Krishna; Roy, Prodip; Ghosh, Subhabrata; Maiti, Somnath

    This paper deals with an eco-epidemiological approach with disease circulating through the predator species. Disease circulation in the predator species can be possible by contact as well as by external sources. Here, we try to discuss the role of external source of infection along with nutritional value on system dynamics. To establish our findings, we have worked out the local and global stability analysis of the equilibrium points with Hopf bifurcation analysis associated with interior equilibrium point. The ecological consequence by ecological basic reproduction number as well as the disease basic reproduction number or basic reproductive ratio are obtained and we have analyzed the community structure of the particular system with the help of ecological and disease basic reproduction numbers. Further we pay attention to the chaotic dynamics which is produced by disease circulating in predator species by contact. Our numerical simulations reveal that eco-epidemiological system without external source of infection induced chaotic dynamics for increasing force of infection due to contact, whereas in the presence of external source of infection, it exhibits stable solution. It is also observed that nutritional value can prevent chaotic dynamics. We conclude that chaotic dynamics can be controlled by the external source of infection as well as nutritional value. We apply basic tools of nonlinear dynamics such as Poincare section and maximum Lyapunov exponent to investigate chaotic behavior of the system.

  18. Overcoming the obstacles of implementing infection prevention and control guidelines.

    PubMed

    Birgand, G; Johansson, A; Szilagyi, E; Lucet, J-C

    2015-12-01

    Reasons for a successful or unsuccessful implementation of infection prevention and control (IPC) guidelines are often multiple and interconnected. This article reviews key elements from the national to the individual level that contribute to the success of the implementation of IPC measures and gives perspectives for improvement. Governance approaches, modes of communication and formats of guidelines are discussed with a view to improve collaboration and transparency among actors. The culture of IPC influences practices and varies according to countries, specialties and healthcare providers. We describe important contextual aspects, such as relationships between actors and resources and behavioural features including professional background or experience. Behaviour change techniques providing goal-setting, feedback and action planning have proved effective in mobilizing participants and may be key to trigger social movements of implementation. The leadership of international societies in coordinating actions at international, national and institutional levels using multidisciplinary approaches and fostering collaboration among clinical microbiology, infectious diseases and IPC will be essential for success. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2015-01-01

    Background. Elite controllers spontaneously suppress human immunodeficiency virus (HIV) viremia but also demonstrate chronic inflammation that may increase risk of comorbid conditions. We compared hospitalization rates and causes among elite controllers to those of immunologically intact persons with medically controlled HIV. Methods. For adults in care at 11 sites from 2005 to 2011, person-years with CD4 T-cell counts ≥350 cells/mm2 were categorized as medical control, elite control, low viremia, or high viremia. All-cause and diagnostic category-specific hospitalization rates were compared between groups using negative binomial regression. Results. We identified 149 elite controllers (0.4%) among 34 354 persons in care. Unadjusted hospitalization rates among the medical control, elite control, low-viremia, and high-viremia groups were 10.5, 23.3, 12.6, and 16.9 per 100 person-years, respectively. After adjustment for demographic and clinical factors, elite control was associated with higher rates of all-cause (adjusted incidence rate ratio, 1.77 [95% confidence interval, 1.21–2.60]), cardiovascular (3.19 [1.50–6.79]) and psychiatric (3.98 [1.54–10.28]) hospitalization than was medical control. Non–AIDS-defining infections were the most common reason for admission overall (24.1% of hospitalizations) but were rare among elite controllers (2.7%), in whom cardiovascular hospitalizations were most common (31.1%). Conclusions. Elite controllers are hospitalized more frequently than persons with medically controlled HIV and cardiovascular hospitalizations are an important contributor. PMID:25512624

  20. Effectiveness of short-term, enhanced, infection control support in improving compliance with infection control guidelines and practice in nursing homes: a cluster randomized trial.

    PubMed

    Gopal Rao, G; Jeanes, A; Russell, H; Wilson, D; Atere-Roberts, E; O'Sullivan, D; Donaldson, N

    2009-10-01

    In this prospective cluster randomized controlled trial we evaluated the impact of short-term provision of enhanced infection control support on infection control practice in nursing homes in South London. Twelve nursing homes were recruited, six each in intervention (300 residents) and control (265 residents) groups. Baseline observations of hand hygiene facilities, environmental cleanliness and safe disposal of clinical waste showed poor compliance in both groups. Post-intervention observations showed improvement in both groups. There was no statistical difference between the two groups in the compliance for hand hygiene facilities (P=0.69); environmental cleanliness (P=0.43) and safe disposal of clinical waste (P=0.96). In both groups, greatest improvement was in compliance with safe disposal of clinical waste and the least improvement was in hand hygiene facilities. Since infection control practice improved in intervention and control groups, we could not demonstrate that provision of short-term, enhanced, infection control support in nursing homes had a significant impact in infection control practice.

