Science.gov

Sample records for program linezolid surveillance

  1. Linezolid Surveillance Results for the United States (LEADER Surveillance Program 2014)

    PubMed Central

    Mendes, Rodrigo E.; Hogan, Patricia A.; Streit, Jennifer M.; Ross, James E.; Jones, Ronald N.

    2016-01-01

    The linezolid experience and accurate determination of resistance (LEADER) surveillance program has monitored linezolid activity, spectrum, and resistance since 2004. In 2014, a total of 6,865 Gram-positive pathogens from 60 medical centers from 36 states were submitted. The organism groups evaluated were Staphylococcus aureus (3,106), coagulase-negative staphylococci (CoNS; 797), enterococci (855), Streptococcus pneumoniae (874), viridans group streptococci (359), and beta-hemolytic streptococci (874). Susceptibility testing was performed by reference broth microdilution at the monitoring laboratory. Linezolid-resistant isolates were confirmed by repeat testing. PCR and sequencing were performed to detect mutations in 23S rRNA, L3, L4, and L22 proteins and acquired genes (cfr and optrA). The MIC50/90 for Staphylococcus aureus was 1/1 μg/ml, with 47.2% of isolates being methicillin-resistant Staphylococcus aureus. Linezolid was active against all Streptococcus pneumoniae strains and beta-hemolytic streptococci with a MIC50/90 of 1/1 μg/ml and against viridans group streptococci with a MIC50/90 of 0.5/1 μg/ml. Among the linezolid-nonsusceptible MRSA strains, one strain harbored cfr only (MIC, 4 μg/ml), one harbored G2576T (MIC, 8 μg/ml), and one contained cfr and G2576T with L3 changes (MIC, ≥8 μg/ml). Among CoNS, 0.75% (six isolates) of all strains demonstrated linezolid MIC results of ≥4 μg/ml. Five of these were identified as Staphylococcus epidermidis, four of which contained cfr in addition to the presence of mutations in the ribosomal proteins L3 and L4, alone or in combination with 23S rRNA (G2576T) mutations. Six enterococci (0.7%) were linezolid nonsusceptible (≥4 μg/ml; five with G2576T mutations, including one with an additional cfr gene, and one strain with optrA only). Linezolid demonstrated excellent activity and a sustained susceptibility rate of 99.78% overall. PMID:26833165

  2. Linezolid

    MedlinePlus

    Avoid eating or drinking large amounts of foods and beverages containing tyraminewhile taking linezolid. Foods and beverages that have been pickled, smoked, or fermented usually contain tyramine. These foods and beverages include alcoholic ...

  3. Five-Year Summary of In Vitro Activity and Resistance Mechanisms of Linezolid against Clinically Important Gram-Positive Cocci in the United States from the LEADER Surveillance Program (2011 to 2015).

    PubMed

    Pfaller, Michael A; Mendes, Rodrigo E; Streit, Jennifer M; Hogan, Patricia A; Flamm, Robert K

    2017-07-01

    This report describes linezolid susceptibility testing results for 6,741 Gram-positive pathogens from 60 U.S. sites collected during 2015 for the LEADER Program. In addition, the report summarizes linezolid in vitro activity, resistance mechanisms, and molecular typing obtained for 2011 to 2015. During 2015, linezolid showed potent activity in testing against Staphylococcus aureus, inhibiting >99.9% of 3,031 isolates at ≤2 µg/ml. Similarly, linezolid showed coverage against 99.2% of coagulase-negative staphylococci, 99.7% of enterococci, and 100.0% of Streptococcus pneumoniae, virdans group, and beta-hemolytic streptococcus isolates tested. The overall linezolid resistance rate remained a modest <1% from 2011 to 2015. Staphylococci, especially Staphylococcus epidermidis, showed a range of linezolid resistance mechanisms. Increased annual trends for the presence of cfr among Staphylococcus aureus isolates were not observed, but 64.3% (9/14) of the isolates with decreased susceptibility (MIC, ≥4 µg/ml) to linezolid carried this transferrable gene (2011 to 2015). The cfr gene was detected in 21.9% (7/32) of linezolid-resistant staphylococci other than S. aureus from 2011 to 2015. The optrA gene was noted in half (2/4) of the population of linezolid-nonsusceptible Enterococcus faecalis isolates from 2011 to 2015, while linezolid-nonsusceptible Enterococcus faecium isolates showed alterations predominantly (16/16) in the 23S rRNA gene (G2576T). This report confirms a long record of linezolid activity against Gram-positive isolates in the United States since regulatory approval in 2000 and reports the oxazolidinones evolving resistance mechanisms. Copyright © 2017 American Society for Microbiology.

  4. An international activity and spectrum analysis of linezolid: ZAAPS Program results for 2011.

    PubMed

    Flamm, Robert K; Mendes, Rodrigo E; Ross, James E; Sader, Helio S; Jones, Ronald N

    2013-06-01

    Through a continuing resistance surveillance monitoring program, linezolid was shown to maintain its spectrum and potency against a collection of 8059 clinically relevant Gram-positive strains collected from patients at 79 medical centers in 33 countries and Hong Kong. Linezolid MIC90 values were 2 μg/mL for methicillin-resistant and -susceptible Staphylococcus aureus and enterococci, and the MIC90 value was 1 μg/mL for coagulase-negative staphylococci (CoNS), β-hemolytic streptococci, Streptococcus pneumoniae, and viridans group streptococci. Reference broth microdilution susceptibility testing for linezolid demonstrated a 99.83% susceptibility rate for all organisms. All S. aureus were inhibited by ≤2 μg/mL. Three (0.3%) of 928 strains of CoNS had a linezolid MIC of 4 μg/mL and contained the cfr resistance gene; 1 also had a mutation in L3. There were 14 linezolid-resistant strains detected from 7 countries (Brazil [5], France [1], Germany [2] Greece [2], Italy [2], Ireland [1], and Spain [1]) representing 5 species (E. faecium, S. capitis, S. epidermidis, S. hominis, S. lugdenensis). A mobile cfr gene was noted in 2 species having elevated linezolid MIC values; one was a S. haemolyticus isolate with a MIC at 4 μg/mL. Resistance rates were as follows for the 6 groups of organisms sampled in the 2011 ZAAPS Program: CoNS, 1.2%; enterococci, 0.39%; among S aureus, S. pneumoniae, viridans group streptococci, and β-hemolytic streptococci, no resistance was detected. As the activities of commonly used antimicrobials continue to be compromised by evolving resistance mechanisms in Gram-positive pathogens, linezolid-resistant strains remain uncommon and without increasing occurrence. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Trends in linezolid susceptibility patterns: report from the 2002-2003 worldwide Zyvox Annual Appraisal of Potency and Spectrum (ZAAPS) Program.

    PubMed

    Anderegg, Tamara R; Sader, Helio S; Fritsche, Thomas R; Ross, James E; Jones, Ronald N

    2005-07-01

    Linezolid is an important oxazolidinone antimicrobial for the treatment of infections caused by Gram-positive cocci, especially vancomycin-resistant enterococci and oxacillin-resistant Staphylococcus aureus (ORSA). Since its introduction, however, ribosomal mutations have been detected that produce resistance; thus, longitudinal surveillance remains necessary to monitor for emerging resistance in all geographic areas of oxazolidinone use. The 2003 Zyvox Annual Appraisal of Potency and Spectrum (ZAAPS) Program compared linezolid minimum inhibitory concentration (MIC) results with 13-15 comparator antimicrobial agents (8089 isolates) and also with results from an earlier surveillance period (2002). Sampling institutions in the United States of America (USA), Canada, Europe (seven nations), South America (three nations) and the Asia-Pacific (three nations) referred 200 Gram-positive cocci to the central laboratory for MIC processing and identification confirmation. Linezolid resistance (MIC > or = 8 mg/L) was established by alternative susceptibility testing methods as well as by ribosomal target characterisation. Concurrent drug use data were collected. Linezolid activity against the six major organism groups did not vary between years or geographic areas. In contrast, penicillin resistance increased 2% in Streptococcus pneumoniae; macrolide resistance was stable among beta-haemolytic streptococci (19-21%), but increased in S. pneumoniae (+2%); ORSA rates increased 4%; and vancomycin resistance in enterococci was present, but varied markedly by region. Non-clonal linezolid-resistant isolates were detected, each having the same G2576U 23S rRNA target mutation. Furthermore, the first linezolid-resistant, non-USA isolate (S. aureus in Greece) was observed, apparently related to linezolid use. In 2003, near complete activity for linezolid against Gram-positive isolates was again documented (99.93% susceptible) in the ZAAPS Program. Rare linezolid-resistant isolates were

  6. General Medical Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on the General Medical Surveillance Program at LeRC is presented. The purpose of the General Medical Surveillance Program at LeRC is outlined, and the specifics of the program are discussed.

  7. Mercury Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on mercury exposure is presented including forms, sources, permissible exposure limits, and physiological effects. The purpose of the Mercury Surveillance Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Mercury Exposure at LeRC are discussed.

  8. Arsenic surveillance program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background information about arsenic is presented including forms, common sources, and clinical symptoms of arsenic exposure. The purpose of the Arsenic Surveillance Program and LeRC is outlined, and the specifics of the Medical Surveillance Program for Arsenic Exposure at LeRC are discussed.

  9. Asbestos Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on asbestos is presented including the different types and the important medical distinctions between those different types. The four diseases associated with asbestos exposure are discussed: mesothelioma, lung cancer, asbestosis, and benign pleural disorders. The purpose of the LeRC Asbestos Surveillance Program is outlined, and the specifics of the Medical Surveillance Program for Asbestos Monitoring at LeRC are discussed.

  10. Lead Surveillance Program

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Background on lead exposure is presented including forms of lead, sources, hematologic effects, neurologic effects, endocrine effects, renal effects, and reproductive and developmental effects. The purpose of the Lead Surveillance Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Lead Exposure at LeRC are discussed.

  11. Boston Collaborative Drug Surveillance Program

    Cancer.gov

    The Boston Collaborative Drug Surveillance Program started in 1966 and conducted epidemiologic research to quantify the potential adverse effects of prescription drugs, utilizing in-hospital monitoring.

  12. Linezolid Injection

    MedlinePlus

    ... vein. It is usually given as an intravenous infusion over 30 minutes to two hours twice a ... more often than prescribed by your doctor.Linezolid infusions are usually given by a doctor or nurse. ...

  13. Military Occupational Health Surveillance Program

    DTIC Science & Technology

    1979-06-01

    Responses were received from 37 HSC medical treatment facilities (100%) regarding their occupational health surveillance programs. The occupational ...personnel determined to be potentially exposed to occupational or job- related hazards, medical surveillance programs are limited, if available at all. An...exposed to occupational or job-related hazards would require more adequate staffing to provide the services. Identification of personnel at risk could be

  14. ZAAPS Program results for 2015: an activity and spectrum analysis of linezolid using clinical isolates from medical centres in 32 countries.

    PubMed

    Pfaller, Michael A; Mendes, Rodrigo E; Streit, Jennifer M; Hogan, Patricia A; Flamm, Robert K

    2017-07-25

    To report the linezolid in vitro activity obtained during the 2015 ZAAPS Program. In total, 7587 organisms causing documented infections were consecutively collected in 65 centres in 32 ex-USA countries. Broth microdilution susceptibility testing was performed. Isolates displaying linezolid MIC results of ≥ 4 mg/L were molecularly characterized. Linezolid inhibited >99.9% of Staphylococcus aureus at ≤ 2 mg/L, with MIC 50 results of 1 mg/L, regardless of methicillin resistance. A similar linezolid MIC 50 result (0.5 mg/L) was observed for CoNS, with the vast majority of isolates (99.7%) also inhibited at ≤ 2 mg/L. Three CoNS (linezolid MIC, 16-64 mg/L) from Italy were found to contain alterations in the 23S rRNA and/or L3/L4 ribosomal proteins. One isolate also harboured cfr . Linezolid exhibited consistent modal MIC and MIC 50 results (1 mg/L) for enterococci regardless of species or vancomycin resistance. One Enterococcus faecalis (linezolid MIC, 8 mg/L) from Galway, Ireland, carried optrA . One Enterococcus faecium (linezolid MIC, 16 mg/L) from Italy contained a G2576T mutation in the 23S rRNA. All Streptococcus pneumoniae , viridans group streptococci and β-haemolytic streptococci were inhibited by linezolid at ≤ 2, ≤ 2 and ≤ 1 mg/L, respectively, with equivalent MIC 90 results (1 mg/L for all groups). These results document the continued long-term and stable in vitro potency of linezolid and a limited number of isolates with decreased susceptibility to linezolid (MIC, ≥4 mg/L). The latter isolates showed primarily mutations in the 23S rRNA gene and/or L3/L4 proteins, with plasmid-mediated resistance ( cfr and optrA ) also present, albeit at a low prevalence.

  15. LEADER Program Results for 2009: an Activity and Spectrum Analysis of Linezolid Using 6,414 Clinical Isolates from 56 Medical Centers in the United States▿†

    PubMed Central

    Farrell, David J.; Mendes, Rodrigo E.; Ross, James E.; Sader, Helio S.; Jones, Ronald N.

    2011-01-01

    The LEADER Program monitors the in vitro activity of linezolid in sampled U.S. medical centers using reference broth microdilution methods with supporting molecular investigations in a central laboratory design. This report summarizes data obtained in 2009, the 6th consecutive year of this longitudinal study. A total of 6,414 isolates from 56 medical centers in all nine Census regions across the United States participated in 2009. For the six leading species/groups, the following linezolid MIC90 values were observed: Staphylococcus aureus, 2 μg/ml; coagulase-negative staphylococci (CoNS), 1 μg/ml; Enterococcus spp., 2 μg/ml; Streptococcus pneumoniae, 1 μg/ml; viridans group streptococci, 1 μg/ml; and beta-hemolytic streptococci, 1 μg/ml. Linezolid resistance was only 0.34% overall, with no evidence of significant increase in the LEADER Program since 2006. The predominant linezolid resistant mechanism found was a G2576T mutation in the 23S rRNA. L3/L4 riboprotein mutations were also found. The mobile multidrug-resistant cfr gene was found in four strains (two S. aureus strains and one strain each of S. epidermidis and S. capitis) from four different states, suggesting persistence but a lack of dissemination. Linezolid continues to exhibit excellent activity and spectrum, and this study documents the need for continued monitoring of emerging mechanisms of resistance over a wide geographic area. PMID:21670176

  16. Reconstitution technique for surveillance programs

    SciTech Connect

    Brumovsky, M.; Novosad, P.

    1996-09-01

    Surveillance programs of reactor pressure vessel materials play very important role in reactor pressure vessel lifetime assessment. Unfortunately, most of them were designed and manufactured many years ago when knowledge about radiation damage as well of fracture mechanics was substantially nonadequate to present requirements. Reconstitution techniques are very effective methods for obtaining necessary data from irradiated and previously tested surveillance specimens. Electron beam welding technique was chosen for reconstitution of irradiated surveillance specimens from WWER-440 reactor pressure vessels. This method was chosen as an effective one as practically no machining is necessary after welding as specimen dimensions and forms are fully maintained. Paper describes the reconstitution method and results obtained from its validation--time dependent temperature in the vicinity of the specimen notch to prove that this method does not affect irradiation damage in reconstituted specimens. Paper also gives results from first tests of re-assessed surveillance program of WWER-440 RPV: comparison of transition temperature shifts from original Charpy V-notch specimens with transition temperature shifts from reconstituted precracked Charpy specimens.

  17. Enhanced surveillance program FY1998 accomplishments

    SciTech Connect

    Kass, J

    1998-10-01

    This report highlights the accomplishments of the Enhanced Surveillance Program (ESP), the highest-priority research and development effort in stockpile management today. This is volume one of eleven, the unclassified summary of selected program highlights. These highlights fall into the following focus areas: pits, high explosives, organics, dynamics, diagnostics, systems, secondaries, materials-aging models, non-nuclear components, and routine surveillance testing system upgrades. Principal investigators from around the DOE complex contributed to this report.

  18. Modernization of existing VVER-1000 surveillance programs

    SciTech Connect

    Kochkin, V.; Erak, D.; Makhotin, D.

    2011-07-01

    According to generally accepted world practice, evaluation of the reactor pressure vessel (RPV) material behavior during operation is carried out using tests of surveillance specimens. The main objective of the surveillance program consists in insurance of safe RPV operation during the design lifetime and lifetime-extension period. At present, the approaches of pressure vessels residual life validation based on the test results of their surveillance specimens have been developed and introduced in Russia and are under consideration in other countries where vodo-vodyanoi energetichesky reactors- (VVER-) 1000 are in operation. In this case, it is necessary to ensure leading irradiation of surveillance specimens (as compared to the pressure vessel wall) and to provide uniformly irradiated specimen groups for mechanical testing. Standard surveillance program of VVER-1000 has several significant shortcomings and does not meet these requirements. Taking into account program of lifetime extension of VVER-1000 operating in Russia, it is necessary to carry out upgrading of the VVER-1000 surveillance program. This paper studies the conditions of a surveillance specimen's irradiation and upgrading of existing sets to provide monitoring and prognosis of RPV material properties for extension of the reactor's lifetime up to 60 years or more. (authors)

  19. Update on Linezolid In Vitro Activity through the Zyvox Annual Appraisal of Potency and Spectrum Program, 2013

    PubMed Central

    Hogan, Patricia A.; Streit, Jennifer M.; Jones, Ronald N.; Flamm, Robert K.

    2015-01-01

    Linezolid showed MIC50s and MIC90s of 1 μg/ml (for both) against Staphylococcus aureus. Two S. aureus strains exhibited higher MICs (4 to 8 μg/ml) caused by cfr and/or target site mutations, including the first detection of cfr in Poland. Linezolid (MIC50 and MIC90, 0.5 and 1 μg/ml) had potent MICs against coagulase-negative staphylococci (CoNS). Four CoNS had MICs of 16 to 128 μg/ml due to alterations in 23S rRNA and/or L3/L4. Linezolid inhibited all enterococci and streptococci at ≤2 μg/ml, except for one Enterococcus faecium strain (MIC, 8 μg/ml; G2576T [Escherichia coli numbering] mutation). PMID:25645839

  20. Veterinary surveillance laboratories: developing the training program.

    PubMed

    Mitchell, Staci L; McCline, Katasha T; Hanfelt, Margery M

    2010-01-01

    The increased need and demand for onsite, frequent, rapid, and portable food and bottled water testing for indicators of microbiological and chemical agents led to the deployment of 2 laboratory veterinary equipment sets. A Surveillance Food Laboratory Program (SFLP) was developed to allow Veterinary Corps commanders to establish targeted testing programs to enhance food safety and wholesomeness, along with faster responses to food defense, suspected foodborne illness, and food/water risk assessment missions. To support the deployment of the veterinary equipment sets and the SFLP, 2 new functional courses were developed by the Department of Veterinary Science. The Surveillance Food Laboratory Technician Course teaches essential technical skills that include sample processing, assay methodologies, results review, and interpretation of results produced by these laboratories. The Surveillance Food Laboratory Manager Course, developed for designated managers of the laboratories and laboratory programs, teaches the skills critical to ensuring proper surveillance laboratory oversight, testing, evaluation of results, risk communication, and response to presumptive positive results produced by the laboratories. Together, the courses allowed for the successful deployment of the unique veterinary equipment sets, resulting in development of fully operational surveillance laboratories in support of food protection missions in every major theater of operations.

  1. Linezolid Resistance in Staphylococci.

    PubMed

    Stefani, Stefania; Bongiorno, Dafne; Mongelli, Gino; Campanile, Floriana

    2010-06-24

    Linezolid, the first oxazolidinone to be used clinically, is effective in the treatment of infections caused by various Gram-positive pathogens, including multidrug resistant enterococci and methicillin-resistant Staphylococus aureus. It has been used successfully for the treatment of patients with endocarditis and bacteraemia, osteomyelitis, joint infections and tuberculosis and it is often used for treatment of complicated infections when other therapies have failed. Linezolid resistance in Gram-positive cocci has been encountered clinically as well as in vitro, but it is still a rare phenomenon. The resistance to this antibiotic has been, until now, entirely associated with distinct nucleotide substitutions in domain V of the 23S rRNA genes. The number of mutated rRNA genes depends on the dose and duration of linezolid exposure and has been shown to influence the level of linezolid resistance. Mutations in associated ribosomal proteins also affect linezolid activity. A new phenicol and clindamycin resistance phenotype has recently been found to be caused by an RNA methyltransferase designated Cfr. This gene confers resistance to lincosamides, oxazolidinones, streptogramin A, phenicols and pleuromutilins, decrease the susceptibility of S. aureus to tylosin, to josamycin and spiramycin and thus differs from erm rRNA methylase genes. Research into new oxazolidinones with improved characteristics is ongoing. Data reported in patent applications demonstrated that some oxazolidinone derivatives, also with improved characteristics with respect to linezolid, are presently under study: at least three of them are in an advanced phase of development.

  2. Identification and characterization of linezolid-resistant cfr-positive Staphylococcus aureus USA300 isolates from a New York City medical center.

    PubMed

    Locke, Jeffrey B; Zuill, Douglas E; Scharn, Caitlyn R; Deane, Jennifer; Sahm, Daniel F; Goering, Richard V; Jenkins, Stephen G; Shaw, Karen J

    2014-11-01

    The cfr gene was identified in three linezolid-resistant USA300 methicillin-resistant Staphylococcus aureus (MRSA) isolates collected over a 3-day period at a New York City medical center in 2011 as part of a routine surveillance program. Each isolate possessed a plasmid containing a pSCFS3-like cfr gene environment. Transformation of the cfr-bearing plasmids into the S. aureus ATCC 29213 background recapitulated the expected Cfr antibiogram, including resistance to linezolid, tiamulin, clindamycin, and florfenicol and susceptibility to tedizolid. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  3. Identification and Characterization of Linezolid-Resistant cfr-Positive Staphylococcus aureus USA300 Isolates from a New York City Medical Center

    PubMed Central

    Zuill, Douglas E.; Scharn, Caitlyn R.; Deane, Jennifer; Sahm, Daniel F.; Goering, Richard V.; Jenkins, Stephen G.; Shaw, Karen J.

    2014-01-01

    The cfr gene was identified in three linezolid-resistant USA300 methicillin-resistant Staphylococcus aureus (MRSA) isolates collected over a 3-day period at a New York City medical center in 2011 as part of a routine surveillance program. Each isolate possessed a plasmid containing a pSCFS3-like cfr gene environment. Transformation of the cfr-bearing plasmids into the S. aureus ATCC 29213 background recapitulated the expected Cfr antibiogram, including resistance to linezolid, tiamulin, clindamycin, and florfenicol and susceptibility to tedizolid. PMID:25136008

  4. Community-Operated Environmental Surveillance Program

    SciTech Connect

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the environmental surveillance activities with which citizens living near the Hanford Site have been participating. Local teachers have been managing and operating three special radiological air sampling stations located in Richland, Basin City, and Franklin County, Washington. Other expansion efforts of this program are also described.

  5. 17 CFR 38.605 - Requirements for financial surveillance program.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Requirements for financial surveillance program. 38.605 Section 38.605 Commodity and Securities Exchanges COMMODITY FUTURES TRADING... financial surveillance program. A designated contract market's financial surveillance program for futures...

  6. 17 CFR 38.605 - Requirements for financial surveillance program.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Requirements for financial surveillance program. 38.605 Section 38.605 Commodity and Securities Exchanges COMMODITY FUTURES TRADING... financial surveillance program. A designated contract market's financial surveillance program for futures...

  7. Recommendations for TMI-2 instrumentation surveillance program

    SciTech Connect

    Jones, J E; Mathis, M V

    1982-04-01

    During and following the TMI-2 accident, a number of instruments failed or were suspected of providing erroneous readings. Because of this problem, industry concerns were focused upon the behavior of instrumenttation under adverse conditions. To better understand failure mechanisms, the Technical Integration Office (TIO) proposed that a surveillance program be implemented to monitor the status of selected TMI-2 instruments during the decontamination process. This monitoring could provide insight into instrumentation degradation under adverse conditions or effects of hostile environments on cable junction points (terminal blocks). This report presents a list of recommended instruments to be included in this surveillance program. In addition, a list of recommended test equipment is provided for performing measurements and a set of general measurement procedures is provided for selected instrument types.

  8. Advanced neutron source materials surveillance program

    SciTech Connect

    Heavilin, S.M.

    1995-01-01

    The Advanced Neutron Source (ANS) will be composed of several different materials, one of which is 6061-T6 aluminum. Among other components, the reflector vessel and the core pressure boundary tube (CPBT), are to be made of 6061-T6 aluminum. These components will be subjected to high thermal neutron fluences and will require a surveillance program to monitor the strength and fracture toughness of the 6061-T6 aluminum over their lifetimes. The purpose of this paper is to explain the steps that were taken in the summer of 1994 toward developing the surveillance program. The first goal was to decide upon standard specimens to use in the fracture toughness and tensile testing. Second, facilities had to be chosen for specimens representing the CPBT and the reflector vessel base, weld, and heat-affected-zone (HAZ) metals. Third, a timetable had to be defined to determine when to remove the specimens for testing.

  9. Conceptual evaluation of population health surveillance programs: method and example.

    PubMed

    El Allaki, Farouk; Bigras-Poulin, Michel; Ravel, André

    2013-03-01

    Veterinary and public health surveillance programs can be evaluated to assess and improve the planning, implementation and effectiveness of these programs. Guidelines, protocols and methods have been developed for such evaluation. In general, they focus on a limited set of attributes (e.g., sensitivity and simplicity), that are assessed quantitatively whenever possible, otherwise qualitatively. Despite efforts at standardization, replication by different evaluators is difficult, making evaluation outcomes open to interpretation. This ultimately limits the usefulness of surveillance evaluations. At the same time, the growing demand to prove freedom from disease or pathogen, and the Sanitary and Phytosanitary Agreement and the International Health Regulations require stronger surveillance programs. We developed a method for evaluating veterinary and public health surveillance programs that is detailed, structured, transparent and based on surveillance concepts that are part of all types of surveillance programs. The proposed conceptual evaluation method comprises four steps: (1) text analysis, (2) extraction of the surveillance conceptual model, (3) comparison of the extracted surveillance conceptual model to a theoretical standard, and (4) validation interview with a surveillance program designer. This conceptual evaluation method was applied in 2005 to C-EnterNet, a new Canadian zoonotic disease surveillance program that encompasses laboratory based surveillance of enteric diseases in humans and active surveillance of the pathogens in food, water, and livestock. The theoretical standard used for evaluating C-EnterNet was a relevant existing structure called the "Population Health Surveillance Theory". Five out of 152 surveillance concepts were absent in the design of C-EnterNet. However, all of the surveillance concept relationships found in C-EnterNet were valid. The proposed method can be used to improve the design and documentation of surveillance programs. It

  10. Surveillance data bases, analysis, and standardization program

    SciTech Connect

    Kam, F.B.K.

    1990-09-26

    The traveler presented a paper at the Seventh ASTM-EURATOM Symposium on Reactor Dosimetry and co-chaired an oral session on Computer Codes and Methods. Papers of considerable interest to the NRC Surveillance Dosimetry Program involved statistically based adjustment procedures and uncertainties. The information exchange meetings with Czechoslovakia and Hungary were very enlightening. Lack of large computers have hindered their surveillance program. They depended very highly on information from their measurement programs which were somewhat limited because of the lack of sophisticated electronics. The Nuclear Research Institute at Rez had to rely on expensive mockups of power reactor configurations to test their fluence exposures. Computers, computer codes, and updated nuclear data would advance their technology rapidly, and they were not hesitant to admit this fact. Both eastern-bloc countries said that IBM is providing an IBM 3090 for educational purposes but research and development studies would have very limited access. They were very apologetic that their currencies were not convertible, and any exchange means that they could provide services or pay for US scientists in their respective countries, but funding for their scientists in the United States, or expenses that involved payment in dollars, must come from us.

  11. Molecular epidemiology of vancomycin-resistant enterococcal bacteraemia: results from the Canadian Nosocomial Infection Surveillance Program, 1999-2009.

    PubMed

    McCracken, M; Wong, A; Mitchell, R; Gravel, D; Conly, J; Embil, J; Johnston, L; Matlow, A; Ormiston, D; Simor, A E; Smith, S; Du, T; Hizon, R; Mulvey, M R

    2013-07-01

    Vancomycin-resistant enterococci (VRE) can be associated with serious bacteraemia. The focus of this study was to characterize the molecular epidemiology of VRE from bacteraemia cases that were isolated from 1999 to 2009 as part of Canadian Nosocomial Infection Surveillance Program (CNISP) surveillance activities. From 1999 to 2009, enterococci were collected from across Canada in accordance with the CNISP VRE surveillance protocol. MICs were determined using broth microdilution. PCR was used to identify vanA, B, C, D, E, G and L genes. Genetic relatedness was examined using multilocus sequence typing (MLST). A total of 128 cases of bacteraemia were reported to CNISP from 1999 to 2009. In 2007, a significant increase in bacteraemia rates was observed in western and central Canada. Eighty-one of the 128 bacteraemia isolates were received for further characterization and were identified as Enterococcus faecium. The majority of isolates were from western Canada (60.5%), followed by central (37.0%) and eastern (2.5%) Canada. Susceptibilities were as follows: daptomycin, linezolid, tigecycline and chloramphenicol, 100%; quinupristin/dalfopristin, 96.3%; high-level gentamicin, 71.6%; tetracycline, 50.6%; high-level streptomycin, 44.4%; rifampicin, 21.0%; nitrofurantoin, 11.1%; clindamycin, 8.6%; ciprofloxacin, levofloxacin and moxifloxacin, 1.2%; and ampicillin, 0.0%. vanA contributed to vancomycin resistance in 90.1% of isolates and vanB in 9.9%. A total of 17 sequence types (STs) were observed. Beginning in 2006 there was a shift in ST from ST16, ST17, ST154 and ST80 to ST18, ST412, ST203 and ST584. The increase in bacteraemia observed since 2007 in western and central Canada appears to coincide with the shift of MLST STs. All VRE isolates remained susceptible to daptomycin, linezolid, chloramphenicol and tigecycline.

  12. Space Surveillance Network Sensor Development, Modification, and Sustainment Programs

    NASA Astrophysics Data System (ADS)

    Colarco, R.

    The paper and presentation will cover status of and plans for sensor development, modification, and sustainment programs supporting the Space Surveillance Network, including: Space Based Space Surveillance early orbit operations Space Surveillance Telescope development and expected performance FPS-85 radar service life extension program Haystack Ultra-Wideband Satellite Imaging Radar modification and expected performance improvement Space Fence development the future of GLOBUS II SSA Environmental Monitoring development Self-Awareness SSA development.

  13. Implementing a medical surveillance program for animal care staff.

    PubMed

    Sharpe, Debra

    2009-08-01

    In animal research facilities, personnel may develop allergies or serious health problems as a result of exposure to chemical or biological agents. Medical surveillance is essential for evaluating the health of prospective or current employees and determining their risk of exposure to occupational hazards. The author discusses the role of institutional medical surveillance programs and presents considerations for implementing such programs.

  14. Application of DNA barcoding in forest biosecurity surveillance programs

    Treesearch

    Leland M. Humble; Jeremy R. deWaard

    2011-01-01

    The ability to distinguish non-indigenous species from the background diversity of native taxa is critical to the success of surveillance programs for detecting new introductions. Surveillance programs for alien taxa rely on the precise diagnosis of species, which can be complicated by sizable trap samples, damaged specimens, immature life stages, and incomplete...

  15. 9975 SHIPPING PACKAGE LIFE EXTENSION SURVEILLANCE PROGRAM RESULTS SUMMARY

    SciTech Connect

    Daugherty, W.; Dunn, K.; Hackney, B.; Hoffman, E.; Skidmore, E.

    2011-01-06

    Results from the 9975 Surveillance Program at the Savannah River Site (SRS) are summarized for justification to extend the life of the 9975 packages currently stored in the K-Area Materials Storage (KAMS) facility from 10 years to 15 years. This justification is established with the stipulation that surveillance activities will continue throughout this extended time to ensure the continued integrity of the 9975 materials of construction and to further understand the currently identified degradation mechanisms. The current 10 year storage life was developed prior to storage. A subsequent report was later used to extend the qualification of the 9975 shipping packages for 2 years for shipping plus 10 years for storage. However the qualification for the storage period was provided by the monitoring requirements of the Storage and Surveillance Program. This report summarizes efforts to determine a new safe storage limit for the 9975 shipping package based on the surveillance data collected since 2005 when the surveillance program began. KAMS is a zero-release facility that depends upon containment by the 9975 to meet design basis storage requirements. Therefore, to confirm the continued integrity of the 9975 packages while stored in KAMS, a 9975 Storage and Surveillance Program was implemented alongside the DOE required Integrated Surveillance Program (ISP) for 3013 plutonium-bearing containers. The 9975 Storage and Surveillance Program performs field surveillance as well as accelerated aging tests to ensure any degradation due to aging, to the extent that could affect packaging performance, is detected in advance of such degradation occurring in the field. The Program has demonstrated that the 9975 package has a robust design that can perform under a variety of conditions. As such the primary emphasis of the on-going 9975 Surveillance Program is an aging study of the 9975 Viton(reg.sign) GLT containment vessel O-rings and the Celotex(reg.sign) fiberboard thermal

  16. Improving linezolid use decreases the incidence of resistance among Gram-positive microorganisms.

    PubMed

    Ramírez, Elena; Gómez-Gil, Rosa; Borobia, Alberto M; Moreno, Francisco; Zegarra, Claudia; Muñoz, Raúl; Reutero, Zaida; de Montreuil, Carolina; González, Diana; Hernández, Sonsoles; Herrero, Alicia; Gutiérrez, Avelino; Frías, Jesús

    2013-02-01

    Surveillance studies have shown the emergence of infections with linezolid-resistant bacteria. The relationship between appropriate linezolid use and the spread of linezolid resistance among Gram-positive microorganisms in a single tertiary referral centre was evaluated. In an initial observational study, a prospective prescription-indication study was conducted on intensive care areas and haematology, neurosurgery, vascular surgery and nephrology wards during 2009. An intervention through follow-up feedback on audit results from May-June 2010 was then conducted. From July-December 2010, a second drug-use study of linezolid was conducted, with the same objectives and methodology. To assess the antimicrobial pressure of linezolid, an ecological study was conducted from 2006-2010 in the same hospital wards. Indications for linezolid in the initial study were considered suitable in 38.5% of cases, whilst in the second study the rate was 51.2% (33% increase). Linezolid consumption fell by 57% in the second half of 2010. A significant correlation was found between its inadequate use (DDD/1000 patient-days) and the incidence of linezolid-resistant strains/1000 patient-days (r=0.93; P=6.9e-024); 85% of the variability in the incidence of linezolid resistance was predicted by its inadequate use. Its partial correlations were significant for Enterococcus faecium (r=0.407; P=0.049), Staphylococcus epidermidis (r=0.874; P=2.3e-008) and Staphylococcus haemolyticus (r=0.406; P=0.049) but not Staphylococcus aureus (r=0.051; P=0.704). A relationship was found between appropriate linezolid use and the incidence of linezolid-resistant strains of E. faecium, S. epidermidis and S. haemolyticus.

  17. Evaluation of the Novel Respiratory Virus Surveillance Program: Pediatric Early Warning Sentinel Surveillance (PEWSS)

    PubMed Central

    Nguyen, Linh M.; Lutman, Michelle L.; Middaugh, John P.

    2013-01-01

    Objectives Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Methods Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Results Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. Conclusion We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable. PMID:23997308

  18. Australian Rotavirus Surveillance Program annual report, 2012.

    PubMed

    Kirkwood, Carl D; Roczo-Farkas, Susie; Bishop, Ruth F; Barnes, Graeme L

    2014-03-31

    This report from the Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, describes the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis during the period 1 January to 31 December 2012. During the survey period, 1,300 faecal samples were referred to the centre for rotavirus G and P genotype analysis, and of these 748 were confirmed as rotavirus positive. A total of 491 specimens were collected from children under 5 years of age, while 257 were from older children and adults. Genotype analysis revealed that G1P[8] was the dominant type in this reporting period, identified in 35% of strains nationally. Genotype G2P[4] was the second most common strain nationally, representing 28% of samples, followed by genotype G12P[8] (23%). This represents the first report where G12P[8] strains are a major cause of disease in this community. Fluctuations in genotype distribution were also observed based on the vaccine type in use. Genotype G2P[4] was more common in states and territories using Rotarix while G1P[8] was more common in states using RotaTeq. This survey of rotavirus strains circulating in 2012 highlights the continued fluctuations in rotavirus genotypes, with an annual change in dominant genotypes as well as emergence of a previously rare genotype, suggesting a dynamic wild-type population.

  19. Developing a Statewide Childhood Body Mass Index Surveillance Program

    ERIC Educational Resources Information Center

    Paul, David R.; Scruggs, Philip W.; Goc Karp, Grace; Ransdell, Lynda B.; Robinson, Clay; Lester, Michael J.; Gao, Yong; Petranek, Laura J.; Brown, Helen; Shimon, Jane M.

    2014-01-01

    Background: Several states have implemented childhood obesity surveillance programs supported by legislation. Representatives from Idaho wished to develop a model for childhood obesity surveillance without the support of state legislation, and subsequently report predictors of overweight and obesity in the state. Methods: A coalition comprised of…

  20. Developing a Statewide Childhood Body Mass Index Surveillance Program

    ERIC Educational Resources Information Center

    Paul, David R.; Scruggs, Philip W.; Goc Karp, Grace; Ransdell, Lynda B.; Robinson, Clay; Lester, Michael J.; Gao, Yong; Petranek, Laura J.; Brown, Helen; Shimon, Jane M.

    2014-01-01

    Background: Several states have implemented childhood obesity surveillance programs supported by legislation. Representatives from Idaho wished to develop a model for childhood obesity surveillance without the support of state legislation, and subsequently report predictors of overweight and obesity in the state. Methods: A coalition comprised of…

  1. A multicenter evaluation of linezolid antimicrobial activity in North America.

    PubMed

    Ballow, Charles H; Jones, Ronald N; Biedenbach, Douglas J

    2002-05-01

    Overall, 141 centers in North America enrolled in this international surveillance study designed to evaluate the in vitro antimicrobial activity and spectrum of linezolid, a new oxazolidinone. Each participant tested the susceptibility of clinical isolates of staphylococcal species (n = 85) against 12 drugs, and enterococcal species (n = 40) against 6 drugs using reference broth microdilution trays; and of streptococcal species (n = 25) against 6 drugs using Etests (AB BIODISK, Solna, Sweden). Quality control testing was conducted using recommended strains, and verification of resistance to linezolid and select other agents was performed by a regional monitor. Of the 20,161 isolates collected from sites across the United States (US; n = 132) and Canada (n = 9), 18,307 were included in this analysis. Oxacillin resistance occurred in 38.7 and 70.6% of Staphylococcus aureus and coagulase-negative staphylococcal (CoNS) isolates, respectively. Vancomycin resistance was reported in 65.9 and 2.6% of Enterococcus faecium and E. faecalis, respectively. Penicillin resistance occurred in 37.2% of Streptococcus pneumoniae, 17.5% constituting high-level resistance (MIC, > or =2 microg/ml). The MIC(90) for linezolid was 1 microg/ml for streptococci, 2 microg/ml for enterococci and CoNS isolates, and 4 microg/ml for S. aureus. Using the US FDA-recommended susceptible breakpoints for linezolid, there were no confirmed reports of linezolid resistance (i.e., MIC > or =8 microg/ml). The occurrence of linezolid MICs was unimodal and generally varied between, 1-4 microg/ml for staphylococci (94% of recorded results), 1-2 microg/ml for enterococci (93%), and 0.5-1 microg/ml for streptococci (85%). Susceptibility to linezolid was not influenced by susceptibility to other antiicrobials such as vancomycin, beta-lactams or macrolides. Only linezolid was universally active against essentially all tested Gram-positive specimens. The unimodal susceptibility pattern is indicative of excellent

  2. Surveillance, Epidemiology, and End Results Program

    Cancer.gov

    A premier source for cancer statistics in the US. We collect incidence, prevalence and survival data and publish reports on these and cancer mortality. For those interested in cancer statistics and surveillance methods.

  3. Master schedule for CY-1981 Hanford environmental surveillance routine program

    SciTech Connect

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1980-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is provided. Questions about specific entries should be referred to the authors since modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Air quality data obtained in a separate program are also reported. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Schedules are presented for the following subjects: air, Columbia River, sanitary water, surface water, ground water, foodstuffs, wildlife, soil and vegetation, external radiation measurement, portable instrument surveys, and surveillance of waste disposal sites. (JGB)

  4. Metadata - Surveillance, Epidemiology, and End Results (SEER) Program

    EPA Pesticide Factsheets

    The Surveillance, Epidemiology, and End Results (SEER) program is an authoritative source of information on cancer incidence and mortality in the United States. SEER collects and publishes cancer data from a set of 17 population.

  5. Australian Rotavirus Surveillance Program annual report, 2014.

    PubMed

    Kirkwood, Carl D; Roczo-Farkas, Suzie

    2015-09-30

    The Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, reports the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis. During the survey period of 1 January to 31 December 2014, 1,022 faecal samples were referred for rotavirus G and P genotype analysis, and of these 733 were confirmed as rotavirus positive. A total of 480 specimens were collected from children under 5 years of age, while 253 were from older children and adults. Genotype analysis of the 733 rotavirus samples collected from both children and adults revealed that G12P[8] was the dominant genotype in this reporting period, identified in 29.6% of strains nationally. Genotype G1P[8] was the 2nd most common strain nationally, representing 22.9% of samples, followed by genotype G3P[8] (14.9%). This report highlights the continued significance of G12P[8] strains as the major cause of disease in this population. The genotype distribution was slightly altered when the analysis was restricted to samples collected from children under 5 years of age, with G1P[8] being the dominant genotype (29%) followed by G12P[8] as the 2nd most common genotype (26%). Fluctuations in genotype distribution were also observed based on the vaccine type in use. Genotype G12P[8] was more common in states and territories using RotaTeq, while G1P[8] was more common in the locations using Rotarix. This survey highlights the yearly fluctuations in rotavirus genotypes observed since vaccine introduction. The continuation of G12P[8] as the dominant genotype further illustrates the dynamic and diversity present in the wild-type rotavirus population evident in the Australian population since vaccine introduction.

  6. Australian Rotavirus Surveillance Program annual report, 2013.

    PubMed

    Kirkwood, Carl D; Roczo-Farkas, Susie

    2014-12-31

    This report from the Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, describes the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis during the period 1 January to 31 December 2013. During the survey period, 1,035 faecal samples were referred for rotavirus G and P genotype analysis. Of these 828 were confirmed as rotavirus positive. A total of 503 specimens were collected from children under 5 years of age, while 325 were from older children and adults. Genotype analysis of the 828 rotavirus samples collected from both children and adults revealed that G12P[8] was the dominant genotype in this reporting period, identified in 33% of strains nationally. Genotype G3P[8] was the second most common strain nationally, representing 31% of samples, followed by genotype G2P[4] (14%). This represents the first report where G12P[8] strains are the major cause of disease in this population. The genotype distribution was slightly altered when the analysis was restricted to samples collected from children under 5 years of age, with G3P[8] being the dominant genotype (39.2%) followed by G12P[8] as the second most common genotype (31%). Fluctuations in genotype distribution were also observed based on the vaccine type in use. Genotype G12P[8] was more common in states and territories using RotaTeq, while G3P[8] was more common in the locations using Rotarix. This survey highlights the yearly fluctuations in rotavirus genotypes observed since vaccine introduction, with changes in dominant genotypes an annual event. The emergence of G12P[8] as the dominant genotype further illustrates the ongoing changes in the wild type rotavirus population evident in the Australian population since vaccine introduction.

  7. Australian Rotavirus Surveillance Program annual report, 2015.

    PubMed

    Roczo-Farkas, Susie; Kirkwood, Carl D; Bines, Julie E

    2016-12-24

    The Australian Rotavirus Surveillance Program, together with collaborating laboratories Australia-wide, reports the rotavirus genotypes responsible for the hospitalisation of children with acute gastroenteritis during the period 1 January to 31 December 2015. During the survey period, 1,383 faecal samples were referred for rotavirus G and P genotype analysis, and of these, 1,031 were confirmed as rotavirus positive. A total of 634 specimens had been collected from children under 5 years of age, while 397 were from older children and adults. Genotype analysis of samples from both children and adults revealed that G12P[8] was the dominant genotype in this reporting period, identified in 48.2% of strains nationally. Genotype G3P[8] was the second most common strain nationally, representing 22.8% of samples, followed by G2P[4] and G1P[8] (9% and 8% respectively). G3P[8] was further divided as equine-like G3P[8] (13.2% of all strains) and other wild-type G3P[8] (9.6%). This report highlights the continued predominance of G12P[8] strains as the major cause of disease in this population. Genotype distribution was distinct between jurisdictions using RotaTeq and Rotarix vaccines. Genotype G12P[8] was more common in states using RotaTeq, while equine-like G3P[8] and G2P[4] were more common in the states and territories using Rotarix. This survey highlights the dynamic change in rotavirus genotypes observed since vaccine introduction, including the emergence of a novel equine-like G3P[8] as a major strain. The prolonged dominance of G12P[8] for a 4th consecutive year further illustrates the unexpected trends in the wild type rotaviruses circulating in the Australian population since vaccine introduction.

  8. 9975 SHIPPING PACKAGE LIFE EXTENSION SURVEILLANCE PROGRAM RESULTS SUMMARY

    SciTech Connect

    Dunn, K.; Daugherty, W.; Hackney, B.; Hoffman, E.; Skidmore, E.

    2011-05-27

    Results from the 9975 shipping package Storage and Surveillance Program at the Savannah River Site (SRS) are summarized for justification to extend the life of the 9975 packages currently stored in the K-Area Complex (KAC). This justification is established with the stipulation that surveillance activities will continue throughout the extended time to ensure the continued integrity of the 9975 materials of construction and to further understand the currently identified degradation mechanisms. The 10 year storage life justification was developed prior to storage. A subsequent report was later used to validate the qualification of the 9975 shipping packages for 10 years in storage. However the qualification for the storage period was provided by the monitoring requirements of the 9975 Storage and Surveillance Program. This report summarizes efforts to determine a new safe storage limit for the 9975 shipping package based on the surveillance data collected since 2005 when the 9975 Storage and Surveillance Program began. The Program has demonstrated that the 9975 package has a robust design that can perform under a variety of conditions. The primary emphasis of the on-going 9975 Storage and Surveillance Program is an aging study of the 9975 Viton{reg_sign} containment vessel O-rings and the Celotex{reg_sign} fiberboard thermal insulation at bounding conditions of radiation, elevated temperatures and/or elevated humidity.

  9. Linezolid Dependence in Staphylococcus epidermidis Bloodstream Isolates

    PubMed Central

    Ntokou, Eleni; Zarkotou, Olympia; Ranellou, Kyriaki; Themeli-Digalaki, Katerina; Stathopoulos, Constantinos; Tsakris, Athanassios

    2013-01-01

    We document linezolid dependence among 5 highly linezolid-resistant (LRSE) Staphylococcus epidermidis bloodstream isolates that grew substantially faster at 32 µg/mL linezolid presence. These isolates carried the mutations T2504A and C2534T in multiple 23S rRNA copies and 2 mutations leading to relevant amino acid substitutions in L3 protein. Linezolid dependence could account for increasing LRSE emergence. PMID:23260390

  10. Results of the surveillance of Tedizolid activity and resistance program: in vitro susceptibility of gram-positive pathogens collected in 2011 and 2012 from the United States and Europe.

    PubMed

    Sahm, Daniel F; Deane, Jennifer; Bien, Paul A; Locke, Jeffrey B; Zuill, Douglas E; Shaw, Karen J; Bartizal, Ken F

    2015-02-01

    The in vitro activity and spectrum of tedizolid and comparators were analyzed against 6884 Gram-positive clinical isolates collected from multiple US and European sites as part of the Surveillance of Tedizolid Activity and Resistance Program in 2011 and 2012. Organisms included 4499 Staphylococcus aureus, 537 coagulase-negative staphylococci (CoNS), 873 enterococci, and 975 β-hemolytic streptococci. The MIC values that inhibited 90% of the isolates within each group (MIC90) were 0.25 μg/mL for Staphylococcus epidermidis and β-hemolytic streptococci and 0.5 μg/mL for S. aureus, other CoNS, and enterococci. Of 16 isolates with elevated tedizolid or linezolid MIC values (intermediate or resistant isolates), 10 had mutations in the genes encoding 23S rRNA (primarily G2576T), 5 had mutations in the genes encoding ribosomal proteins L3 or L4, and 5 carried the cfr multidrug resistance gene. Overall, tedizolid showed excellent activity against Gram-positive bacteria and was at least 4-fold more potent than linezolid against wild-type and linezolid-resistant isolates. Given the low overall frequency of isolates that would be resistant to tedizolid at the proposed break point of 0.5 μg/mL (0.19%) and potent activity against contemporary US and European isolates, tedizolid has the potential to serve as a valuable therapeutic option in the treatment of infections caused by Gram-positive pathogens.

  11. Master schedule for CY-1982 Hanford environmental surveillance routine program

    SciTech Connect

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1981-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites. (ATT)

  12. Enhanced surveillance program FY97 accomplishments. Progress report

    SciTech Connect

    Mauzy, A.; Laake, B.

    1997-10-01

    This annual report is one volume of the Enhanced Surveillance Program (ESP) FY97 Accomplishments. The complete accomplishments report consists of 11 volumes. Volume 1 includes an ESP overview and a summary of selected unclassified FY97 program highlights. Volume 1 specifically targets a general audience, reflecting about half of the tasks conducted in FY97 and emphasizing key program accomplishments and contributions. The remaining volumes of the accomplishments report are classified, organized by program focus area, and present in technical detail the progress achieved in each of the 104 FY97 program tasks. Focus areas are as follows: pits; high explosives; organics; dynamics; diagnostics; systems; secondaries; nonnuclear materials; nonnuclear components; and Surveillance Test Program upgrades.

  13. 3013/9975 Surveillance Program Interim Summary Report

    SciTech Connect

    Dunn, K.; Hackney, B.; McClard, J.

    2011-06-22

    The K-Area Materials Storage (KAMS) Documented Safety Analysis (DSA) requires a surveillance program to monitor the safety performance of 3013 containers and 9975 shipping packages stored in KAMS. The SRS surveillance program [Reference 1] outlines activities for field surveillance and laboratory tests that demonstrate the packages meet the functional performance requirements described in the DSA. The SRS program also supports the complexwide Integrated Surveillance Program (ISP) [Reference 2] for 3013 containers. The purpose of this report is to provide a summary of the SRS portion of the surveillance program activities through fiscal year 2010 (FY10) and formally communicate the interpretation of these results by the Surveillance Program Authority (SPA). Surveillance for the initial 3013 container random sampling of the Innocuous bin and the Pressure bin has been completed and there has been no indication of corrosion or significant pressurization. The maximum pressure observed was less than 50 psig, which is well below the design pressure of 699 psig for the 3013 container [Reference 3]. The data collected during surveillance of these bins has been evaluated by the Materials Identification and Surveillance (MIS) Working Group and no additional surveillance is necessary for these bins at least through FY13. A decision will be made whether additional surveillance of these bins is needed during future years of storage and as additional containers are generated. Based on the data collected to date, the SPA concludes that 3013 containers in these bins can continue to be safely stored in KAMS. This year, 13 destructive examinations (DE) were performed on random samples from the Pressure & Corrosion bin. To date, DE has been completed for approximately 30% of the random samples from the Pressure & Corrosion bin. In addition, DE has been performed on 6 engineering judgment (EJ) containers, for a total of 17 to date. This includes one container that exceeded the 3013

  14. [Risk factors in police activities: operational criticism in surveillance programs].

    PubMed

    Ciprani, Fabrizio; Moroni, Maria; Conte, Giovanni

    2014-01-01

    The planning of specific health surveillance programs for police officers is extremely complex due to difficulty in predictability and variety of occupational hazards. Even in the case of conventional occupational risk factors clearly identified by current regulations, particular working conditions may require specific assessment to effectively identify and quantify the risk of occupational exposure. An extensive program of health surveillance, aimed at promoting overall health and effectiveness of the operators, would be really desirable, in order to help better address a number of risks that cannot be easily predicted. The progressive increase in the average age of the working population and the increasing prevalence of chronic degenerative diseases, may also suggest the need for health surveillance procedures designed to verify continued unqualified suitability to police service, providing for the identification of diversified suitability profiles in relation to age and state of health: accordingly, in regard to our field of interest, there is a close link between medico-legal eligibility and occupational medicine.

  15. Linezolid in late-chronic prosthetic joint infection caused by gram-positive bacteria.

    PubMed

    Cobo, Javier; Lora-Tamayo, Jaime; Euba, Gorane; Jover-Sáenz, Alfredo; Palomino, Julián; del Toro, Ma Dolores; Rodríguez-Pardo, Dolors; Riera, Melchor; Ariza, Javier

    2013-05-01

    Linezolid may be an interesting alternative for prosthetic joint infection (PJI) due to its bioavailability and its antimicrobial spectrum. However, experience in this setting is scarce. The aim of the study was to assess linezolid's clinical and microbiological efficacy, and also its tolerance. This was a prospective, multicenter, open-label, non-comparative study of 25 patients with late-chronic PJI caused by Gram-positive bacteria managed with a two-step exchange procedure plus 6 weeks of linezolid. Twenty-two (88%) patients tolerated linezolid without major adverse effects, although a global decrease in the platelet count was observed. Three patients were withdrawn because of major toxicity, which reversed after linezolid stoppage. Among patients who completed treatment, 19 (86%) demonstrated clinical and microbiological cure. Two patients presented with clinical and microbiological failure, and one showed clinical cure and microbiological failure. In conclusion, linezolid showed good results in chronic PJI managed with a two-step exchange procedure. Tolerance seems acceptable, though close surveillance is required.

  16. Activities of Omadacycline and Comparator Agents against Staphylococcus aureus Isolates from a Surveillance Program Conducted in North America and Europe

    PubMed Central

    Pfaller, Michael A.; Rhomberg, Paul R.; Huband, Michael D.

    2016-01-01

    ABSTRACT Omadacycline is a new broad-spectrum aminomethylcycline in late-stage clinical development for acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia as a once-daily formulation taken orally or intravenously. In this study, omadacycline and comparator agents were tested against 502 isolates of Staphylococcus aureus selected from a 2014 global surveillance program, and the results were compared with those for 7,740 isolates from a 2010 surveillance program. For the 2014 isolates, testing was completed on 252 isolates from Europe and 250 isolates from North America. Each set of isolates was composed of ∼100 hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) isolates (isolated >48 h after hospital admission), 100 community-acquired MRSA (CA-MRSA) isolates (isolated <48 h after hospital admission), and 50 methicillin-susceptible S. aureus (MSSA) isolates. The omadacycline MIC50 and MIC90 for all S. aureus collected during 2014 was 0.12 and 0.12 μg/ml, respectively. The MIC90 values were identical for MRSA, HA-MRSA, and CA-MRSA (0.12 μg/ml). The MIC90 values for isolates from 2010 for S. aureus, MRSA, and CA-MRSA were 0.25 μg/ml (0.5 μg/ml for HA-MRSA; 87.8% were at ≤0.25 μg/ml). All 2014 and 2010 MRSA isolates were susceptible to vancomycin, and ≥99.8% were susceptible to daptomycin, linezolid, and tigecycline. The activity of omadacycline was similar for North American and European isolates, including MRSA (CA-MRSA or HA-MRSA). There was no evidence for emerging resistance to omadacycline between 2010 and 2014. The potent activity of omadacycline against S. aureus indicates that omadacycline merits further study in serious infections where multidrug resistance may be a concern. PMID:27993854

  17. Pancytopenia due to linezolid treatment

    PubMed Central

    Parlak, Emine; Tan, Hüseyin

    2015-01-01

    Antibiotic-resistant infections constitute a significant portion of severe childhood infections. A gradually increasing resistance and treatment difficulty are observed in infections caused by enterococci, staphylococci and pneumococci. Linezolid is one of the new antibiotics which has recently been introduced for clinical use with gram positive efficiency. In this article, a pediatric patient with vancomycin-resistant enterococcus infection who developed reversible bone marrow supression related with use of linesolid was presented. A shunt was inserted in a ten-month old female patient who had been operated at the age of one month because of meningomyelocele and who had developed hydrocephalus. Linezolid and meropenem treatment was started when vancomycin-resistant Enterococcus faecium and extended-spectrum beta-lactamase positive Escherichia coli grew in cerebrospinal fluid culture. In the second week of treatment, cerebrospinal fluid findings improved. However, bone marrow supression was observed. Linezolid treatment was discontinued. In the follow-up, the blood cell counts returned to normal levels. PMID:26568696

  18. Extending cluster lot quality assurance sampling designs for surveillance programs.

    PubMed

    Hund, Lauren; Pagano, Marcello

    2014-07-20

    Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance on the basis of the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than simple random sampling. By applying survey sampling results to the binary classification procedure, we develop a simple and flexible nonparametric procedure to incorporate clustering effects into the LQAS sample design to appropriately inflate the sample size, accommodating finite numbers of clusters in the population when relevant. We use this framework to then discuss principled selection of survey design parameters in longitudinal surveillance programs. We apply this framework to design surveys to detect rises in malnutrition prevalence in nutrition surveillance programs in Kenya and South Sudan, accounting for clustering within villages. By combining historical information with data from previous surveys, we design surveys to detect spikes in the childhood malnutrition rate.

  19. Resistance surveillance program report for selected European nations (2011).

    PubMed

    Jones, Ronald N; Flonta, Mirela; Gurler, Nazahat; Cepparulo, Mario; Mendes, Rodrigo E; Castanheira, Mariana

    2014-04-01

    In the European component of the Regional Resistance Surveillance study for 2011, a total of 21 countries were monitored for antimicrobial resistance patterns including Belgium, Bulgaria (BU), Croatia, Czech Republic, France (F), Germany (GE), Greece (GR), Ireland (IR), Israel (IS), Italy (IT), Poland (PO), Portugal (PT), Romania (RO), Russia (RU), Slovakia (SK), Slovenia, Spain, Sweden (SW), Turkey (T), Ukraine, and United Kingdom. Results from testing 12,572 strains (100 [BU] to 1535 [F] per nation) were interpreted by contemporary published breakpoints. Samples from 47 hospitals were reference tested against agents such as amikacin (AMK), cefoperazone/sulbactam (C/S), colistin (COL), levofloxacin, linezolid (LZD), tigecycline (TIG), vancomycin (VAN), and 21 others. Among Staphylococcus aureus, LZD (MIC90, 2 μg/mL), TIG (MIC90, 0.12 μg/mL), and VAN (MIC90, 1 μg/mL) exhibited complete coverage and methicillin resistance rates among nations (average, 31%) ranged from 0.9% (SW) to 60.0-60.2% (PT, SK). Seven LZD-resistant coagulase-negative staphylococci (only 1.1% resistance overall) were noted in 5 nations, and a Staphylococcus simulans strain (MIC, 8 μg/mL from RO) had L3 mutations (N130D, G152A, F147S, A157R); also 6 LZD-resistant enterococci were detected in 3 countries (GE, IR, T). VAN-resistant enterococci (10% overall; 84% VanA) were found in 14 countries, highest in GE and IR (23.0%). The ESBL phenotype rate for Escherichia coli was 20.1% (range, 0.9% [SW] to 70.0-89.7% [BU, RU]), best inhibited by COL (100.0% S), TIG (100.0%), AMK (83.3-94.1%), C/S (81.0%), and carbapenems (>99.0%; resistant strains in IS and T). Klebsiella spp. had greater ESBL rates (45.7% overall, range 2.5-100.0%), as well as carbapenem resistance (8.3% overall, greatest in BU, GR, IS, IT, PO, RO, RU, T). Non-fermentative Gram-negative bacilli (Pseudomonas aeruginosa, Acinetobacter [ACB]) were generally less susceptible, except against COL (99.2-99.6% S) and TIG (95.0% inhibited at

  20. DoD Global Influenza Surveillance Program Season Summary: October 2004 - April 2005

    DTIC Science & Technology

    2005-09-01

    IOH-RS-BR-TR-2005-0002 UNITED STATES AIR FORCE AFIOH DoD Global Influenza Surveillance Program Season Summary: October 2004 - April 2005 Jill S. Trei...October 2004 - April 2005) 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS DoD Global Influenza Surveillance Program Season Summary: October 2004 - April 2005 6...site component of the DoD Global Influenza Surveillance Program. AFIOH conducts influenza surveillance among 32 U.S. Air Force, Army, Navy, and Coast

  1. OSHA lead in construction compliance directive: Medical surveillance program

    SciTech Connect

    Vernon, L.S.

    1994-11-01

    This article is part of a series that reviews the Occupational Health and Safety Administration (OSHA) Instruction CPL 2-2.58, a compliance directive for 29 CFR 1926.62, Lead Exposure in Construction. The OSHA document is intended to provide guidance to those charged with field enforcement of the lead regulation; however, it also provides vital information to those in industry who must comply with the regulation. This month, the requirements for employer medical surveillance programs are discussed.

  2. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    SciTech Connect

    Lesko, Samuel M.

    2007-07-31

    OBJECTIVES The Northeast Regional Cancer Institute is conducting a program of ongoing epidemiologic research to address cancer disparities in northeast Pennsylvania. Of particular concern are disparities in the incidence of, stage at diagnosis, and mortality from colorectal cancer. In northeast Pennsylvania, age-adjusted incidence and mortality rates for colorectal cancer are higher, and a significantly smaller proportion of new colorectal cancer cases are diagnosed with local stage disease than is observed in comparable national data. Further, estimates of the prevalence of colorectal cancer screening in northeast Pennsylvania are lower than the US average. The Northeast Regional Cancer Institute’s research program supports surveillance of common cancers, investigations of cancer risk factors and screening behaviors, and the development of resources to further cancer research in this community. This project has the following specific objectives: I. To conduct cancer surveillance in northeast Pennsylvania. a. To monitor incidence and mortality for all common cancers, and colorectal cancer, in particular, and b. To document changes in the stage at diagnosis of colorectal cancer in this high-risk, underserved community. II. To conduct a population-based study of cancer risk factors and screening behavior in a six county region of northeast Pennsylvania. a. To monitor and document changes in colorectal cancer screening rates, and b. To document the prevalence of cancer risk factors (especially factors that increase the risk of colorectal cancer) and to identify those risk factors that are unusually common in this community. APPROACH Cancer surveillance was conducted using data from the Northeast Regional Cancer Institute’s population-based Regional Cancer Registry, the Pennsylvania Cancer Registry, and NCI’s SEER program. For common cancers, incidence and mortality were examined by county within the region and compared to data for similar populations in the US

  3. 42 CFR 456.3 - Statewide surveillance and utilization control program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Statewide surveillance and utilization control... § 456.3 Statewide surveillance and utilization control program. The Medicaid agency must implement a statewide surveillance and utilization control program that— (a) Safeguards against unnecessary or...

  4. 42 CFR 456.3 - Statewide surveillance and utilization control program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Statewide surveillance and utilization control... § 456.3 Statewide surveillance and utilization control program. The Medicaid agency must implement a statewide surveillance and utilization control program that— (a) Safeguards against unnecessary or...

  5. 42 CFR 456.3 - Statewide surveillance and utilization control program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Statewide surveillance and utilization control... § 456.3 Statewide surveillance and utilization control program. The Medicaid agency must implement a statewide surveillance and utilization control program that— (a) Safeguards against unnecessary or...

  6. 42 CFR 456.3 - Statewide surveillance and utilization control program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Statewide surveillance and utilization control... § 456.3 Statewide surveillance and utilization control program. The Medicaid agency must implement a statewide surveillance and utilization control program that— (a) Safeguards against unnecessary or...

  7. 42 CFR 456.3 - Statewide surveillance and utilization control program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Statewide surveillance and utilization control... § 456.3 Statewide surveillance and utilization control program. The Medicaid agency must implement a statewide surveillance and utilization control program that— (a) Safeguards against unnecessary or...

  8. [General epidemiology of nosocomial infections. Surveillance systems and programs].

    PubMed

    Pujol, Miquel; Limón, Enric

    2013-02-01

    Infections related to the health-care system are those associated with health care practices in hospitalized patients as well as in out-patients with health-care contact. Nosocomial infections affect 5% of in-patients, and carry a high morbidity, mortality and economic cost. The main types of nosocomial infections are related to invasive procedures, and include respiratory tract infection, surgical site infections, urinary tract infections, and vascular catheter bacteremia. It has been shown that the application of checklists and a bundle of measures are useful in preventing these infections. Epidemiological surveillance, defined as the gathering of information to take actions, is the basis of infection control programs. These have evolved from a global surveillance targeted at processes and indicators of nosocomial infection. The comparison of these indicators can be useful in establishing preventive measures.

  9. The Westinghouse Electric Corporation Reactor Vessel Radiation Surveillance Program

    SciTech Connect

    Mayer, T.R.; Anderson, S.L.; Yanichko, S.E.

    1983-01-01

    Westinghouse recognized that the disruption of the atomic lattice of metals by collision from energetic neutrons could alter the properties of the metals to such an extent that the changes could be of engineering significance. Furthermore, it was recognized that a physical-metallurgical phenomenon such as aging, both thermal and mechanical, also could alter the properties of a metal over its service life. Because of the potential changes in properties, reactor vessel radiation surveillance programs to monitor the effect of neutron radiation and other environmental factors on the reactor vessel materials during operational conditions over the life of the plant were initiated for Westinghouse plants with the insertion of reactor vessel material radiation surveillance capsules into the Yankee Atomic Company's Yankee Rowe plant in 1961.

  10. Development of the New York State Nutrition Surveillance Program.

    PubMed Central

    Dodds, J M; Melnik, T A

    1993-01-01

    New York State established a Nutrition Surveillance Program (NSP) in 1984. Precedents for the program included the Pediatric Nutrition Surveillance System of the Public Health Service's Centers for Disease Control and Prevention and periodic food and nutrition surveys conducted by the National Center for Health Statistics and the Human Nutrition Information Service, Department of Agriculture. The first phase of NSP was connected to a new program, the Supplemental Nutrition Assistance Program (SNAP), which established support for more than 1,000 emergency food programs across the State. SNAP also expanded the home delivered meal program for the frail elderly and the Special Supplemental Food Program for Women, Infants, and Children. NSP provided information on the extent of unmet nutrition needs that was used to establish funding requests and provided data describing the characteristics of SNAP participants that were used in developing new SNAP program components. The second phase of NSP began in 1988. It identified populations that were thought to be at nutrition risk and compiled information about the extent of unmet need, the characteristics of the population, and the status of current nutrition programs to meet the needs. As a result of this review, NSP added a nutrition component to the Dental Survey of School Children; conducted a dietary survey; developed an inventory of information sources in all State agencies; and established an annual work plan using department of health objectives. The third phase of NSP is the policy and planning phase, monitoring the Year 2000 Objectives and the Five-Year Plan of the New York State Food and Nutrition Policy Council. PMID:8464981

  11. Surveillance and in-service inspection (SISI) program at FFTF

    SciTech Connect

    Conrads, T.J.

    1980-01-01

    Assurance of the integrity of the sodium coolant pressure boundaries of the Fast Flux Test Facility systems and components is essential for safe operation. A program has been developed to monitor the integrity of the coolant boundaries and certain plant conditions. Specific equipment and features have been designed into the plant for monitoring. The purpose of SISI is to prevent failures or minimize their consequences through early detection. The program which administers the requirements for monitoring applicable plant conditions whose integrity is necessary to protect public health and safety is known as the Surveillance and In-service Inspection (SISI) Program. The SISI program utilizes a wide range of monitoring techniques to ensure that material degradation or structural deficiencies will not result in the loss of the ability to shut down the reactor, cool the reactor core, or cause the release of radioactive material to the environment.

  12. Linezolid activity against clinical Gram-positive cocci with advanced antimicrobial drug resistance in Iran.

    PubMed

    Houri, Hamidreza; Kazemian, Hossein; Sedigh Ebrahim-Saraie, Hadi; Taji, Asieh; Tayebi, Zahra; Heidari, Hamid

    2017-09-01

    The aim of the study was to investigate the linezolid activity against clinical Gram-positive cocci with advanced antimicrobial drug resistance. A collection of methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant enterococci (VRE), penicillin non-susceptible Streptococcus pneumoniae (PNSP), and group B streptococci (GBS) were isolated from various clinical samples. Antimicrobial susceptibility tests were done using standard methods Subsequently, we investigated linezolid antibacterial activities, the first approved oxazolidinone against isolates by the standard broth microdilution method. According to our results, MRSA and PNSP isolates were multidrug resistant, and almost half of the VRE isolates were high level gentamicin resistant (HLGR). Furthermore, resistance to linezolid was not seen among the isolates. The MIC90 values for MRSA, VRE, PNSP and GBS isolates were 4μg/ml, 2μg/ml, 1μg/ml, and 0.5μg/ml, respectively. Only 6.25% of vancomycin resistant enterococci showed intermediate susceptibility to this antibiotic. These findings indicate that linezolid has an excellent activity against clinical drug resistant Gram-positive isolates in Iran. Constant monitoring and surveillance of linezolid MIC distribution allows the researchers to assess and detect gradual upward MIC drifts. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  13. Australian Rotavirus Surveillance Program: annual report, 2009/2010.

    PubMed

    Kirkwood, Carl D; Boniface, Karen; Bishop, Ruth F; Barnes, Graeme L

    2010-12-01

    The Australian Rotavirus Surveillance Program together with 15 collaborating laboratories Australia-wide conducts a laboratory based rotavirus surveillance program. This report describes the genotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2009 to 30 June 2010, the 3rd year of surveillance following introduction of rotavirus vaccines into the National Immunisation Program. Seven hundred and seventy-eight faecal samples were referred to the centre for G and P genotype analysis using hemi-nested multiplex reverse transcription-polymerase chain reaction. Of the 422 confirmed as rotavirus positive, genotype G1P[8] was the dominant type nationally, representing 49.3%, followed by genotype G2P[4] (21.1%). Genotypes G3P[8], G4P[8] and G9P[8] each represented less than 3% of circulating strains nationally. The dominance of G1P[8] was in part associated with a large outbreak of severe gastroenteritis in the Northern Territory in 2010. The identification of uncommon rotavirus genotype combinations has increased since vaccine introduction, with G1P[4], G2P[8] and G9P[4] identified during this survey. Single strains of G1P[6] and G4P[6] were identified during this study period. This survey continues to highlight the fluctuations in rotavirus genotypes, and results from this survey suggest there is limited genotype selection based on vaccine usage. However, the large G1P[8] outbreak of gastroenteritis in the Northern Territory may have resulted from vaccine pressure on wild-type strains.

  14. Australian Rotavirus Surveillance Program annual report, 2010/11.

    PubMed

    Kirkwood, Carl D; Roczo, Susie; Boniface, Karen; Bishop, Ruth F; Barnes, Graeme L

    2011-12-01

    The Australian Rotavirus Surveillance Program together with collaborating laboratories Australia-wide conducts a laboratory based rotavirus surveillance program. This report describes the genotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during 1 July 2010 to 30 June 2011. This report represents the fourth year of surveillance following introduction of rotavirus vaccines into the National Immunisation Program. One thousand one hundred and twenty-seven faecal samples were referred to the centre for G and P genotype analysis using hemi-nested multiplex reverse transcription-polymerase chain reaction. Eight hundred and sixteen samples were confirmed as rotavirus positive. Of these, 551 were collected from children under 5 years of age, while 265 were from older children and adults. Genotype analysis revealed that a change in the dominant type occurred in this reporting period, such that genotype G2P[4] was the dominant type nationally, representing 51% of samples, followed by genotype G1P[8] (26.1%). Genotypes G3P[8] represented 11% of samples while G4P[8] re-emerged as an important genotype, and was identified in 6% of samples. Uncommon rotavirus G and P combinations continue to be identified, with G2P[8] and G9P[4] identified during this survey. Differences in genotype distribution based on vaccine usage continue to be evident in Australian states. This survey continues to highlight the fluctuations in rotavirus genotypes, with an annual change in dominant genotypes suggesting a more dynamic wild-type population.

  15. Update on linezolid: the first oxazolidinone antibiotic.

    PubMed

    Wilcox, Mark H

    2005-10-01

    Linezolid is the first of an entirely new class of antibiotics, the oxazolidinones, in decades. It has a spectrum of activity against virtually all important Gram-positive pathogens. The unique mechanism of action of linezolid makes cross-resistance with other antimicrobial agents unlikely. Linezolid has both intravenous and oral formulations and the latter is 100% bioavailable. Since its first approval and marketing in March 2000 in the US, linezolid has gained approval for use in many other countries for the treatment of community-acquired and nosocomial pneumonia, complicated and uncomplicated skin and soft-tissue infections, and infections caused by methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, including cases with concurrent bacteraemia. Several earlier comprehensive reviews summarised the chemistry, mechanism of action, pharmacokinetics, clinical efficacy and safety profile of linezolid. The present review provides an update on the latest data regarding the antimicrobial activity of linezolid versus other commonly used agents, the clinical and health-economic outcomes of linezolid versus vancomycin and teicoplanin, and safety issues.

  16. Conversion ratios for the foodstuffs and biota environmental surveillance program

    SciTech Connect

    Fresquez, P.R.; Ferenbaugh, J.K.

    1998-09-01

    The foodstuffs and biota monitoring programs at Los Alamos National Laboratory (LANL) comprises two of the five Environmental Surveillance Programs mandated by Department of Energy Orders, and LANL has conducted these studies since the early 1970s (ESR 1997). Because foodstuffs and biota commonly contain very small amounts of radionuclides in the edible portions of the tissue, samples are commonly ashed to concentrate the radioisotope(s) in order to adequately detect the element; therefore, results are usually reported in units per gram of ash. To compensate for the differing water contents in various matrices (gram of ash are usually two to four orders of magnitude higher than live weights), units in gram of ash are converted to units of gram of dry material--the standard representation of data. Further, results in units per gram dry weight are converted to units of wet weight in order to estimate radiation doses to the public from the ingestion of these products. This paper reports the mean ash to dry and dry to wet weight moisture conversion ratios for a variety of foodstuffs and biota that have been collected as part of the Environmental Surveillance Program at LANL from 1990 to present.

  17. Australian Rotavirus Surveillance Program annual report, 2007/08.

    PubMed

    Kirkwood, Carl D; Cannan, David; Boniface, Karen; Bishop, Ruth F; Barnes, Graeme L

    2008-12-01

    The National Rotavirus Reference Centre together with collaborating laboratories Australia-wide conducts a laboratory based rotavirus surveillance program. This report describes the types of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2007 to 30 June 2008, the first complete year of surveillance following introduction of rotavirus into the National Immunisation Program. Six hundred faecal samples from across Australia were examined using a combined approach of monoclonal antibody immunoassays and reverse transcription-polymerase chain reaction. Of the 419 confirmed as rotavirus positive, serotype G1 was the dominant serotype nationally, representing 52% of specimens, followed by serotype G2 (19.8%), serotype G9 (12.2%), and serotype G3 (11%). No serotype G4 strains were identified. All G1, G3 and G9 strains assayed for P genotype contained the P[8] genotype, while all G2 strains contained the P[4] genotype, except one G2 strain which possessed a P[8]. Uncommon rotavirus genotypes, G8 (n = 2) and P[9] (n = 2) were identified during this study period. There was no evidence of unexpected changes in serotype distribution during the first 12 months of rotavirus vaccine use in the National Immunisation Program.

  18. Multinational Disease Surveillance Programs: Promoting Global Information Exchange for Infectious Diseases.

    PubMed

    Varan, Aiden K; Bruniera-Oliveira, Robson; Peter, Christopher R; Fonseca-Ford, Maureen; Waterman, Stephen H

    2015-09-01

    Cross-border surveillance for emerging diseases such as Ebola and other infectious diseases requires effective international collaboration. We surveyed representatives from 12 multinational disease surveillance programs between January 2013 and April 2014. Our survey identified programmatic similarities despite variation in health priorities, geography, and socioeconomic context, providing a contemporary perspective on infectious disease surveillance networks.

  19. Multinational Disease Surveillance Programs: Promoting Global Information Exchange for Infectious Diseases

    PubMed Central

    Varan, Aiden K.; Bruniera-Oliveira, Robson; Peter, Christopher R.; Fonseca-Ford, Maureen; Waterman, Stephen H.

    2015-01-01

    Cross-border surveillance for emerging diseases such as Ebola and other infectious diseases requires effective international collaboration. We surveyed representatives from 12 multinational disease surveillance programs between January 2013 and April 2014. Our survey identified programmatic similarities despite variation in health priorities, geography, and socioeconomic context, providing a contemporary perspective on infectious disease surveillance networks. PMID:26033019

  20. SRS environmental air surveillance program 1954-2015: General trends

    SciTech Connect

    Abbott, K.; Jannik, T.

    2016-06-02

    The radiological monitoring program at SRS was established under the DuPont Company in June 1951 and was used as a measurement of the effectiveness of plant controls and as an authoritative record of environmental conditions surrounding the plant. It also served as a method of demonstrating compliance with applicable federal regulations and guidance. This document serves as a general summary of changes made specifically to the environmental air monitoring program since its inception, and a discussion of the general trends seen in the air monitoring program at SRS from 1954 to 2015. Initially, the environmental air surveillance program focused not only on releases from SRS but also on fallout from various weapons testing performed through the end of 1978. Flypaper was used to measure the amount of fallout in the atmosphere during this period, and was present at each of the 10 monitoring stations. By 1959, all site stacks were included in the air monitoring program to determine their contribution to the airborne radioactivity onsite, and the number of air surveillance samplers rose to 18. This trend of an increased number of sampling locations continued to a peak of 35 sampling locations before shifting to a downward trend in the mid-1990s. In 1962, 4 outer-range samplers were placed in Savannah and Macon, GA, and in Greenville and Columbia, SC. Until 1976, air samplers were simply placed around the perimeter of the various operation locations (after 1959, this included stacks to determine their contribution to the airborne radioactivity), with the intent of creating as representative a distribution as possible of the air surrounding operations.

  1. Active bacterial core surveillance of the emerging infections program network.

    PubMed Central

    Schuchat, A.; Hilger, T.; Zell, E.; Farley, M. M.; Reingold, A.; Harrison, L.; Lefkowitz, L.; Danila, R.; Stefonek, K.; Barrett, N.; Morse, D.; Pinner, R.

    2001-01-01

    Active Bacterial Core surveillance (ABCs) is a collaboration between the Centers for Disease Control and Prevention and several state health departments and universities participating in the Emerging Infections Program Network. ABCs conducts population-based active surveillance, collects isolates, and performs studies of invasive disease caused by Streptococcus pneumoniae, group A and group B Streptococcus, Neisseria meningitidis, and Haemophilus influenzae for a population of 17 to 30 million. These pathogens caused an estimated 97,000 invasive cases, resulting in 10,000 deaths in the United States in 1998. Incidence rates of these pathogens are described. During 1998, 25% of invasive pneumococcal infections in ABCs areas were not susceptible to penicillin, and 13.3% were not susceptible to three classes of antibiotics. In 1998, early-onset group B streptococcal disease had declined by 65% over the previous 6 years. More information on ABCs is available at www.cdc.gov/ncidod/dbmd/abcs. ABCs specimens will soon be available to researchers through an archive. PMID:11266299

  2. Arthropod surveillance programs: Basic components, strategies, and analysis

    USDA-ARS?s Scientific Manuscript database

    Effective entomological surveillance planning stresses a careful consideration of methodology, trapping technologies, and analysis techniques. Herein, the basic principles and technological components of arthropod surveillance plans are described, as promoted in the symposium “Advancements in arthro...

  3. Regulatory standards applicable or relevant to the independent Hanford environmental surveillance and oversight program

    SciTech Connect

    King, S.E.; Hendrickson, P.L.; Siegel, M.R.; Woodruff, M.G. ); Belfiglio, J.; Elliott, R.W. )

    1990-03-01

    The authors reviewed federal and state statutes and regulations, as well as Department of Energy (DOE) orders and other guidance material, for potential applicability to the environmental surveillance program conducted for the Hanford site by the Pacific Northwest Laboratory (PNL). There are no federal or state statutes or regulations which are directly applicable to the environmental surveillance program. However, other regulatory schemes, while not directly applicable to the environmental surveillance program, are important insofar as they are indicative of regulatory concern and direction. Because of the evolving nature of environmental regulations, this area needs to be closely monitored for future impact on environmental surveillance activities. 9 refs.,

  4. Linezolid-resistant Staphylococcus epidermidis associated with long-term, repeated linezolid use in a pediatric patient.

    PubMed

    Ishiwada, Naruhiko; Takaya, Akiko; Kimura, Asahi; Watanabe, Masaharu; Hino, Moeko; Ochiai, Hidemasa; Matsui, Mari; Shibayama, Keigo; Yamamoto, Tomoko

    2016-03-01

    We report an 8-year-old patient with catheter-related bacteremia caused by linezolid-resistant Staphylococcus epidermidis that was isolated after the long-term, repeated use of linezolid. Three S. epidermidis strains isolated from this patient were bacteriologically analyzed. While the strain isolated prior to linezolid initiation was susceptible to linezolid, two strains after linezolid therapy displayed low-level linezolid susceptibility (MIC, 4 mg/L) and linezolid resistance (MIC, 16 mg/L). T2500A mutation in two copies and G2575T mutations in three copies of 23S rRNA were detected in the low-susceptible strain and the resistant strain, respectively. Linezolid-resistant S. epidermidis infection is rare, but may occur with the long-term administration of linezolid.

  5. Encephalitis Surveillance through the Emerging Infections Program, 1997–2010

    PubMed Central

    Glaser, Carol A.

    2015-01-01

    Encephalitis is a devastating illness that commonly causes neurologic disability and has a case fatality rate >5% in the United States. An etiologic agent is identified in <50% of cases, making diagnosis challenging. The Centers for Disease Control and Prevention Emerging Infections Program (EIP) Encephalitis Project established syndromic surveillance for encephalitis in New York, California, and Tennessee, with the primary goal of increased identification of causative agents and secondary goals of improvements in treatment and outcome. The project represents the largest cohort of patients with encephalitis studied to date and has influenced case definition and diagnostic evaluation of this condition. Results of this project have provided insight into well-established causal pathogens and identified newer causes of infectious and autoimmune encephalitis. The recognition of a possible relationship between enterovirus D68 and acute flaccid paralysis with myelitis underscores the need for ongoing vigilance for emerging causes of neurologic disease. PMID:26295485

  6. Linezolid-induced haematological toxicity.

    PubMed

    Moraza, Libe; Leache, Leire; Aquerreta, Irene; Ortega, Ana

    2015-11-01

    Objetivo: determinar la incidencia de toxicidad hematológica por linezolid. Estudiar la influencia del aclaramiento renal en su aparición y la efectividad de la piridoxina en su prevención. Método: estudio observacional retrospectivo de todos los pacientes tratados con linezolid en un hospital universitario en seis meses. Se consideró toxicidad hematológica a la disminución del 25% de la hemoglobina, del 25% de las plaquetas y/o del 50% de neutrófilos al final respecto al inicio del tratamiento. Se comparó en los pacientes con y sin fallo renal (aclaramiento de creatinina inferior a 50 mL/min), con más o menos de 30 mL/min, y con o sin piridoxina, la incidencia de toxicidad hematológica mediante Chi-Cuadrado y la disminución en el porcentaje de variables analíticas hematológicas mediante U Mann-Whitney. Resultados: se evaluaron 38 pacientes. Dieciséis (42%) presentaron toxicidad hematológica (2 por disminución de hemoglobina, 9 de plaquetas y 8 de neutrófilos). En 2 pacientes (5%) se suspendió el tratamiento por plaquetopenia. La incidencia de toxicidad fue similar en pacientes con y sin insuficiencia renal, 42% vs. 42%, p = 0,970, con más o menos de 30 mL/min, 67% vs. 40%, p = 0,369, con piridoxina o sin ella, 47,8% vs. 33%, p = 0,376. Los pacientes con fallo renal presentaron una reducción significativamente mayor de plaquetas, p = 0,0185. Conclusiones: un 42% de los pacientes presentó toxicidad hematológica, más frecuentemente disminución de plaquetas y neutrófilos. Esta no fue significativamente mayor en los pacientes con fallo renal, ni en aquellos sin piridoxina. Se halló mayor reducción de plaquetas en los pacientes con insuficiencia renal.

  7. Medical surveillance and programs on industrial hygiene at RCRA facilities

    SciTech Connect

    Murphy, T.E.

    1994-12-31

    Some special areas where much progress in industrial hygiene and safety has been made in the past few years are; training, personal protective equipment, uniforms, personal monitoring, area monitoring, and medical surveillance. Before one can begin to construct programs for worker protection, some knowledge of potential exposures must be gained. The best place to start is the Waste Analysis Plan, and the list of wastes that a particular site is authorized to receive. Waste Codes are listed within a facility`s Part A and Part B permits. Actual facility receipt of wastes are well documented within Load Records and other documentation. A facility`s training program forms the heart of a health and safety program. Every TSD facility should have developed a matrix of job titles and required training. Every facility must also make a commitment to providing a wide range of personal protective equipment, including a wide array of disposables. Some facilities will benefit from the occasional use of the newer respirator quantitative fit-testing devices. All facilities are urged to rent or borrow this type of equipment periodically. Quantitative respirator fit-testers are capable of revealing important deficiencies in a respirator program. Providing uniforms is a newer means of protecting workers. The use of uniforms is an effective means for addressing the idea of carry-home-waste. The use of disposables including boots, must be integrated into a Uniform Program if the program is to be effective. In addition, employees must strictly understand that uniforms must not leave the facility at any time, including lunch time.

  8. Challenges in Designing a National Surveillance Program for Inflammatory Bowel Disease in the United States

    PubMed Central

    Long, Millie D.; Hutfless, Susan; Kappelman, Michael D.; Khalili, Hamed; Kaplan, Gil; Bernstein, Charles N.; Colombel, Jean Frederic; Herrinton, Lisa; Velayos, Fernando; Loftus, Edward V.; Nguyen, Geoffrey C.; Ananthakrishnan, Ashwin N.; Sonnenberg, Amnon; Chan, Andrew; Sandler, Robert S.; Atreja, Ashish; Shah, Samir A.; Rothman, Kenneth; Leleiko, Neal S.; Bright, Renee; Boffetta, Paolo; Myers, Kelly D.; Sands, Bruce E.

    2015-01-01

    This review describes the history of US government funding for surveillance programs in IBD, provides current estimates of the incidence and prevalence of inflammatory bowel diseases (IBD) in the United States (US), and enumerates a number of challenges faced by current and future IBD surveillance programs. A rationale for expanding the focus of IBD surveillance beyond counts of incidence and prevalence, in order to provide a greater understanding of the burden of IBD, disease etiology and pathogenesis, is provided. Lessons learned from other countries are summarized, as well as potential resources that may be used to optimize a new form of IBD surveillance in the US. A consensus recommendation on the goals and available resources for a new model for disease surveillance are provided. This new model should focus upon “surveillance of the burden of disease,” including 1) natural history of disease and 2) outcomes and complications of the disease and/or treatments. PMID:24280882

  9. Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

    PubMed

    Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

    2012-10-01

    Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. Serotonin syndrome after concomitant treatment with linezolid and meperidine.

    PubMed

    Das, Prabodh K; Warkentin, Dawn I; Hewko, Robert; Forrest, Donna L

    2008-01-15

    Serotonin syndrome has been reported with administration of linezolid and serotonin reuptake inhibitors. Meperidine blocks the neuronal reuptake of serotonin. Serotonin syndrome after concomitant linezolid and meperidine therapy has not been described. We describe serotonin syndrome after concomitant use of linezolid and meperidine in a 27-year-old man with acute leukemia.

  11. 2003 Long-Term Surveillance and Maintenance Program Report

    SciTech Connect

    2004-07-01

    are part of long-term site management. In response to post-closure care requirements set forth in UMTRCA, DOE Headquarters established the Long-Term Surveillance and Maintenance (LTS&M) Program in 1988 at the DOE office in Grand Junction, Colorado. The program assumed long-term management responsibility for sites remediated under UMTRCA and other programs. Since its inception, the LTS&M Program has evolved in response to changing stakeholder needs, improvements in technology, and the addition of more DOE sites as remediation is completed. The mission of the LTS&M Program was to fulfill DOE’s responsibility to implement all activities necessary to ensure regulatory compliance and to protect the public and the environment from long-lived wastes associated with the nation’s nuclear energy, weapons, and research activities. Key components of the LTS&M Program included stakeholder participation, site monitoring and maintenance, records and information management, and research and technology transfer. This report presents summaries of activities conducted in 2003 in fulfillment of the LTS&M Program mission. On December 15, 2003, DOE established the Office of Legacy Management (LM) to allow for optimum management of DOE’s legacy responsibilities. Offices are located in Washington, DC, Grand Junction, Colorado, Morgantown, West Virginia, and Pittsburgh, Pennsylvania, to perform long-term site management, land management, site transition support, records management, and other related tasks. All activities formerly conducted under the LTS&M Program have been incorporated into the Office of Land and Site Management (LM–50), as well as management of remedies involving ground water and surface water contaminated by former processing activities.

  12. SAVY-4000 Surveillance and Life Extension Program Fiscal Year 2013 Annual Report

    SciTech Connect

    Stone, Timothy A.; Blair, Michael W.; Weis, Eric; Veirs, Douglas K.; Smith, Paul Herrick; Moore, Murray E.; Reeves, Kirk P.; Kelly, Elizabeth J.; Prochnow, David A.; Worl, Laura A.

    2014-03-03

    The Packaging Surveillance Program section of the DOE M441.1-1/sup>1, Nuclear Material Packaging Manual (DOE, 2008) requires DOE contractors to “ensure that a surveillance program is established and implemented to ensure the nuclear material storage package continues to meet its design criteria.” In order to ensure continuing safe storage of nuclear material and the maximization of risk reduction, TA-55 has established a Surveillance Program to ensure storage container integrity for operations within its specified design life. The LANL SAVY-4000 Field Surveillance Plan2 defines the near-term field surveillance plan for SAVY-4000 containers as required by the Manual. A long-term surveillance plan will be established based on the results of the first several years of surveillance and the results of the lifetime extension studies as defined in the Accelerated Aging Plan3. This report details progress in positioning the Surveillance Program for successful implementation in FY14 and status of the Design Life Extension Program in terms of its implementation and data collection for FY13.

  13. Are hepatocellular carcinoma surveillance programs effective at improving the therapeutic options.

    PubMed

    Zapata, E; Zubiaurre, L; Castiella, A; Salvador, P; García-Bengoechea, M; Esandi, P; Arriola, A; Beguiristain, A; Ruiz, I; Garmendia, G; Orcolaga, R; Alustiza, J M

    2010-07-01

    to evaluate whether the current surveillance programs (ultrasonography and alpha-fetoprotein testing every six months) are successful in detecting patients in the early stages. the health records of all patients diagnosed with hepatocellular carcinoma in Donostia Hospital between 2003 and 2005 were reviewed retrospectively. Eighty-five patients (11 women and 74 men) were included in the study and demographic data, risk factors and clinical data were obtained. Patients were split into two groups according to whether or not they had been included in a surveillance program. seventy per cent of patients of the surveillance group is diagnosed in early stage opposite to 26.7% of patients in no surveillance group (p < 0.05). Thirteen patients cannot receive curative treatment in spite of the diagnosis in early stage (9 in the surveillance group and 4 in the no surveillance group. The global sensibility of the surveillance program in our series is 95%. current hepatocellular carcinoma surveillance programs, which comprise six-monthly ultrasonography and alpha-fetoprotein tests, are highly sensitive and effective. These programs result in the detection of hepatocellular carcinoma in its early-stages, when potentially curative treatment may be offered.

  14. Detection of linezolid resistance due to the optrA gene in Enterococcus faecalis from poultry meat from the American continent (Colombia).

    PubMed

    Cavaco, L M; Bernal, J F; Zankari, E; Léon, M; Hendriksen, R S; Perez-Gutierrez, E; Aarestrup, F M; Donado-Godoy, P

    2017-03-01

    Three Enterococcus isolates obtained from retail chicken collected in 2010-11 as part of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS) showed reduced susceptibility towards linezolid (MIC 8 mg/L). This study aimed at characterizing the isolates resistant to linezolid and detecting the resistance mechanism. Strains were analysed in 2011-12 without successful detection of the resistance mechanism. All isolates were found negative for the cfr gene and no 23S rRNA mutations were detected. In 2016, with the novel resistance gene optrA being described, the WGS data were re-analysed using in silico genomic tools for confirmation of species, detection of virulence and resistance genes, MLST and SNP analyses and comparison of the genetic environment with the previously published plasmid pE349. : Three Enterococcus faecalis isolates were found positive for the optrA gene encoding resistance to linezolid and phenicols. Additional screening of 37 enterococci strains from the same study did not detect any further positives. Typing showed that two of the isolates belong to ST59, while the last belongs to ST489. All isolates carry genes encoding resistance to macrolide-lincosamide-streptogramin B, tetracycline and phenicols. In addition, the ST489 isolate also carries genes conferring aminoglycoside resistance and is resistant to quinolones, but no plasmid-mediated gene was detected. The optrA gene regions of the three plasmids showed high similarity to the originally reported optrA -carrying plasmid pE349. To the best of our knowledge, this is the first description of the optrA gene in E. faecalis isolated from poultry meat in the Americas.

  15. Australian Rotavirus Surveillance Program: annual report, 2006-07.

    PubMed

    Kirkwood, Carl D; Cannan, David; Bogdanovic-Sakran, Nada; Bishop, Ruth F; Barnes, Graeme L

    2007-12-01

    The National Rotavirus Reference Centre, together with collaborating laboratories Australia-wide, conducts a laboratory based rotavirus surveillance program. This report describes the serotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2006 to 30 June 2007. One thousand and two faecal samples from across Australia were examined using a combined approach of monoclonal antibody immunoassays, reverse transcription-polymerase chain reaction and polyacrylamide gel analysis. Serotype G1 was the dominant serotype nationally, representing 36.7% of all strains, followed by serotype G9 (31.1%), and serotype G3 (23.3%). Serotype G2 represented less than 5% of strains, while no serotype G4 strains were identified. All G1, G3 and G9 strains assayed for P genotype contained the P[8] genotype, bar one G1 strain, which possessed a P[6]. Uncommon rotavirus genotypes, G8 (n = 1) and G12 (n = 2) were identified in children with acute gastroenteritis during this study period.

  16. Environmental surveillance program. Quarterly progress report, July--September, 1993

    SciTech Connect

    Walker, D.W.; Hall, L.F.; Downs, J.

    1996-02-01

    This report contains data developed from monitoring site measurements and laboratory analyses of environmental samples that were collected during the period of July-September, 1993. Because some laboratory procedures are lengthy and could adversely affect the desired timeliness of reports, results of some analyses from this time period will be included in the next quarterly report. Quarterly reports, then, will be routine periodic documents that present continually updated information concerning the potential presence of environmental contaminants in the vicinity of the Idaho National Engineering Laboratory (INEL). During the third calendar quarter of 1993, Environmental Surveillance Program (ESP) measurements did not reveal unexpected levels of contaminants in any environmental samples measured or analyzed. Most of the results reported in this document are related to off-site air and ground water measurements. Future reports will include results of monitoring at additional locations and for additional environmental materials. Annual reports from the ESP will contain data generated during the previous four calendar quarters, and will display measurement trends for various combinations of locations, contaminants and environmental media. The annual report will also include more interpretive material and discussions than will normally be found in quarterly reports.

  17. [A review on the advancement of internet-based public health surveillance program].

    PubMed

    Zhao, Y Q; Ma, W J

    2017-02-10

    Internet data is introduced into public health arena under the features of fast updating and tremendous volume. Mining and analyzing internet data, researchers can model the internet-based surveillance system to assess the distribution of health-related events. There are two main types of internet-based surveillance systems, i.e. active and passive, which are distinguished by the sources of information. Through passive surveillance system, information is collected from search engine and social media while the active system gathers information through provision of the volunteers. Except for serving as a real-time and convenient complementary approach to traditional disease, food safety and adverse drug reaction surveillance program, Internet-based surveillance system can also play a role in health-related behavior surveillance and policy evaluation. Although several techniques have been applied to filter information, the accuracy of internet-based surveillance system is still bothered by the false positive information. In this article, we have summarized the development and application of internet-based surveillance system in public health to provide reference for a better surveillance program in China.

  18. Therapeutic drug management of linezolid: a missed opportunity for clinicians?

    PubMed

    Cattaneo, Dario; Gervasoni, Cristina; Cozzi, Valeria; Castoldi, Simone; Baldelli, Sara; Clementi, Emilio

    2016-12-01

    Some studies have shown that adjustments to the linezolid dose guided by therapeutic drug monitoring (TDM) can reduce interindividual variability in drug exposure and improve linezolid tolerability. In this study, 6 years of linezolid TDM, a diagnostic service for our hospital and others in the Milan (Italy) area, is described. Samples were collected immediately before the morning dose intake (trough concentrations) in steady-state conditions. Linezolid concentrations were quantified by a validated high-performance liquid chromatography (HPLC) method. Four hundred linezolid trough concentrations from 220 patients were collected. A 20-fold variability in linezolid levels was observed. Positive and significant correlations between linezolid trough concentrations and patient age (r = 0.325, P <0.01) or serum creatinine (r = 0.511, P <0.01) were found. A progressive increase in linezolid concentrations with time was observed in a subgroup of patients with more than one TDM assessment. Elderly patients, especially those aged >80 years and with impaired renal function, are at a higher risk of overexposure to linezolid. Despite the observed progressive increase in linezolid concentrations over time, most physicians did not change the drug dose according to the TDM results, even in the presence of frank overexposure to linezolid.

  19. Linezolid-Dependent Function and Structure Adaptation of Ribosomes in a Staphylococcus epidermidis Strain Exhibiting Linezolid Dependence

    PubMed Central

    Kokkori, Sofia; Apostolidi, Maria; Tsakris, Athanassios; Pournaras, Spyros

    2014-01-01

    Linezolid-dependent growth was recently reported in Staphylococcus epidermidis clinical strains carrying mutations associated with linezolid resistance. To investigate this unexpected behavior at the molecular level, we isolated active ribosomes from one of the linezolid-dependent strains and we compared them with ribosomes isolated from a wild-type strain. Both strains were grown in the absence and presence of linezolid. Detailed biochemical and structural analyses revealed essential differences in the function and structure of isolated ribosomes which were assembled in the presence of linezolid. The catalytic activity of peptidyltransferase was found to be significantly higher in the ribosomes derived from the linezolid-dependent strain. Interestingly, the same ribosomes exhibited an abnormal ribosomal subunit dissociation profile on a sucrose gradient in the absence of linezolid, but the profile was restored after treatment of the ribosomes with an excess of the antibiotic. Our study suggests that linezolid most likely modified the ribosomal assembly procedure, leading to a new functional ribosomal population active only in the presence of linezolid. Therefore, the higher growth rate of the partially linezolid-dependent strains could be attributed to the functional and structural adaptations of ribosomes to linezolid. PMID:24890589

  20. Linezolid-dependent function and structure adaptation of ribosomes in a Staphylococcus epidermidis strain exhibiting linezolid dependence.

    PubMed

    Kokkori, Sofia; Apostolidi, Maria; Tsakris, Athanassios; Pournaras, Spyros; Stathopoulos, Constantinos; Dinos, George

    2014-08-01

    Linezolid-dependent growth was recently reported in Staphylococcus epidermidis clinical strains carrying mutations associated with linezolid resistance. To investigate this unexpected behavior at the molecular level, we isolated active ribosomes from one of the linezolid-dependent strains and we compared them with ribosomes isolated from a wild-type strain. Both strains were grown in the absence and presence of linezolid. Detailed biochemical and structural analyses revealed essential differences in the function and structure of isolated ribosomes which were assembled in the presence of linezolid. The catalytic activity of peptidyltransferase was found to be significantly higher in the ribosomes derived from the linezolid-dependent strain. Interestingly, the same ribosomes exhibited an abnormal ribosomal subunit dissociation profile on a sucrose gradient in the absence of linezolid, but the profile was restored after treatment of the ribosomes with an excess of the antibiotic. Our study suggests that linezolid most likely modified the ribosomal assembly procedure, leading to a new functional ribosomal population active only in the presence of linezolid. Therefore, the higher growth rate of the partially linezolid-dependent strains could be attributed to the functional and structural adaptations of ribosomes to linezolid.

  1. Optimal surveillance program for hepatocellular carcinoma - getting ready, but not yet.

    PubMed

    Wong, Grace Lai-Hung

    2015-08-28

    Hepatocellular carcinoma (HCC) secondary to chronic viral hepatitis is a major health problem in Asian-Pacific regions due to the endemics of chronic hepatitis B and C virus infection. HCC surveillance has been recommended to patients who are at risk to develop HCC. Unfortunately, a significant proportion of patients still died in long run due to tumor recurrence. The key components of an optimal surveillance program include an accurate tumor biomarker and optimal surveillance interval. Serum alpha-fetoprotein (AFP), despite of being the most widely used biomarker for HCC surveillance, it was criticized as neither sensitive nor specific. Other HCC biomarkers, including lectin-reactive AFP (AFP-L3), des-gamma carboxyprothrombin, are still under investigations. Recent study showed cancer-associated genome-wide hypomethylation and copy number aberrations by plasma DNA bisulfite sequencing to be accurate with both sensitivity and specificity close to 90% in detecting HCC in a case-control study. Concerning the optimal surveillance interval, we believe one size does not fit all patients. Accurate risk prediction to assist prognostication with well-validated HCC risk scores would be useful to decide the need for HCC surveillance. These key components of an optimal HCC surveillance program should be further validated at a surveillance setting.

  2. Panopticonics: The Control and Surveillance of Black Female Athletes in a Collegiate Athletic Program.

    ERIC Educational Resources Information Center

    Foster, Kevin Michael

    2003-01-01

    Analyzes black female student athletes' participation in an elite collegiate athletic program by showing how the program maximizes black females' athletic and academic potential through surveillance, control, and discipline. The program instills in black female athletes a model of womanhood whereby they come to expect and achieve academic and…

  3. FINAL REPORT FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

    SciTech Connect

    Joe M. Aldrich

    2004-11-01

    The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004.

  4. Efficacy of Linezolid in Experimental Otitis Media

    PubMed Central

    Pelton, S. I.; Figueira, M.; Albut, R.; Stalker, D.

    2000-01-01

    Therapy for otitis media (OM) due to resistant Streptococcus pneumoniae (MIC of penicillin, ≥2.0 μg/ml) is challenging. Linezolid, an oxazolidinone, represent a new class of antimicrobial agents with excellent in vitro activity against penicillin-resistant S. pneumoniae; however, in vitro activity against nontypeable Haemophilus influenzae (NTHI) is limited. We evaluated its efficacy against experimental acute OM due to a multidrug-resistant S. pneumoniae isolate and two isolates of NTHI. The chinchilla model was utilized to evaluate the efficacy of linezolid against experimental infection due to S. pneumoniae or NTHI. Serum and middle ear antibiotic concentrations were determined, and sterilization of experimental OM was evaluated. Chinchillas were inoculated directly with S. pneumoniae into the superior bulla. Twenty-four hours after inoculation, all animals had positive middle ear and nasopharyngeal cultures. Animals were given linezolid at 25 mg/kg/dose twice a day (b.i.d.) by orogastric feeding tube or amoxicillin at 40 mg/kg/dose b.i.d. intramuscularly for 5 days. By day 5, all animals in the linezolid group had sterile middle ear cultures and eradication of S. pneumoniae from the nasopharynx. In the amoxicillin group, all nine animals remained middle ear and nasopharynx positive (P < 0.01). In animals inoculated with NTHI, 25 and 37.5 mg/kg b.i.d. failed to sterilize middle ear infection or eradicate colonization. Mean levels in middle ear fluid measured during experimental infection were 12.8 μg/ml at 2 to 6 h and 4.1 μg/ml at 16 to 17 h after orogastric dosing at 25 mg/kg. Linezolid achieved a high concentration in the middle ear during experimental OM. Linezolid eradicated multidrug-resistant S. pneumoniae from the middle ear and nasopharynx. Experimental infection and nasopharyngeal colonization due to NTHI persisted despite achievement of concentrations in the middle ear that were above the MIC (for NTHI). PMID:10681334

  5. Arthropod Surveillance Programs: Basic Components, Strategies, and Analysis

    PubMed Central

    Rochon, Kateryn; Duehl, Adrian J.; Anderson, John F.; Barrera, Roberto; Su, Nan-Yao; Gerry, Alec C.; Obenauer, Peter J.; Campbell, James F.; Lysyk, Tim J.; Allan, Sandra A.

    2015-01-01

    Effective entomological surveillance planning stresses a careful consideration of methodology, trapping technologies, and analysis techniques. Herein, the basic principles and technological components of arthropod surveillance plans are described, as promoted in the symposium “Advancements in arthropod monitoring technology, techniques, and analysis” presented at the 58th annual meeting of the Entomological Society of America in San Diego, CA. Interdisciplinary examples of arthropod monitoring for urban, medical, and veterinary applications are reviewed. Arthropod surveillance consists of the three components: 1) sampling method, 2) trap technology, and 3) analysis technique. A sampling method consists of selecting the best device or collection technique for a specific location and sampling at the proper spatial distribution, optimal duration, and frequency to achieve the surveillance objective. Optimized sampling methods are discussed for several mosquito species (Diptera: Culicidae) and ticks (Acari: Ixodidae). The advantages and limitations of novel terrestrial and aerial insect traps, artificial pheromones and kairomones are presented for the capture of red flour beetle (Coleoptera: Tenebrionidae), small hive beetle (Coleoptera: Nitidulidae), bed bugs (Hemiptera: Cimicidae), and Culicoides (Diptera: Ceratopogonidae) respectively. After sampling, extrapolating real world population numbers from trap capture data are possible with the appropriate analysis techniques. Examples of this extrapolation and action thresholds are given for termites (Isoptera: Rhinotermitidae) and red flour beetles. PMID:26543242

  6. Arthropod Surveillance Programs: Basic Components, Strategies, and Analysis.

    PubMed

    Cohnstaedt, Lee W; Rochon, Kateryn; Duehl, Adrian J; Anderson, John F; Barrera, Roberto; Su, Nan-Yao; Gerry, Alec C; Obenauer, Peter J; Campbell, James F; Lysyk, Tim J; Allan, Sandra A

    2012-03-01

    Effective entomological surveillance planning stresses a careful consideration of methodology, trapping technologies, and analysis techniques. Herein, the basic principles and technological components of arthropod surveillance plans are described, as promoted in the symposium "Advancements in arthropod monitoring technology, techniques, and analysis" presented at the 58th annual meeting of the Entomological Society of America in San Diego, CA. Interdisciplinary examples of arthropod monitoring for urban, medical, and veterinary applications are reviewed. Arthropod surveillance consists of the three components: 1) sampling method, 2) trap technology, and 3) analysis technique. A sampling method consists of selecting the best device or collection technique for a specific location and sampling at the proper spatial distribution, optimal duration, and frequency to achieve the surveillance objective. Optimized sampling methods are discussed for several mosquito species (Diptera: Culicidae) and ticks (Acari: Ixodidae). The advantages and limitations of novel terrestrial and aerial insect traps, artificial pheromones and kairomones are presented for the capture of red flour beetle (Coleoptera: Tenebrionidae), small hive beetle (Coleoptera: Nitidulidae), bed bugs (Hemiptera: Cimicidae), and Culicoides (Diptera: Ceratopogonidae) respectively. After sampling, extrapolating real world population numbers from trap capture data are possible with the appropriate analysis techniques. Examples of this extrapolation and action thresholds are given for termites (Isoptera: Rhinotermitidae) and red flour beetles.

  7. LWR pressure vessel surveillance dosimetry improvement program: LWR power reactor surveillance physics-dosimetry data base compendium

    SciTech Connect

    McElroy, W.N.

    1985-08-01

    This NRC physics-dosimetry compendium is a collation of information and data developed from available research and commercial light water reactor vessel surveillance program (RVSP) documents and related surveillance capsule reports. The data represents the results of the HEDL least-squares FERRET-SAND II Code re-evaluation of exposure units and values for 47 PWR and BWR surveillance capsules for W, B and W, CE, and GE power plants. Using a consistent set of auxiliary data and dosimetry-adjusted reactor physics results, the revised fluence values for E > 1 MeV averaged 25% higher than the originally reported values. The range of fluence values (new/old) was from a low of 0.80 to a high of 2.38. These HEDL-derived FERRET-SAND II exposure parameter values are being used for NRC-supported HEDL and other PWR and BWR trend curve data development and testing studies. These studies are providing results to support Revision 2 of Regulatory Guide 1.99. As stated by Randall (Ra84), the Guide is being updated to reflect recent studies of the physical basis for neutron radiation damage and efforts to correlate damage to chemical composition and fluence.

  8. Idaho National Engineering Laboratory Radiological Environmental Surveillance Program 1995 annual report

    SciTech Connect

    Miles, M.; Wilhelmsen, R.N.; Borsella, B.W.; Wright, K.C.

    1996-08-01

    This report describes calendar year 1995 environmental surveillance activities of Environmental Monitoring and Water Resources of Lockheed Martin Idaho Technologies Company, performed at the following Waste Management Facilities: the Radioactive Waste Management Complex, the Waste Experimental Reduction Facility, the Mixed Waste Storage Facility, and tow surplus facilities. Results of the sampling performed by the Radiological Environmental Surveillance Program, Site Environmental Surveillance Program, and the United States Geological Survey at these facilities are included in this report. The primary purposes of monitoring are to evaluate environmental conditions, to provide and interpret data, to verify compliance with applicable regulations or standards and to ensure protection of human health and the environment. This report compares 1995 environmental surveillance data with US DOE Derived Concentration Guides and with data form previous years.

  9. Linezolid induced black hairy tongue: a rare side effect.

    PubMed

    Aijazi, Ishma; Abdulla, Fadhil M

    2014-01-01

    Linezolid induced black hairy tongue is a rare benign reversible side effect of linezolid therapy. We report a case of a 61 year old diabetic lady who developed thrombocytopenia and black hairy discoloration of the tongue after being prescribed linezolid for foot osteomyelitis by the orthopaedic surgeon. Patient was encouraged to practice good oral dental hygiene, advised to use a soft tooth brush, regular mouth wash and baking soda containing tooth paste. The condition resolved four weeks after cessation of the antibiotic therapy.

  10. Dietary tyramine restriction for hospitalized patients on linezolid: an update.

    PubMed

    Rumore, Martha M; Roth, Marc; Orfanos, Areti

    2010-06-01

    Linezolid is a weak, reversible monoamine oxidase inhibitor. The current practice at most hospitals is to place patients receiving linezolid on a tyramine-restricted diet. This process typically involves both the hospital's pharmacy department and the food and nutrition department. A literature search assessing the interaction between linezolid and tyramine was conducted, and the amount of tyramine in a typical unrestricted diet for a hospitalized patient was reviewed. Although patients receiving linezolid should avoid consuming large amounts of foods containing high concentrations of tyramine, such foods in large amounts are not components of meals for inpatients. Therefore, dietary tyramine restriction in hospitalized patients is not generally required.

  11. Linezolid-related adverse effects in clinical practice in children.

    PubMed

    Bayram, Nuri; Düzgöl, Mine; Kara, Ahu; Özdemir, Fatih M; Devrim, İlker

    2017-10-01

    Linezolid may cause adverse effects such as thrombocytopenia, which were found to be dependent on receiving linezolid for longer than 2 weeks. There are limited studies concerning the safety and timing of linezolid-related adverse effects in children. Objective of this study was to evaluate the incidence of adverse effects associated with linezolid, with especially focusing on the time of occurrence. All children (<18 years of age) who received >3 days of linezolid therapy were included in this study. Adverse effects attributed to linezolid and time of occurrence of side effects was evaluated. A total of 179 children were enrolled to the study. The patients' median age was 4 years (6 days to 17 years). During linezolid treatment, 36 (20.1%) patients experienced adverse effects. The most common adverse effect was thrombocytopenia that was detected in 26 patients (14.5%). Other adverse effects were as following; elevated liver enzymes in 4 patients, leucopenia and anemia in 2 patients, renal function impairment in one patient, and serious skin reactions in 3 patients. Adverse effects were detected within median 7.5 days of therapy (ranging from 4 to 18 days). Among 36 patients, 26 (72.2%) patients had adverse effect on the first 10 days of therapy. Transient adverse effects were detected in 20.1% of the patients during linezolid therapy. These adverse effects may be detected earlier than ten days of treatment. Linezolid should be prescribed safely in children with monitoring adverse effects especially platelet count and level of liver enzymes.

  12. Linezolid-induced black hairy tongue: a case report

    PubMed Central

    2013-01-01

    Introduction Linezolid-induced black hairy tongue has been rarely reported. The purpose of this paper is to report a case of linezolid-induced black hairy tongue and review the literature. Case presentation A 56-year-old Caucasian man was admitted with community-acquired pneumonia that failed to respond to levofloxacin 750mg daily. He was started on linezolid and meropenem and was subsequently discharged home on oral linezolid 600mg every 12 hours and intravenous ertapenem 1g daily. On a follow-up clinic visit, day 14 of linezolid therapy, he complained of dysgeusia and his tongue examination was consistent with black hairy tongue. After he finished his antibiotic course, his complaints resolved with regular tongue brushing. Conclusion Black hairy tongue is characterized by abnormal hypertrophy and elongation of filiform papillae. Five reported cases of linezolid-induced black hairy tongue were identified in a MEDLINE search (from January 2000 to June 2012). The Naranjo Probability Scale revealed a probable adverse drug reaction of linezolid-induced black hairy tongue. Potential contributing factors included other antibiotics, drug–drug interaction and poor oral hygiene. Health care professionals should be aware of the possibility of linezolid-induced black hairy tongue. Thorough history for other possible contributing factors should be obtained. Patients on linezolid should be counseled to perform good oral hygiene. PMID:23414605

  13. Produce and fish sampling program of Los Alamos National Laboratory's Environmental Surveillance Group

    SciTech Connect

    Salazar, J.G.

    1984-09-01

    This report describes produce and fish sampling procedures of the Environmental Surveillance Group at the Los Alamos National Laboratory. The program monitors foodstuffs and fish for possible radioactive contamination from Laboratory operations. Data gathered in this program on radionuclide concentrations help to estimate radiation doses to Laboratory personnel and the public. 3 references, 7 figures, 2 tables.