  1. Infection prevention and control measures currently applied in South African audiology.

    PubMed

    Ehlert, Katerina; Naude, Alida M

    2014-11-11

    To counter the global increase in infection-related deaths, infection control has recently developed into an active area of research. Many diseases can be prevented by infection control. In the confines of the audiology clinic, cross-contamination by micro-organisms associated with opportunistic infections remains a real concern. The primary aim of the study was to ascertain the methods that audiologists in South Africa use to prevent and control the spread of infections during and after consultation with clients. A survey study was conducted, using a self-administered questionnaire. Fifty currently practising audiologists participated in the study. The majority (84%; n = 42) of respondents acknowledged the importance of hand hygiene for the purpose of infection control, with 76% (n = 38) making use of no-rinse hand sanitisers. Approximately a third of audiologists wear gloves during procedures such as otoscopy and immittance, and while handling hearing aids. Disinfecting audiological equipment seem to be the preferred choice of infection control, with only 60% (n = 30) of respondents sterilising audiological equipment after each individual patient consultation. Less than half of the respondents disinfected touch surfaces and toys in the reception area. Based on the results, further education and training should focus on measures implemented in infection control, awareness of possible risk factors at work settings, and vaccination as an effective means of infection control.

  2. The etiology, risk factors, and interactions of enteric infections and malnutrition and the consequences for child health and development study (MAL-ED): description of the Tanzanian site.

    PubMed

    Mduma, Estomih R; Gratz, Jean; Patil, Crystal; Matson, Kristine; Dakay, Mary; Liu, Sarah; Pascal, John; McQuillin, Lauren; Mighay, Emmanuel; Hinken, Elizabeth; Ernst, Alexandra; Amour, Caroline; Mvungi, Regisiana; Bayyo, Eliwaza; Zakaria, Yeconia; Kivuyo, Sokoine; Houpt, Eric R; Svensen, Erling

    2014-11-01

    The Haydom, Tanzania, site (TZH) of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) Study is in north-central Tanzania, 300 km from the nearest urban center. TZH is in a remote rural district where most of the population are agropastoralists and grow maize as the staple food. The average household size is 7. The average woman achieves a parity of 6 and has 1 child death. Socioeconomic indicators are poor, with essentially no household having access to electricity, piped water, or improved sanitary facilities (compared with 14%, 7%, and 12%, respectively, reported nationally). The Demographic Health Survey Tanzania 2004 indicated that the region had high rates of stunting and underweight (40% and 31% of children aged <5 years had a height-for-age z score and weight-for-age z score, respectively, of <-2 ) and an under-5 child mortality rate of 5.8%. Human immunodeficiency virus prevalence among 18-month-old children is <0.5%. TZH represents a remote rural African population with profound poverty and malnutrition, but a strong community-based research infrastructure.

  3. Maintenance of foals with combined immunodeficiency: causes and control of secondary infections.

    PubMed

    Perryman, L E; McGuire, T C; Crawford, T B

    1978-06-01

    Sixty-six cases of combined immunodeficiency (CID) in foals were studied to determine the most prevalent causes of infection and death. Lesions of the respiratory system were observed in 59 of the foals and were attributable to infection with equine adenovirus. Pneumocystis carinii, and bacteria. Significant lesions were also observed in liver, pancreas, intestines, heart, and kidneys. Maintenance of foals with CID for experimental purposes is directed at the prevention and control of these secondary infections. Adenovirus can be controlled by administration of horse plasma containing high titers of antiadenovirus antibody. Bacteria are controlled by appropriate antibiotic therapy. Pneumocystis carinii infection remains a significant problem in the maintenance of foals with CID.

  4. The global swine flu pandemic 2: infection control measures and preparedness strategies.

    PubMed

    Pratt, Robert J

    This second in a two-part unit on swine flu looks at infection control measures for nurses. During late spring and early summer, increasing numbers of people became infected with novel swine origin influenza type A virus (influenza A(H1N1)v 2009) and a global pandemic started. Part 1 of this unit explored the biology of influenza viruses and the origins and characteristics of flu pandemics. This part reviews viral transmission, infection prevention and control and pandemic preparedness.

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

    PubMed

    Smith, Catherine M; Downs, Sara H; Mitchell, Andy; Hayward, Andrew C; Fry, Hannah; Le Comber, Steven C

    2015-01-01

    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.

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

    PubMed Central

    Smith, Catherine M.; Downs, Sara H.; Mitchell, Andy; Hayward, Andrew C.; Fry, Hannah; Le Comber, Steven C.

    2015-01-01

    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. PMID:26565626

  7. Basic Microbiologic and Infection Control Information to Reduce the Potential Transmission of Pathogens to Patients via Computer Hardware

    PubMed Central

    Neely, Alice N.; Sittig, Dean F.

    2002-01-01

    Computer technology from the management of individual patient medical records to the tracking of epidemiologic trends has become an essential part of all aspects of modern medicine. Consequently, computers, including bedside components, point-of-care testing equipment, and handheld computer devices, are increasingly present in patients’ rooms. Recent articles have indicated that computer hardware, just as other medical equipment, may act as a reservoir for microorganisms and contribute to the transfer of pathogens to patients. This article presents basic microbiological concepts relative to infection, reviews the present literature concerning possible links between computer contamination and nosocomial colonizations and infections, discusses basic principles for the control of contamination, and provides guidelines for reducing the risk of transfer of microorganisms to susceptible patient populations. PMID:12223502

  8. Basic microbiologic and infection control information to reduce the potential transmission of pathogens to patients via computer hardware.

    PubMed

    Neely, Alice N; Sittig, Dean F

    2002-01-01

    Computer technology from the management of individual patient medical records to the tracking of epidemiologic trends has become an essential part of all aspects of modern medicine. Consequently, computers, including bedside components, point-of-care testing equipment, and handheld computer devices, are increasingly present in patients' rooms. Recent articles have indicated that computer hardware, just as other medical equipment, may act as a reservoir for microorganisms and contribute to the transfer of pathogens to patients. This article presents basic microbiological concepts relative to infection, reviews the present literature concerning possible links between computer contamination and nosocomial colonizations and infections, discusses basic principles for the control of contamination, and provides guidelines for reducing the risk of transfer of microorganisms to susceptible patient populations.

  9. Economics of infection control surveillance technology: cost-effective or just cost?

    PubMed

    Furuno, Jon P; Schweizer, Marin L; McGregor, Jessina C; Perencevich, Eli N

    2008-04-01

    Previous studies have suggested that informatics tools, such as automated alert and decision support systems, may increase the efficiency and quality of infection control surveillance. However, little is known about the cost-effectiveness of these tools. We focus on 2 types of economic analyses that have utility in assessing infection control interventions (cost-effectiveness analysis and business-case analysis) and review the available literature on the economics of computerized infection control surveillance systems. Previous studies on the effectiveness of computerized infection control surveillance have been limited to assessments of whether these tools increase the sensitivity and specificity of surveillance over traditional methods. Furthermore, we identified only 2 studies that assessed the costs associated with computerized infection control surveillance. Thus, it remains unknown whether computerized infection control surveillance systems are cost-effective and whether use of these systems improves patient outcomes. The existing data are insufficient to allow for a summary conclusion on the cost-effectiveness of infection control surveillance technology. All future studies of computerized infection control surveillance systems should aim to collect outcomes and economic data to inform decision making and assist hospitals with completing business-cases analyses.

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

    Treesearch

    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...

  11. Going beyond the Control of Quorum-Sensing to Combat Biofilm Infections

    PubMed Central

    Abraham, Wolf-Rainer

    2016-01-01

    Most bacteria attach to surfaces where they form a biofilm, cells embedded in a complex matrix of polymers. Cells in biofilms are much better protected against noxious agents than free-living cells. As a consequence it is very difficult to control pathogens with antibiotics in biofilm infections and novel targets are urgently needed. One approach aims at the communication between cells to form and to maintain a biofilm, a process called quorum-sensing. Water soluble small-sized molecules mediate this process and a number of antagonists of these compounds have been found. In this review natural compounds and synthetic drugs which do not interfere with the classical quorum-sensing compounds are discussed. For some of these compounds the targets are still not known, but others interfere with the formation of exopolysaccharides, virulence factors, or cell wall synthesis or they start an internal program of biofilm dispersal. Some of their targets are more conserved among pathogens than the receptors for quorum sensing autoinducers mediating quorum-sensing, enabling a broader application of the drug. The broad spectrum of mechanisms, the diversity of bioactive compounds, their activity against several targets, and the conservation of some targets among bacterial pathogens are promising aspects for several clinical applications of this type of biofilm-controlling compound in the future. PMID:27025518