  14. Surveillance in Programming Plagiarism beyond Techniques: An Incentive-Based Fishbone Model

    ERIC Educational Resources Information Center

    Wang, Yanqing; Chen, Min; Liang, Yaowen; Jiang, Yu

    2013-01-01

    Lots of researches have showed that plagiarism becomes a severe problem in higher education around the world, especially in programming learning for its essence. Therefore, an effective strategy for plagiarism surveillance in program learning is much essential. Some literature focus on code similarity algorithm and the related tools can help to…

  15. Linezolid for Infants and Toddlers With Disseminated Tuberculosis: First Steps

    PubMed Central

    Deshpande, Devyani; Srivastava, Shashikant; Pasipanodya, Jotam G.; Bush, Stephen J.; Nuermberger, Eric; Swaminathan, Soumya; Gumbo, Tawanda

    2016-01-01

    Background. Infants and toddlers often present with disseminated and lymph node tuberculosis, in which Mycobacterium tuberculosis (Mtb) is predominantly intracellular. Linezolid, used to treat tuberculosis in adults, has not been formally studied in infants. Infants clear linezolid 5 times faster than adults and achieve lower 0- to 24-hour area under the concentration-time curves (AUC0–24). Methods. To mimic intracellular disease, we infected human-derived THP-1 macrophages with Mtb and inoculated hollow fiber systems. We performed dose-effect and dose-scheduling studies in which we recapitulated the linezolid half-life of 3 hours encountered in infants. Repetitive sampling for linezolid pharmacokinetics, Mtb intracellular burden, viable monocyte count, and RNA sequencing reads were performed up to 28 days. Results. The linezolid extracellular half-life was 2.64 ± 0.38 hours, whereas intracellular half-life was 8.93 ± 1.30 hours (r2 = 0.89). Linezolid efficacy was linked to the AUC0–24 to minimum inhibitory concentration (MIC) ratio (r2 = 0.98). The exposure associated with maximal Mtb kill was an AUC0–24/MIC of 23.37 ± 1.16. We identified a 414-gene transcript on exposure to toxic linezolid doses. The largest number of genes mapped to ribosomal proteins, a signature hitherto not associated with linezolid toxicity. The second-largest number of differentially expressed genes mapped to mitochondrial enzyme inhibition. Linezolid AUC0–24 best explained the mitochondrial gene inhibition, with 50% inhibition at 94 mg × hour/L (highest r2 = 0.98). Conclusions. We identified the linezolid AUC0–24/MIC target for optimal efficacy against pediatric intracellular tuberculosis, and an AUC0–24 threshold associated with mitochondrial inhibition. These constitute a therapeutic window to be targeted for optimal linezolid doses in children with tuberculosis. PMID:27742638

  16. Public Health Practice of Population-Based Birth Defects Surveillance Programs in the United States.

    PubMed

    Mai, Cara T; Kirby, Russell S; Correa, Adolfo; Rosenberg, Deborah; Petros, Michael; Fagen, Michael C

    2016-01-01

    Birth defects remain a leading cause of infant mortality in the United States and contribute substantially to health care costs and lifelong disabilities. State population-based surveillance systems have been established to monitor birth defects, yet no recent systematic examination of their efforts in the United States has been conducted. To understand the current population-based birth defects surveillance practices in the United States. The National Birth Defects Prevention Network conducted a survey of US population-based birth defects activities that included questions about operational status, case ascertainment methodology, program infrastructure, data collection and utilization, as well as priorities and challenges for surveillance programs. Birth defects contacts in the United States, including District of Columbia and Puerto Rico, received the survey via e-mail; follow-up reminders via e-mails and telephone were used to ensure a 100% response rate. Forty-three states perform population-based surveillance for birth defects, covering approximately 80% of the live births in the United States. Seventeen primarily use an active case-finding approach and 26 use a passive case-finding approach. These programs all monitor major structural malformations; however, passive case-finding programs more often monitor a broader list of conditions, including developmental conditions and newborn screening conditions. Active case-finding programs more often use clinical reviewers, cover broader pregnancy outcomes, and collect more extensive information, such as family history. More than half of the programs (24 of 43) reported an ability to conduct follow-up studies of children with birth defects. The breadth and depth of information collected at a population level by birth defects surveillance programs in the United States serve as an important data source to guide public health action. Collaborative efforts at the state and national levels can help harmonize data

  17. Linezolid treatment of ventriculoperitoneal shunt infection without implant removal.

    PubMed

    Castro, P; Soriano, A; Escrich, C; Villalba, G; Sarasa, M; Mensa, J

    2005-09-01

    Ventriculoperitoneal shunt infection is a serious clinical problem for which implant removal is considered the treatment of choice. However, surgery is sometimes associated with considerable risks that may outweigh the benefits. Presented here is a case of ventriculoperitoneal shunt infection treated successfully with linezolid without implant removal. This case shows linezolid could be a therapeutic alternative when surgery is contraindicated.

  18. Establishment of a Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program

    PubMed Central

    Wallace, Ryan M; Reses, Hannah; Franka, Richard; Dilius, Pierre; Fenelon, Natael; Orciari, Lillian; Etheart, Melissa; Destine, Apollon; Crowdis, Kelly; Blanton, Jesse D; Francisco, Calvin; Ludder, Fleurinord; Del Rio Vilas, Victor; Haim, Joseph; Millien, Max

    2015-01-01

    The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 –December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9%) and an additional 36 cases were identified based on clinical diagnosis (5%), representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%). Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries. PMID:26600437

  19. LWR surveillance dosimetry improvement program: PSF metallurgical blind test results

    SciTech Connect

    Kam, F.B.K.; Maerker, R.E.; Stallmann, F.W.

    1984-01-01

    The metallurgical irradiation experiment at the Oak Ridge Research Reactor Poolside Facility (ORR-PSF) was designed as a benchmark to test the accuracy of radiation embrittlement predictions in the pressure vessel wall of light water reactors on the basis of results from surveillance capsules. The PSF metallurgical Blind Test is concerned with the simulated surveillance capsule (SSC) and the simulated pressure vessel capsule (SPVC). The data from the ORR-PSF benchmark experiment are the basis for comparison with the predictions made by participants of the metallurgical ''Blind Test''. The Blind Test required the participants to predict the embrittlement of the irradiated specimen based only on dosimetry and metallurgical data from the SSC1 capsule. This exercise included both the prediction of damage fluence and the prediction of embrittlement based on the predicted fluence. A variety of prediction methodologies was used by the participants. No glaring biases or other deficiencies were found, but neither were any of the methods clearly superior to the others. Closer analysis shows a rather complex and poorly understood relation between fluence and material damage. Many prediction formulas can give an adequate approximation, but further improvement of the prediction methodology is unlikely at this time given the many unknown factors. Instead, attention should be focused on determining realistic uncertainties for the predicted material changes. The Blind Test comparisons provide some clues for the size of these uncertainties. In particular, higher uncertainties must be assigned to materials whose chemical composition lies outside the data set for which the prediction formula was obtained. 16 references, 14 figures, 5 tables.

  20. Detection capacity, information gaps and the design of surveillance programs for invasive forest pests.

    PubMed

    Yemshanov, Denys; Koch, Frank H; Ben-Haim, Yakov; Smith, William D

    2010-12-01

    Integrated pest risk maps and their underlying assessments provide broad guidance for establishing surveillance programs for invasive species, but they rarely account for knowledge gaps regarding the pest of interest or how these can be reduced. In this study we demonstrate how the somewhat competing notions of robustness to uncertainty and potential knowledge gains could be used in prioritizing large-scale surveillance activities. We illustrate this approach with the example of an invasive pest recently detected in North America, Sirex noctilio Fabricius. First, we formulate existing knowledge about the pest into a stochastic model and use the model to estimate the expected utility of surveillance efforts across the landscape. The expected utility accounts for the distribution, abundance and susceptibility of the host resource as well as the value of timely S. noctilio detections. Next, we make use of the info-gap decision theory framework to explore two alternative pest surveillance strategies. The first strategy aims for timely, certain detections and attempts to maximize the robustness to uncertainty about S. noctilio behavior; the second strategy aims to maximize the potential knowledge gain about the pest via unanticipated (i.e., opportune) detections. The results include a set of spatial outputs for each strategy that can be used independently to prioritize surveillance efforts. However, we demonstrate an alternative approach in which these outputs are combined via the Pareto ranking technique into a single priority map that outlines the survey regions with the best trade-offs between both surveillance strategies.

  1. Electronic tuberculosis surveillance systems: a tool for managing today's TB programs.

    PubMed

    Nadol, P; Stinson, K W; Coggin, W; Naicker, M; Wells, C D; Miller, B; Nelson, L J

    2008-03-01

    The World Health Organization (WHO) released the Stop TB Strategy in 2006, along with a revised version of the tuberculosis (TB) recording and reporting forms and register. These publications illustrate the need for an enhanced TB surveillance system that will include such key elements as rapid assessment of the quality of DOTS services; integration and response to the human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) epidemic; TB control challenges, such as increased smear-negative and extra-pulmonary TB and multidrug-resistant TB (MDR-TB); increased engagement of all care providers, such as private health care services and the community; and promotion of research to support program improvement. Electronic surveillance systems utilize computer technology to facilitate the capture, transfer and reporting of the WHO-recommended TB data elements. Electronic surveillance offers several potential advantages over the traditional paper-based systems used in many low-resource settings, such as improved data quality and completeness, more feasible links to other health care programs, quality-enhanced data entry and analysis features and increased data security. These advantages must, however, be weighed against the requirements and costs of electronic surveillance, including implementation and support of a quality paper-based surveillance system and the additional costs associated with infrastructure, training and human resources for the implementation and continuing support of an electronic system. Using examples from three different electronic TB surveillance systems that are being implemented in various resource-limited settings, this article demonstrates the feasibility, requirements and value of such systems to support the WHO-recommended enhancement of TB surveillance.

  2. Detection of imminent vein graft occlusion: what is the optimal surveillance program?

    PubMed

    Tinder, Chelsey N; Bandyk, Dennis F

    2009-12-01

    The prediction of infrainguinal vein bypass failure remains an inexact judgment. Patient demographics, technical factors, and vascular laboratory graft surveillance testing are helpful in identifying a high-risk graft cohort. The optimal surveillance program to detect the bypass at risk for imminent occlusion continues to be developed, but required elements are known and include clinical assessment for new or changes in limb ischemia symptoms, measurement of ankle and/or toe systolic pressure, and duplex ultrasound imaging of the bypass graft. Duplex ultrasound assessment of bypass hemodynamics may be the most accurate method to detect imminent vein graft occlusion. The finding of low graft flow during intraoperative assessment or at a scheduled surveillance study predicts failure; and if associated with an occlusive lesion, a graft revision can prolong patency. The most common abnormality producing graft failure is conduit stenosis caused by myointimal hyperplasia; and the majority can be repaired by an endovascular intervention. Frequency of testing to detect the failing bypass should be individualized to the patient, the type of arterial bypass, and prior duplex ultrasound scan findings. The focus of surveillance is on identification of the low-flow arterial bypass and timely repair of detected critical stenosis defined by duplex velocity spectra criteria of a peak systolic velocity 300 cm/s and peak systolic velocity ratio across the stenosis >3.5-correlating with >70% diameter-reducing stenosis. When conducted appropriately, a graft surveillance program should result in an unexpected graft failure rate of <3% per year.

  3. [Evaluation on the establishment and operation on neonatal tetanus surveillance program in Hainan Province].

    PubMed

    Sun, L; Dong, S; Chen, Z

    1999-02-01

    In order to learn the actual morbidity and influencing factors of neonatal tetanus(NNT) and to provide scientific basis for NNT elimination. A surveillance program was set up in 1997 in Hainan Province and to operate at the same time. 216 NNT cases were investigated in 1997. The number was higher than reported 78 cases. The result from surveillance showed that parturition at home and the old delivering method were the main influencing factors 88.89% of mothers of NNT cases had no TT immunization history. The surveillance data of Sanya City and Qiongzhong County indicated the NNT morbidity in 1997 had declined 61.29%, 82.05% than that in 1996 respectively due to the improvement of TT immunization rate. The study result proved that the most economical and effective measure to eliminate NNT is to increase TT immunization rate of women at child-bearing-age. It was practical integrate the NNT surveillance program into AFP surveillance system and operate along with it.

  4. 9 CFR 145.15 - Diagnostic surveillance program for low pathogenic avian influenza.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... low pathogenic avian influenza. 145.15 Section 145.15 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  5. 9 CFR 145.15 - Diagnostic surveillance program for low pathogenic avian influenza.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... low pathogenic avian influenza. 145.15 Section 145.15 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  6. 9 CFR 145.15 - Diagnostic surveillance program for low pathogenic avian influenza.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... low pathogenic avian influenza. 145.15 Section 145.15 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  7. 9 CFR 145.15 - Diagnostic surveillance program for low pathogenic avian influenza.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... low pathogenic avian influenza. 145.15 Section 145.15 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  8. 9 CFR 145.15 - Diagnostic surveillance program for low pathogenic avian influenza.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... low pathogenic avian influenza. 145.15 Section 145.15 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  9. Comparison of two active surveillance programs for the detection of clinical dengue cases in Iquitos, Peru.

    PubMed

    Rocha, Claudio; Morrison, Amy C; Forshey, Brett M; Blair, Patrick J; Olson, James G; Stancil, Jeffrey D; Sihuincha, Moises; Scott, Thomas W; Kochel, Tadeusz J

    2009-04-01

    Endemic dengue transmission has been documented in the Amazonian city of Iquitos, Peru, since the early 1990s. To better understand the epidemiology of dengue transmission in Iquitos, we established multiple active surveillance systems to detect symptomatic infections. Here we compare the efficacy of distinct community-based (door to door) and school absenteeism-based febrile surveillance strategies in detecting active cases of dengue. Febrile episodes were detected by both systems with equal rapidity after disease onset. However, during the period that both programs were running simultaneously in 2004, a higher number of febrile cases in general (4.52/100 versus 1.64/100 person-years) and dengue cases specifically (2.35/100 versus 1.29/100 person-years) were detected in school-aged children through the community-based surveillance program. Similar results were obtained by direct comparison of 435 participants concurrently enrolled in both programs (P < 0.005). We conclude that, in Iquitos, community-based door-to-door surveillance is a more efficient and sensitive design for detecting active dengue cases than programs based on school absenteeism.

  10. Detection capacity, information gaps and the design of surveillance programs for invasive forest pests

    Treesearch

    Denys Yemshanov; Frank Koch; Yakov Ben-Haim; William Smith

    2010-01-01

    Integrated pest risk maps and their underlying assessments provide broad guidance for establishing surveillance programs for invasive species, but they rarely account for knowledge gaps regarding the pest of interest or how these can be reduced. In this study we demonstrate how the somewhat competing notions of robustness to uncertainty and potential knowledge gains...

  11. [Thirty Years of Health Surveillance of Foods in Barcelona: The "ICSA" Food Quality Research Program].

    PubMed

    Fontcuberta-Famadas, Mireia; Rodellar-Torras, Santiago; Portaña-Tudela, Samuel; Durán-Neira, Julia

    2015-01-01

    The Food Health Quality Research Program (Investigación de la Calidad Sanitaria de los Alimentos [ICSA]) of the Public Health Agency of Barcelona (Agencia de Salud Pública de Barcelona [ASPB]) was initiated in 1984 to carry out surveillance of certain chemical and microbiological parameters related to the sanitary and safety of foods sold in the city. The present article analyzes the importance of health surveillance and provides details of the uses of the ICSA program. The main aim of this program is to evaluate whether marketed foods comply with the absence and/or established tolerance levels of specific parameters. Nevertheless, the program is able to incorporate or suppress parameters or foods that pose emerging dangers or interests not represented in current legislation. Besides, the program not only obtains a view of the parameters studied at a specific time period in each report, but also accumulates data over time, allowing risk assessment, calculation of dietary intake of contaminants, analysis of tendencies, and evaluation of the effectiveness of regulations to reduce contaminants. The program can also help in the planning of food control programs. The information obtained is disseminated nationally and internationally and is included in dossiers of contaminants issued by national and European health agencies. This demonstrates that a locally-developed surveillance system can have a wider scope and broader objectives and can provide useful information for managers, administrations, economic operators and consumers.

  12. An oil spill surveillance program for Lake Pontchartrain.

    PubMed

    Boyd, Ezra; Pereira, Joao F; Retana, Gabriel; Baker, Andy; Lopez, John; McCorquodale, Alex

    2013-01-01

    This article describes an oil spill surveillance strategy implemented in response to BP's 2010 MC252 oil well blowout in the Gulf of Mexico. A three-pronged strategy consisted of Geographic Information System (GIS) monitoring of the surface slick, hydrodynamic modeling of the potential movement of the slick within the Basin, and weekly field reconnaissance. Our analysis was completed in near real time during the event and the results and predictions helped local responders minimize oiling impacts in Lake Pontchartrain. No prior planning was undertaken before this crisis response, and this article reports our support activities as they happened. For the GIS component, a remote sensing derived surface slick outline layer was obtained to produce near daily maps showing the slick's proximity to Lake Pontchartrain along with weather conditions and deployed response assets. This regular monitoring of the slicks' location was complemented by hydrodynamic numerical modeling that simulated the currents that determined the trajectories of oil particles. These data were ground-truthed through weekly reconnaissance trips that assessed the potential routes of oil penetration into Lake Pontchartrain for the presence of sheen, tarballs, and other oil constituents. Despite the ad hoc design and on-the-fly implementation, these three assessments provided consistent and actionable information.

  13. Cfr-mediated linezolid-resistance among methicillin-resistant coagulase-negative staphylococci from infections of humans.

    PubMed

    Cui, Lanqing; Wang, Yang; Li, Yun; He, Tao; Schwarz, Stefan; Ding, Yujing; Shen, Jianzhong; Lv, Yuan

    2013-01-01

    Four methicillin-resistant coagulase-negative staphylococci (MRCoNS), one Staphylococcus haemolyticus and three Staphylococcus cohnii, from infections of humans collected via the Ministry of Health National Antimicrobial Resistance Surveillance Net (Mohnarin) program in China were identified as linezolid-resistant. These four isolates were negative for the 23S rRNA mutations, but positive for the gene cfr. Mutations in the gene for the ribosomal protein L3, which resulted in the amino acid exchanges Gly152Asp and Tyr158Phe, were identified in S. haemolyticus 09D279 and S. cohnii NDM113, respectively. In each isolate, the cfr gene was located on a plasmid of ca. 35.4 kb, as shown by S1 nuclease pulsed-field gel electrophoresis and Southern blotting experiments. This plasmid was indistinguishable from the previously described plasmid pSS-02 by its size, restriction pattern, and a sequenced 14-kb cfr-carrying segment. Plasmid pSS-02 was originally identified in staphylococci isolated from pigs. This is the first time that a cfr-carrying plasmid has been detected in MRCoNS obtained from intensive care patients in China. Based on the similarities to the cfr-carrying plasmid pSS-02 from porcine coagulase-negative staphylococci, a transmission of this cfr-carrying plasmid between staphylococci from pigs and humans appears to be likely.

  14. A four-year surveillance program for detection of Plasmodium falciparum chloroquine resistance in Honduras.

    PubMed

    Fontecha, Gustavo A; Sanchez, Ana L; Mendoza, Meisy; Banegas, Engels; Mejía-Torres, Rosa E

    2014-07-01

    Countries could use the monitoring of drug resistance in malaria parasites as an effective early warning system to develop the timely response mechanisms that are required to avert the further spread of malaria. Drug resistance surveillance is essential in areas where no drug resistance has been reported, especially if neighbouring countries have previously reported resistance. Here, we present the results of a four-year surveillance program based on the sequencing of the pfcrt gene of Plasmodium falciparum populations from endemic areas of Honduras. All isolates were susceptible to chloroquine, as revealed by the pfcrt "CVMNK" genotype in codons 72-76.

  15. Single Shell Tank (SST) System Surveillance & Monitoring Program

    SciTech Connect

    BARNES, D.A.

    2002-02-21

    This document describes the leak detection programs presently being used in the Hanford Single-Shell Tank (SST) System and is submitted to meet the Hanford Federal Facility Agreement and Consent Order (HFFACO) milestone M-23-22-T01.

  16. Master schedule for CY-1984 Hanford environmental surveillance routine sampling program

    SciTech Connect

    Blumer, P.J.; Price, K.R.; Eddy, P.A.; Carlile, J.M.V.

    1983-12-01

    This report provides the current schedule of data collection for the routine Hanford environmental surveillance and ground-water Monitoring Programs at the Hanford Site. The purpose is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. The routine sampling schedule provided herein does not include samples that are planned to be collected during FY-1984 in support of special studies, special contractor support programs, or for quality control purposes.

  17. PUREX environmental radiological surveillance - preoperational and operational support program conducted by Pacific Northwest Laboratory

    SciTech Connect

    Sula, M.J.; Price, K.R.

    1983-10-01

    This report describes the radiological environmental sampling program that is being conducted at the US Department of Energy's (DOE) Hanford Site in support of resumed operation of the PUREX fuel processing plant. The report also summarizes preoperational radiological environmental data collected to date. The activities described herein are part of the ongoing Hanford Environmental Surveillance Program, operated by the Pacific Northwest Laboratory (PNL) for the DOE.

  18. Linezolid desensitization for a patient with multiple medication hypersensitivity reactions.

    PubMed

    Bagwell, Autumn D; Stollings, Joanna L; White, Katie D; Fadugba, Olajumoke O; Choi, Jane J

    2013-01-01

    To describe a case in which a linezolid desensitization protocol was successfully used for a polymicrobial surgical wound infection in a patient with multiple drug hypersensitivity reactions. A 24-year-old woman with vocal cord dysfunction requiring tracheostomy was admitted for a surgical wound infection following a tracheostomy fistula closure procedure. The patient reported multiple antibiotic allergies including penicillins (rash), sulfonamides (rash), vancomycin (anaphylaxis), azithromycin (rash), cephalosporins (anaphylaxis), levofloxacin (unspecified), clindamycin (unspecified), and carbapenems (unspecified). Gram stain of the purulent wound drainage demonstrated mixed gram-negative and gram-positive flora, and bacterial cultures were overgrown with Proteus mirabilis, which precluded identification of other pathogens. Following failed test doses of linezolid, tigecycline, and daptomycin, all of which resulted in hypersensitivity reactions, a 16-step linezolid desensitization protocol was developed and successfully implemented without adverse reactions. The patient completed a 2-week course of antibiotic therapy that included linezolid upon finishing the desensitization protocol. Linezolid is useful in treating complicated and uncomplicated skin and soft tissue infections caused by gram-positive bacteria. With precautions, including premedication, a monitored nursing unit, and immediate availability of an emergency anaphylaxis kit, drug desensitization allows patients the ability to safely use medications to which they may have an immediate hypersensitivity reaction. Minimal data exist on linezolid desensitization protocols. Linezolid desensitization can be a viable option in patients requiring antimicrobial therapy for complicated gram-positive skin infections.

  19. The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies

    PubMed Central

    von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F.; Bjerregaard-Andersen, Morten; Clemens, John D.; Crump, John A.; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H.; Cosmas, Leonard; May, Jürgen; Meyer, Christian G.; Mintz, Eric D.; Montgomery, Joel M.; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R.; Wierzba, Thomas F.; Marks, Florian

    2016-01-01

    Background. New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Methods. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Results. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. Conclusions. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs. PMID:26933028

  20. The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies.

    PubMed

    von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F; Bjerregaard-Andersen, Morten; Clemens, John D; Crump, John A; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H; Cosmas, Leonard; May, Jürgen; Meyer, Christian G; Mintz, Eric D; Montgomery, Joel M; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R; Wierzba, Thomas F; Marks, Florian

    2016-03-15

    New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  1. Effect of Culture-Independent Diagnostic Tests on Future Emerging Infections Program Surveillance

    PubMed Central

    Besser, John; Iwamoto, Martha; Lessa, Fernanda C.; Cronquist, Alicia; Skoff, Tami H.; Chaves, Sandra; Boxrud, Dave; Pinner, Robert W.; Harrison, Lee H.

    2015-01-01

    The Centers for Disease Control and Prevention Emerging Infections Program (EIP) network conducts population-based surveillance for pathogens of public health importance. Central to obtaining estimates of disease burden and tracking microbiological characteristics of these infections is accurate laboratory detection of pathogens. The use of culture-independent diagnostic tests (CIDTs) in clinical settings presents both opportunities and challenges to EIP surveillance. Because CIDTs offer better sensitivity than culture and are relatively easy to perform, their use could potentially improve estimates of disease burden. However, changes in clinical testing practices, use of tests with different sensitivities and specificities, and changes to case definitions make it challenging to monitor trends. Isolates are still needed for performing strain typing, antimicrobial resistance testing, and identifying other molecular characteristics of organisms. In this article, we outline current and future EIP activities to address issues associated with adoption of CIDTs, which may apply to other public health surveillance. PMID:26291736

  2. Effect of Culture-Independent Diagnostic Tests on Future Emerging Infections Program Surveillance.

    PubMed

    Langley, Gayle; Besser, John; Iwamoto, Martha; Lessa, Fernanda C; Cronquist, Alicia; Skoff, Tami H; Chaves, Sandra; Boxrud, Dave; Pinner, Robert W; Harrison, Lee H

    2015-09-01

    The Centers for Disease Control and Prevention Emerging Infections Program (EIP) network conducts population-based surveillance for pathogens of public health importance. Central to obtaining estimates of disease burden and tracking microbiological characteristics of these infections is accurate laboratory detection of pathogens. The use of culture-independent diagnostic tests (CIDTs) in clinical settings presents both opportunities and challenges to EIP surveillance. Because CIDTs offer better sensitivity than culture and are relatively easy to perform, their use could potentially improve estimates of disease burden. However, changes in clinical testing practices, use of tests with different sensitivities and specificities, and changes to case definitions make it challenging to monitor trends. Isolates are still needed for performing strain typing, antimicrobial resistance testing, and identifying other molecular characteristics of organisms. In this article, we outline current and future EIP activities to address issues associated with adoption of CIDTs, which may apply to other public health surveillance.

  3. Future Directions for NCI’s Surveillance Research Program

    Cancer.gov

    Since the early 1970s, NCI’s SEER program has been an invaluable resource for statistics on cancer in the United States. For the past several years, SEER researchers have been working toward a much broader and comprehensive goal for providing cancer stati

  4. Emergency medical services data for cardiovascular disease surveillance, program planning, and evaluation in Maine.

    PubMed

    Meyer, Katie A; Decker, Kathy; Mervis, Cynthia A; Louder, Danielle; Bradshaw, Jay; DeVader, Shannon; Wigand, Debra

    2008-04-01

    Rapid access to medical treatment is a key determinant of outcomes for cardiovascular events. Emergency medical services (EMS) play an important role in delivering early treatment for acute cardiovascular events. Attention has increased on the potential for EMS data to contribute to our understanding of prehospital treatment. Maine recently began to explore the possible role of EMS data in cardiovascular disease surveillance and cardiovascular health program planning and evaluation. We describe the Maine EMS data system, discuss findings on ease of data use and data quality, provide a sample of findings, and share how we plan to use EMS data for program planning and evaluation of community-level interventions and to partner with EMS provider organizations to improve treatment. Our objective is to increase understanding of the promise and limitations of using EMS data for cardiovascular disease surveillance and program planning and evaluation.

  5. Surveillance programs for stage I nonseminomatous germ cell tumors of the testis.

    PubMed

    Segal, Roanne

    2006-01-01

    Germ cell tumors of the testes constitute approximately 1-2% of all tumors in males 15-35 years of age. Half of those present as clinical stage I disease. The traditional approach was either a retroperitoneal node dissection or radiotherapy. A historical review of the literature suggested that 70% of these patients were cured and did not benefit from further therapy. This coupled with the advent of tumor markers, advanced diagnostic techniques, and cisplatin based chemotherapy led to the consideration for surveillance programs, thereby offering therapy only to those who required it. This article reviews the surveillance programs described in the literature to date with respect to both suitability and program design.

  6. The Lawrence Livermore National Laboratory DOE-STD-3013 Surveillance Program for the Storage of Plutonium Packages

    SciTech Connect

    Riley, D

    2005-03-07

    This document presents a site-specific DOE-STD-3013 (3013) surveillance program for 3013 material stored at Lawrence Livermore National Laboratory (LLNL) in the B332 Plutonium Facility. The 3013 standard requires the development of a surveillance program to assure the long-term safety of plutonium storage in 3013 compliant containers. A complex-wide Integrated Surveillance Program in Support of Long-Term Storage of Plutonium-Bearing Materials (ISP)(LA-UR-00-3246, Revision 1, March 2001) has been developed to give guidance on an acceptable surveillance approach and to set up a mechanism to integrate surveillance activities and facilitate the sharing of lessons learned. This LLNL 3013 surveillance program has been developed following guidelines established for Storage Sites in the ISP and is sufficient for the storage in the LLNL Plutonium Facility. The LLNL 3013 surveillance program must be coupled with the DOE complex wide Materials Identification and Surveillance (MIS) program and the ISP led by Savannah River Site (SRS). These programs support the technical basis for continuing safe storage of plutonium packages and provide the technical basis for the limited scope of the site-specific LLNL 3013 surveillance program. The LLNL 3013 surveillance program calls for surveillance of 3013 packages to begin approximately three years after packaging of the first oxide. One percent of the stored packages per year will be randomly selected and nondestructively examined (NDE) by LLNL per the guidelines of the ISP. Additional packages may be selected for NDE if recommended by the ISP Steering Committee and agreed upon by the MIS Working Group. One selected package will be shipped to SRS for destructive analysis each year starting when SRS can receive them. This is expected to be in FY2007. We expect to store a maximum of 400 3013 packages. This would result in an expected maximum of 4 surveillances per year. The activities outlined in the program evolved from the current

  7. Decreased Linezolid Serum Concentrations in Three Critically Ill Patients: Clinical Case Studies of a Potential Drug Interaction between Linezolid and Rifampicin.

    PubMed

    Blassmann, Ute; Roehr, Anka C; Frey, Otto R; Koeberer, Andreas; Briegel, Josef; Huge, Volker; Vetter-Kerkhoff, Cornelia

    2016-01-01

    Linezolid is a valuable treatment option for treating infections caused by multi-resistant gram-positive pathogens. Lack of effective linezolid levels due to the co-administration of rifampicin has been described in healthy subjects. However, the clinical significance of this potential drug interaction (DI) for critically ill patients is still unclear. This was a retrospective analysis of 3 critically ill patients with the combination therapy of linezolid and rifampicin or rifampicin pre-treatment. Despite increasing the dose of linezolid, the majority of observed linezolid trough concentrations in all 3 patients were below 2 mg/l. Furthermore, linezolid trough concentrations remained below 2 mg/l after discontinuation of rifampicin. This potential DI between linezolid and rifampicin could lead to treatment failure. Therefore, we strongly recommend that linezolid serum concentrations be monitored in patients with rifampicin co-administration or rifampicin pretreatment. © 2016 S. Karger AG, Basel.

  8. Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

    PubMed

    Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

    2016-12-01

    There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Systematic Review of Screening and Surveillance Programs to Protect Workers from Nanomaterials

    PubMed Central

    Gulumian, Mary; Verbeek, Jos; Sanabria, Natasha; de Jager, Pieter

    2016-01-01

    Background Screening and surveillance approaches for workers exposed to nanomaterials could aid in early detection of health effects, provide data for epidemiological studies and inform action to decrease exposure. The aim of this review is to identify such screening and surveillance approaches, in order to extract available data regarding (i) the studies that have successfully been implemented in present day, (ii) identification of the most common and/or toxic nano-related health hazards for workers and (iii) possible exposure surveillance markers. This review contributes to the current understanding of the risk associated with nanomaterials by determining the knowledge gap and making recommendations based on current findings. Methods A systematic review was conducted. PubMed and Embase were searched to identify articles reporting on any surveillance-related study that described both exposure to nanomaterials and the health indicators that were measured. Four reviewers worked in pairs to independently assess the eligibility of studies and risk of bias before extraction of data. Studies were categorised according to the type of study and the medical surveillance performed, which included the type of nanomaterial, any exposure details provided, as well as health indicators and biomarkers tested. Results Initially 92 studies were identified, from which 84 full texts were assessed for eligibility. Seven studies met all the inclusion criteria, i.e. those performed in Taiwan, Korea, Czech Republic and the US. Of these, six compared health indicators between exposed and unexposed workers and one study described a surveillance program. All studies were at a high risk of bias. Workers were exposed to a mix of nanomaterials in three studies, carbon-based nanomaterials in two studies, nano-silver in one study and nano-titanium oxide in the other study. Two studies did not find a difference in biomarkers between exposed and unexposed workers. In addition, differences in early

  10. Master schedule for CY-1983 Hanford environmental surveillance routine sampling program

    SciTech Connect

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.; Dirkes, R.L.

    1982-12-01

    The current schedule of data collection for the routine Hanford environmental surveillance and ground-water monitoring programs at the Hanford Site is presented. The purpose of the programs is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. Radiological monitoring data are reported for air (particulate filter and gases/vapor), Columbia River water, sanitary water, onsite pond water, foodstuffs (whole milk, leafy vegetables, fruit, wheat/alfalfa, beef, poultry/eggs), wildlife, soil and vegetation, and direct radiation. Information is also given for on site radiation control audit surveys (roadway, railway, aerial, and waste disposal sites, and the Hanford ground-water monitoring program.

  11. Security Vs. Liberty: How to Measure Privacy Costs in Domestic Surveillance Programs

    DTIC Science & Technology

    2014-03-01

    the moral duty “to violate legal, including constitutional, rights when necessary to avoid catastrophic harm to the nation.”5 This position also...the threat and effectiveness of an intelligence tool to measure the national security interests and the harm to privacy to determine the civil liberty...for the programs argued that the NSA surveillance efforts actually impose little, if any, harm to civil liberties. Neither side made a convincing

  12. Medical Surveillance Programs for Aircraft Maintenance Personnel Performing Nondestructive Inspection and Testing

    DTIC Science & Technology

    2005-11-01

    University Columbus, OH 43210 November 2005 Final Report DOT/ FAA /AM-05/21 Offi ce of Aerospace Medicine Washington, DC 20591 NOTICE This document is...No. DOT/ FAA /AM-05/21 4. Title and Subtitle 5. Report Date November 2005 6. Performing Organization Code Medical Surveillance Programs for...operating condition. A recent FAA report, entitled “Analysis of Airworthiness Directives 1995 to 1999,” indicated that 57% of all Airworthiness

  13. Establishment of a health surveillance program for reintroduction of the Eurasian beaver (Castor fiber) into Scotland.

    PubMed

    Goodman, Gidona; Girling, Simon; Pizzi, Romain; Meredith, Anna; Rosell, Frank; Campbell-Palmer, Roisin

    2012-10-01

    In 2009 and 2010 16 Norwegian Eurasian beavers (Castor fiber) were reintroduced to Knapdale, Scotland as part of a 5-yr reintroduction trial (Scottish Beaver Trial). Despite numerous reintroduction programs throughout Europe there is no published information concerning recommended health surveillance during beaver reintroduction and only one publication describing causes of mortality. We describe the establishment of a health surveillance program based on International Union of Conservation of Nature (IUCN) and governmental guidelines, and report preliminary results based on the fecal and blood samples following the completion of the first stage of reintroduction. Animals underwent at least one general anesthetic to allow collection of fecal and blood samples and a thorough clinical examination. No bacterial enteric pathogens such as Salmonella spp., Campylobacter spp., or Yersinia pseudotuberculosis were isolated, nor were Giardia spp. or Cryptosporidium spp. However, numerous helminths including Travassosius rufus and Stichorchis subtriquetrus were detected. Five animals were positive for Leptospira antibodies. This included Leptospira saxkoebing, Leptospira canicola, Leptospira copenhageni, Leptospira icterohaemorrhagiae, Leptospira autumnalis, and Leptospira javanica. The highest loss of animals (20%) was during the statutory 6-mo rabies quarantine period. No common cause of death was determined. The rabies quarantine conditions were waived for four remaining animals, three of which were introduced to the wild successfully. The authors recommend the shortest possible quarantine period when introducing beavers, but allowing for the minimum recommended IUCN 35 days to allow for implementation of the initial stage of the health surveillance program, examination of animals, sample collection, and processing.

  14. DoD Global Laboratory-Based Influenza Surveillance Program End-of-Year Report, 2013-2014

    DTIC Science & Technology

    2015-07-22

    AFRL-SA-WP-SR-2015-0019 DoD Global Laboratory- Based Influenza Surveillance Program End- of-Year Report, 2013-2014 Tiffany...COVERED (From – To) September 2013 – September 2014 4. TITLE AND SUBTITLE DoD Global Laboratory-Based Influenza Surveillance Program End-of-Year...88ABW-2015-2196, 1 May 2015 13. SUPPLEMENTARY NOTES 14. ABSTRACT During the 2013-2014 influenza season (29 September 2013 - 27 September 2014

  15. Sheen surveillance: An environmental monitoring program subsequent to the 1989 Exxon Valdez shoreline cleanup

    SciTech Connect

    Taft, D.G.; Egging, D.E.; Kuhn, H.A.

    1995-12-31

    In the fall of 1989, an aerial surveillance program was implemented to locate oil sheens (or slicks) originating from shorelines affected by the Exxon Valdez spill. The objectives of the program were to identify any oil on the water that warranted response and to identify those sections of shoreline that would be priority candidates for further cleanup in 1990. The program initially surveyed the entire affected area, but, because proportionally fewer sheens were spotted in the Gulf of Alaska, the program was refocused on Prince Williams Sound in early 1990. The surveillance program consisted of frequent low-altitude flights with trained observers in a deHavilland Twin otter outfitted with observation ports and communication equipment. The primary surveillance technique used was direct visual observation. Other techniques, including photography, were tested but proved less effective. The flights targeted all shorelines of concern, particularly those near fishing, subsistence, and recreational areas.the observers attempted to locate all sheens, estimate their size and color, ad identify the source of the oil found in the sheen. Size and color were used to estimate the volume of oil in each sheen. Samples were collected whenever possible during the summer of 1990 using a floating Teflon{trademark} sampling device that was developed for easy deployment from a boat or the pontoon of a float plane. Forty four samples were analyzed by UV-fluorescence spectroscopy. Eleven of these samples were also analyzed by GC/MS. In general, the analyses confirmed the observers` judgment of source. 16 refs., 9 figs., 2 tabs.

  16. Evaluation of the national health surveillance program of workers previously exposed to asbestos in Spain (2008).

    PubMed

    Gómez, Montserrat García; Castañeda, Rosario; López, Vega García; Vidal, Manuel Martínez; Villanueva, Vicent; Espinosa, Mercedes Elvira

    2012-01-01

    Although asbestos was banned in Spain in 2001, monitoring the health of previously-exposed workers is required. In 2002 the Ministry of Health and the autonomous regions of Spain planned a health surveillance program for workers exposed to asbestos (Programa de Vigilancia de la Salud de los Trabajadores Expuestos al Amianto [PIVISTEA]) with employers' organizations, trade unions and scientific societies. The aim of this study was to evaluate the PIVISTEA to improve its effectiveness. A questionnaire with indicators for the year 2008 was sent to Spain's 17 autonomous regions, as well as to the autonomous cities of Ceuta and Melilla. The results were analyzed by evaluating the compliance of each program with the activities established by the PIVISTEA. In December 2008, a total of 22,158 workers from 14 autonomous regions and 306 companies were included in the program. The program had been started in 88% of the regions but surveillance activities remained scarce in 24%. Fifty-seven percent of the autonomous regions (69% of the total number of workers) provided the information requested. Seven autonomous regions provided data on the relationship between the diseases found and asbestos exposure. Only 5% of these diseases entitled affected individuals to receive compensation for occupational diseases. The health surveillance of workers previously exposed to asbestos in Spain, as well as medical-legal recognition of diseases caused by exposure at work, remain in adequate. Although the trend is positive, the effectiveness of many regional programs is limited, and inter-regional inequalities among affected workers have been detected. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Invited Paper: US Naval Space Surveillance Upgrade Program 1999-2003

    NASA Astrophysics Data System (ADS)

    Schumacher, Paul W., Jr.

    2009-03-01

    This paper reviews some of the main objectives, constraints and lessons learned in a particular US Navy program that ended in 2003 with the transition of the space surveillance mission, personnel and funding to the US Air Force. Because of changing needs for space situational awareness both for national security and global commercial reasons, the Air Force sensor program that is now emerging must necessarily be different in scope from the Navy program. However, the Navy program was the first US space surveillance sensor acquisition that addressed the problem of building a large catalog of small space objects. This problem was, and remains, a new one, because the existing catalog of space objects has been maintained since the launch of the first satellite, Sputnik I, on 4 October 1957. To date, it has always been possible to maintain a complete inventory of space objects without ever re-building the catalog ab initio, because of the relatively slow rate at which new satellites are launched into space. Now, with the probable introduction of new and very sensitive space surveillance systems in several countries in the coming years, the apparent satellite population will grow instantly by orders of magnitude as the previously invisible small-debris background population becomes visible. The problem of building a large catalog of possibly faint objects in a short time has become unavoidable. Yet, all existing methods of managing sensors, associating tracking data and predicting orbital uncertainties are inadequate for this task. For this reason, reviewing from a historical point of view the Navy's attempts to address some of these problems in a conceptual system design may give us a useful perspective, even though that particular program is defunct.My personal involvement with the Navy program included the entire duration and almost all aspects of the effort. Beginning in 1999, I participated in the formal identification of the need to improve the capability of the

  18. Process Evaluation of a Workers' Health Surveillance Program for Meat Processing Workers.

    PubMed

    van Holland, Berry J; Brouwer, Sandra; de Boer, Michiel R; Reneman, Michiel F; Soer, Remko

    2016-07-30

    Objective To evaluate the implementation process of a workers' health surveillance (WHS) program in a Dutch meat processing company. Methods Workers from five plants were eligible to participate in the WHS program. The program consisted of four evaluative components and an intervention component. Qualitative and quantitative methods were used to evaluate seven process aspects. Data were gathered by interviews with stakeholders, participant questionnaires, and from registries of the company and occupational health service. Results Two recruitment strategies were used: open invitation or automatic participation. Of the 986 eligible workers, 305 participated in the program. Average reach was 53 %. Two out of five program components could not be assessed on dose delivered, dose received and fidelity. If components were assessable, 85-100 % of the components was delivered, 66-100 % of the components was received by participants, and fidelity was 100 %. Participants were satisfied with the WHS program (mean score 7.6). Contextual factors that facilitated implementation were among others societal developments and management support. Factors that formed barriers were program novelty and delayed follow-up. Conclusion The WHS program was well received by participants. Not all participants were offered the same number of program components, and not all components were performed according to protocol. Deviation from protocol is an indication of program failure and may affect program effectiveness.

  19. The Canadian Hospitals Injury Reporting and Prevention Program: a dynamic and innovative injury surveillance system

    PubMed Central

    Crain, J.; McFaull, S.; Thompson, W.; Skinner, R.; Do, M. T.; Fréchette, M.; Mukhi, S.

    2016-01-01

    Abstract This status report on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), an emergency department-based injury and poisoning surveillance system, describes the result of migrating from a centralized data entry and coding process to a decentralized process, the web-based eCHIRPP system, in 2011. This secure system is improving the CHIRPP’s overall flexibility and timeliness, which are key attributes of an effective surveillance system. The integrated eCHIRPP platform enables near real-time data entry and access, has user-friendly data management and analysis tools, and allows for easier communication and connectivity across the CHIRPP network through an online collaboration centre. Current pilot testing of automated data monitoring and trend analysis tools—designed to monitor and flag incoming data according to predefined criteria (for example, a new consumer product)—is revealing eCHIRPP’s potential for providing early warnings of new hazards, issues and trends. PMID:27284703

  20. Tracking Pertussis and Evaluating Control Measures through Enhanced Pertussis Surveillance, Emerging Infections Program, United States.

    PubMed

    Skoff, Tami H; Baumbach, Joan; Cieslak, Paul R

    2015-09-01

    Despite high coverage with pertussis-containing vaccines, pertussis remains endemic to the United States. There have been increases in reported cases in recent years, punctuated by striking epidemics and shifting epidemiology, both of which raise questions about current policies regarding its prevention and control. Limited data on pertussis reported through the National Notifiable Disease Surveillance System have proved insufficient to answer these questions. To address shortcomings of national pertussis data, the Emerging Infections Program at the US Centers for Disease Control and Prevention launched Enhanced Pertussis Surveillance (EPS), which is characterized by systematic case ascertainment, augmented data collection, and collection of Bordetella pertussis isolates. Data collected through EPS have been instrumental in understanding the rapidly evolving epidemiology and molecular epidemiology of pertussis and have contributed essential information regarding pertussis vaccines. EPS also serves as a platform for conducting critical and timely evaluations of pertussis prevention and control strategies, including targeting of vaccinations and antimicrobial prophylaxis.

  1. Prevalence of Esophageal Atresia among 18 International Birth Defects Surveillance Programs

    PubMed Central

    Nassar, Natasha; Leoncini, Emanuele; Amar, Emmanuelle; Arteaga-Vázquez, Jazmín; Bakker, Marian K.; Bower, Carol; Canfield, Mark A.; Castilla, Eduardo E.; Cocchi, Guido; Correa, Adolfo; Csáky-Szunyogh, Melinda; Feldkamp, Marcia L.; Khoshnood, Babak; Landau, Danielle; Lelong, Nathalie; López-Camelo, Jorge S.; Lowry, R. Brian; McDonnell, Robert; Merlob, Paul; Métneki, Julia; Morgan, Margery; Mutchinick, Osvaldo M.; Palmer, Miland N.; Rissmann, Anke; Siffel, Csaba; Sìpek, Antonin; Szabova, Elena; Tucker, David; Mastroiacovo, Pierpaolo

    2015-01-01

    BACKGROUND The prevalence of esophageal atresia (EA) has been shown to vary across different geographical settings. Investigation of geographical differences may provide an insight into the underlying etiology of EA. METHODS The study population comprised infants diagnosed with EA during 1998 to 2007 from 18 of the 46 birth defects surveillance programs, members of the International Clearinghouse for Birth Defects Surveillance and Research. Total prevalence per 10,000 births for EA was defined as the total number of cases in live births, stillbirths, and elective termination of pregnancy for fetal anomaly (ETOPFA) divided by the total number of all births in the population. RESULTS Among the participating programs, a total of 2943 cases of EA were diagnosed with an average prevalence of 2.44 (95% confidence interval [CI], 2.35–2.53) per 10,000 births, ranging between 1.77 and 3.68 per 10,000 births. Of all infants diagnosed with EA, 2761 (93.8%) were live births, 82 (2.8%) stillbirths, 89 (3.0%) ETOPFA, and 11 (0.4%) had unknown outcomes. The majority of cases (2020, 68.6%), had a reported EA with fistula, 749 (25.5%) were without fistula, and 174 (5.9%) were registered with an unspecified code. CONCLUSIONS On average, EA affected 1 in 4099 births (95% CI, 1 in 3954–4251 births) with prevalence varying across different geographical settings, but relatively consistent over time and comparable between surveillance programs. Findings suggest that differences in the prevalence observed among programs are likely to be attributable to variability in population ethnic compositions or issues in reporting or registration procedures of EA, rather than a real risk occurrence difference. PMID:22945024

  2. [Maternal mortality in Central America. The basis for national programs on epidemiologic surveillance].

    PubMed

    Kestler, E

    1989-01-01

    Although maternal mortality rates worldwide have declined dramatically over the past several decades, maternal mortality rates in developing countries are considered a public health problem. The true rates of maternal mortality are unknown and frequently underestimated. Data from the UN annual demographic report show that only 4 Central American countries met the requirements for publication of their maternal mortality rates. 1984 rates ranged from the high of 75.6/100,000 live births in Guatemala to the low of 22.4/100,000 in Costa Rica. The principal or only source of maternal mortality data in Central American countries is vital statistics reported by official organizations. Difficulties in reporting and collecting this information and the fact that vital statistics were not developed for study of maternal mortality make them a poor source of data. Death certificates do not include the final cause of death. Review of death certificates of fertile-aged women and combining other sources of data such as clinical histories or autopsy reports with the vital statistics are techniques for improving the registration of maternal deaths. A national system of epidemiologic surveillance of maternal mortality has the advantage of obtaining information from multiple sources, including the press, private physicians, midwives, hospital obstetrics and gynecology departments, health centers and posts, family planning clinics, private hospitals, maternal mortality committees, families, and the local and national vital statistics. A national level surveillance program should be recognized as the coordinator of activities in this area, and the systems of data collection, analysis, and use of the results should be easily adaptable, inexpensive, simple, and able to motivate. An outline of steps to be followed in organizing and developing a system of surveillance is included in this work, beginning with establishing the objectives and determining what data are needed and ending with

  3. Linezolid-resistant mucoid Staphylococcus haemolyticus from a tertiary-care centre in Delhi.

    PubMed

    Matlani, M; Shende, T; Bhandari, V; Dawar, R; Sardana, R; Gaind, R

    2016-05-01

    We report an unusual morphological mucoid variant of Staphylococcus haemolyticus associated with linezolid resistance from a patient with sepsis. Linezolid resistance and mucoid character together made this pathogen difficult to treat. To our knowledge this is the first such report.

  4. The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network

    PubMed Central

    Ha, C; Roquelaure, Y; Leclerc, A; Touranchet, A; Goldberg, M; Imbernon, E

    2009-01-01

    Objectives: An epidemiological surveillance system for work-related musculoskeletal disorders (MSDs) was implemented in 2002 in France’s Pays de la Loire region to assess the incidence and prevalence of MSDs in the general and working populations, identify levels of exposure to occupational risk factors and investigate the proportion of cases attributable to work exposure. Methods: The program combines (1) surveillance of sentinel health events in the general population (carpal tunnel syndrome (CTS) was the sentinel event for upper limb MSDs), (2) assessment of the prevalence of the main upper limb MSDs and their risk factors in the workplace based on a network of occupational physicians and (3) registration of the notification of work-related diseases (WRDs). Results: 1168 incident cases of CTS were included over a 3 year period. The estimated incidence of CTS was 1.00 per 1000 person-years in those aged 20–59 years (0.60 in men and 1.40 in women). The incidence rate was higher in employed than unemployed persons in the year of diagnosis (0.6 per 1000 vs 0.3 in men and 1.7 vs 0.8 in women). The occupational physician network noted high prevalence rates: 11% of men and 15% of women had at least one of the six main upper limb clinically-diagnosed MSDs. The WRD survey showed that MSDs represented 65% of notified WRDs. Conclusion: The Pays de la Loire program plays a significant role in informing the authorities and the public about the state of current MSDs. It is planned to extend it to a routine national surveillance program. PMID:19269944

  5. The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network.

    PubMed

    Ha, C; Roquelaure, Y; Leclerc, A; Touranchet, A; Goldberg, M; Imbernon, E

    2009-07-01

    An epidemiological surveillance system for work-related musculoskeletal disorders (MSDs) was implemented in 2002 in France's Pays de la Loire region to assess the incidence and prevalence of MSDs in the general and working populations, identify levels of exposure to occupational risk factors and investigate the proportion of cases attributable to work exposure. The program combines (1) surveillance of sentinel health events in the general population (carpal tunnel syndrome (CTS) was the sentinel event for upper limb MSDs), (2) assessment of the prevalence of the main upper limb MSDs and their risk factors in the workplace based on a network of occupational physicians and (3) registration of the notification of work-related diseases (WRDs). 1168 incident cases of CTS were included over a 3 year period. The estimated incidence of CTS was 1.00 per 1000 person-years in those aged 20-59 years (0.60 in men and 1.40 in women). The incidence rate was higher in employed than unemployed persons in the year of diagnosis (0.6 per 1000 vs 0.3 in men and 1.7 vs 0.8 in women). The occupational physician network noted high prevalence rates: 11% of men and 15% of women had at least one of the six main upper limb clinically-diagnosed MSDs. The WRD survey showed that MSDs represented 65% of notified WRDs. The Pays de la Loire program plays a significant role in informing the authorities and the public about the state of current MSDs. It is planned to extend it to a routine national surveillance program.

  6. Detection and Elimination of Corynebacterium bovis from Barrier Rooms by Using an Environmental Sampling Surveillance Program

    PubMed Central

    Manuel, Christopher A; Pugazhenthi, Umarani; Spiegel, Shannon P; Leszczynski, Jori K

    2017-01-01

    Rodent health-monitoring programs based on sampling an IVC system's exhaust air dust (EAD) has enhanced and even replaced traditional sentinels for some rodent pathogens. EAD testing by qPCR assay is an optimal surveillance method for the rapid detection of Corynebacterium bovis-infected immunodeficient mice. Here we demonstrate that an active EAD surveillance program for C. bovis can be used to maintain nude mice C. bovis-free after the transition from historically enzootically infected colonies. During 3 events over 3 y, rapid detection of infection, elimination of infected mice, aggressive quarantine measures, and local decontamination prevented the spread of C. bovis within 2 barrier rooms. In total, 4 cages of infected nude mice were identified and removed, preventing the spread of infection to 469 other cages of immunodeficient mice. In addition, we present data regarding a refinement to EAD testing which enables row-specific surveillance of an IVC rack. This technique systemically decreases the amount of testing required to locate an individually infected cage. Due to our ability to rapidly detect and localize an infected cage, we were able to investigate the route of C. bovis introduction into our barrier rooms. Our epidemiologic investigation suggested that the transmission of C. bovis occurred through contaminated, cryopreserved, patient-derived xenograft tumor tissue. This previously unknown source of C. bovis can infect mice used to propagate these tumors. Together, these data demonstrate that a remediation program that combines rapid detection, test-and-cull, and local decontamination under quarantine conditions can eliminate C. bovis from a mouse colony. PMID:28315652

  7. Detection and Elimination of Corynebacterium bovis from Barrier Rooms by Using an Environmental Sampling Surveillance Program.

    PubMed

    Manuel, Christopher A; Pugazhenthi, Umarani; Spiegel, Shannon P; Leszczynski, Jori K

    2017-03-01

    Rodent health-monitoring programs based on sampling an IVC system's exhaust air dust (EAD) has enhanced and even replaced traditional sentinels for some rodent pathogens. EAD testing by qPCR assay is an optimal surveillance method for the rapid detection of Corynebacterium bovis-infected immunodeficient mice. Here we demonstrate that an active EAD surveillance program for C. bovis can be used to maintain nude mice C. bovis-free after the transition from historically enzootically infected colonies. During 3 events over 3 y, rapid detection of infection, elimination of infected mice, aggressive quarantine measures, and local decontamination prevented the spread of C. bovis within 2 barrier rooms. In total, 4 cages of infected nude mice were identified and removed, preventing the spread of infection to 469 other cages of immunodeficient mice. In addition, we present data regarding a refinement to EAD testing which enables row-specific surveillance of an IVC rack. This technique systemically decreases the amount of testing required to locate an individually infected cage. Due to our ability to rapidly detect and localize an infected cage, we were able to investigate the route of C. bovis introduction into our barrier rooms. Our epidemiologic investigation suggested that the transmission of C. bovis occurred through contaminated, cryopreserved, patient-derived xenograft tumor tissue. This previously unknown source of C. bovis can infect mice used to propagate these tumors. Together, these data demonstrate that a remediation program that combines rapid detection, test-and-cull, and local decontamination under quarantine conditions can eliminate C. bovis from a mouse colony.

  8. Detection and Elimination of Corynebacterium bovis from Barrier Rooms by Using an Environmental Sampling Surveillance Program.

    PubMed

    Manuel, Christopher; Pugazhenthi, Umarani; Spiegel, Shannon; Leszczynski, Jori

    2017-02-16

    Rodent health-monitoring programs based on sampling an IVC system's exhaust air dust (EAD) has enhanced and evenreplaced traditional sentinels for some rodent pathogens. EAD testing by qPCR assay is an optimal surveillance methodfor the rapid detection of Corynebacterium bovis-infected immunodeficient mice. Here we demonstrate that an active EADsurveillance program for C. bovis can be used to maintain nude mice C. bovis-free after the transition from historically enzootically infected colonies. During 3 events over 3 y, rapid detection of infection, elimination of infected mice, aggressivequarantine measures, and local decontamination prevented the spread of C. bovis within 2 barrier rooms. In total, 4 cages ofinfected nude mice were identified and removed, preventing the spread of infection to 469 other cages of immunodeficientmice. In addition, we present data regarding a refinement to EAD testing which enables row-specific surveillance of an IVCrack. This technique systemically decreases the amount of testing required to locate an individually infected cage. Due to ourability to rapidly detect and localize an infected cage, we were able to investigate the route of C. bovis introduction into ourbarrier rooms. Our epidemiologic investigation suggested that the transmission of C. bovis occurred through contaminated,cryopreserved, patient-derived xenograft tumor tissue. This previously unknown source of C. bovis can infect mice used topropagate these tumors. Together, these data demonstrate that a remediation program that combines rapid detection, testand-cull, and local decontamination under quarantine conditions can eliminate C. bovis from a mouse colony.

  9. Trends in pleural radiographic findings in the Navy Asbestos Medical Surveillance Program (1990-1999).

    PubMed

    Muller, John G; Bohnker, Bruce K; Philippi, Alan F; Litow, Francesca K; Rudolph, Garry; Hernandez, Jose E

    2005-05-01

    The U.S. Navy Asbestos Medical Surveillance Program is a comprehensive effort to decrease exposure to asbestos, a known health hazard. This study was part of a programmatic review of the Asbestos Medical Surveillance Program database, which included 233,353 radiographic examinations from 1990 to 1999. The initial review focused on incidental findings recorded by B-readers for 23,460 radiographs. Abnormalities reported included bullae (0.68%), cancer (0.56%), cardiac size/ shape abnormalities (1.36%), emphysema (0.74%), subpleural fat (2.62%), fractured ribs (1.24%), hilar adenopathy (0.13%), ill-defined diaphragm (0.46%), ill-defined heart border (0.29%), Kerley lines (0.06%), pleural thickening (2.35%), and tuberculosis (0.27%). The rates by age cohort for pleural abnormalities decreased significantly (30-39 years, chi2 for trend = 23.49, df = 1; 40-49 years, chi2 for trend = 176.21; 50-59 years, chi2 for trend = 401.87), but findings were not significantly different for those > or =60 years of age. This suggests that sequential age cohorts in the program are developing fewer pleural abnormalities; pleural abnormalities have historically been associated with asbestos exposure.

  10. Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan.

    PubMed

    Kuan, Mei-Mei; Chang, Feng-Yee

    2012-08-06

    Dengue has not reached an endemic status in Taiwan; nevertheless, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007-2010. Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R(2)(X:Y) = 0.61, P < 0.005). Additionally, the fluctuating patterns in the cumulative numbers of the imported dengue cases (X) with a 1-2 month lead time (t) was in parallel with that of the domestic dengue cases (Y) based on a consecutive 4-year surveillance (i.e., n = 48, R(2)(X(t-1):Y) = 0.22, R(2)(X(t-2):Y) = 0.31, P < 0.001) from 2007-2010. A moderate sensitivity of detecting dengue at the airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers, including those with or without symptoms, is critical to prevent

  11. Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan

    PubMed Central

    2012-01-01

    Background Dengue has not reached an endemic status in Taiwan; nevertheless, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. Methods We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007–2010. Results Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R2X:Y = 0.61, P < 0.005). Additionally, the fluctuating patterns in the cumulative numbers of the imported dengue cases (X) with a 1–2 month lead time (t) was in parallel with that of the domestic dengue cases (Y) based on a consecutive 4-year surveillance (i.e., n = 48, R2X(t-1):Y = 0.22, R2X(t-2):Y = 0.31, P < 0.001) from 2007–2010. Conclusions A moderate sensitivity of detecting dengue at the airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers

  12. Linezolid-resistant Staphylococcus aureus strain 1128105, the first known clinical isolate possessing the cfr multidrug resistance gene.