  12. Going beyond the Control of Quorum-Sensing to Combat Biofilm Infections.

    PubMed

    Abraham, Wolf-Rainer

    2016-01-09

    Most bacteria attach to surfaces where they form a biofilm, cells embedded in a complex matrix of polymers. Cells in biofilms are much better protected against noxious agents than free-living cells. As a consequence it is very difficult to control pathogens with antibiotics in biofilm infections and novel targets are urgently needed. One approach aims at the communication between cells to form and to maintain a biofilm, a process called quorum-sensing. Water soluble small-sized molecules mediate this process and a number of antagonists of these compounds have been found. In this review natural compounds and synthetic drugs which do not interfere with the classical quorum-sensing compounds are discussed. For some of these compounds the targets are still not known, but others interfere with the formation of exopolysaccharides, virulence factors, or cell wall synthesis or they start an internal program of biofilm dispersal. Some of their targets are more conserved among pathogens than the receptors for quorum sensing autoinducers mediating quorum-sensing, enabling a broader application of the drug. The broad spectrum of mechanisms, the diversity of bioactive compounds, their activity against several targets, and the conservation of some targets among bacterial pathogens are promising aspects for several clinical applications of this type of biofilm-controlling compound in the future.

  13. Prevention of infections in nursing homes: antibiotic prophylaxis versus infection control and antimicrobial stewardship measures.

    PubMed

    Giannella, Maddalena; Tedeschi, Sara; Bartoletti, Michele; Viale, Pierluigi

    2016-01-01

    Because of the lack of structural and human resources for implementing more effective and safe preventive procedures, antimicrobial prophylaxis is often used to prevent infections in nursing homes. However, if data on the efficacy of antibiotic prophylaxis in nursing homes are null, there is a plenty of evidence that the inappropriate use of antimicrobials in this setting is associated with a high rate of colonization and infection with multi-drug-resistant organisms (MDROs), and of Clostridium difficile infection (CDI). Here, we have reviewed the infection epidemiology, the burden of MDROs and CDI, the antibiotic use and some potential infection preventive measures in nursing homes, pointing up the peculiarities of this setting and the absolute need of a more prudential use of antimicrobials.

  14. Influence of a 5-year serial infection control and antibiotic stewardship intervention on cardiac surgical site infections.

    PubMed

    Frenette, Charles; Sperlea, David; Tesolin, Joey; Patterson, Connie; Thirion, Daniel J G

    2016-09-01

    Surgical site infections (SSIs) complicate surgery, resulting in higher morbidity and mortality. Infection control bundles and antibiotic stewardship can be effective at reducing SSIs. The influence of long-term serial interventions is unclear. The goal of this retrospective quasiexperimental study was to assess the influence of a 5-year serial infection control and antibiotic stewardship intervention on SSIs. The multidisciplinary program actively implemented pre-, intra-, and postoperative strategies over a 5-year period from 2009-2014 for all patients undergoing coronary artery bypass graft (CABG), valve replacement, or both at a tertiary care public institution. Outcomes are compared with a 2-year preinterventions period (2007-2009) and 1-year postinterventions period (2014-2015). A total of 6,518 procedures were included. After interventions, the overall combined infection rate for CABG, CABG and valve, and valve procedures decreased by 66.3%, from 11.9%-4.0% (odds ratio, 0.34; 95% confidence interval, 0.23-0.49; P < .001). A significant decrease of >50% (P < .001) relative rate was observed in overall, sternum, leg, CABG, and combined CABG and valve infection rates when comparing pre- and postinterventions groups. The antibiotic stewardship intervention increased overall conformity to the internal surgical prophylaxis protocol by 46.8%, from 39.8%-86.6% (95% confidence interval, 41.0-52.4; P < .001). Long-term, serial comprehensive infection control and antibiotic stewardship interventions decrease overall SSIs in patients undergoing CABG and valve replacement procedures. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Combining Biofilm-Controlling Compounds and Antibiotics as a Promising New Way to Control Biofilm Infections

    PubMed Central

    Estrela, Andréia Bergamo; Abraham, Wolf-Rainer

    2010-01-01

    Many bacteria grow on surfaces forming biofilms. In this structure, they are well protected and often high dosages of antibiotics cannot clear infectious biofilms. The formation and stabilization of biofilms are mediated by diffusible autoinducers (e.g. N-acyl homoserine lactones, small peptides, furanosyl borate diester). Metabolites interfering with this process have been identified in plants, animals and microbes, and synthetic analogues are known. Additionally, this seems to be not the only way to control biofilms. Enzymes capable of cleaving essential components of the biofilm matrix, e.g. polysaccharides or extracellular DNA, and thus weakening the biofilm architecture have been identified. Bacteria also have mechanisms to dissolve their biofilms and return to planktonic lifestyle. Only a few compounds responsible for the signalling of these processes are known, but they may open a completely novel line of biofilm control. All these approaches lead to the destruction of the biofilm but not the killing of the pathogens. Therefore, a combination of biofilm-destroying compounds and antibiotics to handle biofilm infections is proposed. In this article, different approaches to combine biofilm-controlling compounds and antibiotics to fight biofilm infections are discussed, as well as the balance between biofilm formation and virulence. PMID:27713308

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

    SciTech Connect

    Kohio, Hinissan P.; Adamson, Amy L.