    PubMed

    Locke, Jeffrey B; Zuill, Douglas E; Scharn, Caitlyn R; Deane, Jennifer; Sahm, Daniel F; Denys, Gerald A; Goering, Richard V; Shaw, Karen J

    2014-11-01

    The Cfr methyltransferase confers resistance to six classes of drugs which target the peptidyl transferase center of the 50S ribosomal subunit, including some oxazolidinones, such as linezolid (LZD). The mobile cfr gene was identified in European veterinary isolates from the late 1990s, although the earliest report of a clinical cfr-positive strain was the 2005 Colombian methicillin-resistant Staphylococcus aureus (MRSA) isolate CM05. Here, through retrospective analysis of LZD(r) clinical strains from a U.S. surveillance program, we identified a cfr-positive MRSA isolate, 1128105, from January 2005, predating CM05 by 5 months. Molecular typing of 1128105 revealed a unique pulsed-field gel electrophoresis (PFGE) profile most similar to that of USA100, spa type t002, and multilocus sequence type 5 (ST5). In addition to cfr, LZD resistance in 1128105 is partially attributed to the presence of a single copy of the 23S rRNA gene mutation T2500A. Transformation of the ∼37-kb conjugative p1128105 cfr-bearing plasmid from 1128105 into S. aureus ATCC 29213 background strains was successful in recapitulating the Cfr antibiogram, as well as resistance to aminoglycosides and trimethoprim. A 7-kb cfr-containing region of p1128105 possessed sequence nearly identical to that found in the Chinese veterinary Proteus vulgaris isolate PV-01 and in U.S. clinical S. aureus isolate 1900, although the presence of IS431-like sequences is unique to p1128105. The cfr gene environment in this early clinical cfr-positive isolate has now been identified in Gram-positive and Gram-negative strains of clinical and veterinary origin and has been associated with multiple mobile elements, highlighting the versatility of this multidrug resistance gene and its potential for further dissemination.

  13. Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

    PubMed

    Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F; Marks, Florian

    2016-03-15

    Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. © The Author 2016. Published by Oxford University Press for the

  14. Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program

    PubMed Central

    Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A.; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T.; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H.; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G.; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F.; Marks, Florian

    2016-01-01

    Background. Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. Methods. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility–based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Results. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion—namely, 20%–45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania—sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Conclusions. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. PMID

  15. Common cold symptoms in children: results of an Internet-based surveillance program.

    PubMed

    Troullos, Emanuel; Baird, Lisa; Jayawardena, Shyamalie

    2014-06-19

    Conducting and analyzing clinical studies of cough and cold medications is challenging due to the rapid onset and short duration of the symptoms. The use of Internet-based surveillance tools is a new approach in clinical studies that is gradually becoming popular and may become a useful method of recruitment. As part of an initiative to assess the safety and efficacy of cough and cold ingredients in children 6-11 years of age, a surveillance program was proposed as a means to identify and recruit pediatric subjects for clinical studies. The objective of the study was to develop an Internet-based surveillance system and to assess the feasibility of using such a system to recruit children for common cold clinical studies, record the natural history of their cold symptoms, and determine the willingness of parents to have their children participate in clinical studies. Healthy potential subjects were recruited via parental contact online. During the 6-week surveillance period, parents completed daily surveys to record details of any cold symptoms in their children. If a child developed a cold, symptoms were followed via survey for 10 days. Additional questions evaluated the willingness of parents to have their children participate in a clinical study shortly after onset of symptoms. The enrollment target of 248 children was reached in approximately 1 week. Children from 4 distinct geographic regions of the United States were recruited. Parents reported cold symptoms in 163 children, and 134 went on to develop colds. The most prevalent symptoms were runny nose, stuffed-up nose, and sneezing. The most severe symptoms were runny nose, stuffed-up nose, and sore/scratchy throat. The severity of most symptoms peaked 1-2 days after onset. Up to 54% of parents expressed willingness to bring a sick child to a clinical center shortly after the onset of symptoms. Parents found the Internet-based surveys easy to complete. Internet-based surveillance and recruitment can be useful

  16. An analysis of glyphosate data from the California Environmental Protection Agency Pesticide Illness Surveillance Program.

    PubMed

    Goldstein, Daniel A; Acquavella, John F; Mannion, Rhonda M; Farmer, Donna R

    2002-01-01

    Glyphosate is among the pesticides most frequently reported to the California EPA Pesticide Illness Surveillance Program. We analyzed glyphosate-related calls to the Pesticide Illness Surveillance Program in order to assess the number of reports involving systemic symptoms and to better understand the nature and severity of reported cases. Data on glyphosate and other pesticides are available for the years 1982-1997 including: type of exposure (agricultural/other); target organ(s) affected (skin/eye/respiratory/systemic); exposure(s); an assessment of causal relationship (possible, probable, or definite); and limited medical text. Of 815 total glyphosate calls, most involved topical irritation of the eye (n = 399), skin (n = 250), upper airway (n = 7), or combinations of these sites (n = 32) without systemic symptoms. Of the 187 systemic cases, only 22 had symptoms recorded as probably or definitely related to glyphosate exposure alone. The reported symptoms were not severe, expected to be limited in duration, and frequently inconsistent with the route of exposure and/or previous experience with glyphosate. We conclude that call volume is not a reliable indicator of the actual incidence or severity of glyphosate-related incidents in California.

  17. Idaho National Engineering and Environmental Laboratory Offsite Environmental Surveillance Program Report: Third Quarter 1999

    SciTech Connect

    R. Evans

    2000-03-01

    The Environmental Science and Research Foundation conducts an offsite environmental surveillance program for the Department of Energy's Idaho National Engineering and Environmental Laboratory (INEEL). The Foundation's environmental surveillance program monitors the effects, if any, of US Department of Energy (DOE) activities on the offsite environment, collects data to confirm compliance with applicable environmental laws and regulations, and observes any trends in the environmental levels of radioactivity. This report for the third quarter of 1999 is based on 704 samples of air, fine particulates, atmospheric moisture, precipitation, milk, and food. All concentrations of radioactivity found in these samples were consistent with concentrations which have been found in sampling during recent quarters and which have been attributed in the past to natural background radiation, worldwide fallout from past nuclear weapons testing, and nuclear operations around the world. No! measured concentrations could be directly attributed to operations at the INEEL. Concentrations in all samples were below the guidelines set by both the DOE and the US Environmental Protection Agency (EPA) for protection of the public.

  18. Idaho National Engineering and Environmental Laboratory Offsite Environmental Surveillance Program Report: Second Quarter 1999

    SciTech Connect

    R. Evans

    1999-12-01

    The Environmental Science and Research Foundation conducts an Offsite Environmental Surveillance Program at the US Department of Energy's Idaho National Engineering and Environmental Laboratory (INEEL). The Foundation's environmental surveillance program monitors the effects, if any, of US Department of Energy (DOE) activities on the offsite environment, collects data to confirm compliance with applicable environmental laws and regulations, and observes any trends in the environmental levels of radioactivity. This report for the second quarter 1999 is based on 618 samples of air (including airborne radioactivity, fine particulates, and atmospheric moisture), precipitation, milk, drinking water, sheep, wild game tissues, and environmental radiation. All concentrations of radioactivity found in these samples were consistent with concentrations which have been found in sampling during recent quarters and which have been attributed in the past to natural background radiation, worldwide fallout from past nuclear weapons testing, and nuclear operations around the world. No measured concentrations could be directly attributed to operations at the INEEL. Concentrations in all samples were below the guidelines set by both the DOE and the US Environmental Protection Agency (EPA) for protection of the public.

  19. Idaho National Engineering and Environmental Laboratory Offsite Environmental Surveillance Program Report: First Quarter 1999

    SciTech Connect

    R. Evans

    1999-09-01

    The Environmental Science and Research Foundation conducts an Offsite Environmental Surveillance Program at the US Department of Energy's Idaho National Engineering and Environmental Laboratory (INEEL). The Foundation's environmental surveillance program monitors the effects, if any, of US Department of Energy (DOE) activities on the offsite environment, collects data to confirm compliance with applicable environmental laws and regulations, and observes any trends in the environmental levels of radioactivity. This report for the first quarter 1999 is based on 564 samples of air (including airborne radioactivity, fine particulates, and atmospheric moisture), precipitation, milk, and wild game tissues. All concentrations of radioactivity found in these samples were consistent with concentrations which have been found in sampling during recent quarters and which have been attributed in the past to natural background radiation, worldwide fallout from past nuclear weapons ! testing, an d nuclear operations around the world. No measured concentrations could be directly attributed to operations at the INEEL. Concentrations in all samples were below the guidelines set by both the DOE and the US Environmental Protection Agency (EPA) for protection of the public.

  20. Idaho National Engineering and Environmental Laboratory Offsite Environmental Surveillance Program Report: Fourth Quarter 1998

    SciTech Connect

    T. Saffle; R. Evans

    1999-08-01

    The Environmental Science and Research Foundation conducts the Offsite Environmental Surveillance Program at the US Department of Energy's Idaho National Engineering and Environmental Laboratory (INEEL). The Foundation's environmental surveillance program monitors the effects, if any, of US Department of Energy (DOE) activities on the offsite environment, collects data to confirm compliance with applicable environmental laws and regulations, and observes any trends in the environmental levels of radioactivity. This report for the fourth quarter 1998 is based on 622 samples collected of air, fine particulates, atmospheric moisture, precipitation, water, milk, potatoes, and game animals. All concentrations of radioactivity found in these samples were consistent with concentrations which have been found in sampling during recent quarters and which have been attributed in the past to natural background radioactivity, worldwide fallout from past nuclear weapons testing, an! d nuclear operations around the world. No measured concentrations could be directly attributed to operations at the INEEL, although statistical differences did exist between on-site and distant gross beta concentrations. No evidence could be found to link these differences with a specific INEEL source. Concentrations in all samples were below the guidelines set by both the DOE and the US Environmental Protection Agency (EPA) for protection of the public.

  1. Environmental Restoration Program pollution prevention checklist guide for the surveillance and maintenance project phase

    SciTech Connect

    Not Available

    1993-09-01

    DOE Order 5820.2 mandates that a surveillance and maintenance program be established in all shut-down facilities to ensure adequate containment of contamination, provide physical safety and security, and reduce potential public and environmental hazards. A key consideration in this process is the prevention of any waste to be generated from these activities. The purpose of this checklist guide is to assist the user with incorporating pollution prevention/waste minimization (PP/WM) in all Surveillance and Maintenance (S&M) phase projects of the Environmental Restoration (ER) Program. This guide will help users document their PP/WM activities for technology transfer and reporting requirements. Automated computer screens will be created from the checklist data to assist users with implementing and evaluating waste reduction. Users can then establish numerical performance measures to measure progress in planning, training, self-assessments, field implementation, documentation, and technology transfer. Cost savings result as users train and assess themselves and perform preliminary waste assessments.

  2. Investigation of mechanisms and molecular epidemiology of linezolid nonsusceptible Enterococcus faecalis isolated from a teaching hospital in China.

    PubMed

    Li, Bin; Ma, Chuan-Ling; Yu, Xiao; Sun, Yao; Li, Mei-Mei; Ye, Jian-Zhong; Zhang, Ya-Pei; Wu, Qing; Zhou, Tie-Li

    2016-08-01

    The epidemiological and molecular characteristics of eight linezolid nonsusceptible Enterococcus faecalis isolated from a teaching hospital in China (January to July 2014) were investigated. The target site modifications and cfr gene associated with linezolid resistance were not found. Results of the epidemiological investigation indicated that linezolid resistance possibly occurred on several independent occasions and was often not related to linezolid administration.

  3. A Focused Ethnographic Study of Alberta Cattle Veterinarians’ Decision Making about Diagnostic Laboratory Submissions and Perceptions of Surveillance Programs

    PubMed Central

    Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig

    2013-01-01

    The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance. PMID:23741397

  4. A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs.

    PubMed

    Sawford, Kate; Vollman, Ardene Robinson; Stephen, Craig

    2013-01-01

    The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.

  5. Linezolid and Rasagiline – A culprit for serotonin syndrome

    PubMed Central

    Hisham, Mohamed; Sivakumar, Mundalipalayam N.; Nandakumar, V.; Lakshmikanthcharan, S.

    2016-01-01

    A 65-year-old female patient was admitted to the hospital for cellulitis. She had a history of diabetes mellitus and parkinsonism on levodopa/carbidopa, rasagiline, ropinirole, trihexyphenidyl, amantadine, metformin, and glipizide. We present here a case of rare incidence of serotonin syndrome associated with linezolid and rasagiline. PMID:26997732

  6. Linezolid and Rasagiline - A culprit for serotonin syndrome.

    PubMed

    Hisham, Mohamed; Sivakumar, Mundalipalayam N; Nandakumar, V; Lakshmikanthcharan, S

    2016-01-01

    A 65-year-old female patient was admitted to the hospital for cellulitis. She had a history of diabetes mellitus and parkinsonism on levodopa/carbidopa, rasagiline, ropinirole, trihexyphenidyl, amantadine, metformin, and glipizide. We present here a case of rare incidence of serotonin syndrome associated with linezolid and rasagiline.

  7. Decontamination and decommissioning surveillance and maintenance report for FY 1991. Environmental Restoration Program

    SciTech Connect

    Burwinkle, T. W.; Cannon, T. R.; Ford, M. K.; Holder, Jr., L.; Clotfelter, O. K.; Faulkner, R. L.; Smith, D. L.; Wooten, H. O.

    1991-12-01

    The Decontamination and Decommissioning (D&D) Program has three distinct phases: (1) surveillance and maintenance (S&M); (2) decontamination and removal of hazardous materials and equipment (which DOE Headquarters in Washington, D.C., calls Phase I of remediation); and (3) decommissioning and ultimate disposal, regulatory compliance monitoring, and property transfer (which DOE Headquarters calls Phase II of remediation). A large part of D&D is devoted to S&M at each of the sites. Our S&M activities, which are performed on facilities awaiting decommissioning, are designed to minimize potential hazards to human health and the environment by: ensuring adequate containment of residual radioactive and hazardous materials; and, providing physical safety and security controls to minimize potential hazards to on-site personnel and the general public. Typically, we classify maintenance activities as either routine or special (major repairs). Routine maintenance includes such activities as painting, cleaning, vegetation control, minor structural repairs, filter changes, and building system(s) checks. Special maintenance includes Occupational Safety and Health Act facility upgrades, roof repairs, and equipment overhaul. Surveillance activities include inspections, radiological measurements, reporting, records maintenance, and security (as required) for controlling and monitoring access to facilities. This report summarizes out FY 1991 S&M activities for the Tennessee plant sites, which include the K-25 Site, the Gas Centrifuge facilities, ORNL, and the Y-12 Plant.

  8. The US Support Program to IAEA Safeguards Priority of Containment and Surveillance

    SciTech Connect

    Diaz,R.A.

    2008-06-13

    The United States Support Program (USSP) priority for containment and surveillance (US) focuses on maintaining or improving the reliability and cost-effectiveness of C/S systems for IAEA safeguards, expanding the number of systems that are unattended and remotely monitored, and developing verification methods that help streamline the on-site inspection process. Existing IAEA C/S systems have evolved to become complex, integrated systems, which may include active seals, nondestructive assay (NDA) instruments, video cameras, and other sensors. These systems operate autonomously. They send analytical data to IAEA headquarters where it can be reviewed. These systems present challenges to the goals of improved system performance, standardization, reliability, maintainability, documentation, and cost effectiveness. One critical lesson from past experiences is the need for cooperation and common objectives among the IAEA, the developer, and the facility operator, to create a successful, cost effective system. Recent USSP C/S activities include Rokkasho Reprocessing Plant safeguard systems, production of a new shift register, numerous vulnerability assessments of C/S systems, a conduit monitoring system which identifies tampering of IAEA conduit deployed in the field, fiber optic seal upgrades, unattended monitoring system software upgrades, next generation surveillance system which will upgrade existing camera systems, and support of the IAEA's development of the universal nondestructive assay data acquisition platform.

  9. Establishment of a High Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program [corrected].

    PubMed

    Wallace, Ryan M; Reses, Hannah; Franka, Richard; Dilius, Pierre; Fenelon, Natael; Orciari, Lillian; Etheart, Melissa; Destine, Apollon; Crowdis, Kelly; Blanton, Jesse D; Francisco, Calvin; Ludder, Fleurinord; Del Rio Vilas, Victor; Haim, Joseph; Millien, Max

    2015-11-01

    The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 -December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9%) and an additional 36 cases were identified based on clinical diagnosis (5%), representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%). Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries.

  10. Global Emerging Infection Surveillance and Response (GEIS)- Avian Influenza Pandemic Influenza (AI/PI) Program

    DTIC Science & Technology

    2014-10-01

    surveillance, malaria resistance surveillance, diarrhea etiology and antimicrobial resistance surveillance, sexually transmitted illness surveillance, and...4 Body Respiratory Illness…………………………………………………………. 4 Acute Febrile Illness……………………………………………………….. 7 Malaria ...These pillars include respiratory illnesses, acute febrile illnesses, malaria , enterics, sexually transmitted infections and antimicrobial

  11. Using behavioral risk factor surveillance data for heart disease and stroke prevention programs.

    PubMed

    Greenlund, Kurt J; Denny, Clark H; Mokdad, Ali H; Watkins, Nancy; Croft, Janet B; Mensah, George A

    2005-12-01

    An effective state heart disease and stroke prevention program must be able to monitor changes in heart disease and stroke risk factors of the state population. The Behavioral Risk Factor Surveillance System (BRFSS), a state-based telephone survey, has been an important source for monitoring health-related factors and evaluating the success of programs. The BRFSS currently includes modules on hypertension and cholesterol screening and awareness, cardiovascular disease preventive practices, and recognition of the signs and symptoms of heart attack and stroke as well as relevant modules on fruit and vegetable intake, physical activity, tobacco use, and diabetes. Publication topics included monitoring risk factors and clinical services, assessing progress toward national goals, assessing health disparities, and health status and health-related quality of life issues. States have used the BRFSS data for monitoring health risks in the state, assessing state and national health objectives, determining and providing data for public health campaigns, providing information for legislative proposals, and providing information that helps to initiate collaboration. Major methodologic issues involve validating self-reported data against direct measurement and assessing the effects of changes in telecommunications. As Centers for Disease Control's (CDC) national heart disease and stroke prevention program and each state health department program develop, state and even local level data will become more important to measure the burden of disease and program impact. State heart disease and stroke prevention programs are encouraged to work closely with state BRFSS coordinators to obtain vital information to measure the burden of heart disease and stroke in their state and to be able to measure program impact on addressing the first and third leading causes of death in the U.S.

  12. Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P).

    PubMed

    Bonneterre, Vincent; Faisandier, Laurie; Bicout, Dominique; Bernardet, Cyril; Piollat, Jacques; Ameille, Jacques; de Clavière, Caroline; Aptel, Michel; Lasfargues, Gérard; de Gaudemaris, Régis

    2010-03-01

    The French national occupational disease surveillance and prevention network (RNV3P) includes the 30 occupational disease consultation centres in university hospitals to which patients are referred for potentially work-related diseases, and an occupational health service. The aim of this work is to demonstrate the contribution of RNV3P to national health surveillance. Data from consultations are recorded in standardised occupational health reports and coded using international or national classifications. Programmed health surveillance is carried out through annual follow-up of annual referrals to experts for pre-selected disease-exposure associations, as well as incidence estimations for the well characterised working population followed by the occupational health service. Hypotheses on new emerging diseases are generated using statistical methods employed in pharmacosurveillance and by modelling as an exposome to analyse multiple exposures. 58,777 occupational health reports were collected and analysed from 2001 to 2007. Referrals to the 30 university hospital centres increased significantly for asbestos-related diseases, mood disorders and adjustment disorders related to psychological and organisational demands, and for elbow and shoulder disorders related to manual handling. Referrals significantly decreased for asthma and for rhinitis related to exposure to organic dusts (vegetable or animal) or chemicals, except for cosmetics and cleaning products. Estimation of incidences by the occupational health services showed different patterns in different sectors of activity. The methods for detecting emerging diseases are presented and illustrated using the example of systemic sclerosis, identifying new exposures and new sectors of activity to be investigated. The RNV3P collects data from two complementary samples: 30 university hospital centres (workers or former workers) and an occupational health service (current workers). This dual approach is useful for

  13. What Have We Learned From the Typhoid Fever Surveillance in Africa Program?

    PubMed

    Baker, Stephen; Hombach, Joachim; Marks, Florian

    2016-03-15

    The Typhoid Fever Surveillance in Africa Program (TSAP) was established in 2009 to fill the data void concerning invasive Salmonella disease in sub-Saharan Africa, and to specifically estimate the burden of bloodstream infections caused by the key pathogen, Salmonella enterica serovar Typhi. TSAP has achieved this ambitious target, finding high incidences of typhoid fever in both rural and urban populations in several countries in sub-Saharan Africa. The results of TSAP will undoubtedly dictate the direction of future typhoid fever research in Africa, and at last provides a key piece of the disease burden jigsaw puzzle. With the dawn of new Vi conjugate vaccines against Salmonella Typhi, the next priority for the typhoid community must be providing the required data on these vaccines so they can be licensed and provided to those in high-risk groups and locations across sub-Saharan Africa. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  14. Economic evaluation and budget impact analysis of the surveillance program for hepatocellular carcinoma in Thai chronic hepatitis B patients.

    PubMed

    Sangmala, Pannapa; Chaikledkaew, Usa; Tanwandee, Tawesak; Pongchareonsuk, Petcharat

    2014-01-01

    The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One- way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible

  15. 9 CFR 146.14 - Diagnostic surveillance program for H5/H7 low pathogenic avian influenza.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .../H7 low pathogenic avian influenza. 146.14 Section 146.14 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  16. 9 CFR 146.14 - Diagnostic surveillance program for H5/H7 low pathogenic avian influenza.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .../H7 low pathogenic avian influenza. 146.14 Section 146.14 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  17. 9 CFR 146.14 - Diagnostic surveillance program for H5/H7 low pathogenic avian influenza.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .../H7 low pathogenic avian influenza. 146.14 Section 146.14 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  18. 9 CFR 146.14 - Diagnostic surveillance program for H5/H7 low pathogenic avian influenza.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .../H7 low pathogenic avian influenza. 146.14 Section 146.14 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  19. 9 CFR 146.14 - Diagnostic surveillance program for H5/H7 low pathogenic avian influenza.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .../H7 low pathogenic avian influenza. 146.14 Section 146.14 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  20. RELATIVE HUMIDITY TESTS IN SUPPORT OF THE 3013 STORAGE AND SURVEILLANCE PROGRAM

    SciTech Connect

    Mickalonis, J.; Duffey, J.

    2011-08-01

    Techniques to control the initial relative humidity over oxide/salt mixtures have been developed using cerium oxide as a surrogate for plutonium oxide. Such control is required to validate certain assumptions in the Department of Energy Standard DOE-STD-3013, and to provide essential information to support field surveillance at the storage sites for excess plutonium oxides. Concern over the validity of the assumption that corrosion induced degradation in 3013 containers could be controlled by assuring that the moisture content of any stored oxide/salt mixture was below 0.5 w t% arose when stress corrosion cracks were found in test samples exposed at room temperature to plutonium oxide/salt mixtures having a moisture content only marginally above 0.5 wt %. Additionally, analysis of the stress corrosion cracking observations suggests that the initial relative humidity over the oxide/salt mixture may play a major role in the cracking process. The investigations summarized in this report provide the procedures necessary to control the initial relative humidity to selected values within the range of 16 to 50% by controlling the loading relative humidity (18 to 60%) and the oxide/salt mixture water content (0.05 to 0.45 wt %). The studies also demonstrated that the initial relative humidity may be estimated by calculations using software EQ3/6. Cerium oxide/salt mixtures were used in this study because qualification tests with non-radioactive materials will reduce costs while increasing the breadth of the test programs required to support field surveillances of stored 3013 containers.

  1. European surveillance network for influenza in pigs: surveillance programs, diagnostic tools and Swine influenza virus subtypes identified in 14 European countries from 2010 to 2013.

    PubMed

    Simon, Gaëlle; Larsen, Lars E; Dürrwald, Ralf; Foni, Emanuela; Harder, Timm; Van Reeth, Kristien; Markowska-Daniel, Iwona; Reid, Scott M; Dan, Adam; Maldonado, Jaime; Huovilainen, Anita; Billinis, Charalambos; Davidson, Irit; Agüero, Montserrat; Vila, Thaïs; Hervé, Séverine; Breum, Solvej Østergaard; Chiapponi, Chiara; Urbaniak, Kinga; Kyriakis, Constantinos S; Brown, Ian H; Loeffen, Willie

    2014-01-01

    Swine influenza causes concern for global veterinary and public health officials. In continuing two previous networks that initiated the surveillance of swine influenza viruses (SIVs) circulating in European pigs between 2001 and 2008, a third European Surveillance Network for Influenza in Pigs (ESNIP3, 2010-2013) aimed to expand widely the knowledge of the epidemiology of European SIVs. ESNIP3 stimulated programs of harmonized SIV surveillance in European countries and supported the coordination of appropriate diagnostic tools and subtyping methods. Thus, an extensive virological monitoring, mainly conducted through passive surveillance programs, resulted in the examination of more than 9 000 herds in 17 countries. Influenza A viruses were detected in 31% of herds examined from which 1887 viruses were preliminary characterized. The dominating subtypes were the three European enzootic SIVs: avian-like swine H1N1 (53.6%), human-like reassortant swine H1N2 (13%) and human-like reassortant swine H3N2 (9.1%), as well as pandemic A/H1N1 2009 (H1N1pdm) virus (10.3%). Viruses from these four lineages co-circulated in several countries but with very different relative levels of incidence. For instance, the H3N2 subtype was not detected at all in some geographic areas whereas it was still prevalent in other parts of Europe. Interestingly, H3N2-free areas were those that exhibited highest frequencies of circulating H1N2 viruses. H1N1pdm viruses were isolated at an increasing incidence in some countries from 2010 to 2013, indicating that this subtype has become established in the European pig population. Finally, 13.9% of the viruses represented reassortants between these four lineages, especially between previous enzootic SIVs and H1N1pdm. These novel viruses were detected at the same time in several countries, with increasing prevalence. Some of them might become established in pig herds, causing implications for zoonotic infections.

  2. European Surveillance Network for Influenza in Pigs: Surveillance Programs, Diagnostic Tools and Swine Influenza Virus Subtypes Identified in 14 European Countries from 2010 to 2013

    PubMed Central

    Simon, Gaëlle; Larsen, Lars E.; Dürrwald, Ralf; Foni, Emanuela; Harder, Timm; Van Reeth, Kristien; Markowska-Daniel, Iwona; Reid, Scott M.; Dan, Adam; Maldonado, Jaime; Huovilainen, Anita; Billinis, Charalambos; Davidson, Irit; Agüero, Montserrat; Vila, Thaïs; Hervé, Séverine; Breum, Solvej Østergaard; Chiapponi, Chiara; Urbaniak, Kinga; Kyriakis, Constantinos S.; Brown, Ian H.; Loeffen, Willie

    2014-01-01

    Swine influenza causes concern for global veterinary and public health officials. In continuing two previous networks that initiated the surveillance of swine influenza viruses (SIVs) circulating in European pigs between 2001 and 2008, a third European Surveillance Network for Influenza in Pigs (ESNIP3, 2010–2013) aimed to expand widely the knowledge of the epidemiology of European SIVs. ESNIP3 stimulated programs of harmonized SIV surveillance in European countries and supported the coordination of appropriate diagnostic tools and subtyping methods. Thus, an extensive virological monitoring, mainly conducted through passive surveillance programs, resulted in the examination of more than 9 000 herds in 17 countries. Influenza A viruses were detected in 31% of herds examined from which 1887 viruses were preliminary characterized. The dominating subtypes were the three European enzootic SIVs: avian-like swine H1N1 (53.6%), human-like reassortant swine H1N2 (13%) and human-like reassortant swine H3N2 (9.1%), as well as pandemic A/H1N1 2009 (H1N1pdm) virus (10.3%). Viruses from these four lineages co-circulated in several countries but with very different relative levels of incidence. For instance, the H3N2 subtype was not detected at all in some geographic areas whereas it was still prevalent in other parts of Europe. Interestingly, H3N2-free areas were those that exhibited highest frequencies of circulating H1N2 viruses. H1N1pdm viruses were isolated at an increasing incidence in some countries from 2010 to 2013, indicating that this subtype has become established in the European pig population. Finally, 13.9% of the viruses represented reassortants between these four lineages, especially between previous enzootic SIVs and H1N1pdm. These novel viruses were detected at the same time in several countries, with increasing prevalence. Some of them might become established in pig herds, causing implications for zoonotic infections. PMID:25542013

  3. Overview of a comprehensive environmental monitoring and surveillance program: The role of fish and wildlife

    SciTech Connect

    Gray, R.H.

    1988-05-01

    Concern about the effects of potential releases from nuclear and non-nuclear activities on the US Department of Energy's Hanford Site in southeastern Washington has evolved over four decades into a comprehensive environmental monitoring and surveillance program. The program includes field sampling, and chemical and physical analyses of air, surface and ground water, fish and wildlife, soil, foodstuffs, and natural vegetation. In addition to monitoring radioactivity in fish and wildlife, population numbers of key species are determined, usually during the breeding season. Data from monitoring efforts are used to assess the environmental impacts of Hanford operations and calculate the overall radiological dose to humans onsite, at the Site perimeter, or residing in nearby communities. Chinook salmon spawning in the Columbia River at Hanford has increased in recent years with a concomitant increase in winter nesting activity of bald eagles (Haliaeetus leucocephalus). An elk (Cervus elaphus) herd, established by immigration in 1972, is also increasing. Nesting Canada goose (Branta canadensis) and great blue heron (Ardea herodias), and various other animals, e.g., mule deer (Odocoileus hemionus) and coyotes (Canis latrans) are common. Measured exposure to penetrating radiation and calculated radiation doses to the public are well below applicable regulatory limits.

  4. Global Emerging Infection Surveillance and Response (GEIS)- Avian Influenza Pandemic Influenza (AI/PI) Program

    DTIC Science & Technology

    2008-10-01

    are only a few surveillance studies and outbreak reports in the literature; a finding that stems, in part, from the lower priority given to influenza...This surveillance project will utilize USAMRU-K GEIS surveillance sites across Kenya. The study population will include persons of all ages...Flaviviridae and genus flavivirus. It is a member of the Japanese Encephalitis (JE) virus serocomplex. The complex includes the Japanese

  5. Local disease concepts relevant to the design of a community-based surveillance program for influenza in rural Guatemala.

    PubMed

    Cerón, Alejandro; Ortiz, Maria Renee; Álvarez, Danilo; Palmer, Guy H; Cordón-Rosales, Celia

    2016-04-23

    Early detection of emergent influenza strains is a global health priority. However, maintaining active surveillance is economically and logistically challenging. While community-based surveillance is an attractive alternative, design and operation of an effective epidemiological surveillance program requires community engagement that can be linked to public health reporting and response. We report the results of a study in rural Guatemalan communities aimed at identifying opportunities for and barriers to community engagement in disease surveillance. Using an ethnographic approach followed by a descriptive cross-sectional survey, we documented local terms and ideas about animal illnesses, including the possibility of animal-human transmission. The community perceived disease causation principally in terms of changes in the physical environment and weather and categorized illnesses using local terminology based on observable clinical signs. Knowledge about prevention and treatment was derived predominantly from local networks of family and friends without evidence of professionally-based knowledge being regularly introduced into the community. Bridging the divide between professional and community-based descriptive disease terminology, incorporating animal and human health responsiveness to common illnesses, and providing professional knowledge into the community-based networks were identified as addressable challenges to effective implementation of community-based surveillance.

  6. State programs to reduce uncontrolled ammonia releases and associated injury using the hazardous substances emergency events surveillance system.

    PubMed

    Wattigney, Wendy A; Rice, Nancy; Cooper, Debbi L; Drew, James M; Orr, Maureen F

    2009-03-01

    To describe how the Hazardous Substances Emergency Events Surveillance (HSEES) program identifies leading causes of uncontrolled ammonia releases and targets activities aimed at reducing the frequency of these incidents. Ammonia incidents reported to HSEES nationally were examined. HSEES programs in state health departments conducted and evaluated data-driven prevention outreach. The primary targeted ammonia incidents in the three HSEES states that are presented include food manufacturing, agriculture, and events related to the production of illicit methamphetamine. Key to these prevention activities was using state-specific HSEES data to identify problems and evaluate the prevention activity, and developing partnerships with other stakeholders. HSEES data is used to identify determinants of chemical incidents and their outcomes and to help guide strategies to reduce such occurrences. Surveillance of chemical incidents elucidates the causes and consequences of these events and helps identify problems and measure the effectiveness of prevention programs.

  7. Design, baseline characteristics, and early findings of the MPS VI (mucopolysaccharidosis VI) Clinical Surveillance Program (CSP).

    PubMed

    Hendriksz, Christian J; Giugliani, Roberto; Harmatz, Paul; Lampe, Christina; Martins, Ana Maria; Pastores, Gregory M; Steiner, Robert D; Leão Teles, Elisa; Valayannopoulos, Vassili

    2013-03-01

    To outline the design, baseline data, and 5-year follow-up data of patients with mucopolysaccharidosis (MPS) VI enrolled in the Clinical Surveillance Program (CSP), a voluntary, multinational, observational program. The MPS VI CSP was opened in 2005 to collect, for at least 15 years, observational data from standard clinical and laboratory assessments of patients with MPS VI. Baseline and follow-up data are documented by participating physicians in electronic case report forms. Between September 2005 and March 2010 the CSP enrolled 132 patients, including 123 who received enzyme replacement therapy (ERT) with galsulfase. Median age at enrolment was 13 years (range 1-59). Mean baseline data showed impaired growth, hepatosplenomegaly, and reduced endurance and pulmonary function. The most common findings were heart valve disease (90%), reduced visual acuity (79%), impaired hearing (59%), and hepatosplenomegaly (54%). Follow-up data up to 5 years in patients with pre- and post-ERT measurements showed a decrease in urinary glycosaminoglycans and increases in height and weight in patients <16 years and suggested reductions in liver and spleen size and improvements in endurance and pulmonary function after ERT was started. Vision, hearing, and cardiac function were unchanged. Safety data were in line with previous reports. The CSP represents the largest cross-sectional study of MPS VI to date. This first report provides information on the design and implementation of the program and population statistics for several clinical variables in patients with MPS VI. Data collected over 5 years suggest that ERT provides clinical benefit and is well-tolerated with no new safety concerns.

  8. Electronic surveillance systems in infection prevention: organizational support, program characteristics, and user satisfaction.

    PubMed

    Grota, Patti G; Stone, Patricia W; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2010-09-01

    The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs.

  9. 10 CFR Appendix H to Part 50 - Reactor Vessel Material Surveillance Program Requirements

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... light water nuclear power reactors which result from exposure of these materials to neutron irradiation... Practice for Conducting Surveillance Tests for Light-Water Cooled Nuclear Power Reactor Vessels”; and ASTM E 185-82, “Standard Practice for Conducting Surveillance Tests for Light-Water Cooled Nuclear Power...

  10. 10 CFR Appendix H to Part 50 - Reactor Vessel Material Surveillance Program Requirements

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... light water nuclear power reactors which result from exposure of these materials to neutron irradiation... Practice for Conducting Surveillance Tests for Light-Water Cooled Nuclear Power Reactor Vessels”; and ASTM E 185-82, “Standard Practice for Conducting Surveillance Tests for Light-Water Cooled Nuclear Power...

  11. 10 CFR Appendix H to Part 50 - Reactor Vessel Material Surveillance Program Requirements

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... light water nuclear power reactors which result from exposure of these materials to neutron irradiation..., “Standard Recommended Practice for Surveillance Tests for Nuclear Reactor Vessels”; ASTM E 185-79, “Standard Practice for Conducting Surveillance Tests for Light-Water Cooled Nuclear Power Reactor Vessels”; and...

  12. Development and implementation of the first national data quality standards for population-based birth defects surveillance programs in the United States.

    PubMed

    Anderka, Marlene; Mai, Cara T; Romitti, Paul A; Copeland, Glenn; Isenburg, Jennifer; Feldkamp, Marcia L; Krikov, Sergey; Rickard, Russel; Olney, Richard S; Canfield, Mark A; Stanton, Carol; Mosley, Bridget; Kirby, Russell S

    2015-09-19

    Population-based birth defects surveillance is a core public health activity in the United States (U.S.); however, the lack of national data quality standards has limited the use of birth defects surveillance data across state programs. Development of national standards will facilitate data aggregation and utilization across birth defects surveillance programs in the U.S. Based on national standards for other U.S. public health surveillance programs, existing National Birth Defects Prevention Network (NBDPN) guidelines for conducting birth defects surveillance, and information from birth defects surveillance programs regarding their current data quality practices, we developed 11 data quality measures that focused on data completeness (n = 5 measures), timeliness (n = 2), and accuracy (n = 4). For each measure, we established tri-level performance criteria (1 = rudimentary, 2 = essential, 3 = optimal). In January 2014, we sent birth defects surveillance programs in each state, District of Columbia, Puerto Rico, Centers for Disease Control and Prevention (CDC), and the U.S. Department of Defense Birth and Infant Health Registry an invitation to complete a self-administered NBDPN Standards Data Quality Assessment Tool. The completed forms were electronically submitted to the CDC for analyses. Of 47 eligible population-based surveillance programs, 45 submitted a completed assessment tool. Two of the 45 programs did not meet minimum inclusion criteria and were excluded; thus, the final analysis included information from 43 programs. Average scores for four of the five completeness performance measures were above level 2. Conversely, the average scores for both timeliness measures and three of the four accuracy measures were below level 2. Surveillance programs using an active case-finding approach scored higher than programs using passive case-finding approaches for the completeness and accuracy measures, whereas their average scores were lower

  13. Technology, Safety and Costs of Decommissioning a Reference Low-Level Waste Burial Ground Environmental Surveillance Programs

    SciTech Connect

    Denham, D. H.; Eddy, P. A.; Hawley, K. A.; Jaquish, R. E.; Corley, J. P.

    1981-07-01

    This Addendum supplements, and to some extent replaces, the preliminary description of environmental radiological surveillance programs for low-level waste burial grounds (LLWBG) used in the parent document, 11 Technology, Safety and Costs of DecolliTlissioning a Reference Low-Level Waste Burial Ground, 11 NUREG/ CR-0570. The Addendum provides additional detail and rationale for the environmental radiological surveillance programs for the two referenced sites and inventories described in NUREG/CR-0570. The rationale and performance criteria herein are expected to be useful in providing guidance for determining the acceptability of environmental surveillance programs for other inventories and other LLWBG sites. Two generic burial grounds, one located on an arid western site and the other located on a humid eastern site, are reference facilities considered in this Addendum, and as described in the parent document (NUREG/CR-0570). The two sites are assumed to have the same capacity for waste, the same radioactive waste inventory, and similar trench characteristics and operating procedures. The climate, geology, and hydrology of the two reference sites are typical of existing western and eastern sites, altnough a single population distribution was chosen for both. Each reference burial ground occupies about 70 hectares and includes 180 trenches filled with a total of 1.5 x 10{sup 6} m{sup 3} of radioactive waste. In acldition, there are 10 slit trenches containing about 1.5 x 10{sup 3} m{sup 3} of high beta-gamma activity waste. In this Addendum environmental surveillance programs are described for the several periods in the life of a LLWBG: preoperational (prior to nuclear waste receipt); operational (including interim trench closures); post-operational (after all nuclear waste is received), for both short-term {up to three years) and long-term (up to 100 years) storage and custodial care; and decommissioning (only for the special case of waste removal). The specific

  14. Identifying risk factors for brain metastasis in breast cancer patients: Implication for a vigorous surveillance program.

    PubMed

    Chow, Lorraine; Suen, Dacita; Ma, Kwok Kuen; Kwong, Ava

    2015-10-01

    Brain metastasis occurs in 10-15% of metastatic breast cancer patients and is associated with poor prognosis. This study aims to identify tumor characteristics of primary breast cancer, which are related to brain metastases in Hong Kong Chinese patients. A retrospective study of patients with invasive breast cancer receiving treatment in a university hospital from January 2001 to December 2008 was performed. The clinicopathological factors of patients with brain metastases were analyzed and compared with those who had no brain metastasis. Risk factors for brain metastasis were identified by univariate analysis first and then by multivariate analysis. A total of 912 patients with invasive breast cancer were treated during the study period. Of these, 30 patients were found to have distant metastases to brain. Patients with brain metastases had more breast tumors of higher histological grade (Grade III, 78.9% vs. 30.2%; p = 0.001). Their tumors also had a significantly higher rate of negative estrogen receptors (78.9% vs. 30.2%, p = 0.001). On multivariate analysis, only high tumor grading was found to be predictive of developing brain metastasis. Chinese breast cancer patients with brain metastasis were more likely to have high-grade tumors and negative estrogen receptor status. A more vigorous surveillance program for the central nervous system should be considered for this group of patients. Copyright © 2015. Published by Elsevier Taiwan.

  15. Alaska's model program for surveillance and prevention of occupational injury deaths.

    PubMed Central

    Conway, G A; Lincoln, J M; Husberg, B J; Manwaring, J C; Klatt, M L; Thomas, T K

    1999-01-01

    The National Institute for Occupational Safety and Health (NIOSH) established its Alaska Field Station in Anchorage in 1991 after identifying Alaska as the highest-risk state for traumatic worker fatalities. Since then, the Field Station, working in collaboration with other agencies, organizations, and individuals, has established a program for occupational injury surveillance in Alaska and formed interagency working groups to address the risk factors leading to occupational death and injury in the state. Collaborative efforts have contributed to reducing crash rates and mortality in Alaska's rapidly expanding helicopter logging industry and have played an important supportive role in the substantial progress made in reducing the mortality rate in Alaska's commercial fishing industry (historically Alaska's and America's most dangerous industry). Alaska experienced a 46% overall decline in work-related acute traumatic injury deaths from 1991 to 1998, a 64% decline in commercial fishing deaths, and a very sharp decline in helicopter logging-related deaths. Extending this regional approach to other parts of the country and applying these strategies to the entire spectrum of occupational injury and disease hazards could have a broad effect on reducing occupational injuries. PMID:10670623

  16. Postmarketing surveillance of new food ingredients: results from the program with the fat replacer olestra.

    PubMed

    Allgood, G S; Kuter, D J; Roll, K T; Taylor, S L; Zorich, N L

    2001-04-01

    Market introduction of savory snacks containing olestra offered an opportunity to evaluate the safety of olestra in a free-living population and thereby compare the outcome to the previously established safety profile determined in clinical trials in which subjects were required to eat predetermined amounts at prescribed intervals. Therefore, a multifaceted postmarketing surveillance program was designed to evaluate consumer experience and safety of olestra in the marketplace. Customer comments were solicited through toll-free telephone numbers. Collected data were evaluated by both internal and external medical experts. About 10% of toll-free telephone calls reported health effects, most of which were gastrointestinal (GI) in nature. Clinical studies were designed and conducted to determine potential GI effects under the range of consumption patterns reported by toll-free calls. Health effects reported were those found commonly in the general population and analyses of the data found no biological reason to conclude that serious or meaningful health effects were the result of olestra consumption.

  17. Interpreting temporal trends in Great Lakes organochlorine levels: Results from the herring gull surveillance program

    SciTech Connect

    Hebert, C.E.; Shutt, J.L.; Norstrom, R.J.; Weseloh, D.V.

    1995-12-31

    The Canadian Wildlife Service`s herring gull (Larus argentatus) surveillance program has demonstrated the utility of this species as a monitor of spatial and temporal trends in Great Lakes contaminant levels. Organochlorine concentrations in herring gull eggs decreased significantly in the 1970s and early 1980s as a result of control measures. Since the mid-1980s, however, concentrations of many compounds have been relatively constant. In addition, periodic fluctuations in egg contaminant concentrations hamper the ability to interpret more recent temporal trends in organochlorine levels. To evaluate the progress towards achieving the virtual elimination of organochlorines from the Great Lakes the authors must improve their understanding of the factors which regulate organochlorine bioaccumulation. This is particularly important for those species which have been selected as key indicators of ecosystem contamination, such as the herring gull. The goal of this paper is to examine some of the factors which may be responsible for the temporal fluctuations in herring gull egg contaminant concentrations. The regulation of contaminant bioavailability and transfer by changes in weather patterns and food web dynamics will be examined.

  18. The EBR-II materials-surveillance program. 4: Results of SURV-4 and SURV-6

    SciTech Connect

    Ruther, W.E.; Hayner, G.O.; Carlson, B.G.; Ebersole, E.R.; Allen, T.R.

    1998-01-01

    In March of 1965, a set of surveillance (SURV) samples was placed in the EBR-II reactor to determine the effect of irradiation, thermal aging, and sodium corrosion on reactor materials. Eight subassemblies were placed into row 12 positions of EBR-II to determine the effect of irradiation at 370 C. Two subassemblies were placed into the primary sodium basket to determine the effect of thermal aging at 370 C. For both the irradiated and thermally aged samples, one half of all samples were exposed to primary system sodium while one half were sealed in capsules with a helium atmosphere. Fifteen different structural materials were tested in the SURV program. In addition to the fifteen types of metal samples, graphite blocks were irradiated in the SURV subassemblies to determine the effect of irradiation on the graphite neutron shield. In this report, the properties of these materials irradiated at 370 C to a total fluence of 2.2 x 10{sup 22} n/cm{sup 2} (over 2,994 days) are compared with those of similar specimens thermally aged at 370 C for 2,994 days in the storage basket of the reactor. The properties analyzed were weight, density, microstructure, hardness, tensile and yield strength, impact strength, and creep.

  19. The Italian screening program for primary congenital hypothyroidism: actions to improve screening, diagnosis, follow-up, and surveillance.

    PubMed

    Cassio, A; Corbetta, C; Antonozzi, I; Calaciura, F; Caruso, U; Cesaretti, G; Gastaldi, R; Medda, E; Mosca, F; Pasquini, E; Salerno, M C; Stoppioni, V; Tonacchera, M; Weber, G; Olivieri, A

    2013-03-01

    The Italian screening program for primary congenital hypothyroidism (CH) is an integrated system including neonatal screening, diagnosis, treatment, follow-up, and nationwide surveillance of the disease. The aim of the Italian screening program for CH is to identify not only babies with severe permanent CH (core target), but also babies with mild persistent and transient forms of CH who could have a benefit from an early replacement therapy (secondary target). In the last years, despite the important results obtained in terms of standardization of screening and follow-up procedures, it has become clear the need of optimizing the program in order to harmonize the screening strategy and the screening procedures among Regions, and to improve the diagnostic and therapeutic approach in all affected infants. On the basis of available guidelines, the experience of the Italian screening and clinical reference centers, and the knowledge derived from the nation-wide surveillance activity performed by the Italian National Registry of Infants with CH, the Italian Society for Pediatric Endocrinology and Diabetology together with the Italian Society for the Study of Metabolic Diseases and Neonatal Screening and the Italian National Institute of Health promoted actions aimed at improving diagnosis, treatment, follow-up and surveillance of CH in our country. In this paper the most important actions to improve the Italian screening program for CH are described. ©2013, Editrice Kurtis

  20. NASA Astronaut Occupational Surveillance Program and Lifetime Surveillance of Astronaut Health, LSAH, Astronaut Exposures and Risk in the Terrestrial and Spaceflight Environment

    NASA Technical Reports Server (NTRS)

    Keprta, Sean R.; Tarver, William; Van Baalen, Mary; McCoy, Torin

    2015-01-01

    United States Astronauts have a very unique occupational exposure profile. In order to understand these risks and properly address them, the National Aeronautics and Atmospheric Administration, NASA, originally created the Longitudinal Study of Astronaut Health, LSAH. The first LSAH was designed to address a variety of needs regarding astronaut health and included a 3 to 1 terrestrial control population in order to compare United States "earth normal" disease and aging to that of a microgravity exposed astronaut. Over the years that program has been modified, now termed Lifetime Surveillance of Astronaut Health, still LSAH. Astronaut spaceflight exposures have also changed, with the move from short duration shuttle flights to long duration stays on international space station and considerable terrestrial training activities. This new LSAH incorporates more of an occupational health and medicine model to the study of occupationally exposed astronauts. The presentation outlines the baseline exposures and monitoring of the astronaut population to exposures, both terrestrial, and in space.

  1. Annual summary report on the surveillance and maintenance activities for the Oak Rige National Laboratory Environmental Restoration Program for fiscal year 1995

    SciTech Connect

    1995-11-01

    This Annual Summary Report on the Surveillance and Maintenance Activities for the Oak Ridge National Laboratory Environmental Restoration Program for Fiscal Year 1995 was prepared to communicate the accomplishments of the Program during fiscal year 1995. This work was performed under work breakdown structure element 1.4.12.6.1.14.20 (activity data sheet 3314, ``Remedial Action Surveillance and Maintenance``). Publication of this document meets the Life Cycle Baseline milestone date of November 30, 1995. This document provides the accomplishments for both the Remedial Action and Decontamination and Decommissioning Surveillance and Maintenance programs.

  2. Susceptibility of Glycopeptide-Resistant Enterococci to Linezolid, Quinupristin/dalfopristin, Tigecycline and Daptomycin in a Tertiary Greek Hospital

    PubMed Central

    Dimopoulou, Dimitra; Mantadakis, Elpis

    2014-01-01

    We investigated the antibiotic susceptibility of glycopeptide-resistant enterococci (GRE). Seventy consecutive GRE were tested. Sixty-two isolates were identified as Enterococcus faecium (88.6%), and 8 (11.4%) as Enterococcus faecalis. All strains were susceptible to linezolid and daptomycin, while 17.1% (12/70) and 11.4% (8/70) were resistant to quinupristin/dalfopristin (QD) and tigecycline, respectively. All E. faecalis isolates were resistant to QD, while 4 of 62 (6.5%) E. faecium isolates were resistant to QD. All E. faecalis isolates were susceptible to tigecycline, while 14.5% (9/62) E. faecium isolates were resistant. Continued surveillance of GRE antibiotic susceptibilities is important for combating these multi-resistant nosocomial pathogens. PMID:25566405

  3. Impact of potential changes to the current bovine spongiform encephalopathy surveillance programs for slaughter cattle and fallen stock in Japan.

    PubMed

    Sugiura, Katsuaki; Murray, Noel; Shinoda, Naoki; Onodera, Takashi

    2009-07-01

    Cattle slaughtered in Japan for human consumption, regardless of their age, have been tested for bovine spongiform encephalopathy (BSE) since October 2001. Beginning in April 2004, all fallen stock from 24 months of age also have been tested. We evaluated the impact of potential changes to the current BSE surveillance programs for both slaughter cattle and fallen stock using a simple stochastic model. We calculated the probability that a BSE-infected dairy cow, Wagyu beef animal, Wagyu-Holstein cross steer or heifer, or Holstein steer slaughtered for human consumption or arising as fallen stock would be tested and detected. Four surveillance strategies were explored for cattle slaughtered for human consumption, with the minimum age at testing set at 0, 21, 31, or 41 months. Three surveillance strategies were explored for fallen stock, with the minimum age at testing set at 24, 31, or 41 months. Increasing the minimum age of testing from 0 to 21 months for both dairy cattle and Wagyu beef cattle had very little impact on the probability that a BSE-infected animal slaughtered for human consumption would be detected. Although increasing the minimum age at testing from 21 to 31 or 41 months would lead to fewer slaughtered animals being tested, the impact on the probability of detecting infected animals would be insignificant. The probability of infected Wagyu-Holstein crosses and Holstein steers being detected at slaughter or as fallen stock would be very low under all surveillance strategies.

  4. The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre.

    PubMed

    Russo, Philip L; Bull, Ann; Bennett, Noleen; Boardman, Claire; Burrell, Simon; Motley, Jane; Berry, Kylie; Friedman, N Deborah; Richards, Michael

    2006-09-01

    A 1998 survey of acute Victorian public hospitals (VPH) revealed that surveillance of hospital-acquired infections (HAI) was underdeveloped, definitions and methodology varied considerably, and results disseminated inconsistently. The survey identified the need for an effective surveillance system for HAI. To develop and support a standardized surveillance program for HAIs in large acute VPH and to provide risk-adjusted, procedure-specific, HAI rates. In 2002, the independent Victorian Nosocomial Infection Surveillance System (VICNISS) Coordinating Centre (VCC) was established to develop and support the standardized surveillance program. A multidisciplinary team was recruited. A communication strategy, surveillance manual, user groups, and Web site were developed. Formal education sessions were provided to participating infection control nurse consultants (ICCs). Surveillance activities were based on the US Centers for Diseases Control and Prevention's National Nosocomial Infection Surveillance System (NNIS) surgical site infection and intensive care unit (ICU) components. NNIS methods were modified to suit local needs. Data collection was paper based or through existing hospital software. An advisory committee of key stakeholders met every second month. The surveillance program was rolled out over 12 months to all 28 large adult VPH. Data on over 20,000 surgical procedures performed at participating sites between November 11, 2002, and December 31, 2004, were submitted. Thirteen hospitals contributed to the ICU surveillance activities. Following aggregation and analysis by the VCC, hospital- and state-level results were posted on the Web page for hospitals to review. A standardized approach for surveillance of HAI was established in a short time frame in over 28 VPH. VICNISS is a tool that will continue to provide participating hospitals with a basis for continuous quality improvement.

  5. Global analysis of the impact of linezolid onto virulence factor production in S. aureus USA300.

    PubMed

    Bonn, Florian; Pané-Farré, Jan; Schlüter, Rabea; Schaffer, Marc; Fuchs, Stephan; Bernhardt, Jörg; Riedel, Katharina; Otto, Andreas; Völker, Uwe; van Dijl, Jan Maarten; Hecker, Michael; Mäder, Ulrike; Becher, Dörte

    2016-05-01

    The translation inhibitor linezolid is an antibiotic of last resort against Gram-positive pathogens including methicillin resistant strains of the nosocomial pathogen Staphylococcus aureus. Linezolid is reported to inhibit production of extracellular virulence factors, but the molecular cause is unknown. To elucidate the physiological response of S. aureus to linezolid in general and the inhibition of virulence factor synthesis in particular a holistic study was performed. Linezolid was added to exponentially growing S. aureus cells and the linezolid stress response was analyzed with transcriptomics and quantitative proteomics methods. In addition, scanning and transmission electron microscopy experiments as well as fluorescence microscopy analyses of the cellular DNA and membrane were performed. As previously observed in studies on other translation inhibitors, S. aureus adapts its protein biosynthesis machinery to the reduced translation efficiency. For example the synthesis of ribosomal proteins was induced. Also unexpected results like a decline in the amount of extracellular and membrane proteins were obtained. In addition, cell shape and size changed after linezolid stress and cell division was diminished. Finally, the chromosome was condensed after linezolid stress and lost contact to the membrane. These morphological changes cannot be explained by established theories. A new hypothesis is discussed, which suggests that the reduced amount of membrane and extracellular proteins and observed defects in cell division are due to the disintegration of transertion complexes by linezolid.

  6. Reversible Inhibition of Mitochondrial Protein Synthesis during Linezolid-Related Hyperlactatemia▿

    PubMed Central

    Garrabou, Glòria; Soriano, Alejandro; López, Sònia; Guallar, Jordi P.; Giralt, Marta; Villarroya, Francesc; Martínez, Jose A.; Casademont, Jordi; Cardellach, Francesc; Mensa, Josep; Miró, Òscar

    2007-01-01

    The objective of the present study was to determine the mitochondrial toxicity mechanisms of linezolid-related hyperlactatemia. Five patients on a long-term schedule of linezolid treatment were studied during the acute phase of hyperlactatemia and after clinical recovery and lactate normalization following linezolid withdrawal. Mitochondrial studies were performed with peripheral blood mononuclear cells and consisted of measurement of mitochondrial mass, mitochondrial protein synthesis homeostasis (cytochrome c oxidase [COX] activity, COX-II subunit expression, COX-II mRNA abundance, and mitochondrial DNA [mtDNA] content), and overall mitochondrial function (mitochondrial membrane potential and intact-cell oxidative capacity). During linezolid-induced hyperlactatemia, we found extremely reduced protein expression (16% of the remaining content compared to control values [100%], P < 0.001) for the mitochondrially coded, transcribed, and translated COX-II subunit. Accordingly, COX activity was also found to be decreased (51% of the remaining activity, P < 0.05). These reductions were observed despite the numbers of COX-II mitochondrial RNA transcripts being abnormally increased (297%, P = 0.10 [not significant]) and the mitochondrial DNA content remaining stable. These abnormalities persisted even after the correction for mitochondrial mass, which was mildly decreased during the hyperlactatemic phase. Most of the mitochondrial abnormalities returned to control ranges after linezolid withdrawal, lactate normalization, and clinical recovery. Linezolid inhibits mitochondrial protein synthesis, leading to decreased mitochondrial enzymatic activity, which causes linezolid-related hyperlactatemia, which resolves upon discontinuation of linezolid treatment. PMID:17194826

  7. Rapid Emergence of Resistance to Linezolid and Mutator Phenotypes in Staphylococcus aureus Isolates from an Adult Cystic Fibrosis Patient

    PubMed Central

    Tazi, Asmaa; Chapron, Jeanne; Touak, Gerald; Longo, Magalie; Hubert, Dominique; Collobert, Gislène; Dusser, Daniel; Poyart, Claire

    2013-01-01

    Linezolid has emerged as an important therapeutic option for the treatment of Staphylococcus aureus in patients with cystic fibrosis. We report the rapid emergence, upon treatment with linezolid, of linezolid-resistant S. aureus clinical isolates through the accumulation of resistance-associated 23S rRNA mutations, together with acquisition of an altered mutator phenotype. PMID:23917314

  8. Facility Decontamination and Decommissioning Program Surveillance and Maintenance Plan, Revision 2

    SciTech Connect

    Poderis, Reed J.; King, Rebecca A.

    2013-09-30

    This Surveillance and Maintenance (S&M) Plan describes the activities performed between deactivation and final decommissioning of the following facilities located on the Nevada National Security Site, as documented in the Federal Facility Agreement and Consent Order under the Industrial Sites program as decontamination and decommissioning sites: ? Engine Maintenance, Assembly, and Disassembly (EMAD) Facility: o EMAD Building (Building 25-3900) o Locomotive Storage Shed (Building 25-3901) ? Test Cell C (TCC) Facility: o Equipment Building (Building 25-3220) o Motor Drive Building (Building 25-3230) o Pump Shop (Building 25-3231) o Cryogenic Lab (Building 25-3232) o Ancillary Structures (e.g., dewars, water tower, piping, tanks) These facilities have been declared excess and are in various stages of deactivation (low-risk, long-term stewardship disposition state). This S&M Plan establishes and implements a solid, cost-effective, and balanced S&M program consistent with federal, state, and regulatory requirements. A graded approach is used to plan and conduct S&M activities. The goal is to maintain the facilities in a safe condition in a cost-effective manner until their final end state is achieved. This plan accomplishes the following: ? Establishes S&M objectives and framework ? Identifies programmatic guidance for S&M activities to be conducted by National Security Technologies, LLC, for the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) ? Provides present facility condition information and identifies hazards ? Identifies facility-specific S&M activities to be performed and their frequency ? Identifies regulatory drivers, NNSA/NFO policies and procedures, and best management practices that necessitate implementation of S&M activities ? Provides criteria and frequencies for revisions and updates ? Establishes the process for identifying and dispositioning a condition that has not been previously identified or

  9. Acute occupational pesticide-related illness in the US, 1998-1999: surveillance findings from the SENSOR-pesticides program.

    PubMed

    Calvert, Geoffrey M; Plate, David K; Das, Rupali; Rosales, Rachel; Shafey, Omar; Thomsen, Catherine; Male, Dorilee; Beckman, John; Arvizu, Ernest; Lackovic, Michelle

    2004-01-01

    Concern about the adverse public health and environmental effects of pesticide use is persistent. Recognizing the importance of surveillance for acute occupational pesticide-related illness, we report on surveillance for this condition across multiple states. Survey data collected between 1998 and 1999 were obtained from the seven states that conduct acute occupational pesticide-related illness surveillance as part of the Sentinel Event Notification System for Occupational Risks (SENSOR) program. Data were collected by these state programs in a standardized manner and analyzed. Acute occupational pesticide-related illness incidence rates for those employed in agriculture and those employed in non-agricultural industries were also calculated. Between 1998 and 1999, a total of 1,009 individuals with acute occupational pesticide-related illness were identified by states participating in the SENSOR-pesticides program. The mean age was 36 years, and incidence rates peaked among 20-24 year-old workers. The overall incidence rate was 1.17 per 100,000 full time equivalents (FTEs). The incidence rate among those employed in agriculture was higher (18.2/100,000 FTEs) compared to those employed in non-agricultural industries (0.53/100,000 FTEs). Most of the illnesses were of low severity (69.7%). Severity was moderate in 29.6% of the cases, and high in four cases (0.4%). Three fatalities were identified. Insecticides were responsible for 49% of all illnesses. Surveillance is an important tool to assess acute pesticide-related illness, and to identify associated risk factors. Our findings suggest that these illnesses continue to be an important occupational health problem, especially in agriculture. As such, greater efforts are needed to prevent acute occupational pesticide-related illness.

  10. The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks

    PubMed Central

    2011-01-01

    The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program’s ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia. PMID:21388561

  11. Risk factors and outcomes associated with vancomycin-resistant Enterococcus infections with reduced susceptibilities to linezolid.

    PubMed

    Santayana, Elena M; Grim, Shellee A; Janda, William M; Layden, Jennifer E; Lee, Todd A; Clark, Nina M

    2012-09-01

    A retrospective matched case-control study of hospitalized patients with vancomycin-resistant Enterococcus (VRE) infection with reduced susceptibility to linezolid was performed in order to identify risk factors for this infection and describe patient outcomes. Forty-eight linezolid nonsusceptible VRE cases were identified between January 1, 2000, and September 30, 2008, and compared to 96 controls with linezolid-susceptible VRE, matched based on culture date and anatomic site of infection. Demographic, clinical and microbiological data were collected. On univariable analysis, risk factors for reduced linezolid susceptibility included allogeneic hematopoietic stem cell transplant and/or solid organ transplant (odds ratio [OR]: 2.63; 95% confidence interval [CI]: 1.13-6.15; P = 0.025), receipt of immunosuppressive medications (OR: 2.39; 95% CI: 1.08-5.29; P = 0.032) including corticosteroids (OR: 2.40; 95% CI: 1.03-5.58; P = 0.042) and noncorticosteroid immunosuppressives (OR: 2.31; 95% CI: 1.00-5.30; P = 0.049), and receipt of linezolid within 1 year prior to infection (OR: 34.50, 95% CI: 4.60-259.02; P < 0.001). On multivariable analysis, only receipt of linezolid within 1 year remained an independent risk factor for reduced linezolid susceptibility (OR: 31.84; 95% CI: 4.20-241.39; P < 0.001), although most patients with VRE with reduced linezolid susceptibility had not received linezolid in the year prior. Reduced linezolid susceptibility did not impact patient outcomes including clinical or microbiological cure, hospital length of stay, or all-cause mortality.

  12. Epidemiological surveillance linked to an outreach psychological support program after the Xynthia storm in Charente-Maritime, France, 2010.

    PubMed

    Raguenaud, Marie-Eve; Germonneau, Philippe; Leseigneur, Jackie; Chavagnat, Jean-Jacques; Motreff, Yvon; Vivier-Darrigol, Martine; Pirard, Philippe

    2012-10-01

    Following the Xynthia storm of February 2010 in France, an outreach program was initiated by the regional health authorities during the post-emergency phase to improve access to mental health care for the population exposed to the floods. The program was designed to complement routine health and social care services. It relied on a special telephone service and outreach consultations located in the town halls of the five most affected cities. The objective of this outreach service was to provide initial psychological counseling free of charge and without appointment. Another objective was to refer persons for appropriate treatment and follow-up by routine health care services. A surveillance program was developed to monitor the use of mental health services by first-time users, describe outreach service users with psychological manifestations, and provide timely information to decision makers. Health providers working in affected towns were asked to complete an individual record sheet for each person who displayed psychological manifestations directly or indirectly linked with the storm on their first visit, and to send it to the regional health office. Participation was voluntary. Data analysis was performed monthly during the six-month surveillance period. Only mental health providers participated in the surveillance. A total of 227 individual files were sent from April 7 through September 19, 2010. New cases were mainly female adults, and one fifth had a past history of psychiatric illness. Depressive signs and anxiety were the most commonly reported symptoms, followed by signs of post-traumatic stress disorder. A total of five feedback reports were produced for surveillance participants (informants) and authorities. With initiation in the post-emergency phase of a disaster and timely regular feedback, the surveillance program enabled the authors to describe the occurrence of psychological distress, monitor mental health service use by first-time users, and

  13. Status report - The Canadian Hospitals Injury Reporting and Prevention Program: a dynamic and innovative injury surveillance system.

    PubMed

    Crain, J; McFaull, S; Thompson, W; Skinner, R; Do, M T; Fréchette, M; Mukhi, S

    2016-06-01

    This status report on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), an emergency department-based injury and poisoning surveillance system, describes the result of migrating from a centralized data entry and coding process to a decentralized process, the web-based eCHIRPP system, in 2011. This secure system is improving the CHIRPP's overall flexibility and timeliness, which are key attributes of an effective surveillance system. The integrated eCHIRPP platform enables near real-time data entry and access, has user-friendly data management and analysis tools, and allows for easier communication and connectivity across the CHIRPP network through an online collaboration centre. Current pilot testing of automated data monitoring and trend analysis tools-designed to monitor and flag incoming data according to predefined criteria (for example, a new consumer product)-is revealing eCHIRPP's potential for providing early warnings of new hazards, issues and trends.

  14. Influence of border disease virus (BDV) on serological surveillance within the bovine virus diarrhea (BVD) eradication program in Switzerland.

    PubMed

    Kaiser, V; Nebel, L; Schüpbach-Regula, G; Zanoni, R G; Schweizer, M

    2017-01-13

    In 2008, a program to eradicate bovine virus diarrhea (BVD) in cattle in Switzerland was initiated. After targeted elimination of persistently infected animals that represent the main virus reservoir, the absence of BVD is surveilled serologically since 2012. In view of steadily decreasing pestivirus seroprevalence in the cattle population, the susceptibility for (re-) infection by border disease (BD) virus mainly from small ruminants increases. Due to serological cross-reactivity of pestiviruses, serological surveillance of BVD by ELISA does not distinguish between BVD and BD virus as source of infection. In this work the cross-serum neutralisation test (SNT) procedure was adapted to the epidemiological situation in Switzerland by the use of three pestiviruses, i.e., strains representing the subgenotype BVDV-1a, BVDV-1h and BDSwiss-a, for adequate differentiation between BVDV and BDV. Thereby the BDV-seroprevalence in seropositive cattle in Switzerland was determined for the first time. Out of 1,555 seropositive blood samples taken from cattle in the frame of the surveillance program, a total of 104 samples (6.7%) reacted with significantly higher titers against BDV than BVDV. These samples originated from 65 farms and encompassed 15 different cantons with the highest BDV-seroprevalence found in Central Switzerland. On the base of epidemiological information collected by questionnaire in case- and control farms, common housing of cattle and sheep was identified as the most significant risk factor for BDV infection in cattle by logistic regression. This indicates that pestiviruses from sheep should be considered as a source of infection of domestic cattle and might well impede serological BVD surveillance.

  15. Newborn screening for critical congenital heart disease: potential roles of birth defects surveillance programs--United States, 2010-2011.

    PubMed

    2012-10-26

    In September 2011, the Secretary of the U.S. Department of Health and Human Services (HHS) approved the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children (SACHDNC) 2010 recommendation that all newborns be screened for critical congenital heart disease (CCHD) using pulse oximetry, a noninvasive test of blood oxygenation, to prevent mortality and morbidity. CDC partnered with the National Birth Defects Prevention Network (NBDPN) to conduct a survey designed to assess state birth defect surveillance programs' potential roles, capabilities, and readiness to assist with newborn screening activities for CCHD. States were surveyed in November 2010, after the initial SACHDNC recommendation, and again in November 2011, after the Secretary's approval. From 2010 to 2011, the number of birth defects surveillance programs involved in CCHD screening increased from one to 10. Barriers exist, such as the lack of legislative authority, staffing, funding, and informatics infrastructure. Sixty-seven percent of programs take an average of more than 12 months to collect complete data on birth defect cases, including congenital heart defects. An assessment of state birth defects programs' existing data and capability to lead the evaluation of screening for CCHD is warranted.

  16. Air surveillance

    SciTech Connect

    Patton, G.W.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

  17. Anti-inflammatory effects of linezolid on carrageenan-induced paw edema in rats.

    PubMed

    Matsumoto, Kazuaki; Obara, Shigeaki; Kuroda, Yuko; Kizu, Junko

    2015-12-01

    The immunomodulatory activity of linezolid has recently been reported using in vitro experimental models. However, the anti-inflammatory activity of linezolid has not yet been demonstrated using in vivo experimental models. Therefore, the aim of the present study was to demonstrate the anti-inflammatory activity of linezolid and other anti-MRSA agents using the carrageenan-induced rat paw edema model. The pretreatment with 50 mg/kg linezolid significantly suppressed edema rates, compared with control (5% glucose), with edema rates at 0.5 and 3 h after the administration of carrageenan being 17.3 ± 3.5 and 30.8 ± 3.0%, respectively. On the other hand, edema rates were not suppressed by the pretreatments with 50 mg/kg vancomycin, teicoplanin, arbekacin, and daptomycin. Furthermore, we demonstrated that linezolid exhibited anti-inflammatory activity in a concentration-dependent manner. These effects were observed at linezolid concentrations that are achievable in human serum with conventional dosing. In conclusion, the results of the present study suggest that the anti-inflammatory activities of linezolid, in addition to its antimicrobial effects, have a protective effect against destructive inflammatory responses in areas of inflammation. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  18. Investigation of mechanism and molecular epidemiology of linezolid-resistant Enterococcus faecalis in China.

    PubMed

    Wang, Lipeng; He, Yunyan; Xia, Yun; Wang, Huijuan; Liang, Shumei

    2014-08-01

    Enterococcus is a major cause of important nosocomial infections. Linezolid, the first member of an entirely new class of antibiotics (oxazolidinones), is effective against serious infections caused by Enterococcus. However, resistance to linezolid has been discovered throughout the world rapidly. From 2011 to 2013, nine linezolid-resistant E. faecalis isolates were collected and the possible mechanisms of linezolid resistance, including mutations in domain V of 23S rRNA genes and in ribosomal proteins L3 and L4, and the multiresistance gene cfr, were investigated. Furthermore, an epidemiological survey of the nine linezolid-resistant E. faecalis isolates was performed by pulsed field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and DiversiLab. The three methods were compared to evaluate their merits and demerits, respectively. We failed to find the resistance mechanisms that have been revealed in recent years by PCR and sequencing analysis in the linezolid-resistant E. faecalis. Epidemiological investigation suggested that a small-scale outbreak of linezolid-resistant E. faecalis emerged in neurosurgery ICU from March to May of 2013. DiversiLab was a reliable typing tool and a suitable alternative to PFGE because it was as discriminatory as PFGE and better than MLST.

  19. The ZEPHyR study: a randomized comparison of linezolid and vancomycin for MRSA pneumonia.

    PubMed

    Chavanet, P

    2013-12-01

    Methicillin-resistant Staphylococcus aureus (MRSA) accounts for 10-40% of hospital-acquired pneumonia, and even more in intensive care units. The current guidelines for the treatment of MRSA nosocomial pneumonia include vancomycin and linezolid. The authors of 2 prospective randomized trials comparing vancomycin and linezolid in nosocomial pneumonia had concluded to the non-inferiority of linezolid. A slight superiority of linezolid was observed in the MRSA pneumonia subgroup, in terms of clinical success and survival, but no definite conclusion could be drawn. A prospective randomized study was made to compare a fixed linezolid dose to dose-optimized vancomycin for the treatment of bacteriologically proven MRSA nosocomial pneumonia (ZEPHyR Study). Among the 165 patients treated by linezolid (57.6%) in the PP population, 95 were clinically cured at the end of the study, compared to 81 of the 174 patients treated by vancomycin (46.6%) (IC 95% of the difference 0.5%-21.6%, P=0.042). Nephrotoxicity in the mITT population reached 8.4% in the linezolid group compared to 18.2% in the vancomycin group. LNZ was superior to vancomycin for the treatment of MRSA nosocomial pneumonia. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Linezolid, a novel oxazolidinone antibiotic: assessment of monoamine oxidase inhibition using pressor response to oral tyramine.

    PubMed

    Antal, E J; Hendershot, P E; Batts, D H; Sheu, W P; Hopkins, N K; Donaldson, K M

    2001-05-01

    The primary objective of this study was to compare the effects of oral linezolid with moclobemide and placebo on the pressor response to oral tyramine. Secondary objectives were to determine possible mechanisms of the effect based on changes in the pharmacokinetics of tyramine and to evaluate alternative methods for quantifying the pressor effect. Subjects received linezolid (625 mg bid orally), moclobemide (150 mg tid orally), or placebo for up to 7 days. Using the oral tyramine dose producing a >30 mmHg increase in systolic blood pressure (SBP) (PD>30), a positive pressor response was defined as a PD>30 index (pretreatment/treatment ratio of PD>30) of > or = 2. There were 8/10, 11/11, and 1/10 responders with linezolid, moclobemide, and placebo, respectively. Responses returned to baseline within 2 days of drug discontinuation. The ratio of mean greatest SBP and heart rate at the time of greatest SBP (GSBP/HR) increased linearly with tyramine dose both pretreatment and during treatment with linezolid and moclobemide. During treatment, responses to tyramine when subjects took linezolid or moclobemide were significantly different from placebo. Both drugs significantly decreased tyramine oral clearance compared with placebo. Urinary excretion of catecholamines and metabolites was consistent with MAOI activity of the drugs, but results were variable. The MAOI activity of linezolid is similar to that of moclobemide, a drug used clinically without food restrictions. Restrictions to normal dietary intake of tyramine-containing foods are not warranted when taking linezolid.

  1. Bell's palsy associated with linezolid therapy: case report and review of neuropathic adverse events.

    PubMed

    Thai, Xia C; Bruno-Murtha, Lou Ann

    2006-08-01

    Bell's palsy is one of the most common neurologic disorders affecting the seventh cranial nerve. Several disease states have been associated with facial paralysis. Drugs, however, have been rarely implicated as an etiology. We describe a 49-year-old man who developed peripheral facial paralysis after 3 weeks of linezolid therapy, along with recurrence of symptoms on rechallenge. He had insulin-dependent diabetes mellitus and a longstanding history of bilateral diabetes-related foot problems. After hospitalization, debridement, and vancomycin therapy for methicillin-resistant Staphylococcus aureus osteomyelitis, the patient was discharged to home with oral linezolid therapy. On day 23 of linezolid therapy, he developed signs and symptoms that were consistent with Bell's palsy. Linezolid was discontinued; the Bell's palsy gradually improved, with complete resolution occurring at month 3. On rechallenge with linezolid for recurrent osteomyelitis, the patient developed a second episode of Bell's palsy within a similar time frame as in the first episode. Assessment of causality using the Naranjo adverse drug reaction probability scale revealed a probable relationship between this adverse drug event and linezolid therapy. Clinicians should be aware that Bell's palsy may be another neuropathic adverse effect associated with linezolid.

  2. Linezolid-induced lactic acidosis: the thin line between bacterial and mitochondrial ribosomes.

    PubMed

    Santini, Alessandro; Ronchi, Dario; Garbellini, Manuela; Piga, Daniela; Protti, Alessandro

    2017-07-01

    Linezolid inhibits bacterial growth by targeting bacterial ribosomes and by interfering with bacterial protein synthesis. Lactic acidosis is a rare, but potentially lethal, side effect of linezolid. Areas covered: The pathogenesis of linezolid-induced lactic acidosis is reviewed with special emphasis on aspects relevant to the recognition, prevention and treatment of the syndrome. Expert opinion: Linezolid-induced lactic acidosis reflects the untoward interaction between the drug and mitochondrial ribosomes. The inhibition of mitochondrial protein synthesis diminishes the respiratory chain enzyme content and thus limits aerobic energy production. As a result, anaerobic glycolysis and lactate generation accelerate independently from tissue hypoxia. In the absence of any confirmatory test, linezolid-induced lactic acidosis should be suspected only after exclusion of other, more common, causes of lactic acidosis such as hypoxemia, anemia or low cardiac output. Normal-to-high whole-body oxygen delivery, high venous oxygen saturation and lack of response to interventions that effectively increase tissue oxygen provision all suggest a primary defect in oxygen use at the mitochondrial level. During prolonged therapy with linezolid, blood drug and lactate levels should be regularly monitored. The current standard-of-care treatment of linezolid-induced lactic acidosis consists of drug withdrawal to reverse mitochondrial intoxication and intercurrent life support.

  3. Resistance to Linezolid Caused by Modifications at Its Binding Site on the Ribosome

    PubMed Central

    Long, Katherine S.

    2012-01-01

    Linezolid is an oxazolidinone antibiotic in clinical use for the treatment of serious infections of resistant Gram-positive bacteria. It inhibits protein synthesis by binding to the peptidyl transferase center on the ribosome. Almost all known resistance mechanisms involve small alterations to the linezolid binding site, so this review will therefore focus on the various changes that can adversely affect drug binding and confer resistance. High-resolution structures of linezolid bound to the 50S ribosomal subunit show that it binds in a deep cleft that is surrounded by 23S rRNA nucleotides. Mutation of 23S rRNA has for some time been established as a linezolid resistance mechanism. Although ribosomal proteins L3 and L4 are located further away from the bound drug, mutations in specific regions of these proteins are increasingly being associated with linezolid resistance. However, very little evidence has been presented to confirm this. Furthermore, recent findings on the Cfr methyltransferase underscore the modification of 23S rRNA as a highly effective and transferable form of linezolid resistance. On a positive note, detailed knowledge of the linezolid binding site has facilitated the design of a new generation of oxazolidinones that show improved properties against the known resistance mechanisms. PMID:22143525

  4. Combined effect of linezolid and N-acetylcysteine against Staphylococcus epidermidis biofilms.

    PubMed

    Leite, Bruna; Gomes, Fernanda; Teixeira, Pilar; Souza, Clovis; Pizzolitto, Elisabeth; Oliveira, Rosário

    2013-12-01

    Staphylococcus epidermidis is an organism commonly associated with infections caused by biofilms. Biofilms are less sensible to antibiotics and therefore are more difficult to eradicate. Linezolid and N-acetylcysteine (NAC), have demonstrated to be active against gram-positive microorganisms. Therefore and since linezolid and NAC have different modes of action, the main objective of this work was to investigate the single and synergistic effect of linezolid and NAC against S. epidermidis biofilms. This work reports the in vitro effect of linezolid and NAC against S. epidermidis biofilms, treated with MIC (4mgml(-1)) and 10×MIC of NAC, and MIC (1μgml(-1)) and peak serum concentration (PS=18μgml(-1)) of linezolid alone and in combination. After exposure of S. epidermidis biofilms to linezolid and/or NAC for 24h, several biofilm parameters were evaluated, namely the number of cultivable cells [colony forming unit (CFU) enumeration], total biofilm biomass and cellular activity. When tested alone, NAC at 10×MIC was the most effective agent against S. epidermidis biofilms. However, the combination linezolid (MIC)+NAC (10×MIC) showed a synergistic effect and was the most biocidal treatment tested, promoting a 5log reduction in the number of biofilm viable cells. This combination seems to be a potential candidate to combat infections caused by S. epidermidis biofilms, namely as a catheter lock solution therapy. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. OPPIDUM surveillance program: 20 years of information on drug abuse in France.

    PubMed

    Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle

    2013-12-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities.

  6. [Linezolid resistant coagulase-negative Staphylococcus: phenotypical and genotypical characteristics and sensitivity to antibiotic combinations].

    PubMed

    López-Fabal, Fátima; Román Alonso, Federico; Almagro Moltó, María; Sanz Rodríguez, Nuria; Gómez-Garcés, José Luis

    2013-01-01

    We recovered 22 coagulase-negative staphylococci isolates in our hospital to study their identity, susceptibility, epidemiological profile, linezolid resistance mechanisms, and the possibilities of different antibiotic combinations. Isolate identification was performed using mass spectrometry (Vitek-MS, bioMérieux). Susceptibility testing was carried out with the Vitek-2 system and the broth microdilution method according to CLSI guidelines. Pulsed-field gel electrophoresis (PFGE) was performed to analyze the genetic relationship between isolates. Linezolid resistance mechanisms were evaluated by PCR/sequencing: presence of cfr gene, point mutations in domain V of 23S ribosomal RNA and additional ribosomal mutations (in the rplC, rplD and rplV genes). The in vitro activity of linezolid was investigated alone and in combination with another three antibiotics acting on different cellular targets, using E-test strips. Twenty isolates were identified as Staphylococcus epidermidis, and 2 as Staphylococcus hominis. PFGE showed that isolates belonged to diverse clones, 21 of them presented mutations in the domain V region of 23S rRNA and the cfr gene was found in 54.5%. Prior administration of linezolid was documented in most of cases. Linezolid in combination with gentamicin showed a synergistic activity in 45.5% of isolates. Staphylococcus epidermidis was the most prevalent linezolid-resistant coagulase-negative staphylococci. All isolates showed increased MIC values compared to other anti-staphylococcal drugs and several linezolid resistance mechanisms. Our data suggest that linezolid plus gentamicin could be a synergistic combination against linezolid-resistant coagulase-negative staphylococci. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. Intrathecal/Intraventricular Linezolid in Multidrug-Resistant Enterococcus faecalis Ventriculitis

    PubMed Central

    Lich, Brian F.; Conner, Andrew K.; Burks, Joshua D.; Glenn, Chad A.; Sughrue, Michael E.

    2016-01-01

    Background The use of intrathecal antibiotic therapy for the treatment of ventriculitis and/or meningitis has demonstrated efficacy especially when sterilization of the cerebrospinal fluid is not possible with intravenous antibiotics alone. Case Description We describe the successful treatment of Enterococcus faecalis ventriculitis utilizing intrathecal linezolid in a 32-year-old female patient with severe allergy to vancomycin, prohibitive bacterial susceptibilities, and failure of previous attempts to sterilize the cerebrospinal fluid despite multimodal treatment. Conclusion Intrathecal linezolid is a useful treatment in the setting of multidrug-resistant bacterial ventriculitis. We present a useful dosing regimen for the administration of intrathecal linezolid. PMID:27867829

  8. Linezolid treatment of glycopeptide-resistant Enterococcus faecium in very low birth weight premature neonates.

    PubMed

    Hoehn, Rene; Groll, Andreas H; Schaefer, Volker; Bauer, Karl; Schloesser, Rolf L

    2006-03-01

    Glycopeptide-resistant Enterococcus faecium has emerged as an important nosocomial pathogen with limited therapeutic options. Here we report the successful treatment of glycopeptide-resistant E. faecium infection in two very low birth weight premature infants with the new oxazolidinone linezolid. Treatment with linezolid at a dosage of 10 mg/kg every 8 h intravenously for a duration of 16 days and 14 days, respectively, was well tolerated and led to complete clinical recovery and clearance of the organism from all body sites. The two cases support the clinical efficacy and safety of linezolid in very low birth weight premature neonates with glycopeptide-resistant E. faecium infections.

  9. Guidance for implementing the long-term surveillance program for UMTRA Project Title I Disposal Sites

    SciTech Connect

    1996-02-01

    This guidance document has two purposes: it provides guidance for writing site-specific long-term surveillance plans (LTSP) and it describes site surveillance, monitoring, and long-term care techniques for Title I disposal sites of the Uranium Mill Tailings Radiation Control Act (UMTRCA) (42 USC Section 7901 et seq.). Long-term care includes monitoring, maintenance, and emergency measures needed to protect public health and safety and the environment after remedial action is completed. This document applies to the UMTRCA-designated Title I disposal sites. The requirements for long-term care of the Title I sites and the contents of the LTSPs are provided in U.S. Nuclear Regulatory Commission (NRC) regulations (10 CFR Section 40.27) provided in Attachment 1.

  10. A nationwide cohort study of stage I seminoma patients followed on a surveillance program.

    PubMed

    Mortensen, Mette Saksø; Lauritsen, Jakob; Gundgaard, Maria Gry; Agerbæk, Mads; Holm, Niels Vilstrup; Christensen, Ib Jarle; von der Maase, Hans; Daugaard, Gedske

    2014-12-01

    Increasing concerns about late effects after adjuvant treatment for stage I seminoma have made surveillance an attractive alternative. To evaluate the surveillance strategy in a nationwide cohort study. A retrospective, population-based study of Danish patients diagnosed with stage I seminoma between 1984 and 2008 and followed for 5 yr (n=1954). Patient data were linked with national registries on November 30, 2012, to obtain information on late relapse, vital status, and cause of death. Disease-specific survival (DSS), overall survival, relapse rates, time to relapse, detection of relapse, and prognostic factors for relapse were described for the cohort. The Kaplan-Meier method was used to determine survival probabilities. A Cox proportional hazards model was used for multivariate analysis of prognostic factors. Median follow-up time was 15.1 yr. In total, 369 patients relapsed after a median 13.7 mo. DSS after 15 yr was 99.3%. Tumor size was a significant factor for relapse. Either vascular invasion or invasion of epididymis was significant if the other factor was excluded from analysis. Limitations include the retrospective nature of the study and the number of missing values in analysis. In the world's largest study of stage I seminoma patients, we found surveillance to be a safe alternative to adjuvant therapies. Tumor size was a significant factor for relapse, together with either invasion of epididymis or vascular invasion. In this nationwide study, we looked at the outcomes of patients with stage I seminoma followed for 5 yr. We found that surveillance is a safe alternative to adjuvant treatment. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  11. Monitoring the levels and trends of HIV infection: the Public Health Service's HIV surveillance program.

    PubMed Central

    Dondero, T J; Pappaioanou, M; Curran, J W

    1988-01-01

    A comprehensive, multifaceted approach to HIV surveillance is needed to provide the information necessary for public health management and policy. Because HIV infection is not readily or uniformly ascertained, survey methods and sentinel surveillance approaches must be used. At least some of the surveys must be blinded, that is, anonymous and unlinked to identifiable persons, to avoid the uninterpretable impact of self-selection bias that could lead to both significant underestimates and occasional overestimates of HIV prevalence. Other surveys must be nonblinded, with careful interviews of volunteer participants to evaluate risk factors for HIV infection. These various surveys must continue over time to evaluate trends in infection. A comprehensive family of complementary HIV surveys and studies and a national household-based HIV seroprevalence survey have been undertaken by the Public Health Service in collaboration with other Federal agencies, State and local health departments, blood collection agencies, and medical research institutions. These projects focus on accessible segments of the general population, childbearing women, persons at high risk for HIV, and persons in special settings such as prisons and colleges. This comprehensive surveillance approach will help monitor the levels and trends of HIV infection in the United States and help prioritize, target, and evaluate HIV prevention activities. PMID:3131809

  12. A Surveillance Program on Canine Leishmaniasis in the Public Kennels of Emilia-Romagna Region, Northern Italy

    PubMed Central

    Santi, Annalisa; Renzi, Maria; Baldelli, Raffaella; Calzolari, Mattia; Caminiti, Antonino; Dell'Anna, Silvia; Galletti, Giorgio; Lombardini, Annalisa; Paternoster, Giulia

    2014-01-01

    Abstract Since 2007, a canine leishmaniasis (CanL) surveillance program has been carried out in public kennels of the Emilia-Romagna region with the aim of providing health guarantees for dog adoptions. According to this program, monitoring activities were performed to verify the presence of sandflies and infected dogs, and a specific CanL risk class was assigned to each kennel, resulting in different control approaches (entomological and/or serological monitoring, clinical surveillance, therapeutic treatment of infected dogs, protections against vector bites). From 2007 to 2012, 20,931 dogs, 89.8% of which were identified by microchip and housed in 73 kennels, were examined using an indirect fluorescent antibody test. In all, 528 (2.8%) dogs tested positive, and 43.0% of these were asymptomatic. The authors used monitoring results, in particular serological tests performed on dogs at admittance to the kennel and annual controls of sentinel dogs, to estimate CanL risk in the whole region and to evaluate the efficacy of the preventive measures adopted. CanL seroprevalence in dogs tested at the admittance in kennels increased significantly from 2010 (1.0%; 29/2858) to 2012 (2.4%; 69/2841). In contrast, the number of seroconversions in sentinel dogs was stable in 2010 (1.2%; 11/896) and 2011 (1.6%; 13/825) and decreased in 2012 (0.9%; 8/850), suggesting the efficacy of the preventive measures applied. PMID:24575787

  13. Linezolid-induced optic neuropathy in XDR pulmonary TB: A case series.

    PubMed

    Srivastava, Anand; Kshetrimayum, Silpa; Gupta, Sanjiv Kumar; Kant, Surya

    2017-04-01

    Optic neuropathy has been reported as a side effect of long-term use of linezolid. This is particularly seen in cases of extensively drug resistant tuberculosis (XDR-TB) where treatment with linezolid may continue for about 24-30 months. We, hereby, report two cases of XDR-TB treated patients with a regimen containing linezolid who developed progressive painless loss of vision during the course of treatment. In both the cases, the visual symptoms resolved completely on withdrawing linezolid. Early recognition of this rare side effect and timely withdrawal may salvage the eyesight of such patients. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  14. FY 1994 annual summary report of the surveillance and maintenance activities for the Oak Ridge National Laboratory Environmental Restoration Program

    SciTech Connect

    Not Available

    1994-11-01

    The Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Surveillance and Maintenance (S and M) Program was initiated to manage former waste management and environmental research sites contaminated with radioactive materials and/or hazardous chemicals. The S and M Program is responsible for managing designated sites/facilities from the end of their operating lives until final disposition or site stabilization. To effectively manage and perform the various S and M Program responsibilities, five summary-level work breakdown structure (WBS) elements have been established: S and M Preliminary Investigations, Special Projects, Routine S and M, Inactive Groundwater Wells, and Project Management. Routine S and M activities were conducted as scheduled throughout fiscal years (FY) 1994 at applicable inactive waste management (WM) and other contaminated areas. Overall, the ER S and M Program maintains 47 facilities, performs vegetation maintenance on approximately 230 acres, maintains 54 inactive tanks, and provides overall site management on over 700 acres. In addition to the routine S and M activities, detailed site inspections were conducted at established frequencies on appropriate sites in the ER S and M Program. This document provides a summary of the FY 1994 ORNL ER S and M Program accomplishments.

  15. Disease surveillance system evaluation as a model for improved integration and standardization of the laboratory component in the Field Epidemiology and Laboratory Training Program (FELTP) curriculum worldwide.

    PubMed

    Rush, Thomas

    2012-11-01

    Integration of laboratory training into the Centers for Disease Control and Prevention's (CDC) Field Epidemiology Training Program (FETP) began in 2004 and has advanced the training of laboratory scientists worldwide on the basic principles of epidemiology, disease surveillance, and outbreak investigation. The laboratory component of the FE(L)TP training has traditionally been disease specific, revolving around classroom and bench training on laboratory methods, and field placement in areas where services are needed. There is however a need to improve the integration of epidemiology elements used in surveillance, outbreak investigation, and evaluation activities with specific measurable laboratory activities that could in turn impact the overall disease surveillance and response. A systematic and clear evaluation guideline for the laboratory components of disease surveillance systems alongside the corresponding epidemiological indicators can better identify, address, and mitigate weaknesses that may exist in the entire surveillance system, and also help to integrate and standardize the FE(L)TP curriculum content. The institution of laboratory Quality Management System principles linked to a comprehensive surveillance evaluation scheme will result in improved disease surveillance, response, and overall laboratory capacity over time.

  16. U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

    SciTech Connect

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-10-01

    The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

  17. Safety of long-term use of linezolid: results of an open-label study

    PubMed Central

    Vazquez, Jose A; Arnold, Anthony C; Swanson, Robert N; Biswas, Pinaki; Bassetti, Matteo

    2016-01-01

    Objective The objective of this study was to assess the long-term safety of linezolid in patients with chronic infections requiring treatment for ≥6 weeks. Enhanced monitoring for optic neuropathy was included to characterize the early development of this side effect and to identify ophthalmologic tests that might be valuable in early detection of this event. Methods This was a multicenter, open-label, pilot study of patients aged ≥18 years on long-term linezolid therapy. Matched control patients were included for baseline assessment comparison. Patients were assessed at study entry, monthly while on treatment, at the end of treatment, and 30 days following the last dose. Aggregate ocular safety data were reviewed. Response to treatment was reported. Results The study was terminated owing to slow enrollment. Twenty-four patients received linezolid; nine patients were included as matched controls. Linezolid was prescribed for a median of 80.5 days (range, 50–254 days). In patients with a reported clinical outcome, the majority were considered improved or cured. Common treatment-related adverse events (AEs) included anemia, peripheral neuropathy, polyneuropathy, vomiting, and asthenia, and were consistent with the known safety profile. Most AEs resolved or stabilized with discontinuation of treatment. Results of ophthalmologic tests in the one case adjudicated as probable linezolid-associated optic neuropathy revealed abnormal color vision, characteristic changes in the optic disk, and central scotomas in each eye. Conclusion In our small population, linezolid was generally well tolerated and AEs were consistent with the known safety profile. Extensive ophthalmologic testing of all 24 linezolid-treated patients identified one case adjudicated as probable, linezolid-associated optic neuropathy. PMID:27621644

  18. Serotonin toxicity as a consequence of linezolid use in revision hip arthroplasty.

    PubMed

    Mason, Lyndon W; Randhawa, Kiran S; Carpenter, Eleanor C

    2008-11-01

    Linezolid is the first in a new group of antibiotics called oxazolidinones. As a potent antimicrobial, it has activity against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, penicillin-resistant Streptococcus pneumoniae, and macrolide-resistant streptococci. There are several documented case reports of serotonin toxicity when used with selective serotonin reuptake inhibitors. The symptoms of serotonin syndrome are alteration of mental state, autonomic dysfunction, and neuromuscular disorders. This article presents a case of an interaction of the serotonin reuptake inhibitor venlafaxine and linezolid and the possible diagnostic problems that can occur. A 58-year-old woman presented with signs of systemic infection. Her medical history included bladder resection for transitional cell carcinoma, bilateral total hip arthroplasty (THA), and depression, for which she was on venlafaxine. Serological and imaging investigations revealed MRSA infection of the bilateral THA. The patient was started on vancomycin and rifampicin intravenously. As intravenous access was becoming problematic and long-term antibiotics were needed, treatment was changed to oral linezolid and oral rifampicin. Four days after the commencement of linezolid, the patient was acutely disorientated with generalized cerebellar signs and no autonomic dysfunction. A computed tomography scan of the head and lumbar puncture revealed no abnormal findings. A diagnosis of serotonin toxicity was made. The patient recovered when linezolid and venlafaxine were discontinued and supportive measures were provided. Linezolid is a popular choice of antibiotic, especially for the treatment of orthopedic-related MRSA infections. Patients who commonly require linezolid as an antimicrobial are those with complex infections where other antibiotic treatment has failed. It is therefore important to be vigilant with linezolid use. Physicians should be aware of the nonspecific presentation

  19. Daptomycin versus linezolid for the treatment of vancomycin-resistant enterococcal bacteraemia: implications of daptomycin dose.

    PubMed

    Chuang, Y-C; Lin, H-Y; Chen, P-Y; Lin, C-Y; Wang, J-T; Chang, S-C

    2016-10-01

    Treatment options for vancomycin-resistant enterococci (VRE) bloodstream infection are limited. Studies comparing daptomycin or linezolid in treating VRE bloodstream infection have conflicting results and suggest daptomycin underdosing. The responses to different daptomycin doses have not been studied. We conducted a multicentre prospective cohort study to compare linezolid and daptomycin (≥6 mg/kg) for the treatment of VRE bloodstream infection. The primary outcome was 14-day mortality. We used multivariate logistic regression analysis for outcome analysis and a generalized additive model for dose-dependent response estimation. Two hundred twelve patients were included (daptomycin, n = 141; linezolid, n = 71). All-cause 14-day mortality was higher in the daptomycin group (36.9% vs. 21.1%; p 0.03). After adjusting for confounders in logistic regression, mortality was lower in the linezolid group (adjusted odds ratio (aOR), 0.45; 95% confidence interval (CI), 0.21-0.96; p 0.04). The generalized additive model showed that higher-dose daptomycin (≥9 mg/kg) was associated with better survival than lower-dose daptomycin (6-9 mg/kg). Logistic regression showed that linezolid (aOR, 0.36; 95% CI, 0.17-0.79; p 0.01) and higher-dose daptomycin (aOR, 0.26; 95% CI, 0.09-0.74; p 0.01) independently predicted lower mortality compared to lower-dose daptomycin. Linezolid was not superior to higher-dose daptomycin in terms of mortality (aOR, 1.40; 95% CI, 0.45-4.37; p 0.57). Higher-dose daptomycin had lower mortality than lower-dose daptomycin. Despite higher mortality for lower-dose daptomycin than linezolid, linezolid conferred no survival benefit compared to higher-dose daptomycin. Our findings suggest that the recommended daptomycin dose is suboptimal for treating VRE bacteraemia.

  20. Predictors of Inadequate Linezolid Concentrations after Standard Dosing in Critically Ill Patients

    PubMed Central

    Taubert, Max; Maier, Barbara; Frechen, Sebastian; Scharf, Christina; Holdt, Lesca-Miriam; Frey, Lorenz; Vogeser, Michael; Fuhr, Uwe; Zander, Johannes

    2016-01-01

    Adequate linezolid blood concentrations have been shown to be associated with an improved clinical outcome. Our goal was to assess new predictors of inadequate linezolid concentrations often observed in critically ill patients. Fifty-two critically ill patients with severe infections receiving standard dosing of linezolid participated in this prospective observational study. Serum samples (median, 32 per patient) were taken on four consecutive days, and total linezolid concentrations were quantified. Covariates influencing linezolid pharmacokinetics were identified by multivariate analysis and a population pharmacokinetic model. Target attainment (area under the concentration-time curve over 12 h [AUC12]/MIC ratio of >50; MIC = 2 mg/liter) was calculated for both the study patients and a simulated independent patient group (n = 67,000). Target attainment was observed for only 36% of the population on both days 1 and 4. Independent covariates related to significant decreases of linezolid concentrations included higher weight, creatinine clearance rates, and fibrinogen and antithrombin concentrations, lower concentrations of lactate, and the presence of acute respiratory distress syndrome (ARDS). Linezolid clearance was increased in ARDS patients (by 82%) and in patients with elevated fibrinogen or decreased lactate concentrations. In simulated patients, most covariates, including fibrinogen and lactate concentrations and weight, showed quantitatively minor effects on target attainment (difference of ≤9% between the first and fourth quartiles of the respective parameters). In contrast, the presence of ARDS had the strongest influence, with only ≤6% of simulated patients reaching this target. In conclusion, the presence of ARDS was identified as a new and strong predictor of insufficient linezolid concentrations, which might cause treatment failure. Insufficient concentrations might also be a major problem in patients with combined alterations of other covariate

  1. Crystal Structure of the Oxazolidinone Antibiotic Linezolid Bound to the 50S Ribosomal Subunit

    SciTech Connect

    Ippolito,J.; Kanyo, Z.; Wang, D.; Franceschi, F.; Moore, P.; Steitz, T.; Duffy, E.

    2008-01-01

    The oxazolidinone antibacterials target the 50S subunit of prokaryotic ribosomes. To gain insight into their mechanism of action, the crystal structure of the canonical oxazolidinone, linezolid, has been determined bound to the Haloarcula marismortui 50S subunit. Linezolid binds the 50S A-site, near the catalytic center, which suggests that inhibition involves competition with incoming A-site substrates. These results provide a structural basis for the discovery of improved oxazolidinones active against emerging drug-resistant clinical strains.

  2. Successes and Short Comings in Four Years of an International External Quality Assurance Program for Animal Influenza Surveillance

    PubMed Central

    Spackman, Erica; Cardona, Carol; Muñoz-Aguayo, Jeannette; Fleming, Susan

    2016-01-01

    The US National institutes of Health-Centers of Excellence for Influenza Research and Surveillance is a research consortium that funds numerous labs worldwide to conduct influenza A surveillance in diverse animal species. There is no harmonization of testing procedures among these labs; therefore an external quality assurance (EQA) program was implemented to evaluate testing accuracy among labs in the program in 2012. Accurate detection of novel influenza A variants is crucial because of the broad host range and potentially high virulence of the virus in diverse species. Two molecular detection sample sets and 2 serology sample sets (one with avian origin isolates, and one with mammalian origin isolates each) were made available at approximately six month intervals. Participating labs tested the material in accordance with their own protocols. During a five year period a total of 41 labs from 23 countries ordered a total of 132 avian molecular, 121 mammalian molecular and 90 serology sample sets. Testing was completed by 111 individuals. Detection of type A influenza by RT-PCR was reliable with a pass rate (80% or greater agreement with expected results) of 86.6% for avian and 86.2% for mammalian origin isolates. However, identification of subtype by RT-PCR was relatively poor with 54.1% and 75.9% accuracy for avian and mammalian influenza isolates respectively. Serological testing had an overall pass rate of 86.9% and 22/23 labs used commercial ELISA kits. Based on the results of this EQA program six labs modified their procedures to improve accuracy and one lab identified an unknown equipment problem. These data represent the successful implementation of an international EQA program for an infectious disease; insights into the logistics and test design are also discussed. PMID:27788155

  3. Laboratory surveillance of invasive pneumococcal disease in Australia, 2003 predicting the future impact of the universal childhood conjugate vaccine program.

    PubMed

    Watson, Michael; Roche, Paul; Bayley, Kathy; Bell, Jan M; Collignon, Peter; Gilbert, Gwendolyn L; Hogg, Geoff; Keil, Anthony D; Krause, Vicki; Murphy, Denise; Smith, Helen V; Brown, Mitchell; Stylianopoulos, Joanne; Turnidge, John

    2004-01-01

    A comprehensive invasive pneumococcal disease (IPD) laboratory surveillance program was carried out in Australia in 2003. This program provided data on the prevalence of pneumococcal serotypes and antimicrobial resistance. There were 1,995 isolates tested with 34 per cent (683) from children aged less than five years and 27 per cent (535) from the elderly aged more than 65 years. One thousand eight hundred and sixty were isolates from blood, 79 from CSF and 56 from other sterile sites. In young children, 84 per cent of isolates were a serotype and 92 per cent a serogroup in the 7-valent pneumococcal conjugate vaccine (7vPCV). Of penicillin resistant isolates in children less than five years of age 85 per cent and 98 per cent were a serotype and serogroup in the 7vPCV respectively. When the universal 7vPCV vaccine program in young children is introduced in 2005, a proportion of cases of IPD should also be prevented in young adults (estimated reduction of 54 cases annually) and elderly Australians (an estimated reduction of 110 cases annually) as a result of improved herd immunity. Pneumococcal serotypes with higher rates of penicillin resistance (19F, 14 and 6B) were more prevalent in the elderly than in young children. In contrast, erythromycin resistance was more common in children less than five years of age (24%) compared to the elderly (15%). The predominant serotype with erythromycin resistance in Australia was serotype 14 and thus there is likely to be a major reduction in erythromycin resistance as a result of 7vPCV vaccination. Continued surveillance of pneumococcal serotype distribution and antibiotic susceptibility will be essential in order to identify serotype replacement by non-vaccine serotypes and to monitor the overall impact of current and future vaccine programs on invasive pneumococcal disease in Australia, not only in young children but also in other age groups.

  4. Post-retirement surveillance of workers exposed to asbestos or wood dust: first results of the French national SPIRALE Program

    PubMed Central

    Carton, Matthieu; Bonnaud, Sophie; Nachtigal, Mélissa; Serrano, Angel; Carole, Claudette; Bonenfant, Sébastien; Coste, Dominique; Lepinay, Patrick; Varsat, Brigitte; Wadoux, Bertrand; Zins, Marie; Goldberg, Marcel

    2011-01-01

    Objectives In France, 15 000–20 000 cancers attributable to occupational exposure occur each year. These cancers appear most often after the worker has retired. Since 1995, a system of post-retirement medical surveillance (PRMS) has been set up for former workers, but it remains largely underused. Design The SPIRALE program is a public health intervention aimed at identifying the former workers having been exposed to asbestos or wood dust during their working life and to propose them a PRMS. Additionally, it is also an epidemiologic research on the long-term effects of occupational exposure. We report the results of first years of the program conducted in 2006–2008, in 13 districts. Setting and participants A self-administered questionnaire was sent to 50 000 newly retired men, to identify potential past occupational carcinogen exposure. For respondents detected as possibly exposed, exposure was assessed in Health Screening Centres and a PRMS was recommended if necessary. Main outcome measures participation rate, rate of confirmed exposure, increased rate of PRMS, satisfaction about the program. Results The participation rate was 24%. From 12 002 questionnaires analysed, 72% of respondents were identified as possibly exposed: 3% to wood dust, 50% to asbestos and 19% to both exposures. Exposure to asbestos was confirmed for 73.4%, and according to the level of exposure, PRMS was recommended for 47.1%. Wood dust exposure was confirmed for 56.7%. In these districts, PRMS for asbestos increased by 45% and for wood dust by 600%. Additional surveys showed that participants showed a high degree of satisfaction about the program. Conclusions The results are positive in terms of detection, information and medical surveillance of exposed workers. PMID:22166778

  5. Post-retirement surveillance of workers exposed to asbestos or wood dust: first results of the French national SPIRALE Program.

    PubMed

    Carton, Matthieu; Bonnaud, Sophie; Nachtigal, Mélissa; Serrano, Angel; Carole, Claudette; Bonenfant, Sébastien; Coste, Dominique; Lepinay, Patrick; Varsat, Brigitte; Wadoux, Bertrand; Zins, Marie; Goldberg, Marcel

    2011-01-01

    In France, 15 000-20 000 cancers attributable to occupational exposure occur each year. These cancers appear most often after the worker has retired. Since 1995, a system of post-retirement medical surveillance (PRMS) has been set up for former workers, but it remains largely underused. The SPIRALE program is a public health intervention aimed at identifying the former workers having been exposed to asbestos or wood dust during their working life and to propose them a PRMS. Additionally, it is also an epidemiologic research on the longterm effects of occupational exposure.We report the results of first years of the program conducted in 2006-2008, in 13 districts. a self-administered questionnaire was sent to 50 000 newly retired men, to identify potential past occupational carcinogen exposure. For respondents detected as possibly exposed, exposure was assessed in Health Screening Centres and a PRMS was recommended if necessary. Participation rate, rate of confirmed exposure, increased rate of PRMS, satisfaction about the program. The participation rate was 24%. From 12 002 questionnaires analysed, 72% of respondents were identified as possibly exposed: 3%to wood dust, 50%to asbestos and 19%to both exposures. Exposure to asbestos was confirmed for 73.4%, and according to the level of exposure, PRMS was recommended for 47.1%. Wood dust exposure was confirmed for 56.7%. In these districts, PRMS for asbestos increased by 45% and for wood dust by 600%. Additional surveys showed that participants showed a high degree of satisfaction about the program. The results are positive in terms of detection, information and medical surveillance of exposed workers.

  6. Retrospective study of tolerability and efficacy of linezolid in patients with multidrug-resistant tuberculosis (1998-2014).

    PubMed

    Ramírez-Lapausa, Marta; Pascual Pareja, José Francisco; Carrillo Gómez, Raquel; Martínez-Prieto, Mónica; González-Ruano Pérez, Patricia; Noguerado Asensio, Arturo

    2016-02-01

    Although linezolid is known to be effective when used as an adjunct therapy in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB), the clinical experience is limited. In this study the efficacy and adverse effects of linezolid treatment were evaluated. A retrospective study of tolerability and efficacy of linezolid in MDR-TB patients was performed in Madrid, Spain. Demographic characteristics, microbiological and clinical features and data on treatment tolerability were collected. Regimens were constructed with a target of prescribing, at least, five anti-tuberculosis agents likely to be effective. Linezolid, at a dosage of 1200 or 600 mg daily, was included to complete the treatment if no other sensitive drugs were available. Vitamin B6 was used to reduce toxicity. Treatment outcome and clinical status at last contact were compared between patients with linezolid-containing regimens and with those without linezolid-containing regimens. During the period 1998-2014, 55 patients with MDR-TB received treatment. In 21 of these patients, linezolid was added. The median of linezolid administration was 23.9 months (IQT 13.1-24.7). Patients using linezolid showed a greater resistance to drugs, with a median of 6 (IQR 5-7) compared with those who did not use it, with a median of 4 drugs (IQR 3-5) (p<0.001). The median time to sputum culture conversion of the patients in the linezolid group (73.5 days) did not differ significantly from those in the non-linezolid group (61 days) (p=0.29). There were no significant differences in the outcomes of the two patient groups. There were no reported adverse events in 81% of patients assigned to linezolid therapy. Only four patients developed toxicity attributed to linezolid. The most serious adverse event in these patients was anemia observed in the two patients treated with 1200 mg per day. One of them also developed moderate paresthesia. In both cases the dosage was reduced to 600 mg per day, with improvement

  7. Early and Extended Early Bactericidal Activity of Linezolid in Pulmonary Tuberculosis

    PubMed Central

    Dietze, Reynaldo; Hadad, David Jamil; McGee, Bryan; Molino, Lucilia Pereira Dutra; Maciel, Ethel Leonor Noia; Peloquin, Charles A.; Johnson, Denise F.; Debanne, Sara M.; Eisenach, Kathleen; Boom, W. Henry; Palaci, Moises; Johnson, John L.

    2008-01-01

    Rationale: Linezolid, the first oxazolidinone approved for clinical use, has effective in vitro and promising in vivo activity against Mycobacterium tuberculosis. Objectives: To evaluate the early and extended early bactericidal activity of linezolid in patients with pulmonary tuberculosis. Methods: Randomized open label trial. Thirty patients with newly diagnosed smear-positive pulmonary tuberculosis (10 per arm) were assigned to receive isoniazid (300 mg daily) and linezolid (600 mg twice daily or 600 mg once daily) for 7 days. Sputum for quantitative culture was collected for 2 days before and then daily during 7 days of study drug administration. Bactericidal activity was estimated by measuring the decline in bacilli during the first 2 days (early bactericidal activity) and the last 5 days of study drug administration (extended early bactericidal activity). Measurements and Main Results: The mean early bactericidal activity of isoniazid (0.67 log10 cfu/ml/d) was greater than that of linezolid twice and once daily (0.26 and 0.18 log10 cfu/ml/d, respectively). The extended early bactericidal activity of linezolid between Days 2 and 7 was minimal. Conclusions: Linezolid has modest early bactericidal activity against rapidly dividing tubercle bacilli in patients with cavitary pulmonary tuberculosis during the first 2 days of administration, but little extended early bactericidal activity. Clinical trial registered with www.clinicaltrials.gov (NCT00396084). PMID:18787216

  8. AGM-69A SRAM Explosive Components Surveillance Program Summary Report and FY74 Service Life Estimate

    DTIC Science & Technology

    1975-01-01

    BRAN Motor - Regression Baliistic Parameters 2-5 T 2-3 SRAN Motor - Regr.ssion Structural Parameters 2-6 T 2-. SRAN Ordnance Surveillance Test-Ordnance...procedures/ techniques which were modified to accommodate features unique of the SRAM weapon system, such as: 1-1 (1) A tvo-pulse motor technology vs...each of the following ordnahce de rices will be made upon the completion of aged testing: 3-14 1. Igniter Pressure Cartridge 2. Fin Unlock System

  9. Mode of encapsulation of linezolid by β-cyclodextrin and its role in bovine serum albumin binding.

    PubMed

    Natesan, Sudha; Sowrirajan, Chandrasekaran; Yousuf, Sameena; Enoch, Israel V M V

    2015-01-22

    We describe, in this article, the associative interaction between Linezolid and β-Cyclodextrin, and the influence of β-Cyclodextrin on Linezolid's binding to Bovine serum albumin. β-Cyclodextrin forms a 1:1 inclusion complex with Linezolid, with a binding constant value of 3.51×10(2)M(-1). The binding is studied using ultraviolet-visible absorption, fluorescence, nuclear magnetic resonance, and rotating-frame overhauser effect spectroscopic techniques. The amide substituent on the oxazolidinone ring of Linezolid is involved in its binding to β-Cyclodextrin. The binding of the Linezolid to bovine serum albumin, in the absence and the presence of β-Cyclodextrin, is studied by analyzing the fluorescence quenching and Förster resonance energy transfer. The Stern-Volmer quenching constant, the binding constant, and energy transfer occurring on the interaction of the Linezolid with BSA are found to be smaller in the presence of β-Cyclodextrin than in water.

  10. [Evaluation on the risks of H5, H7 and H9 avian influenza infections in Guangzhou: using data from the 2006-2012 avian influenza surveillance program].

    PubMed

    Chen, Zong-qiu; Lu, Jian-yun; Xiao, Xin-cai; Liu, Hui; DI, Biao; Li, Kui-biao; Lu, En-jie; Luo, Lei; Yang, Zhi-cong

    2013-09-01

    To analyze the results of avian influenza surveillance program in Guangzhou from 2006 to 2012 and to evaluate the risk of infections with H5, H7 and H9 subtypes avian influenza viruses. Avian influenza surveillance system in Guangzhou consisted five components:serum surveillance on occupational population, environmental specimen surveillance of avian influenza virus, avian flu emergency surveillance, influenza viruses surveillance on ILI patient and surveillance on pneumonia of unknown causes. Hemagglutination inhibition test was conducted to detect the antibodies against H5, H7 and H9 while RT-PCR was used to test the nucleic acid of H5, H7 and H9 viruses. From 2006 to 2012, 4103 serum specimens were collected from occupational populations and the overall positive rate of H5/H7/H9 antibodies was 3.82% . The antibody positive rates for H5, H7 and H9 were 0.22% ,0.00% and 3.70% respectively. 4 serum specimens for H5 and H9 simultaneously showed antibody positive. The positive rate of H9 among occupational populations(4.21%)appeared higher than that from the control population(2.16%). 2028 specimens were collected from poultry sites and 55 samples found positive for H5 nucleic acid (positive rate:2.71%), 14 samples positive for H9 nucleic acid (positive rate:0.69%), 5 specimens, simultaneously positive for H5 and H9 nucleic acids. However, none of the samples showing H7 nucleic acid positive. From 2006 to 2012, all the tested H5/H7/H9 virus were negative from the respiratory/serum specimens among those close contacts of patients or high risk groups through the avian flu emergency surveillance program,ILI patient influenza virus surveillance programs or pneumonia of unknown causes surveillance program. Contamination of H5/H9 avian influenza virus did exist in the poultry sites in Guangzhou, especially in the wet Markets. The H5/H9 avian influenza virus caused asymptomatic infection was proved to be existed within the population exposed to the poultry, suggesting that

  11. Soil and vegetation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    Soil sampling and analysis evaluates long-term contamination trends and monitors environmental radionuclide inventories. This section of the 1994 Hanford Site Environmental Report summarizes the soil and vegetation surveillance programs which were conducted during 1994. Vegetation surveillance is conducted offsite to monitor atmospheric deposition of radioactive materials in areas not under cultivation and onsite at locations adjacent to potential sources of radioactivity.

  12. U.S. Department of Energy, Illness and Injury Surveillance Program, Worker Health Summary, 1995-2004

    SciTech Connect

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-10-01

    The Department of Energy’s (DOE) Illness and Injury Surveillance Program has created an opportunity to assess illness and injury rates and patterns among workers at participating sites for well over a decade. The Worker Health Summary introduces an additional perspective on worker health with the introduction of analyses comparing the experience of sites in different program offices and a focus on time trends covering a decade of worker illness and injury experience. These analyses by program office suggest that illness and injury patterns among National Nuclear Security Administration (NNSA) workers diverge in many ways from those seen among Environmental Management (EM) and Science workers for reasons not yet understood. These differences will receive further investigation in future special focus studies, as will other findings of interest. With the time depth now available in our data, the Worker Health Summary reveals an additional nuance in worker health trends: changing health patterns in a specialized and skilled but aging work force. Older workers are becoming an increasing percentage of the work force, and their absence rates for diseases such as diabetes and hypertension are increasing as well. The impact of these emerging health issues, if properly addressed, can be managed to maintain or even enhance worker health and productivity. Prevention strategies designed to reduce the toll of these health conditions appear warranted, and this report gives us an indication of where to focus them. The analyses that follow reflect the Illness and Injury Surveillance Program’s continued commitment to apply a public health perspective in protecting the health of DOE’s work force.

  13. Differential Effects of Linezolid and Ciprofloxacin on Toxin Production by Bacillus anthracis in an In Vitro Pharmacodynamic System

    PubMed Central

    VanScoy, Brian D.; Heine, Henry S.; Liu, Weiguo; Abshire, Terry; Holman, Kari; Kulawy, Robert; Brown, David L.; Drusano, George L.