    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.

  17. Research needed to strengthen science and programs for the control of iron deficiency and its consequences in young children.

    PubMed

    Stoltzfus, Rebecca J

    2008-12-01

    The purpose of this article is to highlight critical research needs for the effective prevention and control of iron deficiency and its consequences in children living in low-income countries. Four types of research are highlighted: The first involves scaling up interventions that we know are effective, namely iron supplementation of pregnant women, delayed cord clamping at delivery, immediate and exclusive breast-feeding, and continued exclusive breast-feeding for approximately 6 mo. The second entails evaluation research of alternative interventions that are likely to work, to find the most cost-effective strategies for a given social, economic, and epidemiological context. This research is especially needed to expand the implementation of appropriate complementary feeding interventions. In this area, research needs to be designed to provide causal evidence, to measure cost-effectiveness, and to measure potential effect modifiers. The third is efficacy research to discover promising practices where we lack proven interventions. Examples include how to detect infants younger than 6 mo who are at high risk of iron deficiency, efficacious and safe interventions for those young high-risk infants, and best protocols for the treatment of severe anemia. The fourth includes basic research to elucidate physiological processes and mechanisms underlying the risks and benefits of supplemental iron for children exposed to infectious diseases, especially malaria. Strategic research in all 4 areas will ensure that interventions to control pediatric iron deficiency are integrated into national programs and global initiatives to make pregnancy safer, reduce newborn deaths, and promote child development, health, and survival.

  18. Long-term ecological consequences of herbicide treatment to control the invasive grass, Spartina anglica, in an Australian saltmarsh

    NASA Astrophysics Data System (ADS)

    Shimeta, Jeff; Saint, Lynnette; Verspaandonk, Emily R.; Nugegoda, Dayanthi; Howe, Steffan

    2016-07-01

    Invasive plants acting as habitat modifiers in coastal wetlands can have extensive ecological impacts. Control of invasive plants often relies on herbicides, although little is known about subsequent environmental impacts. Studying effects of herbicides on non-target species and long-term cascading consequences may yield insights into the ecology of invasive species by revealing interactions with native species. We conducted a long-term field experiment measuring effects of treating the invasive saltmarsh grass, Spartina anglica, with the herbicide Fusilade Forte®. No changes in sedimentary macrofaunal abundances or species richness, diversity, or assemblages were detected 1-2 months after spraying, despite known toxicity of Fusilade Forte® to fauna. This lack of impact may have been due to low exposure, since the herbicide was taken up primarily by plant leaves, with the small amount that reached the sediment hydrolyzing rapidly. Six months after spraying, however, total macrofauna in treated plots was more than four times more abundant than in unsprayed control plots, due to a fifteen-fold increase in annelids. This population growth correlated with increased sedimentary organic matter in treated plots, likely due to decomposition of dead S. anglica leaves serving as food for annelids. After another year, no differences in macrofauna or organic matter remained between treatments. The indirect effect on annelid populations from herbicide treatment could benefit management efforts by providing greater food resources for wading birds, in addition to improving birds' access to sediments by reducing plant cover. This study shows that an invasive grass can have a significant impact on native fauna through food-web interactions, influenced by herbicide usage.

  19. Hemodynamic Consequences of Malignant Ascites in Epithelial Ovarian Cancer Surgery*: A Prospective Substudy of a Randomized Controlled Trial.

    PubMed

    Hunsicker, Oliver; Fotopoulou, Christina; Pietzner, Klaus; Koch, Mandy; Krannich, Alexander; Sehouli, Jalid; Spies, Claudia; Feldheiser, Aarne

    2015-12-01

    Malignant ascites (MA) is most commonly observed in patients scheduled for epithelial ovarian cancer (EOC) surgery and is supposed as a major risk factor promoting perioperative hemodynamic deterioration. We aimed to assess the hemodynamic consequences of MA on systemic circulation in patients undergoing cytoreductive EOC surgery.This study is a predefined post-hoc analysis of a randomized controlled pilot trial comparing intravenous solutions within a goal-directed algorithm to optimize hemodynamic therapy in patients undergoing cytoreductive EOC surgery. Ascites was used to stratify the EOC patients prior to randomization in the main study. We analyzed 2 groups according to the amount of ascites (NLAS: none or low ascites [<500 mL] vs HAS: high ascites group [>500 mL]). Differences in hemodynamic variables with respect to time were analyzed using nonparametric analysis for longitudinal data and multivariate generalized estimating equation adjusting the analysis for the randomized study groups of the main study.A total of 31 patients in the NLAS and 16 patients in the HAS group were analyzed. Although cardiac output was not different between groups suggesting a similar circulatory blood flow, the HAS group revealed higher heart rates and lower stroke volumes during surgery. There were no differences in pressure-based hemodynamic variables. In the HAS group, fluid demands, reflected by the time to reindication of a fluid challenge after preload optimization, increased steadily, whereas stroke volume could not be maintained at baseline resulting in hemodynamic instability after 1.5 h of surgery. In contrast, in the NLAS group fluid demands were stable and stroke volume could be maintained during surgery. Clinically relevant associations of the type of fluid replacement with hemodynamic consequences were particularly observed in the HAS group, in which transfusion of fresh frozen plasma (FFP) was associated to an improved circulatory flow and reduced