    2012-01-01

    Bacillus anthracis causes anthrax. Ciprofloxacin is a gold standard for the treatment of anthrax. Previously, using the non-toxin-producing ΔSterne strain of B. anthracis, we demonstrated that linezolid was equivalent to ciprofloxacin for reducing the total (vegetative and spore) bacterial population. With ciprofloxacin therapy, the total population consisted of spores. With linezolid therapy, the population consisted primarily of vegetative bacteria. Linezolid is a protein synthesis inhibitor, while ciprofloxacin is not. Since toxins are produced only by vegetative B. anthracis, the effect of linezolid and ciprofloxacin on toxin production is of interest. The effect of simulated clinical regimens of ciprofloxacin and linezolid on the vegetative and spore populations and on toxin production was examined in an in vitro pharmacodynamic model over 15 days by using the toxin-producing Sterne strain of B. anthracis. Ciprofloxacin and linezolid reduced the total Sterne population at similar rates. With ciprofloxacin therapy, the total Sterne population consisted of spores. With linezolid therapy, >90% of the population was vegetative B. anthracis. With ciprofloxacin therapy, toxin was first detectable at 3 h and remained detectable for at least 5 h. Toxin was never detected with linezolid therapy. Ciprofloxacin and linezolid reduced the total Sterne population at similar rates. However, the B. anthracis population was primarily spores with ciprofloxacin therapy and was primarily vegetative bacteria with linezolid therapy. Toxin production was detected for at least 5 h with ciprofloxacin therapy but was never detected with linezolid treatment. Linezolid may have an advantage over ciprofloxacin for the treatment of B. anthracis infections. PMID:22064542

  14. Linezolid-induced serotonin toxicity in a patient not taking monoamine oxidase inhibitors or serotonin receptor antagonists

    PubMed Central

    Sutton, Jacob; Stroup, Jeff

    2016-01-01

    Linezolid is an oxazolidinone antibiotic with weak monoamine oxidase (MAO) type A and MAO type B inhibitory effects. Linezolid has been associated with serotonin toxicity when used concomitantly with multiple medications that are known to increase serotonin concentrations. We report the case of a 65-year-old woman with signs and symptoms of serotonin toxicity following administration of linezolid for treatment of methicillin-resistant Staphylococcus aureus pneumonia. PMID:27034576

  15. Bluetongue sentinel surveillance program and cross-sectional serological survey in cattle in Belgium in 2010-2011.

    PubMed

    Vangeel, I; De Leeuw, I; Méroc, E; Vandenbussche, F; Riocreux, F; Hooyberghs, J; Raemaekers, M; Houdart, P; Van der Stede, Y; De Clercq, K

    2012-10-01

    Bluetongue virus serotype 8 (BTV-8) emerged in Central Western Europe in 2006 causing a large scale epidemic in 2007 that involved several European Union (EU) countries including Belgium. As in several other EU member states, vaccination against BTV-8 with inactivated vaccines was initiated in Belgium in spring 2008 and appeared to be successful. Since 2009, no clinical cases of Bluetongue (BT) have been reported in Belgium and BTV-8 circulation seemed to have completely disappeared by spring 2010. Therefore, a series of repeated cross-sectional surveys, the BT sentinel surveillance program, based on virus detection in blood samples by means of real-time RT-PCR (RT-qPCR) were carried out in dairy cattle from the end of 2010 onwards with the aim to demonstrate the absence of BTV circulation in Belgium. This paper describes the results of the first two sampling rounds of this BT sentinel surveillance program carried out in October-November 2010 and January-February 2011. In addition, the level of BTV-specific maternal antibodies in young non-vaccinated animals was monitored and the level of herd immunity against BTV-8 after 3 consecutive years of compulsory BTV-8 vaccination was measured by ELISA. During the 1st sampling round of the BT sentinel surveillance program, 15 animals tested positive and 2 animals tested doubtful for BTV RNA by RT-qPCR. During the 2nd round, 17 animals tested positive and 5 animals tested doubtful. The positive/doubtful animals in both rounds were re-sampled 2-4 weeks after the original sampling and then all tested negative by RT-qPCR. These results demonstrate the absence of BTV circulation in Belgium in 2010 at a minimum expected prevalence of 2% and 95% confidence level. The study of the maternal antibodies in non-vaccinated animals showed that by the age of 7 months maternal antibodies against BTV had disappeared in most animals. The BTV seroprevalence at herd level after 3 years of compulsory BTV-8 vaccination was very high (97.4% [95

  16. Geocoding capacity of birth defects surveillance programs: results from the National Birth Defects Prevention Network Geocoding Survey.

    PubMed

    Wang, Ying; O'Leary, Leslie A; Rickard, Russel S; Mason, Craig A

    2010-01-01

    A Web-based survey focusing on geocoding of birth defects data was developed and administrated to gain an understanding of the capacity of state birth defects programs to geocode maternal residence and to identify barriers to geocoding birth defects data. The survey consisted of 21 questions related to geocoding of maternal residence, type of software used, barriers to geocoding, and data linkage. In August 2007, an e-mail with a Web link to the survey was sent to all state birth defects program contacts in the United States, including the District of Columbia, Puerto Rico, and the Centers for Disease Control and Prevention (CDC) requesting they complete the online survey. By October 2007, 39 (74%) out of 53 birth defects program contacts completed the survey. Although nearly all birth defects programs collect maternal residential data, many are not currently geocoding that data. Results indicated that 97% of the programs that completed the survey reported they collected data on maternal residence, 53% of which reported that the birth defects surveillance data were geocoded to the street address level using maternal residential address at delivery. Twenty six percent of the programs that do not currently geocode the data identified "Software and address reference file are not available" as the most significant barrier to geocoding; another 16% chose "Lack of funding" as the most significant barrier to geocoding. Since geocoding is an important component of spatial analyses used to detect potential clusters of birth defects, leveraging resources to overcome the barriers that prevent programs from geocoding is important.

  17. [Italian Program for Surveillance of Acute Pesticide-Related Illnesses: cases identified in 2005].

    PubMed

    Settimi, L; Davanzo, F; Travaglia, A; Locatelli, C; Cilento, I; Volpe, C; Russo, A; Miceli, G; Fracassi, A; Maiozzi, P; Marcello, I; Sesan, F; Urbani, E

    2007-01-01

    In 2005, the Italian System for Surveillance of Acute Pesticide-Related Illnesses (SIAF) identified 625 cases, among which 520 unintentionally exposed. The majority of these subjects were men (75%) and aged 26-65 years (65%). About 63% of all exposures occurred at work. Severity for these illnesses was low for 94% and moderate for 5%. Four cases were classified as illnesses of high severity. Some 70% of all the reported exposures occurred between May and September. The active ingredients responsible for the largest number of cases were: glyphosate (n. 56), copper sulphate (n. 55), methomyl (n. = 52), metam-sodium (n. 24). Three episodes of collective environmental exposure to soil fumigants involving 23 subjects were also detected.

  18. [Surveillance system on drug abuse: Interest of the French national OPPIDUM program of French addictovigilance network].

    PubMed

    Frauger, Elisabeth; Pochard, Liselotte; Boucherie, Quentin; Giocanti, Adeline; Chevallier, Cécile; Daveluy, Amélie; Gibaja, Valérie; Caous, Anne-Sylvie; Eiden, Céline; Authier, Nicolas; Le Boisselier, Reynald; Guerlais, Marylène; Jouanjus, Émilie; Lepelley, Marion; Pizzoglio, Véronique; Pain, Stéphanie; Richard, Nathalie; Micallef, Joëlle

    2017-09-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data. OPPIDUM is a cross-sectional survey repeated each year since 1995. In 2015, 5003 patients described the modality of use of 10,159 psychoactive drugs. Among them, 77% received an opiate maintenance treatment: 68% methadone (half of them consumed capsule form) and 27% buprenorphine (39% consumed generic form). Brand-name buprenorphine is more often injected than generic buprenorphine (10% vs. 2%) and among methadone consumers 7% of methadone capsule consumers have illegally obtained methadone (vs. 9% for syrup form). The proportion of medications among psychoactive drugs injected is important (42%), with morphine representing 21% of the total psychoactive drugs injected and buprenorphine, 16%. OPPIDUM highlighted emergent behaviors of abuse with some analgesic opioids (like tramadol, oxycodone or fentanyl), pregabalin, or quetiapine. OPPIDUM highlighted variations of drugs use regarding geographic approaches or by drug dependence care centers (like in harm reduction centers). OPPIDUM clearly demonstrated that collection of valid and useful data on drug abuse is possible, these data have an interest at regional, national and international levels. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  19. Linezolid vs Glycopeptide Antibiotics for the Treatment of Suspected Methicillin-Resistant Staphylococcus aureus Nosocomial Pneumonia

    PubMed Central

    O’Donnell, Max R.; Wiener, Renda Soylemez

    2011-01-01

    Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of nosocomial pneumonia. Societal guidelines suggest linezolid may be the preferred treatment of MRSA nosocomial pneumonia. We investigated the efficacy of linezolid compared with glycopeptide antibiotics (vancomycin or teicoplanin) for nosocomial pneumonia. Methods: This was a systematic review and meta-analysis of English language, randomized, controlled trials comparing linezolid to glycopeptide antibiotics for suspected MRSA pneumonia in subjects > 12 years of age. A highly sensitive search of PubMed MEDLINE and Cochrane Central Register of Controlled Trials databases identified relevant studies. Results: Eight trials encompassing 1,641 subjects met entry criteria. Linezolid was not superior to glycopeptide antibiotics for end points of clinical success (relative risk [RR] linezolid vs glycopeptide, 1.04; 95% CI, 0.97-1.11; P = .28), microbiologic success (RR, 1.13; 95% CI, 0.97-1.31; P = .12), or mortality (RR, 0.91; 95% CI, 0.69-1.18; P = .47). In addition, clinical success in the subgroup of subjects with MRSA-positive respiratory tract culture (RR, 1.23; 95% CI, 0.97-1.57; P = .09) was not significantly different from those without MRSA (RR, 0.95; 95% CI, 0.83-1.09; P = .48), P for interaction, 0.07. The risk for adverse events was not different between the two antibiotic classes (RR, 0.96; 95% CI, 0.86-1.07; P = .48). Conclusion: Randomized controlled trials do not support superiority of linezolid over glycopeptide antibiotics for the treatment of nosocomial pneumonia. We recommend that decisions between linezolid or glycopeptide antibiotics for empirical or MRSA-directed therapy of nosocomial pneumonia depend on local availability, antibiotic resistance patterns, preferred routes of delivery, and cost, rather than presumed differences in efficacy. PMID:20864609

  20. Bicytopenia, especially thrombocytopenia in hemodialysis and non-hemodialysis patients treated with linezolid therapy.

    PubMed

    Kato, Hideo; Hamada, Yukihiro; Hagihara, Mao; Hirai, Jun; Yamagishi, Yuka; Matsuura, Katsuhiko; Mikamo, Hiroshige

    2015-10-01

    One of the major adverse events associated with linezolid treatment is pancytopenia. However, there are few reports about the tolerability of linezolid among patients undergoing hemodialysis. This study retrospectively investigated the frequency of bicytopenia (thrombocytopenia and erythropenia) secondary to linezolid treatment in patients undergoing and not-undergoing hemodialysis. In total, 181 patients treated with linezolid from January 2010 to July 2012 at Aichi Medical University Hospital were divided into three groups; patients undergoing hemodialysis (HD group), those with creatinine clearance (CLCR) of <50 mL/min (CLCR < 50 group) and those with CLCR of ≥ 50 mL/min (CLCR ≥ 50 group). The incidence of thrombocytopenia, and changes in the platelet (PLT) counts during and after linezolid therapy were compared among three groups. Thrombocytopenia (<75% of the baseline level) occurred in 125 patients (69.1%). PLT reached its nadir 3-4 days after the end of linezolid therapy. In particular, the PLT nadir in HD group occurred earlier than that in non-HD groups (HD, 11.5 days [4-31 days]; CLCR < 50, 14 days [5-43 days]; CLCR ≥ 50, 15.5 days [4-49 days]; p = 0.11). HD group exhibited the greatest rate of reduction of PLT (HD, 24.0% [0.4-93.8%]; CLCR < 50, 23.8% [0.8-92.9%]; CLCR ≥ 50, 22.4% [0.92-92.9%]; p = 0.003). Finally, HD group exhibited the slowest recovery of PLT to its baseline level (HD, 10 days [5-29 days]; CLCR < 50, 9 days [2-16 days]; CLCR ≥ 50, 8 days [3-17 days]; p = 0.09). The incidence of erythropenia was not significantly different among three groups. These results indicate the need to monitor the PLT count during and after linezolid treatment in patients undergoing hemodialysis.

  1. Surveillance and maintenance activities of waste area groupings at Oak Ridge National Laboratory. Annual summary report for period ending September 30, 1991: Environmental Restoration Program

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.; Jones, R.G.

    1991-12-01

    Surveillance and maintenance (S & M) of 75 sites were conductd by the Remedial Action Section for the Environmental Restoration Program for surplus facilities and sites contaminated with radioactive materials and/or hazardous chemicals. S & M activities on these sites were conducted from the end of their operating life until final facility disposal or site stabilization. The objectives of the Waste Area Grouping S & M Program are met by maintaining a program of routine S & M as well as by implementing interim corrective maintenance when deemed necessary as a result of site surveillance. This report briefly presents this program`s activities and includes tables indicating tank levels and dry well data for FY 1991.

  2. Annual summary report of the Decontamination and Decommissioning surveillance and maintenance program at Oak Ridge National Laboratory for period ending September 30, 1992. Environmental Restoration Program

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.

    1992-09-01

    The Oak Ridge National Laboratory (ORNL) Decontamination and Decommissioning (D&D) Program is part of the Department of Energy (DOE) Environmental Restoration D&D Program and has continued to provide surveillance and maintenance (S&M) support for 34 surplus facilities. The objectives are (1) to ensure adequate containment of residual radioactive materials remaining in the facilities, (2) to provide safety and security controls to minimize the potential hazards to on-site personnel and to the general public, and (3) to manage the facilities in the most cost-effective manner while awaiting decommissioning. This support has included work in three principal areas: (1) S&M planning, (2) routine S&M, and (3) special projects designed to correct serious facility deficiencies beyond the scope of routine maintenance.

  3. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers.

    PubMed

    van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    2017-03-24

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer's perspective were performed as well. Results Primary outcomes sickness absence (OR = 1.40), work ability (B = -0.63) and productivity (OR = 0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B = 0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1-3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.

  4. Optimization of nebulized delivery of linezolid, daptomycin, and vancomycin aerosol

    PubMed Central

    Zarogoulidis, Paul; Kioumis, Ioannis; Lampaki, Sofia; Organtzis, John; Porpodis, Konstantinos; Spyratos, Dionysios; Pitsiou, Georgia; Petridis, Dimitris; Pataka, Athanasia; Huang, Haidong; Li, Qiang; Yarmus, Lonny; Hohenforst-Schmidt, Wolfgang; Pezirkianidis, Nikolaos; Zarogoulidis, Konstantinos

    2014-01-01

    Background At this time, several antibiotics have been investigated as possibilities for aerosol administration, but local therapy has been found to be more efficient in several diseases. Materials and methods The drugs linezolid (Zyvox), vancomycin (Voncon), and daptomycin (Cubicin) were tested with three jet nebulizers with seven different residual cups and different loadings. Moreover, three ultrasound nebulizers were again tested with these drugs, with different loadings and mouthpiece attachments. Results When drugs are combined with particular cup designs, they significantly lower the droplet size to 1.60 and 1.80 μm, which represents the best combination of Zyvox and cup G and Cubicin and cup D, respectively. Cup design D is suggested as the most effective cup for lowering the droplet size (2.30 μm) when considering a higher loading level (8 mL). Conclusion Modification of current drugs from dry powder to solution is possible, and the residual cup design plays the most important role in droplet size production when the nebulization systems have the same properties. PMID:25143711

  5. 40 CFR 172.8 - Program surveillance and reporting of data.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) PESTICIDE PROGRAMS EXPERIMENTAL USE PERMITS Federal Issuance of Experimental Use Permits § 172.8 Program... report immediately to the Administrator, or to any person designated by him, any adverse effects from use of, or exposure to, the pesticide. (b) The permittee shall submit the following reports to the...

  6. Linezolid-Associated Optic Neuropathy in Drug-Resistant Tuberculosis Patients in Mumbai, India

    PubMed Central

    Mehta, Salil; Das, Mrinalini; Laxmeshwar, Chinmay; Jonckheere, Sylvie; Thi, Sein Sein; Isaakidis, Petros

    2016-01-01

    Background Patients on linezolid-containing drug-resistant TB (DR-TB) regimen often develop adverse-events, particularly peripheral and optic neuropathy. Programmatic data and experiences of linezolid-associated optic neuropathy from high DR-TB burden settings are lacking. The study aimed to determine the frequency of and risk-factors associated with linezolid-associated optic neuropathy and document the experiences related to treatment/care of DR-TB patients on linezolid-containing regimens. Methods This was a retrospective cohort study using routine clinical and laboratory data in Médecins Sans Frontières (MSF) HIV/DR-TB clinic in collaboration with Lilavati Hospital & Research Center, Mumbai, India. All DR-TB patients on linezolid-containing treatment regimens were included in the study and underwent routine evaluations for systemic and/or ocular complaints. Ophthalmological evaluation by a consultant ophthalmologist included visual-acuity screening, slit-lamp examination and dilated fundus examination. Results During January 2013-April 2016, 86 of 136 patients (with/without HIV co-infection) initiated linezolid-containing DR-TB treatment. The median age of these 86 patients was 25 (20–35) years and 47% were males. 20 percent of them had HIV co-infection. Of 86, 24 (27.9%) had at least one episode of ocular complaints (the majority blurred-vision) and among them, five (5.8%) had optic neuropathy. Patients received appropriate treatment and improvements were observed. None of the demographic/clinical factors were associated with optic neuropathy in Poissons or multivariate binary logistic-regression models. Discussion This is the first report focusing on optic neuropathy in a cohort of complex DR-TB patients, including patients co-infected with HIV, receiving linezolid-containing regimens. In our study, one out of four patients on linezolid had at least one episode of ocular complaints; therefore, systematic monitoring of patients by primary physicians

  7. Results from the Canadian Nosocomial Infection Surveillance Program on Carbapenemase-Producing Enterobacteriaceae, 2010 to 2014

    PubMed Central

    Mataseje, Laura F.; Abdesselam, Kahina; Vachon, Julie; Mitchel, Robyn; Bryce, Elizabeth; Roscoe, Diane; Boyd, David A.; Embree, Joanne; Katz, Kevin; Kibsey, Pamela; Simor, Andrew E.; Taylor, Geoffrey; Turgeon, Nathalie; Langley, Joanne; Gravel, Denise; Amaratunga, Kanchana

    2016-01-01

    Carbapenemase-producing Enterobacteriaceae (CPE) are increasing globally; here we report on the investigation of CPE in Canada over a 5-year period. Participating acute care facilities across Canada submitted carbapenem-nonsusceptible Enterobacteriaceae from 1 January 2010 to 31 December 2014 to the National Microbiology Laboratory. All CPE were characterized by antimicrobial susceptibilities, pulsed-field gel electrophoresis, multilocus sequence typing, and plasmid restriction fragment length polymorphism analysis and had patient data collected using a standard questionnaire. The 5-year incidence rate of CPE was 0.09 per 10,000 patient days and 0.07 per 1,000 admissions. There were a total of 261 CPE isolated from 238 patients in 58 hospitals during the study period. blaKPC-3 (64.8%) and blaNDM-1 (17.6%) represented the highest proportion of carbapenemase genes detected in Canadian isolates. Patients who had a history of medical attention during international travel accounted for 21% of CPE cases. The hospital 30-day all-cause mortality rate for the 5-year surveillance period was 17.1 per 100 CPE cases. No significant increase in the occurrence of CPE was observed from 2010 to 2014. Nosocomial transmission of CPE, as well as international health care, is driving its persistence within Canada. PMID:27600052

  8. [Role of the National Poliovirus Laboratory for the Program of eradication and poliomyelitis surveillance].

    PubMed

    Trallero, Gloria; Cabrerizo, María; Avellón, Ana

    2013-01-01

    The Spanish acute flaccid paralysis surveillance network is coordinated by the National Poliovirus Laboratory (NPL), which, since 1998, carries out polioviruses (PV) and other enteroviruses detected characterization by cell culture and molecular techniques. A total of 110,725 (70046+40679) samples were studied between 1998-2012 and enteroviruses were detected in 8% of these. Among these enteroviruses 241 PV were characterized as PV Sabin-like, except samples belong to an imported poliomyelitis case, all of which were characterised as vaccine derived PV type 2. The NPL has carried out the serotyping and the intratypic differentiation of all the isolated PV in Spain of any syndrome. It is shown that wild PV has not circulated in our country during the 15 years studied and that has led to the signing of the Act of the "eradication of poliomyelitis in Spain" by WHO in 2001, and the /"certification of the eradication of wild PV free for European countries" on 21 June 2002. Currently only 3 countries have endemic transmission of wild PV (Pakistan, Afghanistan and Nigeria). Until a complete worldwide eradication, was achieved, Spain will actively continue to participate in the maintenance of the poliomyelitis eradication infrastructure by monitoring and vaccination as well as the wild PV containment plan to avoid the spread of wild PV.

  9. Comparative Efficacy of Ceftaroline with Linezolid against Staphylococcus aureus and Methicillin Resistant Staphylococcus aureus.

    PubMed

    Hafeez, Amira; Munir, Tehmina; Rehman, Sabahat; Najeeb, Sara; Gilani, Mehreen; Latif, Mahwish; Ansari, Maliha; Saad, Nadia

    2015-04-01

    To compare the in vitro antimicrobial efficacy of ceftaroline with linezolid against Staphylococcus aureus and methicillin resistant Staphylococcus aureus. Quasi-experimental study. Microbiology Department, Army Medical College, Rawalpindi, from January to December 2013. Clinical samples from respiratory tract, blood, pus and various catheter tips routinely received in the Department of Microbiology, Army Medical College, Rawalpindi were innoculated on blood and MacConkey agar. Staphylococcus aureus was identified by colony morphology, Gram reaction, catalase test and coagulase test. Methicillin resistant Staphylococcus aureus detection was done by modified Kirby Bauer disc diffusion method using cefoxitin disc (30 μg) and the isolates were considered methicillin resistant if the zone of inhibition around cefoxitin disc was ≤ 21 mm. Bacterial suspensions of 56 Staphylococcus aureus isolates and 50 MRSA isolates were prepared, which were standardized equal to 0.5 McFarland's turbidity standard and inoculated on Mueller-Hinton agar plates followed by application of ceftaroline and linezolid disc (Oxoid, UK), according to manufacturer's instructions. The plates were then incubated at 37 °C aerobically for 18 - 24 hours. Diameters of inhibition zone were measured and interpretated as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Out of 106 isolates all of the 56 Staphylococcus aureus (100%) were sensitive to ceftaroline and linezolid. However, out of 50 methicillin resistant Staphylococcus aureus, 48 (96%) were sensitive to ceftaroline whereas, 49 (98%) were sensitive to linezolid. Ceftaroline is equally effective as linezolid against Staphylococcus aureus and methicillin resistant Staphylococcus aureus.

  10. Development and Validation of Stability-indicating HPLC Method for Simultaneous Estimation of Cefixime and Linezolid

    PubMed Central

    Patel, Nidhi S.; Tandel, Falguni B.; Patel, Yogita D.; Thakkar, Kartavya B.

    2014-01-01

    A stability-indicating reverse phase high performance liquid chromatography method was developed and validated for cefixime and linezolid. The wavelength selected for quantitation was 276 nm. The method has been validated for linearity, accuracy, precision, robustness, limit of detection and limit of quantitation. Linearity was observed in the concentration range of 2-12 μg/ml for cefixime and 6-36 μg/ml for linezolid. For RP-HPLC, the separation was achieved by Phenomenex Luna C18 (250×4.6 mm) 5 μm column using phosphate buffer (pH 7):methanol (60:40 v/v) as mobile phase with flow rate 1 ml/min. The retention time of cefixime and linezolid were found to be 3.127 min and 11.986 min, respectively. During force degradation, drug product was exposed to hydrolysis (acid and base hydrolysis), H2O2, thermal degradation and photo degradation. The % degradation was found to be 10 to 20% for both cefixime and linezolid in the given condition. The method specifically estimates both the drugs in presence of all the degradants generated during forced degradation study. The developed methods were simple, specific and economic, which can be used for simultaneous estimation of cefixime and linezolid in tablet dosage form. PMID:25593387

  11. A preliminary study for the development of indices and the current state of surgical site infections (SSIs) in Korea: the Korean Surgical Site Infection Surveillance (KOSSIS) program.

    PubMed

    Park, Sun Jin; Lee, Kil Yeon; Park, Ji Won; Lee, Jae Gil; Choi, Hee Jung; Chun, Hee Kyung; Kang, Jung Gu

    2015-03-01

    We aimed to develop an effective system for surgical site infection (SSI) surveillance and examine the current domestic state of SSIs for common abdominal surgeries in Korea. The Korean Surgical Site Infection Surveillance (KOSSIS) program was developed as an SSI surveillance system. A prospective multicenter study in nine university-affiliated or general hospitals was conducted for patients who underwent gastrectomy, cholecystectomy, appendectomy, colectomy, or proctectomy between August 16 and September 30 in 2012. Patients were monitored for up to 30 days by combining direct observation and a postdischarge surgeon survey. Data on SSIs were prospectively collected with KOSSIS secretarial support according to a common protocol. Operation-specific SSI rates were stratified according to risk factors and compared with data from the Korean Nosocomial Infections Surveillance System (KONIS) and National Healthcare Safety Network. A focus group interview was conducted with participating hospitals for feedback. A total of 1,088 operations were monitored: 207 gastrectomies, 318 cholecystectomies, 270 appendectomies, 197 colectomies, and 96 proctectomies. Operation-specific SSI rates determined by the KOSSIS program were substantially higher than those found in KONIS (7.73% [95% confidence interval, 4.5%-12.3%] vs. 3.4% for gastrectomies, 10.15% [95% confidence interval, 6.1%-15.2%] vs. 4.0% for colectomy, and 13.5% [95% confidence interval, 7.4%-22.0%] vs. 4.2% for proctectomy). Despite a short surveillance period and heterogenous group of hospitals, our results suggest that KOSSIS could be a useful program to enhance SSI surveillance in Korea.

  12. Imaging surveillance programs for women at high breast cancer risk in Europe: Are women from ethnic minority groups adequately included? (Review).

    PubMed

    Belkić, Karen; Cohen, Miri; Wilczek, Brigitte; Andersson, Sonia; Berman, Anne H; Márquez, Marcela; Vukojević, Vladana; Mints, Miriam

    2015-09-01

    Women from ethnic minority groups, including immigrants and refugees are reported to have low breast cancer (BC) screening rates. Active, culturally-sensitive outreach is vital for increasing participation of these women in BC screening programs. Women at high BC risk and who belong to an ethnic minority group are of special concern. Such women could benefit from ongoing trials aimed at optimizing screening strategies for early BC detection among those at increased BC risk. Considering the marked disparities in BC survival in Europe and its enormous and dynamic ethnic diversity, these issues are extremely timely for Europe. We systematically reviewed the literature concerning European surveillance studies that had imaging in the protocol and that targeted women at high BC risk. The aim of the present review was thereby to assess the likelihood that women at high BC risk from minority ethnic groups were adequately included in these surveillance programs. Twenty-seven research groups in Europe reported on their imaging surveillance programs for women at increased BC risk. The benefit of strategies such as inclusion of magnetic resonance imaging and/or more intensive screening was clearly documented for the participating women at increased BC risk. However, none of the reports indicated that sufficient outreach was performed to ensure that women at increased BC risk from minority ethnic groups were adequately included in these surveillance programs. On the basis of this systematic review, we conclude that the specific screening needs of ethnic minority women at increased BC risk have not yet been met in Europe. Active, culturally-sensitive outreach is needed to identify minority women at increased BC risk and to facilitate their inclusion in on-going surveillance programs. It is anticipated that these efforts would be most effective if coordinated with the development of European-wide, population-based approaches to BC screening.

  13. Waterborne Release Monitoring and Surveillance Programs at the Savannah River Site

    SciTech Connect

    Blanchard, A.

    1999-03-26

    This report documents the liquid release environmental compliance programs currently in place at the Savannah river Site (SRS). Included are descriptions of stream monitoring programs, which measure chemical parameters and radionuclides in site streams and the Savannah river and test representative biological communities within the streams for chemical and radiological uptake. This report also explains the field sampling and analytical capabilities that are available at SRS during both normal and emergency conditions.

  14. Rasch scaling procedures for informing development of a valid Fetal Surveillance Education Program multiple-choice assessment

    PubMed Central

    Zoanetti, Nathan; Griffin, Patrick; Beaves, Mark; Wallace, Euan M

    2009-01-01

    Background It is widely recognised that deficiencies in fetal surveillance practice continue to contribute significantly to the burden of adverse outcomes. This has prompted the development of evidence-based clinical practice guidelines by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and an associated Fetal Surveillance Education Program to deliver the associated learning. This article describes initial steps in the validation of a corresponding multiple-choice assessment of the relevant educational outcomes through a combination of item response modelling and expert judgement. Methods The Rasch item response model was employed for item and test analysis and to empirically derive the substantive interpretation of the assessment variable. This interpretation was then compared to the hierarchy of competencies specified a priori by a team of eight subject-matter experts. Classical Test Theory analyses were also conducted. Results A high level of agreement between the hypothesised and derived variable provided evidence of construct validity. Item and test indices from Rasch analysis and Classical Test Theory analysis suggested that the current test form was of moderate quality. However, the analyses made clear the required steps for establishing a valid assessment of sufficient psychometric quality. These steps included: increasing the number of items from 40 to 50 in the first instance, reviewing ineffective items, targeting new items to specific content and difficulty gaps, and formalising the assessment blueprint in light of empirical information relating item structure to item difficulty. Conclusion The application of the Rasch model for criterion-referenced assessment validation with an expert stakeholder group is herein described. Recommendations for subsequent item and test construction are also outlined in this article. PMID:19402898

  15. Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program

    PubMed Central

    Doi, André Mario; Pignatari, Antonio Carlos Campos; Edmond, Michael B.; Marra, Alexandre Rodrigues; Camargo, Luis Fernando Aranha; Siqueira, Ricardo Andreotti; da Mota, Vivian Pereira; Colombo, Arnaldo Lopes

    2016-01-01

    Candidemia is a growing problem in hospitals all over the world. Despite advances in the medical support of critically ill patients, candidiasis leads to prolonged hospitalization, and has a crude mortality rate around 50%. We conducted a multicenter surveillance study in 16 hospitals distributed across five regions of Brazil to assess the incidence, species distribution, antifungal susceptibility, and risk factors for bloodstream infections due to Candida species. From June 2007 to March 2010, we studied a total of 2,563 nosocomial bloodstream infection (nBSI) episodes. Candida spp. was the 7th most prevalent agent. Most of the patients were male, with a median age of 56 years. A total of 64 patients (46.7%) were in the ICU when candidemia occurred. Malignancies were the most common underlying condition (32%). The crude mortality rate of candidemia during the hospital admission was 72.2%. Non-albicans species of Candida accounted for 65.7% of the 137 yeast isolates. C. albicans (34.3%), Candida parapsilosis (24.1%), Candida tropicalis (15.3%) and Candida glabrata (10.2%) were the most prevalent species. Only 47 out of 137 Candida isolates were sent to the reference laboratory for antifungal susceptibility testing. All C. albicans, C. tropicalis and C. parapsilosis isolates were susceptible to the 5 antifungal drugs tested. Among 11 C. glabrata isolates, 36% were resistant to fluconazole, and 64% SDD. All of them were susceptible to anidulafungin and amphotericin B. We observed that C. glabrata is emerging as a major player among non-albicans Candida spp. and fluconazole resistance was primarily confined to C. glabrata and C. krusei strains. Candida resistance to echinocandins and amphotericin B remains rare in Brazil. Mortality rates remain increasingly higher than that observed in the Northern Hemisphere countries, emphasizing the need for improving local practices of clinical management of candidemia, including early diagnosis, source control and precise

  16. Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program.

    PubMed

    Doi, André Mario; Pignatari, Antonio Carlos Campos; Edmond, Michael B; Marra, Alexandre Rodrigues; Camargo, Luis Fernando Aranha; Siqueira, Ricardo Andreotti; da Mota, Vivian Pereira; Colombo, Arnaldo Lopes

    2016-01-01

    Candidemia is a growing problem in hospitals all over the world. Despite advances in the medical support of critically ill patients, candidiasis leads to prolonged hospitalization, and has a crude mortality rate around 50%. We conducted a multicenter surveillance study in 16 hospitals distributed across five regions of Brazil to assess the incidence, species distribution, antifungal susceptibility, and risk factors for bloodstream infections due to Candida species. From June 2007 to March 2010, we studied a total of 2,563 nosocomial bloodstream infection (nBSI) episodes. Candida spp. was the 7th most prevalent agent. Most of the patients were male, with a median age of 56 years. A total of 64 patients (46.7%) were in the ICU when candidemia occurred. Malignancies were the most common underlying condition (32%). The crude mortality rate of candidemia during the hospital admission was 72.2%. Non-albicans species of Candida accounted for 65.7% of the 137 yeast isolates. C. albicans (34.3%), Candida parapsilosis (24.1%), Candida tropicalis (15.3%) and Candida glabrata (10.2%) were the most prevalent species. Only 47 out of 137 Candida isolates were sent to the reference laboratory for antifungal susceptibility testing. All C. albicans, C. tropicalis and C. parapsilosis isolates were susceptible to the 5 antifungal drugs tested. Among 11 C. glabrata isolates, 36% were resistant to fluconazole, and 64% SDD. All of them were susceptible to anidulafungin and amphotericin B. We observed that C. glabrata is emerging as a major player among non-albicans Candida spp. and fluconazole resistance was primarily confined to C. glabrata and C. krusei strains. Candida resistance to echinocandins and amphotericin B remains rare in Brazil. Mortality rates remain increasingly higher than that observed in the Northern Hemisphere countries, emphasizing the need for improving local practices of clinical management of candidemia, including early diagnosis, source control and precise

  17. Cryptococcosis in Colombia: results of the national surveillance program for the years 2006-2010.

    PubMed

    Escandón, Patricia; de Bedout, Catalina; Lizarazo, Jairo; Agudelo, Clara Inés; Tobón, Angela; Bello, Solmara; Restrepo, Angela; Castañeda, Elizabeth

    2012-09-01

    A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. To analyze the data obtained during this period. Retrospective analysis of the corresponding surveys. A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4 x 106 inhabitants while in AIDS patients this rate rose to 3.3 x 103. In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%. Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia.

  18. A trial of a job-specific workers' health surveillance program for construction workers: study protocol

    PubMed Central

    2011-01-01

    Background Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians. Methods/Design The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement. Discussion This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions

  19. Linezolid-induced lactic acidosis in two liver transplant patients with the mitochondrial DNA A2706G polymorphism.

    PubMed

    Del Pozo, J L; Fernández-Ros, N; Sáez, E; Herrero, J I; Yuste, J R; Banales, J M

    2014-07-01

    Mitochondrial toxicity has been recently suggested to be the underlying mechanism of long-term linezolid-associated toxicity in patients with 16S rRNA genetic polymorphisms. Here, we report for the first time two cases of lactic acidosis due to long-term linezolid exposure in liver transplant recipients who presented an A2706G mitochondrial DNA polymorphism.

  20. Comparison of results of fluconazole and voriconazole disk diffusion testing for Candida spp. with results from a central reference laboratory in the ARTEMIS DISK Global Antifungal Surveillance Program.

    PubMed

    Pfaller, Michael A; Boyken, Linda; Hollis, Richard J; Kroeger, Jennifer; Messer, Shawn A; Tendolkar, Shailesh; Diekema, Daniel J

    2009-09-01

    The accuracy of antifungal susceptibility testing is important for reliable resistance surveillance and for the clinical management of patients with serious infections due to Candida spp. Our primary objective was to compare the results of fluconazole and voriconazole disk diffusion testing of 3227 Candida spp. performed by 47 centers participating in the ARTEMIS program with disk diffusion and MIC results obtained by the central reference laboratory. The overall categoric agreement between participant disk diffusion test results and reference MIC results was 87% for fluconazole and 95.2% for voriconazole. Likewise good agreement was observed between participant disk diffusion test results and reference laboratory disk diffusion test results, with an agreement of 90.5%, 1% very major error (VME), and 3.4% major error (ME) for fluconazole and 94.2%, 1.1% VME, and 2.5% ME for voriconazole. The disk diffusion test was reliable for detecting those isolates of Candida spp. that were characterized as resistant to fluconazole and voriconazole by MIC testing. External quality assurance data obtained by surveillance programs such as the ARTEMIS Global Antifungal Surveillance Program ensure the generation of useful surveillance data and result in the continued improvement of antifungal susceptibility testing protocols.

  1. [Design of a computer program for the registration of implantable medical device, field safety corrective action and advers events, as a tool for medical device surveillance].

    PubMed

    Márquez-Peiró, Juan Francisco; Gaspar-Carreño, Marisa; Jiménez-Torres, José; Selva-Otaolaurruchi, Juan

    2016-03-01

    To describe the features of computer program to support the activity of the responsible for surveillance of medical devices. To evaluate their use after one year of implementation in a hospital. The stages of the process were: description of the activities of medical devices surveillance and implant registration, definition of functionality and data processing, creation of databases, implementation in a private hospital which manages PS, validation of the program and analysis of their usefulness. SIVIPS was developed using Acces. Main variables were described for all the activities of the responsible for medical device surveillance (implants, alert, medical device incidents, including for in vitro diagnostics) and all the functionalities of the computer program. SIVIPS was introduced in a pharmacy service with one pharmacist for the management of medical devices. One year after its implementation we had registered 564 implants with a description by type of implant, 31 alerts and 6 incidents. SIVIPS allow monitoring of the actions taken in these cases. SIVIPS is the first tool to support the activity of medical device surveillance. It is an easy tool that allows the registration of alerts and medical device related incidents, and registration of implants performed in the center, which will improve the traceability of the PS. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  2. Reductions of budgets, staffing, and programs among local health departments: results from NACCHO's economic surveillance surveys, 2009-2013.

    PubMed

    Ye, Jiali; Leep, Carolyn; Newman, Sarah

    2015-01-01

    To provide an overview of budget cuts, job losses, and program reductions among local health departments (LHDs) and to examine the association between LHD infrastructure characteristics and the likelihood of budget cuts. Data from 4 waves of the economic surveillance survey (July-August 2009, September-November 2010, January-February 2012, and January-March 2013) conducted by the National Association of County & City Health Officials were analyzed to assess cuts to budgets, jobs, and programs since 2009. Data from the 2013 National Profile of Local Health Departments survey were used to assess the infrastructural characteristics associated with budget cuts. When asked in early 2013, more than a quarter of LHDs (26.9%) reported a reduced budget, continuing the trend of a substantial proportion of LHDs experiencing financial hardship in recent years. The percentages of LHDs that made cuts to programmatic areas fluctuated from year to year but have never been lower than 40%. Maternal and child health services were among areas most often cut during all 4 time points of the survey. Governance type, total expenditures, and percentage of revenues from local sources were significantly associated with LHD budget cuts. Cuts in LHD budgets, staff, and activities have been widespread for a period that lasted long after the official end of the Great Recession. There is a great need for substantive and consistent funding to ensure the retention of the workforce and the delivery of essential public health services.

  3. Postmarketing surveillance of new food ingredients: design and implementation of the program for the fat replacer olestra.

    PubMed

    Slough, C L; Miday, R K; Zorich, N L; Jones, J K

    2001-04-01

    Following U.S. Food and Drug Administration (FDA) approval for the use of olestra, a noncaloric fat substitute (brand name Olean) in food snacks, the manufacturer agreed to provide safety updates on market experience to the FDA. However, guidelines for food product postmarketing surveillance (PMS) are not available and those typically used with medical products were only partly applicable. In modeling the Olean program, we drew from experience with consumer products and incorporated elements typical of medical product PMS. A cooperative effort was established with Olean snack manufacturers and a two-tiered, multidisciplinary approach enlisting Consumer Relations and Medical Affairs personnel was used to maximize use of specialized skills. The result of this effort was implementation of a reliable PMS system which could handle a high volume of reports from consumers while providing pertinent data required for medical interpretation of these reports. Summaries of data for the Olean snack manufacturers and FDA were generated in timely fashion. In addition to collection of the spontaneous reports from consumers, a clinical studies program was undertaken and an independent medical advisory panel was established. Through these, we gained perspective on the spontaneous reports and additional confirmation of the safety of olestra in savory snacks.

  4. Successful Treatment of Necrotizing Fasciitis and Streptococcal Toxic Shock Syndrome with the Addition of Linezolid

    PubMed Central

    Bojikian, Karine D.; Lucar, Jose

    2017-01-01

    Necrotizing fasciitis is a deep-seated subcutaneous tissue infection that is commonly associated with streptococcal toxic shock syndrome (TSS). Surgical debridement plus penicillin and clindamycin are the current standard of care. We report a case of necrotizing fasciitis and streptococcal TSS where linezolid was added after a failure to improve with standard therapy. Briefly after isolation of Streptococcus pyogenes from tissue cultures, the patient underwent two surgical debridement procedures and was changed to standard of care therapy. While the patient was hemodynamically stable, the patient's wounds, leukocytosis, and thrombocytopenia all progressively worsened. After initiation of linezolid, the patient slowly improved clinically. The present report is the first to highlight the role of linezolid in streptococcal necrotizing fasciitis and TSS not improving with standard therapy. PMID:28299216

  5. Annual summary report of the Decontamination and Decommissioning Surveillance and Maintenance Program at Oak Ridge National Laboratory for period ending September 30, 1993. Environmental Restoration Program

    SciTech Connect

    Not Available

    1993-11-01

    The Oak Ridge National Laboratory (ORNL) Decontamination and Decommissioning (D&D) Program has continued to provide surveillance and maintenance (S&M) support for 34 surplus facilities. The objectives are to (1) ensure adequate containment of residual radioactive materials remaining in the facilities, (2) provide safety and security controls to minimize the potential hazards to on-site personnel and the general public, and (3) manage the facilities in the most cost-effective manner while awaiting decommissioning. This support has included work in three principal areas: (1) S&M planning, (2) routine S&M, and (3) special projects designed to correct serious facility deficiencies beyond the scope of routine maintenance.

  6. Pharmacokinetic/pharmacodynamic evaluation of linezolid for the treatment of staphylococcal infections in critically ill patients.

    PubMed

    Dong, Haiyan; Xie, Jiao; Wang, Taotao; Chen, Lihong; Zeng, Xiaoyan; Sun, Jinyao; Wang, Xue; Dong, Yalin

    2016-09-01

    Several studies have demonstrated that the ideal therapeutic effect of linezolid cannot be achieved in critically ill patients with the recommended standard dosing regimen of 600 mg every 12 h (q12h). Moreover, the optimal strategy for successful treatment is still lacking. This study analysed factors influencing the efficacy of linezolid treatment and determined the target for successful treatment by logistic regression in 27 critically ill patients with staphylococcal infection who received linezolid 600 mg q12h. The results showed that only the 24-h area under the concentration-time curve to minimum inhibitory concentration (AUC24/MIC) ratio was significantly associated with staphylococcal eradication. Reaching 80% bacterial eradication required an AUC24/MIC of 120.5, defining the therapeutic target. Different dosing regimens were evaluated using Monte Carlo simulation to determine the optimal dosage strategy for linezolid. Although the probability of target attainment (PTA) was high (>99.9%) for the standard dosing regimen at MIC ≤ 1 mg/L, the PTA was almost 0 at MIC = 2 mg/L, thus the dosing regimen required adjustment. In addition, if the dosing regimen was adjusted to 600 mg every 8 h or 600 mg every 6 h, the major staphylococci (except for MRSA and MSSA) exhibited a cumulative fraction of response of >80%, showing a higher treatment success. These findings indicate that a strategy of high linezolid dosage may be needed to increase the probability of successful treatment at MIC > 1 mg/L. The role of therapeutic drug monitoring should be encouraged for optimising linezolid exposure in critically ill patients. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  7. Cefazolin and linezolid penetration into sternal cancellous bone during coronary artery bypass grafting.

    PubMed

    Andreas, Martin; Zeitlinger, Markus; Wisser, Wilfried; Jaeger, Walter; Maier-Salamon, Alexandra; Thalhammer, Florian; Kocher, Alfred; Hiesmayr, Joerg-Michael; Laufer, Guenther; Hutschala, Doris

    2015-11-01

    Deep sternal wound infection is a severe complication after cardiac surgery. Insufficient antibiotic target site concentrations may account for variable success of perioperative prophylaxis. Therefore, we measured perioperative penetration of cefazolin and of linezolid into sternal cancellous bone after sternotomy in coronary artery bypass grafting (CABG) patients by in vivo microdialysis. Nine patients underwent CABG using a skeletonized left internal mammary artery. Standard antibiotic prophylaxis consisted of 4 g cefazolin prior to skin incision and additional 2 g during skin closure. In addition, 600 mg of linezolid were administered prior to skin incision and after 12 h for study purposes. Two microdialysis probes were inserted into the sternal cancellous bone (left and right side) after sternotomy. First mean peak cefazolin and linezolid plasma concentrations were 273 ± 92 µg/ml and 22.1 ± 8.9 µg/ml, respectively. Mean peak concentrations of antibiotics in sternal cancellous bone on the left and right sternal side were 112 ± 59 µg/ml and 159 ± 118 µg/ml for cefazolin and 10.9 ± 4.0 µg/ml and 12.6 ± 6.1 µg/ml for linezolid, respectively. Cefazolin exceeded the required tissue concentrations for relevant pathogens by far, but linezolid did not gain effective tissue concentrations in all patients for some relevant pathogens. Mammary artery harvesting had no significant effect on antibiotic tissue penetration. Direct measurement of antibiotic concentration in sternal cancellous bone with in vivo microdialysis is technically demanding but safe and feasible. We could demonstrate sufficient antibiotic coverage with our standard cefazolin-dosing regimen in the sternal cancellous bone during cardiac surgery. Mammary artery harvesting had no clinically relevant effect on tissue penetration. Linezolid concentrations were not sufficient for some relevant pathogens. © The Author 2014. Published by Oxford University Press on behalf of the European Association

  8. Correlation between linezolid zone diameter and minimum inhibitory concentration values determined by regression analysis.

    PubMed

    Dimitriu, G; Poiata, Antonia; Tuchiluş, Cristina; Buiuc, D

    2006-01-01

    Linezolid is a new synthetic antibiotic belonging to the oxazolidinone class, available for the therapy of gram-positive infections, caused by methicillin-resistant staphylococci, vancomycin-resistant enterococci and penicillin-resistant pneumococci. The aim of the study was to determine the in vitro activity of linezolid against staphylococci strains and also to determine the relationship between the minimum inhibitory concentration (MIC) and inhibition zone diameter by calculating the regression analysis. We tested one hundred S. aureus isolates, obtained from healthy persons (naso-pharyngeal swabs) during 2005 year. The antibiotic susceptibility of strains was determined by disk diffusion standardized method and by agar dilution method using a multipoint inoculator. The relationship between the diameter of the inhibition zone produced by a linezolid disc impregnated with a fixed amount (30 eg) was determined by regression performed with the least squares method, considering the log2 of the minimum inhibitory concentrations (MICs) as the independent variable and the zone diameter as the dependent variable. The MIC values expressed in logarithmic form are plotted against inhibition zone diameter (arithmetic scale) of the same strain. The activity of linezolid against staphylococci was very good, with MIC 90 of 1 mg/l. All strains were fully sensitive. The regression line for linezolid passes through a continuous series of points that all are approximately located on the a straight line. For each of the MIC values the differences result no greater than 23 mm in diameter sizes were registered. Regression equation was y= -0.188x + 8.048. In conclusion, the regression line analysis calculated for linezolid, demonstrates a significant correlation between MIC values and the inhibition zone diameters obtained by a 30 mg disc.

  9. Linezolid versus Vancomycin in Treatment of Complicated Skin and Soft Tissue Infections

    PubMed Central

    Weigelt, John; Itani, Kamal; Stevens, Dennis; Lau, William; Dryden, Matthew; Knirsch, Charles

    2005-01-01

    Skin and soft tissue infections (SSTIs) are a common cause of morbidity in both the community and the hospital. An SSTI is classified as complicated if the infection has spread to the deeper soft tissues, if surgical intervention is necessary, or if the patient has a comorbid condition hindering treatment response (e.g., diabetes mellitus or human immunodeficiency virus). The purpose of this study was to compare linezolid to vancomycin in the treatment of suspected or proven methicillin-resistant gram-positive complicated SSTIs (CSSTIs) requiring hospitalization. This was a randomized, open-label, comparator-controlled, multicenter, multinational study that included patients with suspected or proven methicillin-resistant Staphylococcus aureus (MRSA) infections that involved substantial areas of skin or deeper soft tissues, such as cellulitis, abscesses, infected ulcers, or burns (<10% of total body surface area). Patients were randomized (1:1) to receive linezolid (600 mg) every 12 h either intravenously (i.v.) or orally or vancomycin (1 g) every 12 h i.v. In the intent-to-treat population, 92.2% and 88.5% of patients treated with linezolid and vancomycin, respectively, were clinically cured at the test-of-cure (TOC) visit (P = 0.057). Linezolid outcomes (124/140 patients or 88.6%) were superior to vancomycin outcomes (97/145 patients or 66.9%) at the TOC visit for patients with MRSA infections (P < 0.001). Drug-related adverse events were reported in similar numbers in both the linezolid and the vancomycin arms of the trial. The results of this study demonstrate that linezolid therapy is well tolerated, equivalent to vancomycin in treating CSSTIs, and superior to vancomycin in the treatment of CSSTIs due to MRSA. PMID:15917519

  10. Optimal Clinical Doses of Faropenem, Linezolid, and Moxifloxacin in Children With Disseminated Tuberculosis: Goldilocks

    PubMed Central

    Srivastava, Shashikant; Deshpande, Devyani; Pasipanodya, Jotam; Nuermberger, Eric; Swaminathan, Soumya; Gumbo, Tawanda

    2016-01-01

    Background. When treated with the same antibiotic dose, children achieve different 0- to 24-hour area under the concentration-time curves (AUC0–24) because of maturation and between-child physiological variability on drug clearance. Children are also infected by Mycobacterium tuberculosis isolates with different antibiotic minimum inhibitory concentrations (MICs). Thus, each child will achieve different AUC0–24/MIC ratios when treated with the same dose. Methods. We used 10 000-subject Monte Carlo experiments to identify the oral doses of linezolid, moxifloxacin, and faropenem that would achieve optimal target exposures associated with optimal efficacy in children with disseminated tuberculosis. The linezolid and moxifloxacin exposure targets were AUC0–24/MIC ratios of 62 and 122, and a faropenem percentage of time above MIC >60%, in combination therapy. A linezolid AUC0–24 of 93.4 mg × hour/L was target for toxicity. Population pharmacokinetic parameters of each drug and between-child variability, as well as MIC distribution, were used, and the cumulative fraction of response (CFR) was calculated. We also considered drug penetration indices into meninges, bone, and peritoneum. Results. The linezolid dose of 15 mg/kg in full-term neonates and infants aged up to 3 months and 10 mg/kg in toddlers, administered once daily, achieved CFR ≥ 90%, with <10% achieving linezolid AUC0–24 associated with toxicity. The moxifloxacin dose of 25 mg/kg/day achieved a CFR > 90% in infants, but the optimal dose was 20 mg/kg/day in older children. The faropenem medoxomil optimal dosage was 30 mg/kg 3–4 times daily. Conclusions. The regimen and doses of linezolid, moxifloxacin, and faropenem identified are proposed to be adequate for all disseminated tuberculosis syndromes, whether drug-resistant or -susceptible. PMID:27742641

  11. 10 CFR Appendix H to Part 50 - Reactor Vessel Material Surveillance Program Requirements

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... in the fracture toughness properties of ferritic materials in the reactor vessel beltline region of... and the thermal environment. Under the program, fracture toughness test data are obtained from... requirements for number of materials to be irradiated, specimen types, or number of specimens per reactor is...

  12. 10 CFR Appendix H to Part 50 - Reactor Vessel Material Surveillance Program Requirements

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... in the fracture toughness properties of ferritic materials in the reactor vessel beltline region of... and the thermal environment. Under the program, fracture toughness test data are obtained from... requirements for number of materials to be irradiated, specimen types, or number of specimens per reactor is...

  13. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    ERIC Educational Resources Information Center

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

  14. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    ERIC Educational Resources Information Center

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

  15. Minuteman Stage III Operational Surveillance Program Seven-Year Testing Bondline Aging Study,

    DTIC Science & Technology

    1985-12-01

    Liner Gel Fraction at Various Motor Locations ......... . . 25 14 Liner Moisture at Various Motor Locations ............. ... 26 6 15 Motor TC 30005 ...PageI ,,. 18 Shore A Hardness Gradient of ANB-3066 Propellant at the Forward Equator ........ ...................... .. 30 19 Motor TC 30005 ...75 I 2 Matrix for Minuteman Stage III Bondline Aging Program ........ 76 3 Motor TC 30005 Material Properties Data, Forward

  16. Neonatal thyrotropin profile as an index for severity of iodine deficiency and surveillance of iodine prophylactic program.

    PubMed

    Rajatanavin, R; Unachak, K; Winichakoon, P; Chailurkit, L O; Vilasdechanon, N; Tananchai, P; Srinawat, S

    1997-08-01

    Neonatal serum thyrotropin (TSH) level has been proposed as an index for the monitoring and surveillance of an iodine prophylactic program. We have determined an effective way to put this idea into practice. During the first phase of our study, neonatal serum TSH levels were obtained from umbilical cord blood of neonates born in Chiangmai and Nan provinces, where several districts were areas of severe iodine deficiency, and were compared with those of neonates born in Bangkok, which was a control area. The median and (95% CI [confidence interval]) of serum TSH level of neonates born in Chiangmai 5.8 (5.7-5.9) microU/mL was significantly higher than in Nan 5.1 (5.0-5.2) microU/mL, and in Bangkok 3.7 (3.7-3.8) microU/mL. Neonatal serum free thyroxine (FT4) concentration in Bangkok was higher than in Nan; while the reciprocal was true for neonatal TSH concentration in randomly selected samples (FT4 1.6 [1.6-1.7] ng/dL vs. 1.5 [1.5-1.6] ng/dL and TSH 3.5 [3.3-3.9] microU/mL vs. 5.5 [5.2-5.9] microU/mL, respectively.) When odds ratio of the likelihood of having neonatal TSH level higher than in Bangkok was calculated using 95th percentile value of neonatal TSH level in Bangkok as a cut-off point, the odds ratio of TSH profile in all districts in Chiangmai and Nan were greater than unity. In the second phase of our study, data were collected from 32 district and 10 provincial hospitals. The optimum number of samples in each hospital derived from the first phase of our study was at least 178. Discrepancy between goiter rate and odds ratio of TSH profile was observed, but there was a significant correlation between the two indices (r = 0.67, p < .001). Our study confirmed the practical utility of neonatal TSH profile as a biological index for assessment and monitoring and surveillance of an iodine prophylactic program at a district hospital in a developing country.

  17. The World Trade Center health surveillance program: results of the first 10 years and implications for prevention.

    PubMed

    Lucchini, R G; Crane, M A; Crowley, L; Globina, Y; Milek, D J; Boffetta, P; Landrigan, P J

    2012-01-01

    The terrorist attacks on the World Trade Center (WTC) of September 11, 2001 resulted in the deaths of 2,823 persons. They also generated a long-lasting burden of multiple physical and mental health illnesses among the cohort of 50,000 rescue workers who responded to the attacks and in the 400,000 residents and workers in nearby areas of New York City. A comprehensive health surveillance program was developed from the first months after the accidents and was further developed in the subsequent ears. Individual exposure and health data were stored in ad hoc databases and produced epidemiological outcomes on the various exposure-related illnesses. About 10 years of longitudinal assessment of this large cohort of WTC rescue and recovery workers, yielded data from participants in the WTC Screening, Monitoring, and Treatment Program. Police officers, firefighters, construction workers, and municipal workers were included in the cohort. Cumulative and annual incidence were estimated for various physical disorders including asthma, sinusitis, and gastroesophageal reflux disease, mental health disorders including depression, post-traumatic stress disorder [PTSD], and panic disorder. Respiratory functionality was also assessed. Exposure was characterized with qualitative parameter including working on the pile and being engulfed in the dust cloud, and quantitative parameters including the time of arrival on site and the exposure duration. Upper and lower respiratory conditions such as rhinosinusitis and asthma have been found in a significant number of people in WTC-exposed populations. A lack of appropriate respiratory protection may have contributed to these effects. Other commonly observed physical health conditions include gastro-esophageal reflux disease, obstructive sleep apnea and musculo-skeletal injuries. Many WTC-exposed individuals also suffer from mental health conditions, primarily post-traumatic stress disorder, depression, panic disorder, and substantial

  18. The impact of surveillance method and record source on autism prevalence: collaboration with Utah Maternal and Child Health programs.

    PubMed

    Pinborough-Zimmerman, Judith; Bilder, Deborah; Satterfield, Robert; Hossain, Shaheen; McMahon, William

    2010-05-01

    With the increasing number of Utah children identified with autism spectrum disorders (ASDs), information on the prevalence and characteristics of these children could help Maternal Child Health (MCH) programs develop population building activities focused on prevention, screening, and education. The purpose of this study is to describe Utah's autism registry developed in collaboration with state MCH programs and assess the impact of different record-based surveillance methods on state ASD prevalence rates. The study was conducted using 212 ASD cases identified from a population of 26,217 eight year olds living in one of the three most populous counties in Utah (Davis, Salt Lake, and Utah) in 2002. ASD prevalence was determined using two records based approaches (administrative diagnoses versus abstraction and clinician review) by source of record ascertainment (education, health, and combined). ASD prevalence ranged from 7.5 per 1000 (95% CI 6.4-8.5) to 3.2 per 1000 (95% CI 2.5-3.9) varying significantly (P < .05) based on method and record source. The ratio of male-to-female ranged from 4.7:1 to 6.4:1. No significant differences were found between the two case ascertainment methods on 18 of the 23 case characteristics including median household income, parental education, and mean age of diagnosis. Broad support is needed from both education and health sources as well as collaboration with MCH programs to address the growing health concerns, monitoring, and treatment needs of children and their families impacted by autism spectrum disorders.

  19. Surveillance data analysis of Revised National Tuberculosis Control Program of Kangra, Himachal Pradesh

    PubMed Central

    Gupta, Surender Nikhil; Gupta, Naveen; Gupta, Shivani

    2013-01-01

    Background: The annual risk of tuberculosis infection is 1.9% in Himachal Pradesh against a national average of 1%. Revised national tuberculosis control program (RNTCP) in Kangra was introduced in October, 1998. We analyzed the 5-year (2001-2005) RNTCP secondary data from Kangra to evaluate the performance of the program. Materials and Methods: We collected data from all the five tuberculosis units the district. We calculated the following indicators-case detection rate, tuberculosis cases by category-new smear positive (or smear negative but seriously ill) defaulters, relapses and failures, extra-pulmonary, and new smear negative cases. We compared the results with Himachal Pradesh and India. We employed the standardized program indicators-sputum positivity, cure, death, failure and default rates. Results: Extra pulmonary cases ranged in between 56% and 73%, normal being 15-20%. The highest category-1 varies from 42% to 48%. New smear positive case detection rates (78-90%) and cure rates (88-91%) were the highest as compared to figures of the state and country. Failure rate was maximum in Kangra Tuberculosis Units (TU)-6.5% and the default rate was 7.2% in TU Palampur. The tuberculosis cases have fallen down from 6,462/100, 000 in 1999 to 2,195/100, 000 in 2005 following the introduction of RNTCP in 1999. Age specific (15-55 years) and sex-wise males were more affected than the females (59-64%). Conclusions: Continue investment in the program to sustain progress achieved. Investigate the cause of high proportion of extra-pulmonary tuberculosis. Investigate Kangra TU unit with a high default rate. PMID:24479092

  20. Successes and short comings in four years of an international external quality assurance program for animal Influenza surveillance

    USDA-ARS?s Scientific Manuscript database

    The US National institutes of Health-Centers of Excellence for Influenza Research and Surveillance is a research consortium that funds numerous labs worldwide to conduct influenza A surveillance in diverse animal species. There is no harmonization of testing procedures among these labs; therefore an...

  1. Evaluation of the US Army Institute of Public Health Destination Monitoring Program, a food safety surveillance program.

    PubMed

    Rapp-Santos, Kamala; Havas, Karyn; Vest, Kelly

    2015-01-01

    The Destination Monitoring Program, operated by the US Army Public Health Command (APHC), is one component that supports the APHC Veterinary Service's mission to ensure safety and quality of food procured for the Department of Defense (DoD). This program relies on retail product testing to ensure compliance of production facilities and distributors that supply food to the DoD. This program was assessed to determine the validity and timeliness by specifically evaluating whether sample size of items collected was adequate, if food samples collected were representative of risk, and whether the program returns results in a timely manner. Data was collected from the US Army Veterinary Services Lotus Notes database, including all food samples collected and submitted from APHC Region-North for the purposes of destination monitoring from January 1, 2013 to December 31, 2013. For most food items, only one sample was submitted for testing. The ability to correctly identify a contaminated food lot may be limited by reliance on test results from only one sample, as the level of confidence in a negative test result is low. The food groups most frequently sampled by APHC correlated with the commodities that were implicated in foodborne illness in the United States. Food items to be submitted were equally distributed among districts and branches, but sections within large branches submitted relatively few food samples compared to sections within smaller branches and districts. Finally, laboratory results were not available for about half the food items prior to their respective expiration dates.

  2. A distinctive avian assemblage (Aves: Passeriformes) in Western Darién, Panama is uncovered through a disease surveillance program.

    PubMed

    Miller, Matthew J

    2014-06-01

    Basic knowledge about the distribution of flora and fauna is lacking for most tropical areas. Improving our knowledge of the tropical biota will help address contemporary global problems, including emerging tropical diseases. Less appreciated is the role that applied studies can have in improving our understanding of basic biological patterns and processes in the tropics. Here, I describe a novel avifauna assemblage uncovered in Western Darién province in the Republic of Panama that was uncovered during a vector-borne disease surveillance program. I compared the passerine bird species composition at 16 sites using records from recent ornithological expeditions sponsored by the Smithsonian Tropical Research Institute in Central and Eastern Panama. Based on the results of a Mantel test, geographic distance did not correlate with pairwise distinctiveness of sites. instead, based on an index of distinctiveness modified from the Chao-Jaccard index, most sites were more or less similarly distinctive, with one site, Aruza Abajo, significantly more distinctive than the rest. I found that the distinctiveness of this site was due not only to the presence of several rare and range-restricted taxa, but also to the absence of taxa that are common elsewhere. This finding provides more evidence of high species composition turnover (beta-diversity) in the Panamanian biota, which appears to be driven by a combination of soil and climate differences over narrow distances.

  3. [Literature review on human influenza epidemics occurred before the implementation plan for sentinel surveillance program in the DRC].

    PubMed

    Nkwembe-Ngabana, Edith; Ahuka-Mundeke, Steve; Kebela-Ilunga, Benoit; Londa, Emile Okitolo; Muyembe-Tamfum, Jean-Jacques

    2017-01-01

    In the Democratic Republic of the Congo (DRC), several influenza epidemics are ignored because they are confused with other infectious diseases which have similar symptoms. Our study aims to assess influenza epidemics occurred in the DRC before 2008, year of the implementation of the influenza surveillance program in the DRC. We searched all the documents [articles, report,…] about influenza epidemic or acute respiratory infections [ARI] in the DRC before 2008 by using chosen key words. Epidemic description elements were identified and analyzed in each report. 4 documents have been found that had no article published. The sites of the epidemic outbreak were the rural health zones in Koshibanda and Kahemba, Bandundu [1995 and 2007], in Bosobolo, Equator [2002] and in Kinshasa [2002-2003]. Attack and lethality rates were 3.9% and 16% in Koshibanda respectively; 0.1% and 2% in Kinshasa; 47.5% and 1.5% in Bosobolo and 14.6% and 2.9% in Kahemba. Children less than 5 years of age were the most affected. Their attack rates ranged between 22.6 and 57.7% and lethality rates ranged between 3.2 and 3.7%. The two epidemics in Bosobolo and Kinshasa were associated with H3N2 influenza virus. This literature review highlights a high morbidity and mortality due to rare influenza epidemics in the DRC.

  4. Quality assessment of lymph node sampling in rhabdomyosarcoma: A surveillance, epidemiology, and end results (SEER) program study.

    PubMed

    Lobeck, Inna; Dupree, Phylicia; Karns, Rebekah; Rodeberg, David; von Allmen, Daniel; Dasgupta, Roshni

    2017-04-01

    Lymph node sampling is integral in the management of extremity and paratesticular rhabdomyosarcoma (RMS). The aim of this study was to determine overall surgical compliance with treatment protocols and impact of nodal sampling outcomes in these tumors. A query of the surveillance, epidemiology, and end results program (SEER) database was performed from 2003 to 2008 for patients <19years of age with RMS. Data obtained included demographics, five-year survival and rate of nodal sampling. Analysis was performed utilizing chi-squared, Kaplan-Meier and hazard ratio modeling. Of 537 patients with extremity RMS, nodal sampling was performed in 25.7% (n=138). This lack of nodal sampling had a negative outcome on survival (p=0.004). Sixty five patients with paratesticular RMS aged greater than 10 were identified and also displayed low rates of lymph node sampling (47.7%, n=31). For paratesticular patients, a similar increase in survival was seen in patients who underwent nodal evaluation (p=0.024). Lymph node sampling is the standard of care in RMS. However, surgical compliance with treatment protocols is poor. Nodal evaluation correlated significantly with overall survival. These findings suggest a need for improved education among surgeons and oncologists regarding the need lymph node assessment in pediatric oncology patients. Evidence rating/classification: Prognosis study, Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. A tailored health surveillance program unveils a case of MALT lymphoma in an HCV-positive health-care worker.

    PubMed

    Rapisarda, Venerando; Marconi, Andrea; Candido, Saverio; Nicolosi, Daria; Salmeri, Mario; Gangemi, Pietro; Proietti, Lidia; Spandidos, Demetrios A; Bracci, Massimo; Fenga, Cettina; Libra, Massimo

    2013-02-01

    Non-Hodgkin lymphoma (NHL) may occur among hepatitis C virus (HCV)-infected individuals. HCV is one of the most common blood-borne pathogens transmitted from patients to health-care workers (HCWs). The development of NHL among HCV-infected HCWs has recently been shown. To investigate this issue further a tailored health surveillance program was applied to 3,138 HCWs from four Medical Institutions. To this aim, all employees were screened for both anti-HCV antibodies and HCV-related extrahepatic manifestations. The HCV prevalence rate, similar among all the HCW subgroups, was 7.3%. The occurrence of a gastric mucosa-associated lymphoma tissue (MALT) lymphoma, diagnosed in a physician following a long history of HCV chronic infection, was observed. Molecular characterization of MALT tissue indicated that immunoglobuline gene combinations were those usually found among HCV-associated lymphomas. Furthermore, B-cell expansion exhibited t(14;18) translocation, as a genetic abnormality associated with the development of MALT lymphomas from HCV-positive patients. Overall, these findings support the hypothesis that HCV viral infection potentially affects the pathway of transformation and progression of lymphoma cells. The occurrence of B-cell NHL, among HCV-positive HCWs, is an additional reason to apply the standard precautions to reduce the risk of blood-borne pathogen transmission.

  6. A tailored health surveillance program unveils a case of MALT lymphoma in an HCV-positive health-care worker

    PubMed Central

    RAPISARDA, VENERANDO; MARCONI, ANDREA; CANDIDO, SAVERIO; NICOLOSI, DARIA; SALMERI, MARIO; GANGEMI, PIETRO; PROIETTI, LIDIA; SPANDIDOS, DEMETRIOS A.; BRACCI, MASSIMO; FENGA, CETTINA; LIBRA, MASSIMO

    2013-01-01

    Non-Hodgkin lymphoma (NHL) may occur among hepatitis C virus (HCV)-infected individuals. HCV is one of the most common blood-borne pathogens transmitted from patients to health-care workers (HCWs). The development of NHL among HCV-infected HCWs has recently been shown. To investigate this issue further a tailored health surveillance program was applied to 3,138 HCWs from four Medical Institutions. To this aim, all employees were screened for both anti-HCV antibodies and HCV-related extrahepatic manifestations. The HCV prevalence rate, similar among all the HCW subgroups, was 7.3%. The occurrence of a gastric mucosa-associated lymphoma tissue (MALT) lymphoma, diagnosed in a physician following a long history of HCV chronic infection, was observed. Molecular characterization of MALT tissue indicated that immunoglobuline gene combinations were those usually found among HCV-associated lymphomas. Furthermore, B-cell expansion exhibited t(14;18) translocation, as a genetic abnormality associated with the development of MALT lymphomas from HCV-positive patients. Overall, these findings support the hypothesis that HCV viral infection potentially affects the pathway of transformation and progression of lymphoma cells. The occurrence of B-cell NHL, among HCV-positive HCWs, is an additional reason to apply the standard precautions to reduce the risk of blood-borne pathogen transmission. PMID:23420489

  7. Surveillance and maintenance plan for Waste Area Groupings at Oak Ridge National Laboratory, Oak Ridge, Tennessee, for FY 1993--2002. Environmental Restoration Program

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.; Jones, R.G.

    1992-12-01

    The Oak Ridge National Laboratory (ORNL) Waste Area Grouping (WAG) Surveillance and Maintenance (S&M) program was designed for the management of sites contaminated with radioactive materials and/or hazardous chemicals from the end of their operating life until final facility disposition or site stabilization in accordance with environmental regulations and good management practices. Program objectives include (1) S&M of sites/facilities awaiting final disposition; (2) planning for safe and orderly final closure at each site/facility; and (3) implementing a program to accomplish final disposition in a safe, cost-effective, and timely manner.

  8. Annual summary report of the decontamination and decommissioning surveillance and maintenance program at Oak Ridge National Laboratory for period ending September 30, 1991

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.

    1991-09-01

    The Surplus Facilities Management Program and Defense Facilities Decommissioning Program were established at Oak Ridge National Laboratory (ORNL) in 1976 in order to provide collective management of all surplus sites under ORNL control on the Oak Ridge Reservation. Some 34 facilities, classified into 3 civilian-related and 8 defense-related projects, are currently managed by the recently integrated Decontamination and Decommissioning Program. Support includes (1) surveillance and maintenance (S M) planning, (2) routine S M, and (3) special maintenance projects. This report documents routine S M, special projects, and special maintenance performed on these facilities for the period of October 1990 through September 1991.

  9. Radio spectrum surveillance station

    NASA Technical Reports Server (NTRS)

    Hersey, D. R.

    1979-01-01

    The paper presents a general and functional description of a low-cost surveillance station designed as the first phase of NASA's program to develop a radio spectrum surveillance capability for deep space stations for identifying radio frequency interference sources. The station described has identified several particular interferences and is yielding spectral signature data which, after cataloging, will serve as a library for rapid identification of frequently observed interference. Findings from the use of the station are discussed.

  10. Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer

    PubMed Central

    Tosoian, Jeffrey J.; Mamawala, Mufaddal; Epstein, Jonathan I.; Landis, Patricia; Wolf, Sacha; Trock, Bruce J.; Carter, H. Ballentine

    2015-01-01

    Purpose To assess long-term outcomes of men with favorable-risk prostate cancer in a prospective, active-surveillance program. Methods Curative intervention was recommended for disease reclassification to higher cancer grade or volume on prostate biopsy. Primary outcomes were overall, cancer-specific, and metastasis-free survival. Secondary outcomes were the cumulative incidence of reclassification and curative intervention. Factors associated with grade reclassification and curative intervention were evaluated in a Cox proportional hazards model. Results A total of 1,298 men (median age, 66 years) with a median follow-up of 5 years (range, 0.01 to 18.00 years) contributed 6,766 person-years of follow-up since 1995. Overall, cancer-specific, and metastasis-free survival rates were 93%, 99.9%, and 99.4%, respectively, at 10 years and 69%, 99.9%, and 99.4%, respectively, at 15 years. The cumulative incidence of grade reclassification was 26% at 10 years and was 31% at 15 years; cumulative incidence of curative intervention was 50% at 10 years and was 57% at 15 years. The median treatment-free survival was 8.5 years (range, 0.01 to 18 years). Factors associated with grade reclassification were older age (hazard ratio [HR], 1.03 for each additional year; 95% CI, 1.01 to 1.06), prostate-specific antigen density (HR, 1.21 per 0.1 unit increase; 95% CI, 1.12 to 1.46), and greater number of positive biopsy cores (HR, 1.47 for each additional positive core; 95% CI, 1.26 to 1.69). Factors associated with intervention were prostate-specific antigen density (HR, 1.38 per 0.1 unit increase; 95% CI, 1.22 to 1.56) and a greater number of positive biopsy cores (HR, 1.35 for one additional positive core; 95% CI, 1.19 to 1.53). Conclusion Men with favorable-risk prostate cancer should be informed of the low likelihood of harm from their diagnosis and should be encouraged to consider surveillance rather than curative intervention. PMID:26324359

  11. Antimicrobial susceptibilities of Proteus mirabilis: a longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program.

    PubMed

    Wang, Jann-Tay; Chen, Pei-Chen; Chang, Shan-Chwen; Shiau, Yih-Ru; Wang, Hui-Ying; Lai, Jui-Fen; Huang, I-Wen; Tan, Mei-Chen; Lauderdale, Tsai-Ling Yang

    2014-09-05

    Longitudinal nationwide data on antimicrobial susceptibility in Proteus mirabilis from different sources are rare. The effects of the revised Clinical and Laboratory Standards Institute (CLSI) β-lactam breakpoints on susceptibility rates and on detecting extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase-producers in this species are also seldom evaluated. The present study analyzed data from the Taiwan Surveillance of Antimicrobial Resistance program to address these issues. Isolates were collected biennially between 2002 and 2012 from 25 to 28 hospitals in Taiwan. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. All isolates with aztreonam, ceftazidime, or cefotaxime MIC ≥ 2 mg/L were checked for the presence of ESBL by CLSI confirmatory test and subjected to ESBL and AmpC β-lactamases gene detection by PCR. Univariate and multivariate analyses were performed. Between 2002 and 2012, a total of 1157 P. mirabilis were studied. Susceptibility to cefotaxime, ceftazidime, and ciprofloxacin decreased significantly during the past decade, from 92.6% to 81.7%, 100% to 95.2%, and 80.1% to 53.8%, respectively (P < 0.01). The revised CLSI breakpoints had significant impact on susceptibility to cefazolin (2009 vs. current breakpoints, 71.9% vs. 0.9%) and imipenem (99.8% vs. 55.1%) (P < 0.001 for both). However, using the 2014 cefazolin breakpoints for urinary tract infections, 81.2% of the urine isolates were susceptible. Susceptibilities of isolates from different specimen types were mostly similar but outpatient isolates were more susceptible than inpatient isolates. The overall prevalence of ESBL- and AmpC- producers was 8.2% and 4.7%, respectively, but AmpC carriage increased significantly over the years (from 0 to 7.0%, P < 0.001). ESBL and AmpC β-lactamase-producers were more likely to be found in elderly and ICU patients. The predominant ESBL and AmpC β-lactamase genes were CTX-M- and CMY

  12. Bloodstream Infections Due to Candida Species: SENTRY Antimicrobial Surveillance Program in North America and Latin America, 1997-1998

    PubMed Central

    Pfaller, M. A.; Jones, R. N.; Doern, G. V.; Sader, H. S.; Messer, S. A.; Houston, A.; Coffman, S.; Hollis, R. J.

    2000-01-01

    An international program of surveillance of bloodstream infections (BSI) in the United States, Canada, and Latin America detected 306 episodes of candidemia in 34 medical centers (22 in the United States, 6 in Canada, and 6 in Latin America) in 1997 and 328 episodes in 34 medical centers (22 in the United States, 5 in Canada, and 7 in Latin America) in 1998. Of the 634 BSI, 54.3% were due to Candida albicans, 16.4% were due to C. glabrata, 14.9% were due to C. parapsilosis, 8.2% were due to C. tropicalis, 1.6% were due to C. krusei, and 4.6% were due to other Candida spp. The percentage of BSI due to C. albicans decreased very slightly in the United States between 1997 and 1998 (56.2 to 54.4%; P = 0.68) and increased in both Canada (52.6 to 70.1%; P = 0.05) and Latin America (40.5 to 44.6%; P = 0.67). C. glabrata was the second most common species observed overall, and the percentage of BSI due to C. glabrata increased in all three geographic areas between 1997 and 1998. C. parapsilosis was the third most prevalent BSI isolate in both Canada and Latin America, accounting for 7.0 and 18.5% of BSI, respectively. Resistance to fluconazole (MIC, ≥64 μg/ml) and itraconazole (MIC, ≥1.0 μg/ml) was observed infrequently in both 1997 (2.3 and 8.5%, respectively) and 1998 (1.5 and 7.6%, respectively). Among the different species of Candida, resistance to fluconazole and itraconazole was observed in C. glabrata and C. krusei, whereas isolates of C. albicans, C. parapsilosis, and C. tropicalis were all highly susceptible to both fluconazole (98.9 to 100% susceptible) and itraconazole (96.4 to 100% susceptible). Isolates from Canada and Latin America were generally more susceptible to both triazoles than U.S. isolates were. Continued surveillance appears necessary to detect these important changes. PMID:10681349

  13. Gas generation over plutonium oxides in the 94-1 shelf-life surveillance program.

    SciTech Connect

    Berg, J. M.; Harradine, D. M.; Hill, D. D.; McFarlan, James T.; Padilla, D. D.; Prenger, F. Coyne; Veirs, D. K.; Worl, L. A.

    2002-01-01

    The Department of Energy (DOE) is embarking upon a program to store large quantities of plutonium-bearing materials for up to fifty years. The Los Alamos National Laboratory Shelf Life Project was established to bound the behavior of plutonium-bearing material meeting the DOE 3013 Standard. The shelf life study monitors temperature, pressure and gas composition over oxide materials in a limited number of large-scale 3013 inner containers and in many small-scale containers. For the large-scale study, baseline plutonium oxides, oxides exposed to high-humidity atmospheres, and oxides containing chloride salt impurities are planned. The first large-scale container represents a baseline and contains dry plutonium oxide prepared according to the 3013 Standard. This container has been observed for pressure, temperature and gas compositional changes for less than a year. Results indicate that no detectable changes in pressure and gas composition are observed.

  14. Gas Generation over Plutonium Oxides in the 94-1 Shelf-Life Surveillance Program.

    SciTech Connect

    Berg, John M.; Hill, Dallas D.; McFarlan, James T.; Padilla, Dennis D.; Prenger, F. Coyne; Veirs, D. Kirk; Worl, Laura A.

    2003-08-13

    The Department of Energy (DOE) is embarking upon a program to store large quantities of plutoniumbearing materials for up to fifty years. The Los Alamos National Laboratory Shelf Life Project was established to bound the behavior of plutoniumbearing material meeting the DOE 3013 Standard. The shelf life study monitors temperature, pressure and gas composition over oxide materials in a limited number of large-scale 3013 inner containers and in many small-scale containers. For the large-scale study, baseline plutonium oxides, oxides exposed to high-humidity atmospheres, and oxides containing chloride salt impurities are planned. The first largescale container represents a baseline and contains dry plutonium oxide prepared according to the 3013 Standard. This container has been observed for pressure, temperature and gas compositional changes for less than a year. Results indicate that no detectable changes in pressure and gas composition are observed.

  15. Surveillance program for former PCB-exposed workers of a transformer and capacitor recycling company, family members, employees of surrounding companies, and area residents--executive summary.

    PubMed

    Kraus, Thomas; Gube, Monika; Lang, Jessica; Esser, Andre; Sturm, Walter; Fimm, Bruno; Willmes, Klaus; Neulen, Joseph; Baron, Jens Malte; Merk, Hans; Schettgen, Thomas; Konrad, Kerstin; Deisz, Sabine; Rink, Lothar; Hagmann, Michael; Fillies, Birgit; Zschiesche, Wolfgang; Wittsiepe, Jürgen; Wilhelm, Michael

    2012-01-01

    In a German company polychlorinated biphenyls (PCB)-containing transformers and capacitors were recycled on a large scale. Human biomonitoring revealed a high PCB body burden in workers of the recycling company, in surrounding locations of this plant, in companies in the neighborhood of this plant, and in family members of these employees. In order to clarify whether possible adverse health effects occurred or may occur in the future, a prospective surveillance program was initiated. After an extensive literature search, an interdisciplinary group of experts developed a surveillance program based on current knowledge with respect to possible adverse health effects that might occur in the recycling process of transformers and capacitors. Exposure to various hazardous substances (PCB, polychlorinated dibenzo-p-dioxins and dibenzo-furans [PCDD/F], metals, solvents) was considered. Criteria derived from human biomonitoring results of PCB were used for admission to the program. Participants in the surveillance program are first informed about risks and aims of the program. Subsequently, physicians started a detailed documentation of participants' general and occupational history, with their complaints, diseases, and nutritional habits, as well as information regarding their living areas, by means of a standardized questionnaire. In addition, separate examinations were performed to detect possible neurological, immunological, (neuro)psychological, hormonal, and skin effects. Moreover, DNA exposure as assessed by the comet assay and antioxidative status were determined. The program will be offered at yearly intervals for 3 years, and then at 5 and 10 years after program onset. Until now the program has proved to be feasible, and acceptance among workers and their families has been high. Based on the results, criteria will be developed to define adverse health effects that might be attributable to a hazardous substance exposure.

  16. A Population Health Surveillance Theory

    PubMed Central

    Bigras-Poulin, Michel; Michel, Pascal; Ravel, André

    2012-01-01

    OBJECTIVES Despite its extensive use, the term "Surveillance" often takes on various meanings in the scientific literature pertinent to public health and animal health. A critical appraisal of this literature also reveals ambiguities relating to the scope and necessary structural components underpinning the surveillance process. The authors hypothesized that these inconsistencies translate to real or perceived deficiencies in the conceptual framework of population health surveillance. This paper presents a population health surveillance theory framed upon an explicit conceptual system relative to health surveillance performed in human and animal populations. METHODS The population health surveillance theory reflects the authors' system of thinking and was based on a creative process. RESULTS Population health surveillance includes two broad components: one relating to the human organization (which includes expertise and the administrative program), and one relating to the system per se (which includes elements of design and method) and which can be viewed as a process. The population health surveillance process is made of five sequential interrelated steps: 1) a trigger or need, 2) problem formulation, 3) surveillance planning, 4) surveillance implementation, and 5) information communication and audit. CONCLUSIONS The population health surveillance theory provides a systematic way of understanding, organizing and evaluating the population health surveillance process. PMID:23251837

  17. The Establishment of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS): A Pilot Project on Poultry Farms, Slaughterhouses and Retail Market.

    PubMed

    Donado-Godoy, P; Castellanos, R; León, M; Arevalo, A; Clavijo, V; Bernal, J; León, D; Tafur, M A; Byrne, B A; Smith, W A; Perez-Gutierrez, E

    2015-04-01

    The development of antimicrobial resistance among bacteria (AMR) is currently one of the world's most pressing public health problems. The use of antimicrobial agents in humans and animals has resulted in AMR which has narrowed the potential use of antibiotics for the treatment of infections in humans. To monitor AMR and to develop control measures, some countries, such as the USA, Canada and Denmark, have established national integrated surveillance systems (FDA, , CIPARS, 2007, DANMAP,2002). The components of these programs monitor changes in susceptibility/resistance to antimicrobial agents of selected zoonotic pathogens and commensal organisms recovered from animals, retail meats and humans. The rapid development of Colombia's animal production industry has raised food safety issues including the emergence of antibiotic resistance. The Colombian Integrated Surveillance Program for Antimicrobial Resistance (COIPARS) was established as a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets.

  18. Linezolid bladder irrigation as adjunctive treatment for a vancomycin-resistant Enterococcus faecium catheter-associated urinary tract infection.

    PubMed

    Hill, David M; Wood, G Christopher; Hickerson, William L

    2015-02-01

    To describe the first reported successful use of adjunctive linezolid bladder irrigation. An 89-year-old woman with 10% TBSA burns developed septic shock and anuric acute kidney insufficiency. She acquired a urinary tract infection caused by vancomycin-resistant Enterococcus faecium (VREfm). Based on clinical status, a linezolid bladder irrigation was initiated in addition to high-dose intravenous linezolid and demonstrated microbiological cure with 7 days of treatment. Linezolid is primarily hepatically cleared and has no labeled indication for urinary tract infections. Anuria adds an additional complication of potentially reduced urinary drug concentrations. Bladder irrigation offers the benefit of achieving high local drug concentrations, but there are no data regarding such a route for linezolid. This case report is the first demonstrating the use, stability, safety, and efficacy of linezolid as a continuous bladder irrigation. Linezolid use as a bladder irrigation may be a feasible route of administration in anuric, critically ill patients with VREfm and few antimicrobial options. Further studies are warranted. © The Author(s) 2014.

  19. Emergence of cfr-harbouring coagulase-negative staphylococci among patients receiving linezolid therapy in two hospitals in China.

    PubMed

    Yang, Xue-Jing; Chen, Yan; Yang, Qing; Qu, Ting-Ting; Liu, Li-Lin; Wang, Hai-Ping; Yu, Yun-Song

    2013-06-01

    This study reports on the emergence of cfr-harbouring coagulase-negative staphylococci (CoNS) among patients who received linezolid therapy in two hospitals in Hangzhou, China. The mechanisms of resistance and transmission were analysed for these resistant isolates. Eight Staphylococcus capitis isolates, one Staphylococcus epidermidis isolate and one Staphylococcus hominis isolate, obtained from patients who had received linezolid therapy in two hospitals in Hangzhou, China, were confirmed as linezolid resistant, with MICs ranging from 8 to >256 mg l(-1). The linezolid usage data of the ten patients before isolation of the linezolid-resistant CoNS were collected. PFGE analysis showed that the eight S. capitis isolates from the two hospitals belonged to the same clone. Nine of the linezolid-resistant CoNS isolates carried the cfr gene, which was located on plasmids of a similar size. A 5.3 kb fragment containing the cfr gene, revealing 99 % identity to the sequence of the cfr-harbouring plasmid pSS-01 reported previously, was determined by PCR mapping for all cfr-positive isolates, and the cfr gene was flanked by two copies of IS256-like elements. Thus, these results document the emergence of linezolid-resistant CoNS isolates carrying the cfr gene in Hangzhou, China. Effective nosocomial infection control strategies and the judicious use of antibiotics will be required to prevent further spread of this resistance mechanism.

  20. The Emergence of Linezolid Resistance among Enterococci in Intestinal Microbiota of Treated Patients Is Unrelated to Individual Pharmacokinetic Characteristics

    PubMed Central

    Nguyen, T. T.; Defrance, G.; Massias, L.; Alavoine, L.; Lefort, A; Noel, V.; Senneville, E.; Doucet-Populaire, F.; Mentré, F.; Andremont, A.; Duval, X.

    2014-01-01

    Linezolid is an antimicrobial agent for the treatment of multiresistant Gram-positive infections. We assessed the impact of linezolid on the microbiota and the emergence of resistance and investigated its relationship with plasma pharmacokinetics of the antibiotic. Twenty-eight patients were treated for the first time with linezolid administered orally (n = 17) or parenterally (n = 11) at 600 mg twice a day. Linezolid plasma pharmacokinetic analysis was performed on day 7. Colonization by fecal enterococci, pharyngeal streptococci, and nasal staphylococci were assessed using selective media with or without supplemental linezolid. The resistance to linezolid was characterized. The treatment led to a decrease of enterococci, staphylococci, and streptococci in the fecal (P = 0.03), nasal, and pharyngeal (P < 0.01) microbiotas. The appearance of resistant strains was observed only in enterococci from the fecal microbiota between the 7th and 21st days of treatment in four patients (14.3%). The resistance was mainly due for the first time to the mutation G2447T in the 23S rRNA gene. No pharmacokinetic parameters were significantly different between the patients, regardless of the appearance of resistance. The emergence of linezolid resistance during treatment was observed only in the intestinal microbiota and unrelated to pharmacokinetic parameters. However, colonization by Gram-positive bacteria was reduced as a result of treatment in all microbiotas. PMID:24566182

  1. Detection of high levels of resistance to linezolid and vancomycin in Staphylococcus aureus.

    PubMed

    Azhar, Aysha; Rasool, Samreen; Haque, Asma; Shan, Sidra; Saeed, Muhammad; Ehsan, Beenish; Haque, Abdul

    2017-09-01

    Both methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) are rapidly overcoming the current array of drugs. One hundred and fifty isolates from a hospital were studied for resistance towards linezolid and vancomycin. Fifty-four (36.0 %) isolates were MRSA. Both MRSA and MSSA showed high resistance towards linezolid when using the disc diffusion method, with the figures being 48.1 and 29.2 %, respectively. The figures for the E-test were 46.3 and 27.0 %, respectively. The vancomycin resistance was remarkable in MRSA (14.8 %), but relatively low in MSSA (3.1 %). The E-test results were 13.0 and 4.16 %, respectively. The cfr gene was detected in 78 % of linezolid-resistant isolates and the vanA operon was detected in 74 % of vancomycin-resistant isolates. This level of resistance against linezolid and vancomycin is unprecedented. These results are alarming and highlight the threat of non-treatable S. aureus strains.

  2. Bedaquiline and Linezolid for Extensively Drug-Resistant Tuberculosis in Pregnant Woman.

    PubMed

    Jaspard, Marie; Elefant-Amoura, Elisabeth; Melonio, Isabelle; De Montgolfier, Inés; Veziris, Nicolas; Caumes, Eric

    2017-10-01

    A woman with extremely drug-resistant tuberculosis treated with a drug regimen including linezolid and bedaquiline during her last 3 weeks of pregnancy gave birth to a child without abnormalities. No fetal toxicities were noted by 2 years after delivery. This drug combination might be safe during the late third trimester of pregnancy.

  3. Rational development and validation of a new microbiological assay for linezolid and its measurement uncertainty.

    PubMed

    Saviano, Alessandro Morais; Francisco, Fabiane Lacerda; Lourenço, Felipe Rebello

    2014-09-01

    The aim of this work was to develop and validate a new microbiological assay to determine potency of linezolid in injectable solution. 2(4) factorial and central composite designs were used to optimize the microbiological assay conditions. In addition, we estimated the measurement uncertainty based on residual error of analysis of variance of inhibition zone diameters. Optimized conditions employed 4 mL of antibiotic 1 medium inoculated with 1% of Staphylococcus aureus suspension, and linezolid in concentrations from 25 to 100 µg mL(-1). The method was specific, linear (Y=10.03X+5.00 and Y=9.20X+6.53, r(2)=0.9950 and 0.9987, for standard and sample curves, respectively), accurate (mean recovery=102.7%), precise (repeatability=2.0% and intermediate precision=1.9%) and robust. Microbiological assay׳s overall uncertainty (3.1%) was comparable to those obtained for other microbiological assays (1.7-7.1%) and for determination of linezolid by spectrophotometry (2.1%) and reverse-phase ultra-performance liquid chromatography (RP-UPLC) (2.5%). Therefore, it is an acceptable alternative method for the routine quality control of linezolid in injectable solution. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Effects of continuous renal replacement therapy on linezolid pharmacokinetic/pharmacodynamics: a systematic review.

    PubMed

    Villa, Gianluca; Di Maggio, Paola; De Gaudio, A Raffaele; Novelli, Andrea; Antoniotti, Riccardo; Fiaccadori, Enrico; Adembri, Chiara

    2016-11-19

    Major alterations in linezolid pharmacokinetic/pharmacodynamic (PK/PD) parameters might be expected in critically ill septic patients with acute kidney injury (AKI) who are undergoing continuous renal replacement therapy (CRRT). The present review is aimed at describing extracorporeal removal of linezolid and the main PK-PD parameter changes observed in critically ill septic patients with AKI, who are on CRRT. Citations published on PubMed up to January 2016 were systematically reviewed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. All authors assessed the methodological quality of the studies and consensus was used to ensure studies met inclusion criteria. In-vivo studies in adult patients with AKI treated with linezolid and on CRRT were considered eligible for the analysis only if operational settings of the CRRT machine, membrane type, linezolid blood concentrations and main PK-PD parameters were all clearly reported. Among 68 potentially relevant articles, only 9 were considered eligible for the analysis. Across these, 53 treatments were identified among the 49 patients included (46 treated with high-flux and 3 with high cut-off membranes). Continuous veno-venous hemofiltration (CVVH) was the most frequent treatment performed amongst the studies. The extracorporeal clearance values of linezolid across the different modalities were 1.2-2.3 L/h for CVVH, 0.9-2.2 L/h for hemodiafiltration and 2.3 L/h for hemodialysis, and large variability in PK/PD parameters was reported. The optimal area under the curve/minimum inhibitory concentration (AUC/MIC) ratio was reached for pathogens with an MIC of 4 mg/L in one study only. Wide variability in linezolid PK/PD parameters has been observed across critically ill septic patients with AKI treated with CRRT. Particular attention should be paid to linezolid therapy in order to avoid antibiotic failure in these patients. Strategies to improve the effectiveness of

  5. Influence of Mitochondrial Genetics on the Mitochondrial Toxicity of Linezolid in Blood Cells and Skin Nerve Fibers.

    PubMed

    Garrabou, G; Soriano, À; Pinós, T; Casanova-Mollà, J; Pacheu-Grau, D; Morén, C; García-Arumí, E; Morales, M; Ruiz-Pesini, E; Catalán-Garcia, M; Milisenda, J C; Lozano, E; Andreu, A L; Montoya, J; Mensa, J; Cardellach, F

    2017-09-01

    The antibiotic linezolid is a ribosomal inhibitor with excellent efficacy. Although the administration period has been reduced to 28 days, side effects, usually of hematologic or neuropathic origin, are still reported due to secondary inhibition of mitochondrial protein synthesis. Susceptibility to linezolid toxicity remains unknown. Therefore, the objective of this study was to gain an understanding of clinical heterogeneity in response to identical linezolid exposures through exhaustive examination of the molecular basis of tissue-dependent mitotoxicity, consequent cell dysfunction, and the association of mitochondrial genetics with adverse effects of linezolid administered for the recommended period. Peripheral blood mononuclear cells (PBMC) and skin nerve fibers from 19 and 6 patients, respectively, were evaluated before and after a 28-day linezolid treatment in order to assess toxic effects on mitochondria and cells. Mitochondrial DNA haplotypes and single nucleotide polymorphisms (SNPs) in ribosomal sequences where linezolid binds to mitochondrial ribosomes were also analyzed to investigate their genetic contributions. We found that linezolid reduced mitochondrial protein levels, complex IV activity, and mitochondrial mass in PBMC and was associated with a trend toward an increase in the rate of apoptosis. In skin tissue, mitochondrial mass increased within nerve fibers, accompanied by subclinical axonal swelling. Mitochondrial haplogroup U, mutations in 12S rRNA, and the m.2706A→G, m.3197T→C, and m.3010G→A polymorphisms in 16S rRNA showed a trend toward an association with increased mitochondrial and clinical adverse effects. We conclude that even when linezolid is administered for a shorter time than formerly, adverse effects are reported by 63% of patients. Linezolid exerts tissue-dependent mitotoxicity that is responsible for downstream cellular consequences (blood cell death and nerve fiber swelling), leading to adverse hematologic and peripheral

  6. The added value of a surveillance human biomonitoring program: The case of FLEHS in Flanders (Belgium).

    PubMed

    Reynders, Hans; Colles, Ann; Morrens, Bert; Mampaey, Maja; Coertjens, Dries; Koppen, Gudrun; Schoeters, Greet; Loots, Ilse; Chovanova, Hana; Winderickx, Wim; Van Campenhout, Karen

    2016-09-20

    Since 2002, the Flemish Government decided to carry out the Flemish Environment and Health Survey (FLEHS), an extended human biomonitoring (HBM) program, which is integrated in the environmental health policy. Through the FLEHS studies, a vast amount of data such as biomarkers of exposure and effect, exposure-effect associations, time trends and geographical differences, became available to the Flemish policy makers. In order to facilitate the policy interpretation, a phased action-plan was developed collaboratively by FLEHS researchers and policy makers. In this article we look back on more than 15 years of investments of the Flemish government in HBM and reflect on how this large scaled and challenging HBM-initiative contributed to shaping the environmental health policy in Flanders. We used the FLEHS I (2002-2006) and II (2007-2011) results on persistent organic pollutants (POPs) and the resulting policy actions as an example to illustrate the added value of HBM for policy making. Policy measures for POPs, including source-related regulation (e.g. further optimization and tightening of existing Flemish legislation on open fires), investment in monitoring networks and communication and awareness campaigns, are presented and the added value for environmental health policy is discussed. We also reflect on how HBM can support science and innovation in the environmental monitoring context. Finally, we describe what society can gain from HBM in terms of opportunities for (1) feeding the political and societal debate, (2) stimulating community involvement and (3) empowering participants and citizens. All together, the gained insights and phased action plan showed that next to compliance with high scientific standards, results of the Flemish human biomonitoring campaign could be translated in targeted policy actions even for chemicals that have since long been regulated.

  7. Risk Factors for a Low Linezolid Trough Plasma Concentration in Acute Infections

    PubMed Central

    Morata, Laura; Cuesta, Marta; Rojas, Jhon F.; Rodriguez, Sebastian; Brunet, Merce; Casals, Gregori; Cobos, Nazareth; Hernandez, Cristina; Martínez, José A.; Mensa, Josep

    2013-01-01

    Linezolid is an antibiotic with time-dependent activity, and both the percentage of time that plasma concentrations exceed the MIC and the area under the concentration-time curve over 24 h in the steady state divided by the MIC (AUC24/MIC ratio) are associated with clinical response. The aim of this study was to analyze the linezolid trough plasma concentration (Cmin) and to determine factors associated with a Cmin < 2 mg/liter and other clinically relevant thresholds. Characteristics of 78 patients receiving 600 mg/12 h of linezolid with a Cmin determination at the steady state and within the first 10 days of treatment were retrospectively reviewed. Concentrations were measured using high-pressure liquid chromatography. Univariate and multivariate analysis were performed to identify risk factors of low Cmin. A total of 29.5% of patients had a Cmin < 2 mg/liter. The percentage was significantly higher in patients with an estimated glomerular filtration (eGF) > 80 ml/min, in intensive care unit (ICU) patients, and in patients with an infection due to Staphylococcus aureus. The independent predictors of Cmin < 2 mg/liter were an eGF > 80 ml/min (odds ratio [OR], 10; 95% confidence interval [CI], 2.732 to 37.037; P = 0.001) and infection due to S. aureus (OR, 5.906; 95% CI, 1.651 to 21.126; P = 0.006). A linezolid Cmin of <2 mg/liter was found in 29.5% of cases, and the risk was significantly higher among those with an eGF > 80 ml/min and in infections due to S. aureus. In patients with severe sepsis, a loading dose or continuous infusion and drug monitoring could improve the pharmacodynamic parameters associated with linezolid efficacy. PMID:23403416

  8. Risk factors for a low linezolid trough plasma concentration in acute infections.

    PubMed

    Morata, Laura; Cuesta, Marta; Rojas, Jhon F; Rodriguez, Sebastian; Brunet, Merce; Casals, Gregori; Cobos, Nazareth; Hernandez, Cristina; Martínez, José A; Mensa, Josep; Soriano, Alex

    2013-04-01

    Linezolid is an antibiotic with time-dependent activity, and both the percentage of time that plasma concentrations exceed the MIC and the area under the concentration-time curve over 24 h in the steady state divided by the MIC (AUC24/MIC ratio) are associated with clinical response. The aim of this study was to analyze the linezolid trough plasma concentration (C(min)) and to determine factors associated with a C(min) < 2 mg/liter and other clinically relevant thresholds. Characteristics of 78 patients receiving 600 mg/12 h of linezolid with a C(min) determination at the steady state and within the first 10 days of treatment were retrospectively reviewed. Concentrations were measured using high-pressure liquid chromatography. Univariate and multivariate analysis were performed to identify risk factors of low C(min). A total of 29.5% of patients had a C(min) < 2 mg/liter. The percentage was significantly higher in patients with an estimated glomerular filtration (eGF) > 80 ml/min, in intensive care unit (ICU) patients, and in patients with an infection due to Staphylococcus aureus. The independent predictors of C(min) < 2 mg/liter were an eGF > 80 ml/min (odds ratio [OR], 10; 95% confidence interval [CI], 2.732 to 37.037; P = 0.001) and infection due to S. aureus (OR, 5.906; 95% CI, 1.651 to 21.126; P = 0.006). A linezolid C(min) of <2 mg/liter was found in 29.5% of cases, and the risk was significantly higher among those with an eGF > 80 ml/min and in infections due to S. aureus. In patients with severe sepsis, a loading dose or continuous infusion and drug monitoring could improve the pharmacodynamic parameters associated with linezolid efficacy.

  9. In vitro activity of retapamulin against linezolid and methicillin-resistant Staphylococcus aureus isolates.

    PubMed

    Candel, F J; Morales, G; Picazo, J J

    2011-09-01

    To determine the in vitro activity of retapamulin and other topical antibiotics (mupirocin, bacitracin, and fusidic acid) usually employed for nasal decolonization, against methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and linezolid and methicillin-resistant S. aureus. The minimum inhibitory concentrations (MICs) were determined on Mueller-Hinton agar according to the guidelines of the Clinical and Laboratory Standards Institute and of the European Committee for Antimicrobial Susceptibility Testing. Presence of the cfr gene in linezolid and methicillin-resistant S. aureus isolates was detected using polymerase chain reaction. Retapamulin inhibited all the isolates of MSSA and MRSA at 0.125 mg/L, but the 18 linezolid-resistant-MRSA strains proved resistant, with MICs over 32 mg/L. Most MSSA isolates (9/10) were susceptible to mupirocin with MICs under 0.19 mg/L, although this value decreased to half against MRSA, and almost all linezolid-resistant MRSA (17/18) strains were resistant to mupirocin with an MIC range of between 8 mg/L and 28 mg/L. The MIC of fusidic acid increased substantially against linezolid-resistant MRSA, whereas that of bacitracin showed no differences. Retapamulin demonstrated excellent in vitro activity against MSSA and MRSA strains, but not against MRSA isolates harbouring the cfr gene. The results of this in vitro study support cut-off values for retapamulin of ≤ 0.5, 1, and ≥ 2 mg/L for susceptible, intermediate, and resistant strains, respectively.

  10. Linezolid-resistant staphylococcal bacteraemia: A multicentre case-case-control study in Italy.

    PubMed

    Russo, Alessandro; Campanile, Floriana; Falcone, Marco; Tascini, Carlo; Bassetti, Matteo; Goldoni, Paola; Trancassini, Maria; Della Siega, Paola; Menichetti, Francesco; Stefani, Stefania; Venditti, Mario

    2015-03-01

    The aim of this multicentre study was to analyse the characteristics of patients with bloodstream infections due to staphylococcal strains resistant to linezolid. This was a retrospective case-case-control study of patients hospitalised in three large teaching hospitals in Italy. A linezolid-resistant (LIN-R) Staphylococcus spp. group and a linezolid-susceptible (LIN-S) Staphylococcus spp. group were compared with control patients to determine the clinical features and factors associated with isolation of LIN-R strains. All LIN-R Staphylococcus spp. strains underwent molecular typing. Compared with the LIN-S group, central venous catheters were the main source of infection in the LIN-R group. The LIN-R and LIN-S groups showed a similar incidence of severe sepsis or septic shock, and both showed a higher incidence of these compared with the control group. Overall, patients in the LIN-R group had a higher 30-day mortality rate. Multivariate analysis found previous linezolid therapy, linezolid therapy >14 days, antibiotic therapy in the previous 30 days, antibiotic therapy >14 days, previous use of at least two antibiotics and hospitalisation in the previous 90 days as independent risk factors associated with isolation of a LIN-R strain. The G2576T mutation in domain V of 23S rRNA was the principal mechanism of resistance; only one strain of Staphylococcus epidermidis carried the cfr methylase gene (A2503), together with L4 insertion (71GGR72) and L3 substitution (H146Q). LIN-R strains are associated with severe impairment of clinical conditions and unfavourable patient outcomes. Reinforcement of infection control measures may have an important role in preventing these infections.

  11. Comparative evaluation of serotonin toxicity among veterans affairs patients receiving linezolid and vancomycin.

    PubMed

    Lodise, T P; Patel, N; Rivera, A; Tristani, L; Lazariu, V; Vandewall, H; McNutt, L A

    2013-12-01

    Despite the theoretical risk of serotonin toxicity (ST) with linezolid, "real-world" clinical evaluations of the risk of ST in patients receiving linezolid have been limited to case reports and noncomparator studies. An observational, matched-cohort study was conducted to evaluate the risk of ST among hospitalized patients who received linezolid or vancomycin at the Upstate New York Veterans Affairs Healthcare Network (Veterans Integrated Service Network 2 [VISN-2]). Matching criteria included VISN-2 hospital, hospital ward, prior hospital length of stay, age, and baseline platelet counts. The patients' electronic medical records were evaluated for symptoms consistent with ST and the Hunter serotonin toxicity criteria (HSTC) using an intensive, natural word search algorithm. The study included 251 matched pairs. Demographics and comorbidities were similar between groups. Over half of the study population received at least one concurrent medication with serotonergic activity. Receipt of agents with serotonergic activity was more pronounced in the vancomycin group, and the higher frequency was due to concomitant antihistamine and antiemetic use. Antidepressant use, including selective serotonin reuptake inhibitors (SSRIs), was similar between groups. No patients in either group were found to meet the criteria using the word search algorithm for ST. Fewer linezolid patients than vancomycin patients met the HSTC overall (3.2% versus 8.8%) and when stratified by receipt of a concurrent serotonergic agent (4.3% versus 12.4%). Of the patients meeting the HSTC, most had past or present comorbidities that may have contributed to or overlapped the HSTC. This study of hospitalized patients revealed comparably low frequencies of adverse events potentially related to ST among patients who received linezolid or vancomycin.

  12. Comparative Evaluation of Serotonin Toxicity among Veterans Affairs Patients Receiving Linezolid and Vancomycin

    PubMed Central

    Patel, N.; Rivera, A.; Tristani, L.; Lazariu, V.; Vandewall, H.; McNutt, L. A.

    2013-01-01

    Despite the theoretical risk of serotonin toxicity (ST) with linezolid, “real-world” clinical evaluations of the risk of ST in patients receiving linezolid have been limited to case reports and noncomparator studies. An observational, matched-cohort study was conducted to evaluate the risk of ST among hospitalized patients who received linezolid or vancomycin at the Upstate New York Veterans Affairs Healthcare Network (Veterans Integrated Service Network 2 [VISN-2]). Matching criteria included VISN-2 hospital, hospital ward, prior hospital length of stay, age, and baseline platelet counts. The patients' electronic medical records were evaluated for symptoms consistent with ST and the Hunter serotonin toxicity criteria (HSTC) using an intensive, natural word search algorithm. The study included 251 matched pairs. Demographics and comorbidities were similar between groups. Over half of the study population received at least one concurrent medication with serotonergic activity. Receipt of agents with serotonergic activity was more pronounced in the vancomycin group, and the higher frequency was due to concomitant antihistamine and antiemetic use. Antidepressant use, including selective serotonin reuptake inhibitors (SSRIs), was similar between groups. No patients in either group were found to meet the criteria using the word search algorithm for ST. Fewer linezolid patients than vancomycin patients met the HSTC overall (3.2% versus 8.8%) and when stratified by receipt of a concurrent serotonergic agent (4.3% versus 12.4%). Of the patients meeting the HSTC, most had past or present comorbidities that may have contributed to or overlapped the HSTC. This study of hospitalized patients revealed comparably low frequencies of adverse events potentially related to ST among patients who received linezolid or vancomycin. PMID:24041888

  13. Influence of ethylene-oxy spacer group on the activity of linezolid: synthesis of potent antibacterials possessing a thiocarbonyl group.

    PubMed

    Selvakumar, N; Raheem, Mohammed A; Khera, Manoj Kumar; Rajale, Trideep V; Kumar, Magadi Sitaram; Kandepu, Sreenivas; Das, Jagattaran; Rajagopalan, R; Iqbal, Javed; Trehan, Sanjay

    2003-12-01

    The influence of an ethylene-oxy spacer element between the heterocycle and the aromatic ring in linezolid is reported. The introduction of such spacer group generated compounds with inferior antibacterial activity. However, the conversion of the acetamide group present in the linezolid analogues to either thiocarbamate or thioacetamide functionality restored the activity. The synthesis of linezolid analogues possessing the ethylene-oxy spacer group along with SAR studies with different heterocycles and preparation of some thiocarbonyl compounds possessing potent antibacterial property are presented.

  14. National addictions vigilance intervention and prevention program (NAVIPPRO): a real-time, product-specific, public health surveillance system for monitoring prescription drug abuse.

    PubMed

    Butler, Stephen F; Budman, Simon H; Licari, Andrea; Cassidy, Theresa A; Lioy, Katherine; Dickinson, James; Brownstein, John S; Benneyan, James C; Green, Traci Craig; Katz, Nathaniel

    2008-12-01

    The National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) is a scientific, comprehensive risk management program for scheduled therapeutics. NAVIPPRO provides post-marketing surveillance, signal detection, signal verification and prevention and intervention programs. Here we focus on one component of NAVIPPRO surveillance, the Addiction Severity Index-Multimedia Version (ASI-MV) Connect, a continuous, real-time, national data stream that assesses pharmaceutical abuse by patients entering substance abuse treatment by collecting product-specific, geographically-detailed information. We evaluate population characteristics for data collected through the ASI-MV Connect in 2007 and 2008 and assess the representativeness, geographic coverage, and timeliness of report of the data. Analyses based on 41,923 admissions to 265 treatment centers in 29 states were conducted on product-specific opioid abuse rates, source of drug, and route of administration. ASI-MV Connect data revealed that 11.5% of patients reported abuse of at least one opioid analgesic product in the 30 days prior to entering substance abuse treatment; differences were observed among sub-populations of prescription opioid abusers, among products, and also within various geographic locations. The ASI-MV Connect component of NAVIPPRO represents a potentially valuable data stream for post-marketing surveillance of prescription drugs. Analyses conducted with data obtained from the ASI-MV Connect allow for the characterization of product-specific and geospatial differences for drug abuse and can serve as a tool to monitor responses of the abuse population to newly developed "abuse deterrent" drug formulations. Additional data, evaluation, and comparison to other systems are important next steps in establishing NAVIPPRO as a comprehensive, post-marketing surveillance system for prescription drugs. Copyright (c) 2008 John Wiley & Sons, Ltd.

  15. Correlation of β-Lactamase Production and Colistin Resistance among Enterobacteriaceae Isolates from a Global Surveillance Program

    PubMed Central

    Bradford, Patricia A.; Biedenbach, Douglas J.; Wise, Mark G.; Hackel, Meredith; Sahm, Daniel F.

    2015-01-01

    The increasing use of carbapenems for treating multidrug-resistant (MDR) Gram-negative bacterial infections has contributed to the global dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Serine and metallo-β-lactamases (MBLs) that hydrolyze carbapenems have become prevalent and endemic in some countries, necessitating the use of older classes of agents, such as colistin. A total of 19,719 isolates of Enterobacteriaceae (excluding Proteeae and Serratia spp., which have innate resistance to colistin) were collected from infected patients during 2012 and 2013 in a global surveillance program and tested for antimicrobial susceptibility using CLSI methods. Isolates of CRE were characterized for carbapenemases and extended-spectrum β-lactamases (ESBLs) by PCR and sequencing. Using EUCAST breakpoints, the rate of colistin susceptibility was 98.4% overall, but it was reduced to 88.0% among 482 carbapenemase-positive isolates. Colistin susceptibility was higher among MBL-positive isolates (92.6%) than those positive for a KPC (87.9%) or OXA-48 (84.2%). Of the agents tested, only tigecycline (MIC90, 2 to 4 μg/ml) and aztreonam-avibactam (MIC90, 0.5 to 1 μg/ml) consistently tested with low MIC values against colistin-resistant, ESBL-positive, and carbapenemase-positive isolates. Among the 309 (1.6%) colistin-resistant isolates from 10 species collected in 38 countries, 58 carried a carbapenemase that included KPCs (38 isolates), MBLs (6 isolates), and OXA-48 (12 isolates). These isolates were distributed globally (16 countries), and 95% were Klebsiella pneumoniae. Thirty-nine (67.2%) isolates carried additional ESBL variants of CTX-M, SHV, and VEB. This sample of Enterobacteriaceae demonstrated a low prevalence of colistin resistance overall. However, the wide geographic dispersion of colistin resistance within diverse genus and species groups and the higher incidence observed among carbapenemase-producing MDR pathogens are concerning. PMID:26666920

  16. Carbapenem Non-Susceptible Enterobacteriaceae in Quebec, Canada: Results of a Laboratory Surveillance Program (2010–2012)

    PubMed Central

    Lefebvre, Brigitte; Lévesque, Simon; Bourgault, Anne-Marie; Mulvey, Michael R.; Mataseje, Laura; Boyd, David; Doualla-Bell, Florence; Tremblay, Cécile

    2015-01-01

    The emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE) represent a major public health concern because these bacteria are usually extensively resistant to most antibiotics. In order to evaluate their dissemination in Quebec, a surveillance program was introduced in 2010. We report the molecular and epidemiological profiles of CPE isolates collected. Between August 2010 and December 2012, a total of 742 non-duplicate isolates non-susceptible to carbapenems were analysed. AmpC β-lactamase and metallo-β-lactamase production were detected by Etest and carbapenemase production by the modified Hodge test (MHT). Antibiotic susceptibility profiles were determined using broth microdilution or Etest. Clonality of Klebsiella pneumoniae carbapenemase (KPC) strains was analyzed by pulsed-field gel electrophoresis (PFGE). The presence of genes encoding carbapenemases as well as other β-lactamases was detected using PCR. Of the 742 isolates tested, 169 (22.8%) were CPE. Of these 169 isolates, 151 (89.3%) harboured a blaKPC gene while the remaining isolates carried blaSME (n = 9), blaOXA-48 (n = 5), blaNDM (n = 3), and blaNMC (n = 1) genes. Among the 93 KPC strains presenting with a unique pattern (unique PFGE pattern and/or unique antibiotics susceptibility profile), 99% were resistant to ertapenem, 95% to imipenem, 87% to meropenem, 97% to aztreonam, 31% to colistin and 2% to tigecycline. In 19 patients, 2 to 5 KPC strains from different species or with a different PFGE pattern were isolated. CPE strains were present in the province of Quebec with the majority of strains harbouring KPC. Alternately, SME, OXA-48 and NMC containing strains were rarely found. PMID:25910041

  17. Evaluation of high blood pressure and obesity among US coal miners participating in the Enhanced Coal Workers' Health Surveillance Program.

    PubMed

    Casey, Megan Lauren; Fedan, Kathleen B; Edwards, Nicole; Blackley, David J; Halldin, Cara N; Wolfe, Anita L; Laney, Anthony Scott

    2017-08-01

    Since 2005, the Enhanced Coal Workers' Health Surveillance Program (ECWHSP) has offered respiratory examinations to coal miners in a mobile examination unit. As little is known about the cardiovascular health of coal miners, we describe the prevalence of high blood pressure (BP) and obesity among ECWHSP participants. During 2015, 1402 ECWHSP health examinations were performed. The prevalence of BP consistent with hypertension (systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg), prehypertension (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg), and hypertensive crisis (systolic BP ≥ 180 mm Hg or diastolic BP ≥ 110 mm Hg) were calculated and compared with the US adult population using standardized morbidity ratios (SMRs). Most participants were male (N = 1317, 94%), White (N = 1303, 93%) and non-Hispanic (N = 1316, 94%). Thirty-one percent (N = 440) of participants had BP in the hypertensive range and 87% (N = 1215) were overweight/obese. Twenty-four participants (2%) had a BP reading consistent with a hypertensive crisis. Prevalence of obesity (52%, SMR = 1.52, 95% confidence interval = 1.41-1.64) and BP consistent with hypertension (31%, SMR = 1.60, 95% confidence interval = 1.45-1.76) was higher than the US adult population.The prevalence of obesity and BP consistent with hypertension in this population of coal miners is substantial, indicating a need for cardiovascular health interventions in coal mining communities. Published by Elsevier Inc.