  20. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

    PubMed

    Sehulster, Lynne; Chinn, Raymond Y W

    2003-06-06

    The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air

  1. Infection control systems in transition: the challenges for post-Soviet Bloc countries.

    PubMed

    Ider, B-E; Adams, J; Morton, A; Whitby, M; Clements, A

    2012-04-01

    Just two decades ago, 30 of today's countries in Europe and Asia had socialist governments under Soviet dominance or direct administration. Intensive health system reforms have altered infection control in many of these countries. However, much of the literature from these countries is difficult to access by international scientists. To summarize existing infection control policies and practices in post-Soviet Bloc countries. In addition to PubMed and Google search engines, we explored local websites and grey literature. In total, 192 references published in several languages were reviewed. Infection control in these countries is in the midst of transition. Three groups of countries were identified. First, Eastern European and Baltic countries building surveillance systems for specific pathogens and antibiotic use; second, European post-Soviet Bloc countries focusing on the harmonization of recently established infection control infrastructure with European surveillance programmes; third, countries such as those formerly in the Union of Soviet Socialist Republics, Mongolia and post-conflict Eastern European countries that are in the first stages of reform. Poor commitment, resource scarcity and shortages of expertise were identified. Underreporting of official infection control statistics is widespread. Guidance from international organizations has been crucial in initiating and developing contemporary infection control programmes. More support from the international community will be needed for the third group of countries, where infection control has remained a neglected issue. Copyright © 2012 The Healthcare Infection Society. All rights reserved.

  2. Association for Professionals in Infection Control and Epidemiology

    MedlinePlus

    ... Announcements Publications American Journal of Infection Control—August 2017 8/14/2017 Highlights: Use of a patient empowerment tool for ... study View Issue Public Policy Updates 10/10/2017 FDA approves Zika screening test for blood donations ...

  3. Infection

    DTIC Science & Technology

    2010-09-01

    standing, diagnosis, and treatment of musculoskeletal infections. Key Words: musculoskeletal infection, biofilm , bacteria, biomaterial (J Orthop Trauma...form a biofilm , or slime layer.1 The recurrence of infections is often the result of microbial biofilm formation on the implant, enabling the persistence...Klebsiella pneumoniae). Staphylococcus species is by far the most studied pathogen in musculoskeletal infections and can produce a multilayered biofilm

  4. Improving patient safety through infection control: a new healthcare imperative.

    PubMed

    Yokoe, Deborah S; Classen, David

    2008-10-01

    Many healthcare organizations, professional associations, government and accrediting agencies, legislators, regulators, payers, and consumer advocacy groups have advanced the prevention of healthcare-associated infections as a national imperative, stimulating the creation of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in this supplement. In this introduction, we provide background and context and discuss the major issues that shaped the recommendations included in the compendium.

  5. Hand hygiene: back to the basics of infection control.

    PubMed

    Mathur, Purva

    2011-11-01

    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.

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

    PubMed Central

    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

  7. Promyelocytic Leukemia Protein (PML) Controls Listeria monocytogenes Infection

    PubMed Central

    Ribet, David; Lallemand-Breitenbach, Valérie; Ferhi, Omar; Nahori, Marie-Anne; Varet, Hugo

    2017-01-01

    ABSTRACT The promyelocytic leukemia protein (PML) is the main organizer of stress-responsive subnuclear structures called PML nuclear bodies. These structures recruit multiple interactors and modulate their abundance or their posttranslational modifications, notably by the SUMO ubiquitin-like modifiers. The involvement of PML in antiviral responses is well established. In contrast, the role of PML in bacterial infection remains poorly characterized. Here, we show that PML restricts infection by the pathogenic bacterium Listeria monocytogenes but not by Salmonella enterica serovar Typhimurium. During infection, PML undergoes oxidation-mediated multimerization, associates with the nuclear matrix, and becomes de-SUMOylated due to the pore-forming activity of the Listeria toxin listeriolysin O (LLO). These events trigger an antibacterial response that is not observed during in vitro infection by an LLO-defective Listeria mutant, but which can be phenocopied by specific induction of PML de-SUMOylation. Using transcriptomic and proteomic microarrays, we also characterized a network of immunity genes and cytokines, which are regulated by PML in response to Listeria infection but independently from the listeriolysin O toxin. Our study thus highlights two mechanistically distinct complementary roles of PML in host responses against bacterial infection. PMID:28074026

  8. Promyelocytic Leukemia Protein (PML) Controls Listeria monocytogenes Infection.

    PubMed

    Ribet, David; Lallemand-Breitenbach, Valérie; Ferhi, Omar; Nahori, Marie-Anne; Varet, Hugo; de Thé, Hugues; Cossart, Pascale

    2017-01-10

    The promyelocytic leukemia protein (PML) is the main organizer of stress-responsive subnuclear structures called PML nuclear bodies. These structures recruit multiple interactors and modulate their abundance or their posttranslational modifications, notably by the SUMO ubiquitin-like modifiers. The involvement of PML in antiviral responses is well established. In contrast, the role of PML in bacterial infection remains poorly characterized. Here, we show that PML restricts infection by the pathogenic bacterium Listeria monocytogenes but not by Salmonella enterica serovar Typhimurium. During infection, PML undergoes oxidation-mediated multimerization, associates with the nuclear matrix, and becomes de-SUMOylated due to the pore-forming activity of the Listeria toxin listeriolysin O (LLO). These events trigger an antibacterial response that is not observed during in vitro infection by an LLO-defective Listeria mutant, but which can be phenocopied by specific induction of PML de-SUMOylation. Using transcriptomic and proteomic microarrays, we also characterized a network of immunity genes and cytokines, which are regulated by PML in response to Listeria infection but independently from the listeriolysin O toxin. Our study thus highlights two mechanistically distinct complementary roles of PML in host responses against bacterial infection.

  9. Compliance with infection prevention and control in oral health-care facilities: a global perspective.

    PubMed

    Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel

    2014-12-01

    Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control.

  10. A co-infection model of malaria and cholera diseases with optimal control.

    PubMed

    Okosun, K O; Makinde, O D

    2014-12-01

    In this paper we formulate a mathematical model for malaria-cholera co-infection in order to investigate their synergistic relationship in the presence of treatments. We first analyze the single infection steady states, calculate the basic reproduction number and then investigate the existence and stability of equilibria. We then analyze the co-infection model, which is found to exhibit backward bifurcation. The impact of malaria and its treatment on the dynamics of cholera is further investigated. Secondly, we incorporate time dependent controls, using Pontryagin's Maximum Principle to derive necessary conditions for the optimal control of the disease. We found that malaria infection may be associated with an increased risk of cholera but however, cholera infection is not associated with an increased risk for malaria. Therefore, to effectively control malaria, the malaria intervention strategies by policy makers must at the same time also include cholera control.

  11. [Effect of comprehensive schistosomiasis control measures based on infection source control in mountainous areas of Yunnan Province].

    PubMed

    Chen, Shao-rong; Li, Bing-gui; Luo, Jia-jun; Li, Wen-bao; Mu, Liang-Xian; Tian, Shu-hui; Li, Ping; Liu Yu-Hua; Yang, Hui; Wang, Shang-wei; Chen, Feng; Luo, Bing-rong; Li, Ke-rong; Duan, Yu-chun

    2015-02-01

    To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. From 2006 to 2004, four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town, Heqing County, two villages each type, and the comprehensive control measures were implemented, including the examination and treatment of schistosomiasis, Oncomelania hupensis snail survey and control, health education, improving drinking water and lavatories, banning grazing, constructing sanitary pen of livestock, replacing cattle with machine, etc. The schistosome infection state and snail status in 2006 were treated as the baseline information, and the effect of the comprehensive measures were evaluated. Results The infection rate of human in plateau canyon areas decreased from 4.94% in 2006 to 0.06% in 2014, and that of livestock decreased from 1.11% to 0. In plateau basin areas, there was only 1 case of schistosomiasis found in Xiaolian Village in 2007, and no any other cases found in the other years, the infection rates of livestock dropped from 7.38% to 0. Compared with 2006, the snail areas in the two type areas decreased by 74.89% and 75.30%, respectively, meanwhile, the percentage of snail area, the occurrence rate of frames with snails, as well as the average density of living snails also decreased, and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009, and Xiao-lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. The comprehensive schistosomiasis control measures based on infection source control can effectively control the endemic situation of schistosomiasis in plateau areas of Yunnan Province. In the future, we should pay an equal attention to the infection sources control and snail control to

  12. Associated Factors and Consequences of Risk of Bias in Randomized Controlled Trials of Yoga: A Systematic Review

    PubMed Central

    Cramer, Holger; Langhorst, Jost; Dobos, Gustav; Lauche, Romy

    2015-01-01

    Background Bias in randomized controlled trials (RCTs) of complementary therapy interventions seems to be associated with specific factors and to potentially distort the studies’ conclusions. This systematic review assessed associated factors of risk of bias and consequences for the studies’ conclusions in RCTs of yoga as one of the most commonly used complementary therapies. Methods Medline/PubMed, Scopus, IndMED and the Cochrane Library were searched through February 2014 for yoga RCTs. Risk of selection bias was assessed using the Cochrane tool and regressed to a) publication year; b) country of origin; c) journal type; and d) impact factor using multiple logistic regression analysis. Likewise, the authors’ conclusions were regressed to risk of bias. Results A total of 312 RCTs were included. Impact factor ranged from 0.0 to 39.2 (median = 1.3); 60 RCT (19.2%) had a low risk of selection bias, and 252 (80.8%) had a high or unclear risk of selection bias. Only publication year and impact factor significantly predicted low risk of bias; RCTs published after 2001 (adjusted odds ratio (OR) = 12.6; 95% confidence interval (CI) = 1.7, 94.0; p<0.001) and those published in journals with impact factor (adjusted OR = 2.6; 95%CI = 1.4, 4.9; p = 0.004) were more likely to have low risk of bias. The authors’ conclusions were not associated with risk of bias. Conclusions Risk of selection bias was generally high in RCTs of yoga; although the situation has improved since the publication of the revised CONSORT statement 2001. Pre-CONSORT RCTs and those published in journals without impact factor should be handled with increased care; although risk of bias is unlikely to distort the RCTs’ conclusions. PMID:26629905

  13. Getting to zero: Reduction in the incidence of multidrug-resistant organism infections using an integrated infection control protocol in an intensive care unit.

    PubMed

    Gupta, Rohit; Hannon, Emily; Huprikar, Shirish; Bassily-Marcus, Adel; Manasia, Anthony; Oropello, John; Kohli-Seth, Roopa

    2016-12-01

    Environmental cleaning is a vital component of infection control. We describe the use of an integrated infection control protocol in an intensive care unit and its influence on multidrug-resistant organism infection rates. Sustained reductions in multidrug-resistant organism infections can be achieved if individual processes and weaknesses in intensive care unit environments are identified and addressed in a systematic and comprehensive manner.

  14. Airway epithelial control of Pseudomonas aeruginosa infection in cystic fibrosis

    PubMed Central

    Campόdonico, Victoria L; Gadjeva, Mihaela; Paradis-Bleau, Catherine; Uluer, Ahmet; Pier, Gerald B

    2013-01-01

    Defective expression or function of the cystic fibrosis transmembrane conductance regulator (CFTR) underlies the hypersusceptibility of cystic fibrosis (CF) patients to chronic airway infections, particularly with Pseudomonas aeruginosa. CFTR is involved in the specific recognition of P. aeruginosa, thereby contributing to effective innate immunity and proper hydration of the airway surface layer (ASL). In CF, the airway epithelium fails to initiate an appropriate innate immune response, allowing the microbe to bind to mucus plugs that are then not properly cleared because of the dehydrated ASL. Recent studies have identified numerous CFTR-dependent factors that are recruited to the epithelial plasma membrane in response to infection and that are needed for bacterial clearance, a process that is defective in CF patients hypersusceptible to infection with this organism. PMID:18262467

  15. Broadly neutralizing antibodies: An approach to control HIV-1 infection.

    PubMed

    Yaseen, Mahmoud Mohammad; Yaseen, Mohammad Mahmoud; Alqudah, Mohammad Ali

    2017-01-02

    Although available antiretroviral therapy (ART) has changed human immunodeficiency virus (HIV)-1 infection to a non-fatal chronic disease, the economic burden of lifelong therapy, severe adverse ART effects, daily ART adherence, and emergence of ART-resistant HIV-1 mutants require prospecting for alternative therapeutic modalities. Indeed, a growing body of evidence suggests that broadly neutralizing anti-HIV-1 antibodies (BNAbs) may offer one such feasible alternative. To evaluate their therapeutic potential in established HIV-1 infection, we sought to address recent advances in pre-clinical and clinical investigations in this area of HIV-1 research. In addition, we addressed the obstacles that may impede the success of such immunotherapeutic approach, suggested strategic solutions, and briefly compared this approach with the currently used ART to open new insights for potential future passive immunotherapy for HIV-1 infection.

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

    PubMed

    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 eviden