  18. Determinants of receiving breast-conserving surgery. The Surveillance, Epidemiology, and End Results Program, 1983-1986.

    PubMed

    Samet, J M; Hunt, W C; Farrow, D C

    1994-05-01

    Although breast-conserving surgery was used with increasing frequency during the 1980s for management of breast cancer, most women still undergo mastectomy, and a substantial variation has been documented in the proportion of women receiving breast-conserving surgery across regions of the country. Using data from the Surveillance, Epidemiology, and End Results (SEER) Program for 1983-1986, we assessed characteristics of the county of residence as predictors of receipt of breast-conserving surgery and determined whether regional variation persisted after considering these characteristics. The data used involved all 19,661 non-Hispanic white women with localized breast cancer diagnosed in 1983 through 1986 in the nine SEER regions. Information on county characteristics was obtained from standard sources and merged with the SEER data. Univariate multivariate statistical methods were used to assess the effects of county characteristics on type of surgery for breast cancer. As anticipated, age was a strong predictor of type of surgery. In analyses that controlled for age, county characteristics that significantly predicted receipt of breast-conserving surgery included physician-to-population ratio, education and income levels, the presence of cancer center, and the presence of a city of at least 100,000. After controlling for these factors using multiple logistic regression, substantial regional variation persisted. Regional variation in treatment of localized breast cancer across the SEER regions is not explained by patient's age or county characteristics. Research is needed to address the decision making of individual patients and their physicians regarding type of surgery.

  19. Bayesian pretest probability estimation for primary malignant bone tumors based on the Surveillance, Epidemiology and End Results Program (SEER) database.

    PubMed

    Benndorf, Matthias; Neubauer, Jakob; Langer, Mathias; Kotter, Elmar

    2017-03-01

    In the diagnostic process of primary bone tumors, patient age, tumor localization and to a lesser extent sex affect the differential diagnosis. We therefore aim to develop a pretest probability calculator for primary malignant bone tumors based on population data taking these variables into account. We access the SEER (Surveillance, Epidemiology and End Results Program of the National Cancer Institute, 2015 release) database and analyze data of all primary malignant bone tumors diagnosed between 1973 and 2012. We record age at diagnosis, tumor localization according to the International Classification of Diseases (ICD-O-3) and sex. We take relative probability of the single tumor entity as a surrogate parameter for unadjusted pretest probability. We build a probabilistic (naïve Bayes) classifier to calculate pretest probabilities adjusted for age, tumor localization and sex. We analyze data from 12,931 patients (647 chondroblastic osteosarcomas, 3659 chondrosarcomas, 1080 chordomas, 185 dedifferentiated chondrosarcomas, 2006 Ewing's sarcomas, 281 fibroblastic osteosarcomas, 129 fibrosarcomas, 291 fibrous malignant histiocytomas, 289 malignant giant cell tumors, 238 myxoid chondrosarcomas, 3730 osteosarcomas, 252 parosteal osteosarcomas, 144 telangiectatic osteosarcomas). We make our probability calculator accessible at http://ebm-radiology.com/bayesbone/index.html . We provide exhaustive tables for age and localization data. Results from tenfold cross-validation show that in 79.8 % of cases the pretest probability is correctly raised. Our approach employs population data to calculate relative pretest probabilities for primary malignant bone tumors. The calculator is not diagnostic in nature. However, resulting probabilities might serve as an initial evaluation of probabilities of tumors on the differential diagnosis list.

  20. Systematic review of reporting rates of adverse events following immunization: an international comparison of post-marketing surveillance programs with reference to China.

    PubMed

    Guo, Biao; Page, Andrew; Wang, Huaqing; Taylor, Richard; McIntyre, Peter

    2013-01-11

    China is the most populous country in the world, with an annual birth cohort of approximately 16 million, requiring an average of 500 million vaccine doses administered annually. In China, over 30 domestic and less than 10 overseas vaccine manufacturers supply over 60 licensed vaccine products, representing a growing vaccine market mainly due to recent additions to the national immunization schedule, but data on post-marketing surveillance for adverse events following immunization (AEFI) are sparse. To compare reporting rates for various categories of AEFI from China with other routine post-marketing surveillance programs internationally. Systematic review of published studies reporting rates of AEFI by vaccine, category of reaction and age from post-marketing surveillance systems in English and Chinese languages. Overall AEFI reporting rates (all vaccines, all ages) in Chinese studies were consistent with those from similar international studies elsewhere, but there was substantial heterogeneity in regional reporting rates in China (range 2.3-37.8/100,000 doses). The highest AEFI reporting rates were for diphtheria-tetanus-pertussis whole-cell (DTwP) and acellular (DTaP) vaccines (range 3.3-181.1/100,000 doses for DTwP; range 3.5-92.6/100,000 doses for DTaP), with higher median rates for DTwP than DTaP, and higher than expected rates for DTaP vaccine. Similar higher rates for DTwP and DTaP containing vaccines, and relatively lower rates for vaccines against hepatitis B virus, poliovirus, and Japanese encephalitis virus were found in China and elsewhere in the world. Overall AEFI reporting rates in China were consistent with similar post-marketing surveillance systems in other countries. Sources of regional heterogeneity in AEFI reporting rates, and their relationships to differing vaccine manufacturers versus differing surveillance practices, require further exploration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Western equine encephalitis surveillance in Utah.

    PubMed

    Wagstaff, K H; Dickson, S L; Bailey, A

    1986-06-01

    The history of WEE surveillance in Utah is reviewed, beginning with the 1933 outbreak involving 3,958 horses. The step by step formation of the Utah Mosquito Abatement Associations surveillance program from 1957 to the present is discussed. Results of an enlarged sentinel chicken flock surveillance program in Utah during 1983 (3 sero-conversions in September), 1984 and 1985 (no sero-conversion) show the lack of WEE activity in the surveillance area.

  2. Analysis to evaluate predictors of fiberboard aging to guide surveillance sampling for the 9975 life extension program

    SciTech Connect

    Kelly, Elizabeth J.; Daugherty, William L.; Hackney, Elizabeth R.

    2016-05-09

    During surveillance of the 9975 shipping package at the Savannah River Site K-Area Complex, several package dimensions are recorded. The analysis described in this report shows that, based on the current data analysis, two of these measurements, Upper Assembly Outer Diameter (UAOD) and Upper Assembly Inside Height (UAIH), do not have statistically significant aging trends regardless of wattage levels. In contrast, this analysis indicates that the measurement of Air Shield Gap (ASGap) does show a significant increase with age. It appears that the increase is greater for high wattage containers, but this result is dominated by two measurements from high-wattage containers. For all three indicators, additional high-wattage, older containers need to be examined before any definitive conclusions can be reached. In addition, the current analysis indicates that ASGap measurements for low and medium wattage containers are increasing slowly over time. To reduce uncertainties and better capture the aging trend for these containers, additional low and medium wattage older containers should also be examined. Based on this analysis, surveillance guidance is to augment surveillance containers resulting from 3013 surveillance with 9975-focused sampling that targets older, high wattage containers and also includes some older, low and medium wattage containers. This focused sampling began in 2015 and will continue in 2016. The UAOD, UAIH and ASGap data are highly variable. It is possible that additional factors such as seasonal variation and packaging site location might reduce variability and be useful for focusing surveillance and predicting aging.

  3. Surveillance Metrics Sensitivity Study

    SciTech Connect

    Bierbaum, R; Hamada, M; Robertson, A

    2011-11-01

    In September of 2009, a Tri-Lab team was formed to develop a set of metrics relating to the NNSA nuclear weapon surveillance program. The purpose of the metrics was to develop a more quantitative and/or qualitative metric(s) describing the results of realized or non-realized surveillance activities on our confidence in reporting reliability and assessing the stockpile. As a part of this effort, a statistical sub-team investigated various techniques and developed a complementary set of statistical metrics that could serve as a foundation for characterizing aspects of meeting the surveillance program objectives. The metrics are a combination of tolerance limit calculations and power calculations, intending to answer level-of-confidence type questions with respect to the ability to detect certain undesirable behaviors (catastrophic defects, margin insufficiency defects, and deviations from a model). Note that the metrics are not intended to gauge product performance but instead the adequacy of surveillance. This report gives a short description of four metrics types that were explored and the results of a sensitivity study conducted to investigate their behavior for various inputs. The results of the sensitivity study can be used to set the risk parameters that specify the level of stockpile problem that the surveillance program should be addressing.

  4. Surveillance metrics sensitivity study.

    SciTech Connect

    Hamada, Michael S.; Bierbaum, Rene Lynn; Robertson, Alix A.

    2011-09-01

    In September of 2009, a Tri-Lab team was formed to develop a set of metrics relating to the NNSA nuclear weapon surveillance program. The purpose of the metrics was to develop a more quantitative and/or qualitative metric(s) describing the results of realized or non-realized surveillance activities on our confidence in reporting reliability and assessing the stockpile. As a part of this effort, a statistical sub-team investigated various techniques and developed a complementary set of statistical metrics that could serve as a foundation for characterizing aspects of meeting the surveillance program objectives. The metrics are a combination of tolerance limit calculations and power calculations, intending to answer level-of-confidence type questions with respect to the ability to detect certain undesirable behaviors (catastrophic defects, margin insufficiency defects, and deviations from a model). Note that the metrics are not intended to gauge product performance but instead the adequacy of surveillance. This report gives a short description of four metrics types that were explored and the results of a sensitivity study conducted to investigate their behavior for various inputs. The results of the sensitivity study can be used to set the risk parameters that specify the level of stockpile problem that the surveillance program should be addressing.

  5. GEIS Surveillance Network Program

    DTIC Science & Technology

    2013-10-01

    for Flavivirus, Orthobunyavirus, Alphavirus, RVFV, Filoviruses, CCCHFV, Hepatitis A and E and they tested negative for all. A total of 4 mosquito...Morbidity) changes. Information on pregnancy as well as Verbal Autopsy interviews (to determine causes of death on reported deaths) is also being

  6. Trends in Drug Resistance of Acinetobacter baumannii over a 10-year Period: Nationwide Data from the China Surveillance of Antimicrobial Resistance Program

    PubMed Central

    Gao, Lei; Lyu, Yuan; Li, Yun

    2017-01-01

    Background: Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. Methods: Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China. Minimum inhibitory concentrations (MICs) were determined by a 2-fold agar dilution method, and antimicrobial susceptibility was established using the 2014 Clinical Laboratory Standards Institute-approved breakpoints. Isolates not susceptible to all the tested aminoglycosides, fluoroquinolones, β-lactams, β-lactam/β-lactam inhibitors and carbapenems were defined as extensively drug resistant. Results: The rates of nonsusceptibility to common antimicrobial agents remained high (>65%) over the years with some fluctuations to certain agents. The prevalence of imipenem-resistant A. baumannii (IRAB) increased from 13.3% in 2004 to 70.5% in 2014 and that of extensively drug-resistant A. baumannii (XDRAB) increased from 11.1% in 2004 to 60.4% in 2014. The activity of tigecycline was stable with MIC90 ≤4 mg/L against A. baumannii from 2009 to 2014. Susceptibility to colistin remained high (97.0%) from 2009 to 2014. The prevalence of XDRAB increased in all the three surveillance regions over the years and was significantly higher in Intensive Care Unit (ICU) wards than non-ICU wards. Conclusions: This longitudinal multicenter surveillance program revealed the nationwide emergence of A. baumannii in China and showed a significant increase in prevalence from 2004 to 2014. High levels of bacterial resistance were detected among samples collected from clinical settings in China, with IRAB and XDRAB being especially prevalent. This study will help to guide empirical therapy and identify at-risk groups requiring more

  7. Plasma and cerebrospinal fluid concentrations of linezolid in neurosurgical critically ill patients with proven or suspected central nervous system infections.

    PubMed

    Luque, S; Grau, S; Alvarez-Lerma, F; Ferrández, O; Campillo, N; Horcajada, J P; Basas, M; Lipman, J; Roberts, J A

    2014-11-01

    Linezolid is a valuable treatment option for central nervous system (CNS) infections caused by multidrug-resistant Gram-positive micro-organisms. Data regarding its penetration into the CNS have shown wide variability. The aim of this study was to describe the population pharmacokinetics of linezolid in plasma and cerebrospinal fluid (CSF) in critically ill patients with external CSF drainage and proven or suspected CNS infections. This was an observational pharmacokinetic (PK) study in 11 critically ill patients with proven or suspected CNS infection receiving linezolid. Serial blood and CSF samples were taken and were subject to population PK analysis. The median (interquartile range) of AUC(0-12h) was 47.6 (17.9-58.6) mgh/L in plasma and 21.1 (18.8-30.4) mgh/L in CSF, with a median CSF/plasma ratio of 0.77. At pre-dose at steady state, a strong positive correlation was observed between linezolid concentrations in CSF and plasma (Spearman's rho=0.758; P=0.011). For a minimum inhibitory concentration (MIC) of 2 mg/L, the median AUC(0-24h)/MIC values in plasma and CSF were <80 in all patients. A three-compartment linear model was found to be most appropriate. The mean value for linezolid clearance was 16.6L/h and mean volume of distribution was 101.3 L. No covariate relationships could be supported on any of the parameters. Linezolid demonstrated good penetration into the CNS but high interindividual PK variability. Administration of higher than standard doses of linezolid and therapeutic drug monitoring should therefore be considered as options to optimise linezolid dosing in critically ill patients with CNS infections.

  8. Linezolid: an effective, safe and cheap drug for patients failing multidrug-resistant tuberculosis treatment in India.

    PubMed

    Singla, R; Caminero, J A; Jaiswal, A; Singla, N; Gupta, S; Bali, R K; Behera, D

    2012-04-01

    Linezolid is identified as an effective drug with which to treat patients failing multidrug-resistant (MDR)-tuberculosis (TB) treatment. However, cost and safety are the concerns. In India, the average price of a 600-mg pill of linezolid is less than one US dollar, much cheaper than most of the third-line drugs. A prospective study of 29 MDR-TB treatment failure patients (16 with laboratory-proven extensively drug-resistant (XDR)-TB and the remaining 13 with MDR-TB with resistance to any quinolone but sensitive to injectables) was carried out in Delhi, India. All patients received daily unsupervised therapy with linezolid, one injectable agent, one fluoroquinolone and two or more other drugs. Patients received a median of six anti-mycobacterial agents. Besides linezolid, capreomycin, moxifloxacin, levofloxacin and amoxycillin-clavulanic acid were used in 41.4%, 58.6%, 41.4%, and 79.3% of patients. Out of a total of 29 patients, 89.7% patients achieved sputum smear and culture conversion; 72.4% showed interim favourable outcome; 10.3% died, 6.8% failed and 10.3% patients defaulted. Linezolid had to be stopped in three (10.3%) patients due to adverse reactions. The outcome of treatment of 16 XDR-TB patients was comparable to the other 13 MDR-TB patients. Linezolid is an effective, cheap and relatively safe drug for patients failing MDR-TB treatment, including those with confirmed XDR-TB.

  9. A simple high-performance liquid chromatography for the determination of linezolid in human plasma and saliva.

    PubMed

    Hara, Shuuji; Uchiyama, Masanobu; Yoshinari, Masami; Matsumoto, Taichi; Jimi, Shiro; Togawa, Atsushi; Takata, Tohru; Takamatsu, Yasushi

    2015-09-01

    Linezolid is an antimicrobial agent for the treatment of multiresistant Gram-positive infections. A practical high-performance liquid chromatography method was developed for the determination of linezolid in human plasma and saliva. Linezolid and an internal standard (o-ethoxybenzamide) were extracted from plasma and saliva with ethyl acetate and analyzed on a Capcell Pak C18 MG column with UV detection at 254 nm. The calibration curve was linear through the range 0.5-50 µg/mL using a 200 μL sample volume. The intra- and interday precisions were all <6.44% for plasma and 5.60% for saliva. The accuracies ranged from 98.8 to 110% for both matrices. The mean recoveries of linezolid were 80.8% for plasma and 79.0% for saliva. This method was used to determine the plasma and saliva concentrations of linezolid in healthy volunteers who were orally administered a 600 mg dose of linezolid. Our liquid-liquid extraction procedure is easy and requires a small volume of plasma or saliva (200 μL). This small volume can be advantageous in clinical pharmacokinetic studies, especially if children participate.

  10. The Incidence and Prevalence of Systemic Lupus Erythematosus in New York County (Manhattan), New York: The Manhattan Lupus Surveillance Program.

    PubMed

    Izmirly, Peter M; Wan, Isabella; Sahl, Sara; Buyon, Jill P; Belmont, H Michael; Salmon, Jane E; Askanase, Anca; Bathon, Joan M; Geraldino-Pardilla, Laura; Ali, Yousaf; Ginzler, Ellen M; Putterman, Chaim; Gordon, Caroline; Helmick, Charles G; Parton, Hilary

    2017-10-01

    The Manhattan Lupus Surveillance Program (MLSP) is a population-based registry designed to determine the prevalence of systemic lupus erythematosus (SLE) in 2007 and the incidence from 2007 to 2009 among residents of New York County (Manhattan), New York, and to characterize cases by race/ethnicity, including Asians and Hispanics, for whom data are lacking. We identified possible SLE cases from hospital records, rheumatologist records, and administrative databases. Cases were defined according to the American College of Rheumatology (ACR) classification criteria, the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, or the treating rheumatologist's diagnosis. Rates among Manhattan residents were age-standardized, and capture-recapture analyses were conducted to assess case underascertainment. By the ACR definition, the age-standardized prevalence and incidence rates of SLE were 62.2 and 4.6 per 100,000 person-years, respectively. Rates were ∼9 times higher in women than in men for prevalence (107.4 versus 12.5) and incidence (7.9 versus 1.0). Compared with non-Hispanic white women (64.3), prevalence was higher among non-Hispanic black (210.9), Hispanic (138.3), and non-Hispanic Asian (91.2) women. Incidence rates were higher among non-Hispanic black women (15.7) compared with non-Hispanic Asian (6.6), Hispanic (6.5), and non-Hispanic white (6.5) women. Capture-recapture adjustment increased the prevalence and incidence rates (75.9 and 6.0, respectively). Alternate SLE definitions without capture-recapture adjustment revealed higher age-standardized prevalence and incidence rates (73.8 and 6.2, respectively, by the SLICC definition and 72.6 and 5.0 by the rheumatologist definition) than the ACR definition, with similar patterns by sex and race/ethnicity. The MLSP confirms findings from other registries on disparities by sex and race/ethnicity, provides new estimates among Asians and Hispanics, and provides estimates using the

  11. Antimicrobial activity of the pleuromutilin antibiotic BC-3781 against bacterial pathogens isolated in the SENTRY antimicrobial surveillance program in 2010.

    PubMed

    Paukner, Susanne; Sader, Helio S; Ivezic-Schoenfeld, Zrinka; Jones, Ronald N

    2013-09-01

    BC-3781 is a novel semisynthetic pleuromutilin antibiotic inhibiting bacterial protein synthesis. BC-3781 has completed a phase 2 clinical trial in acute bacterial skin and skin structure infections (ABSSSI). Its antibacterial spectrum additionally covers the predominant pathogens causing community-acquired bacterial pneumonia (CABP). In this study, the antibacterial activity of BC-3781 was evaluated against a contemporary collection of 10,035 bacterial isolates predominately causing ABSSSI and CABP, among other infections, collected within the SENTRY Antimicrobial Surveillance Program worldwide in 2010. BC-3781 exhibited potent activity against organisms commonly isolated from ABSSSI such as Staphylococcus aureus (MIC50/90, 0.12/0.12 μg/ml; 99.8% inhibited at ≤0.5 μg/ml), beta-hemolytic streptococci (MIC50/90, 0.03/0.03 μg/ml; 99.3% inhibited at ≤0.5 μg/ml), and coagulase-negative staphylococci (CoNS; MIC50/90, 0.06/0.12 μg/ml; 97.8% inhibited at ≤1 μg/ml). BC-3781 displayed similar MIC distributions among methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) S. aureus strains. BC-3781 was also active against Enterococcus faecium, with 76.3% of vancomycin-susceptible and 97.0% of vancomycin-resistant isolates being inhibited at BC-3781 concentrations of ≤1 μg/ml. Beta-hemolytic and viridans group streptococci were highly susceptible to BC-3781, with 99.3% and 96.7% of isolates inhibited at ≤0.5 μg/ml, respectively. Further, activity of BC-3781 against Streptococcus pneumoniae (MIC50/90, 0.12/0.25 μg/ml), Haemophilus influenzae (MIC50/90, 1/2 μg/ml), and Moraxella catarrhalis (MIC50/90, 0.12/0.25 μg/ml) was not negatively influenced by β-lactamase production or resistance to other antimicrobial classes tested. In all, BC-3781 displayed a very potent antibacterial profile including the most prevalent bacterial pathogens causing ABSSSI and CABP, thus warranting further clinical development of this antibiotic in these and possibly other

  12. Antimicrobial Activity of the Pleuromutilin Antibiotic BC-3781 against Bacterial Pathogens Isolated in the SENTRY Antimicrobial Surveillance Program in 2010

    PubMed Central

    Sader, Helio S.; Ivezic-Schoenfeld, Zrinka; Jones, Ronald N.

    2013-01-01

    BC-3781 is a novel semisynthetic pleuromutilin antibiotic inhibiting bacterial protein synthesis. BC-3781 has completed a phase 2 clinical trial in acute bacterial skin and skin structure infections (ABSSSI). Its antibacterial spectrum additionally covers the predominant pathogens causing community-acquired bacterial pneumonia (CABP). In this study, the antibacterial activity of BC-3781 was evaluated against a contemporary collection of 10,035 bacterial isolates predominately causing ABSSSI and CABP, among other infections, collected within the SENTRY Antimicrobial Surveillance Program worldwide in 2010. BC-3781 exhibited potent activity against organisms commonly isolated from ABSSSI such as Staphylococcus aureus (MIC50/90, 0.12/0.12 μg/ml; 99.8% inhibited at ≤0.5 μg/ml), beta-hemolytic streptococci (MIC50/90, 0.03/0.03 μg/ml; 99.3% inhibited at ≤0.5 μg/ml), and coagulase-negative staphylococci (CoNS; MIC50/90, 0.06/0.12 μg/ml; 97.8% inhibited at ≤1 μg/ml). BC-3781 displayed similar MIC distributions among methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) S. aureus strains. BC-3781 was also active against Enterococcus faecium, with 76.3% of vancomycin-susceptible and 97.0% of vancomycin-resistant isolates being inhibited at BC-3781 concentrations of ≤1 μg/ml. Beta-hemolytic and viridans group streptococci were highly susceptible to BC-3781, with 99.3% and 96.7% of isolates inhibited at ≤0.5 μg/ml, respectively. Further, activity of BC-3781 against Streptococcus pneumoniae (MIC50/90, 0.12/0.25 μg/ml), Haemophilus influenzae (MIC50/90, 1/2 μg/ml), and Moraxella catarrhalis (MIC50/90, 0.12/0.25 μg/ml) was not negatively influenced by β-lactamase production or resistance to other antimicrobial classes tested. In all, BC-3781 displayed a very potent antibacterial profile including the most prevalent bacterial pathogens causing ABSSSI and CABP, thus warranting further clinical development of this antibiotic in these and possibly other

  13. Cervical cord compression in mucopolysaccharidosis VI (MPS VI): Findings from the MPS VI Clinical Surveillance Program (CSP).

    PubMed

    Solanki, Guirish A; Sun, Peter P; Martin, Kenneth W; Hendriksz, Christian J; Lampe, Christina; Guffon, Nathalie; Hung, Annie; Sisic, Zlatko; Shediac, Renée; Harmatz, Paul R

    2016-08-01

    To gain insight into the frequency, age of onset, and management of cervical cord compression in mucopolysaccharidosis VI (MPS VI). Cervical spine magnetic resonance imaging (MRI) data and/or cervical decompression surgery data collected between 30 June 2005 and 1 September 2015 were analyzed from subjects enrolled in the MPS VI Clinical Surveillance Program (CSP) (ClinicalTrials.gov: NCT00214773), an ongoing multicenter, observational, retrospective and prospective registry. Of 213 subjects enrolled in the CSP, 134 (62.9%) had at least one documented cervical spine MRI assessment. An additional four subjects were identified through surgery records alone to yield a study population comprising 138 subjects (mean age at enrollment =15.1years; age range=0.80-65.0years). Cervical cord compression was documented in 101 (75.4%) of the 134 subjects with ≥1 MRI assessment, the majority (95.0%) by the time of the first recorded MRI. In general, subjects with cervical cord compression had significantly lower height Z-scores compared to those without cervical cord compression (p<0.0001); nevertheless, a few subjects of taller stature had documented cervical cord compression at a young age. Most subjects >20years of age (31/33, 93.9%) presented with cervical cord compression. There was an insufficient number of subjects with both pre- and post-enzyme replacement therapy (ERT) MRI data to determine any association between ERT and cervical cord compression. Surgical decompression was performed on 58 subjects (42.0%), with mean age at first surgery of 13.1years. Decompression plus stabilization procedures accounted for 12.1% of surgeries. Eight subjects (13.8%) underwent reoperation. Complications during or following surgery were reported in 3 subjects, with anesthesia-related complications resulting in two deaths. All individuals with MPS VI are at high risk of developing cervical cord compression at an early age. Routine MRI assessments should be initiated from the time of

  14. Nocardia asteroides peritoneal dialysis-related peritonitis: First case in pediatrics, treated with protracted linezolid.

    PubMed

    El-Naggari, Mohamed; El Nour, Ibtisam; Al-Nabhani, Dana; Al Muharrmi, Zakaria; Gaafar, Heba; Abdelmogheth, Anas A W

    2016-01-01

    Nocardia asteroides is a rare pathogen in peritoneal dialysis-related peritonitis. We report on a 13-year-old female with Nocardia asteroides peritonitis complicated by an intra-abdominal abscess. Linezolid was administered intravenously for 3 months and followed by oral therapy for an additional 5 months with close monitoring for adverse effects. The patient was discharged after 3 months of hospitalization on hemodialysis. The diagnosis and management of such cases can be problematic due to the slow growth and difficulty of identifying Nocardia species. The optimal duration of treatment for Nocardia peritonitis is not known. Linezolid can be used for prolonged periods in cases of trimethoprim/sulfamethoxazole-resistant cases with close monitoring for adverse effects. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  15. In vitro antimicrobial activity of linezolid tested against vancomycin-resistant enterococci isolated in Brazilian hospitals.

    PubMed

    Reis, A O; Cordeiro, J C; Machado, A M; Sader, H S

    2001-10-01

    The emergence of vancomycin-resistant enterococci (VRE) has been described recently in Brazil. This is in contrast to the USA and Europe, where the VRE appeared in the late 1980s. The progressive increase in VRE isolation poses important problems in the antimicrobial therapy of nosocomial infections. Treatment options and effective antimicrobial agents for VRE are often limited and the possibility of transfer of vancomycin genes to other Gram-positive microorganisms continues. In the search for antimicrobial agents for multiresistant Gram-positive cocci, compounds such as linezolid and quinupristin/dalfopristin have been evaluated. The present study was conducted to evaluate the in vitro activity of the oxazolidinone linezolid and 10 other antimicrobial agents, including quinupristin-dalfopristin, against multiresistant enterococci isolated in Brazilian hospitals. Thirty-three vancomycin resistant isolates (17 Enterococcus faecium and 16 E. faecalis), were analyzed. Strains were isolated from patients at São Paulo Hospital, Oswaldo Cruz Hospital, Hospital do Servidor Público Estadual, Santa Marcelina Hospital, Santa Casa de Misericórdia de São Paulo, and Hospital de Clínicas do Paraná. The samples were tested by a broth microdilution method following the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. All isolates were molecular typed using pulsed-field gel electrophoresis (PFGE). Linezolid was the most active compound against these multiresistant enterococci, showing 100% inhibition at the susceptible breakpoints. Quinupristin/dalfopristin and teicoplanin showed poor activity against both species. The molecular typing results suggest that there has been interhospital spread of vancomycin resistant E. faecium and E. faecalis among Brazilian hospitals. The results of this study indicate that linezolid is an appropriate therapeutic option for the treatment of vancomycin-resistant enterococci infections in Brazil.

  16. Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening: a monocenter study in Germany.

    PubMed

    Vetter, Lisa; Keller, Monika; Bruckner, Thomas; Golatta, Michael; Eismann, Sabine; Evers, Christina; Dikow, Nicola; Sohn, Christof; Heil, Jörg; Schott, Sarah

    2016-04-01

    Breast cancer (BC) is the leading cancer among women worldwide and in 5-10 % of cases is of hereditary origin, mainly due to BRCA1/2 mutations. Therefore, the German Consortium for Familial Breast and Ovarian Cancer (HBOC) with its 15 specialized academic centers offers families at high risk for familial/hereditary cancer a multimodal breast cancer surveillance program (MBCS) with regular breast MRI, mammography, ultrasound, and palpation. So far, we know a lot about the psychological effects of genetic testing, but we know little about risk-correlated adherence to MBCS or prophylactic surgery over time. The aim of this study was to investigate counselees' adherence to recommendations for MBCS in order to adjust the care supply and define predictors for incompliance. All counselees, who attended HBOC consultation at the University Hospital Heidelberg between July 01, 2009 and July 01, 2011 were eligible to participate. A tripartite questionnaire containing sociodemographic information, psychological parameters, behavioral questions, and medical data collection from the German consortium were used. A high participation rate was achieved among the study population, with 72 % returning the questionnaire. This study showed a rate of 59 % of full-adherers to the MBCS. Significant predictors for partial or full adherence were having children (p = 0.0221), younger daughters (p = 0.01795), a higher awareness of the topic HBOC (p = 0.01795, p < 0.0001), a higher perceived breast cancer risk (p < 0.0001), and worries (p = 0.0008)/impairment (p = 0.0257) by it. Although the current data suggest a good adherence of MBCS, prospective studies are needed to understand counselees' needs to further improve surveillance programs and adherence to them. Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening-a monocenter study in Germany.

  17. In vitro Activity of Linezolid in Combination with Photodynamic Inactivation Against Staphylococcus aureus Biofilms

    PubMed Central

    Kashef, Nasim; Akbarizare, Mahboobeh; Razzaghi, Mohammad Reza

    2017-01-01

    Background: Biofilm infections are a major challenge in medical practice. Bacteria that live in a biofilm phenotype are more resistant to both antimicrobial therapy and host immune responses compared to their planktonic counterparts. So, there is need for new therapeutic strategies to combat these infections. A promising approach [known as Photodynamic Inactivation (PDI)] to kill bacteria growing as biofilms uses light in combination with a photosensitizer to induce a phototoxic reaction which produces reactive oxygen species that can destroy lipids and proteins causing cell death. PDI does not always guarantee full success, so, combination of PDI with antibiotics may give increased efficiency. This study aimed to determine if PDI was effective in the eradication of Staphylococcus aureus (S. aureus) biofilms in combination with linezolid. Methods: The susceptibility of biofilm cultures of three S. aureus strains to Methylene Blue (MB) and Toluidine Blue O (TBO)-mediated PDI was determined alone and in combination with linezolid. Results: Bactericidal activity (≥3 log10 reduction in viable cell count) was not achieved with MB/TBO-PDI or antibiotic treatment alone. When antibiotic treatment was combined with TBO-PDI, a greater reduction in viable count than antibiotic alone was observed for two strains. Conclusion: This study showed that although TBO-PDI did not have good bactericidal activity against S. aureus biofilms; it increased the antimicrobial activity of linezolid against these bacteria. PMID:28090280

  18. Determination of linezolid in human plasma by high-performance liquid chromatography with ultraviolet detection.

    PubMed

    Cattaneo, Dario; Baldelli, Sara; Conti, Francesca; Cozzi, Valeria; Clementi, Emilio

    2010-08-01

    A high-performance liquid chromatographic method for the determination of linezolid in human plasma was developed and validated. After precipitation of plasma proteins with perchloric acid, the protein-free supernatant was separated by isocratic reverse-phase chromatography on a X Bridge C18 column. The mobile phase consisted of a mixture of phosphoric acid 0.05%: acetonitrile (75:25, v/v) with a flow rate of 1 mL/min. The column elute was monitored at 254 nm. The method was linear from 0.2 to 48 mg/L (mean r2 = 0.9996, n = 10). The observed intra- and inter-day assay imprecision ranged from 2.83% to 8.16% (18.80% at the lower limit of quantification); inaccuracy varied between -0.33% and 8.18%. Mean drug recovery was 99.8% for linezolid and 90.0% for the internal standard (para-toluic acid). The method was found to be precise and accurate and suitable for therapeutic drug monitoring of linezolid in routine clinical practice.

  19. Designing a risk-based surveillance program for Mycobacterium avium ssp. paratuberculosis in Norwegian dairy herds using multivariate statistical process control analysis.

    PubMed

    Whist, A C; Liland, K H; Jonsson, M E; Sæbø, S; Sviland, S; Østerås, O; Norström, M; Hopp, P

    2014-11-01

    Surveillance programs for animal diseases are critical to early disease detection and risk estimation and to documenting a population's disease status at a given time. The aim of this study was to describe a risk-based surveillance program for detecting Mycobacterium avium ssp. paratuberculosis (MAP) infection in Norwegian dairy cattle. The included risk factors for detecting MAP were purchase of cattle, combined cattle and goat farming, and location of the cattle farm in counties containing goats with MAP. The risk indicators included production data [culling of animals >3 yr of age, carcass conformation of animals >3 yr of age, milk production decrease in older lactating cows (lactations 3, 4, and 5)], and clinical data (diarrhea, enteritis, or both, in animals >3 yr of age). Except for combined cattle and goat farming and cattle farm location, all data were collected at the cow level and summarized at the herd level. Predefined risk factors and risk indicators were extracted from different national databases and combined in a multivariate statistical process control to obtain a risk assessment for each herd. The ordinary Hotelling's T(2) statistic was applied as a multivariate, standardized measure of difference between the current observed state and the average state of the risk factors for a given herd. To make the analysis more robust and adapt it to the slowly developing nature of MAP, monthly risk calculations were based on data accumulated during a 24-mo period. Monitoring of these variables was performed to identify outliers that may indicate deviance in one or more of the underlying processes. The highest-ranked herds were scattered all over Norway and clustered in high-density dairy cattle farm areas. The resulting rankings of herds are being used in the national surveillance program for MAP in 2014 to increase the sensitivity of the ongoing surveillance program in which 5 fecal samples for bacteriological examination are collected from 25 dairy herds

  20. 28 CFR 550.41 - Urine surveillance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...

  1. 28 CFR 550.41 - Urine surveillance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...

  2. 28 CFR 550.41 - Urine surveillance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...

  3. 28 CFR 550.41 - Urine surveillance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...

  4. 28 CFR 550.41 - Urine surveillance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Urine surveillance. 550.41 Section 550.41... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.41 Urine surveillance. A program of urine testing for drug use shall be established in contract CTCs. (a)...

  5. Viral surveillance and discovery.

    PubMed

    Lipkin, Walter Ian; Firth, Cadhla

    2013-04-01

    The field of virus discovery has burgeoned with the advent of high throughput sequencing platforms and bioinformatics programs that enable rapid identification and molecular characterization of known and novel agents, investments in global microbial surveillance that include wildlife and domestic animals as well as humans, and recognition that viruses may be implicated in chronic as well as acute diseases. Here we review methods for viral surveillance and discovery, strategies and pitfalls in linking discoveries to disease, and identify opportunities for improvements in sequencing instrumentation and analysis, the use of social media and medical informatics that will further advance clinical medicine and public health. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Clinical experience with linezolid in the treatment of resistant gram-positive infections.

    PubMed Central

    Antony, S. J.; Diaz-Vasquez, E.; Stratton, C.

    2001-01-01

    This study presents our clinical experience with linezolid in 19 patients with serious resistant gram-positive infections enrolled as part of the compassionate study. In this prospective, non-randomized, noncomparative study, 19 patients were enrolled as part of the National Compassionate Study Protocol conducted by Pharmacia-Upjohn. At the time of this writing, these patients had not been published in the literature. All of the patients had to have documented evidence of serious gram-positive infections in normally sterile sites and should have been unable to tolerate available antimicrobial therapy or be unresponsive to available drugs. Clinical characteristics, laboratory values, and pharmacokinetic and pharmacodynamic parameters were obtained. Patients were followed both short-term and long-term after completion of therapy. Nineteen patients were enrolled: 13 females and 6 males. The average age was 63 years. The average length of therapy with linezolid was 22 days. Methicillin-resistant Staphylococcus aureus (MRSA) was treated in eight patients, methicillin-resistant Staphylococcus epidermidis (MRSE) in two patients, vancomycin-resistant Enterococcus faecium (VREF) in eight patients, and coagulase-negative Staphylococcus in two patients. Co-infecting organisms include Enterococcus species colonization in six patients, Pseudomonas species in one patient, Serratia marcenens in one patient, and Candida albicans in one patient. Sterile sites that were infected included bone and joint (wounds and septic joints) in six patients, gastrointestinal system (hepatobiliary, liver abscess, Crohn's) in five patients, genitourinary (kidney and urine) in two patients, blood in five patients, respiratory in one patient, and aortic valve in 1 patient. Linezolid was given at 600 mg IV every 12 hours with a mean length of therapy of 22 days. Surgical drainage was used in combination with linezolid in 11 of the patients. Seventy nine percent of these patients achieved clinical and

  7. Concentration-Dependent Synergy and Antagonism of Linezolid and Moxifloxacin in the Treatment of Childhood Tuberculosis: The Dynamic Duo

    PubMed Central

    Deshpande, Devyani; Srivastava, Shashikant; Nuermberger, Eric; Pasipanodya, Jotam G.; Swaminathan, Soumya; Gumbo, Tawanda

    2016-01-01

    Background. No treatment regimens have been specifically designed for children, in whom tuberculosis is predominantly intracellular. Given their activity as monotherapy and their ability to penetrate many diseased anatomic sites that characterize disseminated tuberculosis, linezolid and moxifloxacin could be combined to form a regimen for this need. Methods. We examined microbial kill of intracellular Mycobacterium tuberculosis (Mtb) by the combination of linezolid and moxifloxacin multiple exposures in a 7-by-7 mathematical matrix. We then used the hollow fiber system (HFS) model of intracellular tuberculosis to identify optimal dose schedules and exposures of moxifloxacin and linezolid in combination. We mimicked pediatric half-lives and concentrations achieved by each drug. We sampled the peripheral compartment on days 0, 7, 14, 21, and 28 for Mtb quantification, and compared the slope of microbial kill of Mtb by these regimens to the standard regimen of isoniazid, rifampin, and pyrazinamide, based on exponential decline regression. Results. The full exposure-response surface identified linezolid-moxifloxacin zones of synergy, antagonism, and additivity. A regimen based on each of these zones was then used in the HFS model, with observed half-lives of 4.08 ± 0.66 for linezolid and 3.80 ± 1.34 hours for moxifloxacin. The kill rate constant was 0.060 ± 0.012 per day with the moxifloxacin-linezolid regimen in the additivity zone vs 0.083 ± 0.011 per day with standard therapy, translating to a bacterial burden half-life of 11.52 days vs 8.53 days, respectively. Conclusions. We identified doses and dose schedules of a linezolid and moxifloxacin backbone regimen that could be highly efficacious in disseminated tuberculosis in children. PMID:27742639

  8. EPIMIC: A Simple Homemade Computer Program for Real-Time EPIdemiological Surveillance and Alert Based on MICrobiological Data.

    PubMed

    Colson, Philippe; Rolain, Jean-Marc; Abat, Cédric; Charrel, Rémi; Fournier, Pierre-Edouard; Raoult, Didier

    2015-01-01

    Infectious diseases (IDs) are major causes of morbidity and mortality and their surveillance is critical. In 2002, we implemented a simple and versatile homemade tool, named EPIMIC, for the real-time systematic automated surveillance of IDs at Marseille university hospitals, based on the data from our clinical microbiology laboratory, including clinical samples, tests and diagnoses. This tool was specifically designed to detect abnormal events as IDs are rarely predicted and modeled. EPIMIC operates using Microsoft Excel software and requires no particular computer skills or resources. An abnormal event corresponds to an increase above, or a decrease below threshold values calculated based on the mean of historical data plus or minus 2 standard deviations, respectively. Between November 2002 and October 2013 (11 years), 293 items were surveyed weekly, including 38 clinical samples, 86 pathogens, 79 diagnosis tests, and 39 antibacterial resistance patterns. The mean duration of surveillance was 7.6 years (range, 1 month-10.9 years). A total of 108,427 Microsoft Excel file cells were filled with counts of clinical samples, and 110,017 cells were filled with counts of diagnoses. A total of 1,390,689 samples were analyzed. Among them, 172,180 were found to be positive for a pathogen. EPIMIC generated a mean number of 0.5 alert/week on abnormal events. EPIMIC proved to be efficient for real-time automated laboratory-based surveillance and alerting at our university hospital clinical microbiology laboratory-scale. It is freely downloadable from the following URL: http://www.mediterranee-infection.com/article.php?larub=157&titre=bulletin-epidemiologique (last accessed: 20/11/2015).

  9. EPIMIC: A Simple Homemade Computer Program for Real-Time EPIdemiological Surveillance and Alert Based on MICrobiological Data

    PubMed Central

    Colson, Philippe; Rolain, Jean-Marc; Abat, Cédric; Charrel, Rémi; Fournier, Pierre-Edouard; Raoult, Didier

    2015-01-01

    Background and Aims Infectious diseases (IDs) are major causes of morbidity and mortality and their surveillance is critical. In 2002, we implemented a simple and versatile homemade tool, named EPIMIC, for the real-time systematic automated surveillance of IDs at Marseille university hospitals, based on the data from our clinical microbiology laboratory, including clinical samples, tests and diagnoses. Methods This tool was specifically designed to detect abnormal events as IDs are rarely predicted and modeled. EPIMIC operates using Microsoft Excel software and requires no particular computer skills or resources. An abnormal event corresponds to an increase above, or a decrease below threshold values calculated based on the mean of historical data plus or minus 2 standard deviations, respectively. Results Between November 2002 and October 2013 (11 years), 293 items were surveyed weekly, including 38 clinical samples, 86 pathogens, 79 diagnosis tests, and 39 antibacterial resistance patterns. The mean duration of surveillance was 7.6 years (range, 1 month-10.9 years). A total of 108,427 Microsoft Excel file cells were filled with counts of clinical samples, and 110,017 cells were filled with counts of diagnoses. A total of 1,390,689 samples were analyzed. Among them, 172,180 were found to be positive for a pathogen. EPIMIC generated a mean number of 0.5 alert/week on abnormal events. Conclusions EPIMIC proved to be efficient for real-time automated laboratory-based surveillance and alerting at our university hospital clinical microbiology laboratory-scale. It is freely downloadable from the following URL: http://www.mediterranee-infection.com/article.php?larub=157&titre=bulletin-epidemiologique (last accessed: 20/11/2015). PMID:26658293

  10. The West Africa Field Epidemiology and Laboratory Training Program, a strategy to improve disease surveillance and epidemic control in West Africa

    PubMed Central

    Mutabaruka, Evariste; Sawadogo, Mamadou; Tarnagda, Zekiba; Ouédraogo, Lauren; Sangare, Lassana; Ousmane, Badolo; Ndjakani, Yassa; Namusisi, Olivia; Mukanga, David; Evering-Watley, Michele; Hounton, Sennen; Nsubuga, Peter

    2011-01-01

    The West Africa Field Epidemiology and Laboratory Training Program (WA-FELTP) which was established in September 2007, is an inter-country, competency-based, in-service and post -graduate training program in applied epidemiology and public health that builds the capacity to strengthen the surveillance and response system as well as epidemic control in the French-speaking countries where they are implemented. The overall purpose is to provide epidemiological and public health laboratory services to the public health systems at national, provincial, district and local levels. The program includes four countries: Burkina Faso, Mali, Niger, and Togo with an overarching goal to progressively cover all French speaking countries in West Africa through a phased-in approach. WA-FELTP's 2- year Master's program was launched in 2010 with 12 residents, three from each country, and consists of medical and veterinary doctors, pharmacists, and laboratory scientists. The training comprises 25% didactic sessions and 75% practical in-the-field mentored training. During the practical training, residents rovide service to their respective ministries of health and ministries of animal resources by contributing to outbreak investigations and activities that help to improve national surveillance systems at national, regional, district and local levels. The pressing challenges that the program must address consist of the lack of funds to support the second cohort of trainees, though trainee selection was completed, inadequate funds to support staff compensation, and shortage of funds to support trainees’ participation in critical activities in field epidemiology practice, and a need to develop a 5-year plan for sustainability. PMID:22359698

  11. The West Africa Field Epidemiology and Laboratory Training Program, a strategy to improve disease surveillance and epidemic control in West Africa.

    PubMed

    Mutabaruka, Evariste; Sawadogo, Mamadou; Tarnagda, Zekiba; Ouédraogo, Lauren; Sangare, Lassana; Ousmane, Badolo; Ndjakani, Yassa; Namusisi, Olivia; Mukanga, David; Evering-Watley, Michele; Hounton, Sennen; Nsubuga, Peter

    2011-01-01

    The West Africa Field Epidemiology and Laboratory Training Program (WA-FELTP) which was established in September 2007, is an inter-country, competency-based, in-service and post -graduate training program in applied epidemiology and public health that builds the capacity to strengthen the surveillance and response system as well as epidemic control in the French-speaking countries where they are implemented. The overall purpose is to provide epidemiological and public health laboratory services to the public health systems at national, provincial, district and local levels. The program includes four countries: Burkina Faso, Mali, Niger, and Togo with an overarching goal to progressively cover all French speaking countries in West Africa through a phased-in approach. WA-FELTP's 2- year Master's program was launched in 2010 with 12 residents, three from each country, and consists of medical and veterinary doctors, pharmacists, and laboratory scientists. The training comprises 25% didactic sessions and 75% practical in-the-field mentored training. During the practical training, residents rovide service to their respective ministries of health and ministries of animal resources by contributing to outbreak investigations and activities that help to improve national surveillance systems at national, regional, district and local levels. The pressing challenges that the program must address consist of the lack of funds to support the second cohort of trainees, though trainee selection was completed, inadequate funds to support staff compensation, and shortage of funds to support trainees' participation in critical activities in field epidemiology practice, and a need to develop a 5-year plan for sustainability.

  12. Public involvement in environmental surveillance at Hanford

    SciTech Connect

    Hanf, R.W. Jr.; Patton, G.W.; Woodruff, R.K.; Poston, T.M.

    1994-08-01

    Environmental surveillance at the Hanford Site began during the mid-1940s following the construction and start-up of the nation`s first plutonium production reactor. Over the past approximately 45 years, surveillance operations on and off the Site have continued, with virtually all sampling being conducted by Hanford Site workers. Recently, the US Department of Energy Richland Operations Office directed that public involvement in Hanford environmental surveillance operations be initiated. Accordingly, three special radiological air monitoring stations were constructed offsite, near hanford`s perimeter. Each station is managed and operated by two local school teaches. These three stations are the beginning of a community-operated environmental surveillance program that will ultimately involve the public in most surveillance operations around the Site. The program was designed to stimulate interest in Hanford environmental surveillance operations, and to help the public better understand surveillance results. The program has also been used to enhance educational opportunities at local schools.

  13. Discordant detection of avian influenza virus subtypes in time and space between poultry and wild birds; Towards improvement of surveillance programs

    PubMed Central

    Verhagen, Josanne H.; Lexmond, Pascal; Vuong, Oanh; Schutten, Martin; Guldemeester, Judith; Osterhaus, Albert D. M. E.; Elbers, Armin R. W.; Slaterus, Roy; Hornman, Menno; Koch, Guus; Fouchier, Ron A. M.

    2017-01-01

    Avian influenza viruses from wild birds can cause outbreaks in poultry, and occasionally infect humans upon exposure to infected poultry. Identification and characterization of viral reservoirs and transmission routes is important to develop strategies that prevent infection of poultry, and subsequently virus transmission between poultry holdings and to humans. Based on spatial, temporal and phylogenetic analyses of data generated as part of intense and large-scale influenza surveillance programs in wild birds and poultry in the Netherlands from 2006 to 2011, we demonstrate that LPAIV subtype distribution differed between wild birds and poultry, suggestive of host-range restrictions. LPAIV isolated from Dutch poultry were genetically most closely related to LPAIV isolated from wild birds in the Netherlands or occasionally elsewhere in Western Europe. However, a relatively long time interval was observed between the isolations of related viruses from wild birds and poultry. Spatial analyses provided evidence for mallards (Anas platyrhynchos) being more abundant near primary infected poultry farms. Detailed year-round investigation of virus prevalence and wild bird species distribution and behavior near poultry farms should be used to improve risk assessment in relation to avian influenza virus introduction and retarget avian influenza surveillance programs. PMID:28278281

  14. Discordant detection of avian influenza virus subtypes in time and space between poultry and wild birds; Towards improvement of surveillance programs.

    PubMed

    Verhagen, Josanne H; Lexmond, Pascal; Vuong, Oanh; Schutten, Martin; Guldemeester, Judith; Osterhaus, Albert D M E; Elbers, Armin R W; Slaterus, Roy; Hornman, Menno; Koch, Guus; Fouchier, Ron A M

    2017-01-01

    Avian influenza viruses from wild birds can cause outbreaks in poultry, and occasionally infect humans upon exposure to infected poultry. Identification and characterization of viral reservoirs and transmission routes is important to develop strategies that prevent infection of poultry, and subsequently virus transmission between poultry holdings and to humans. Based on spatial, temporal and phylogenetic analyses of data generated as part of intense and large-scale influenza surveillance programs in wild birds and poultry in the Netherlands from 2006 to 2011, we demonstrate that LPAIV subtype distribution differed between wild birds and poultry, suggestive of host-range restrictions. LPAIV isolated from Dutch poultry were genetically most closely related to LPAIV isolated from wild birds in the Netherlands or occasionally elsewhere in Western Europe. However, a relatively long time interval was observed between the isolations of related viruses from wild birds and poultry. Spatial analyses provided evidence for mallards (Anas platyrhynchos) being more abundant near primary infected poultry farms. Detailed year-round investigation of virus prevalence and wild bird species distribution and behavior near poultry farms should be used to improve risk assessment in relation to avian influenza virus introduction and retarget avian influenza surveillance programs.

  15. Molecular characterization of acinetobacter isolates collected in intensive care units of six hospitals in Florence, Italy, during a 3-year surveillance program: a population structure analysis.

    PubMed

    Donnarumma, Francesca; Sergi, Simona; Indorato, Cristina; Mastromei, Giorgio; Monnanni, Roberto; Nicoletti, Pieluigi; Pecile, Patrizia; Cecconi, Daniela; Mannino, Roberta; Bencini, Sara; Fanci, Rosa; Bosi, Alberto; Casalone, Enrico

    2010-04-01

    The strain diversity and the population structure of nosocomial Acinetobacter isolated from patients admitted to different hospitals in Florence, Italy, during a 3-year surveillance program, were investigated by amplified fragment length polymorphism (AFLP). The majority of isolates (84.5%) were identified as A. baumannii, confirming this species as the most common hospital Acinetobacter. Three very distinct A. baumannii clonal groups (A1, A2, and A3) were defined. The A1 isolates appeared to be genetically related to the well-characterized European EU II clone. A2 was responsible for three outbreaks which occurred in two intensive care units. Space/time population dynamic analysis showed that A1 and A2 were successful nosocomial clones. Most of the A. baumannnii isolates were imipenem resistant. The genetic determinants of carbapenem resistance were investigated by multiplex PCR, showing that resistance, independently of hospital origin, period of isolation, or clonal group, was associated with the presence of a bla (OXA-58-like) gene and with ISAba2 and ISAba3 elements flanking this gene. bla (OXA-58) appeared to be horizontally transferred. This study showed that the high discriminatory power of AFLP is useful for identification and typing of nosocomial Acinetobacter isolates. Moreover the use of AFLP in a real-time surveillance program allowed us the recognition of clinically relevant and widespread clones and their monitoring in hospital settings. The correlation between clone diffusion, imipenem resistance, and the presence of the bla(OXA-58-like) gene is discussed.

  16. The effectiveness of a health-surveillance program for caisson saturation divers in a tunnel-boring machine: a microbiological survey.

    PubMed

    Van Rees Vellinga, T P; Sterk, W; Van Dijk, F J H

    2010-01-01

    The purpose of this field study is to report and evaluate the implementation of a health surveillance program we developed to monitor the microbiological load for saturation divers, including preventive and therapeutic interventions. We extended the DMAC protocol for Saturation Diving Chamber Hygiene and added some components: ear inspections, swabs and environmental swabs every third day. The implementation was evaluated by analyzing the results of the activities. In a pre-saturation dive check we examined a total of 17 divers. Here we present the data from all seven saturation phases, collected over a period of 1.5 years. In every saturation phase we have found pathogenic bacteria or fungi in divers and in the environment, but more in some periods than in others. We did not observe any serious infection that required a diver to abort his stay in the living chamber. This health surveillance program has demonstrated the potential value of an early warning system to prevent problems. The bacterial load found in divers and in the environment was clearly visible. Prevention could be improved by more consistent implementation of the protocol. Fortunately, the infections had no serious consequences for the health of the workers or for the continuation of the work process.

  17. Annual summary report of the Decontamination and Decommissioning surveillance and maintenance program at Oak Ridge National Laboratory for period ending September 30, 1992

    SciTech Connect

    Ford, M.K.; Holder, L. Jr.

    1992-09-01

    The Oak Ridge National Laboratory (ORNL) Decontamination and Decommissioning (D D) Program is part of the Department of Energy (DOE) Environmental Restoration D D Program and has continued to provide surveillance and maintenance (S M) support for 34 surplus facilities. The objectives are (1) to ensure adequate containment of residual radioactive materials remaining in the facilities, (2) to provide safety and security controls to minimize the potential hazards to on-site personnel and to the general public, and (3) to manage the facilities in the most cost-effective manner while awaiting decommissioning. This support has included work in three principal areas: (1) S M planning, (2) routine S M, and (3) special projects designed to correct serious facility deficiencies beyond the scope of routine maintenance.

  18. International Surveillance of Bloodstream Infections Due to Candida Species: Frequency of Occurrence and In Vitro Susceptibilities to Fluconazole, Ravuconazole, and Voriconazole of Isolates Collected from 1997 through 1999 in the SENTRY Antimicrobial Surveillance Program

    PubMed Central

    Pfaller, M. A.; Diekema, D. J.; Jones, R. N.; Sader, H. S.; Fluit, A. C.; Hollis, R. J.; Messer, S. A.

    2001-01-01

    A surveillance program (SENTRY) of bloodstream infections (BSI) in the United States, Canada, Latin America, and Europe from 1997 through 1999 detected 1,184 episodes of candidemia in 71 medical centers (32 in the United States, 23 in Europe, 9 in Latin America, and 7 in Canada). Overall, 55% of the yeast BSIs were due to Candida albicans, followed by Candida glabrata and Candida parapsilosis (15%), Candida tropicalis (9%), and miscellaneous Candida spp. (6%). In the United States, 45% of candidemias were due to non-C. albicans species. C. glabrata (21%) was the most common non-C. albicans species in the United States, and the proportion of non-C. albicans BSIs was highest in Latin America (55%). C. albicans accounted for 60% of BSI in Canada and 58% in Europe. C. parapsilosis was the most common non-C. albicans species in Latin America (25%), Canada (16%), and Europe (17%). Isolates of C. albicans, C. parapsilosis, and C. tropicalis were all highly susceptible to fluconazole (97 to 100% at ≤8 μg/ml). Likewise, 97 to 100% of these species were inhibited by ≤1 μg/ml of ravuconazole (concentration at which 50% were inhibited [MIC50], 0.007 to 0.03 μg/ml) or voriconazole (MIC50, 0.007 to 0.06 μg/ml). Both ravuconazole and voriconazole were significantly more active than fluconazole against C. glabrata (MIC90s of 0.5 to 1.0 μg/ml versus 16 to 32 μg/ml, respectively). A trend of increased susceptibility of C. glabrata to fluconazole was noted over the three-year period. The percentage of C. glabrata isolates susceptible to fluconazole increased from 48% in 1997 to 84% in 1999, and MIC50s decreased from 16 to 4 μg/ml. A similar trend was documented in both the Americas (57 to 84% susceptible) and Europe (22 to 80% susceptible). Some geographic differences in susceptibility to triazole were observed with Canadian isolates generally more susceptible than isolates from the United States and Europe. These observations suggest susceptibility patterns and trends

  19. [Evaluation of vancomycin, teicoplanin, linezolide and tigecycline susceptibilities of nosocomial methicillin-resistant Staphylococcus strains by E-test].

    PubMed

    Pelitli, Tamer Sami; Cesur, Salih; Kınıklı, Sami; Irmak, Hasan; Demiröz, Ali Pekcan; Karakoç, Esra

    2011-10-01

    The aim of this study was to determine the minimal inhibitory concentration (MIC) values of vancomycin, teicoplanin, tigecycline and linezolid in 100 methicillin-resistant staphylococci [21 methicillin-resistant Staphylococcus aureus (MRSA) and 79 methicillin-resistant coagulase negative staphylococcus (MR-CNS)] isolated as agents of nosocomial infection from patients at Ankara Training and Research Hospital between June 2005-March 2007. The MIC values for vancomycin, teicoplanin, linezolid and tigecycline were tested by E-test method (AB Biodisk, Sweden). For 21 MRSA strains MIC50 and MIC90 values were as follows: vancomycin 0.125 µg/ml and 1 µg/ml; teicoplanin 0.5 µg/ml and 3 µg/ml, linezolid 0.047 µg/ml and 0.19 µg/ml; tigecycline 0.094 µg/ml and 0.5 µg/ml, respectively. For 79 MR-CNS strains MIC50 and MIC90 values were as follows: vancomycin 0.5 µg/ml and 2 µg/ml; teicoplanin 2 µg/ml and 4 µg/ml; linezolid 0.125 µg/ml and 0.25 µg/ml; tigecycline 0.38 µg/ml and 0.5 µg/ml, respectively. No resistance to vancomycin, teicoplanin, tigecycline and linezolid were determined in methicillin-resistant staphylococcus strains isolated from the inpatients in our hospital. Among glycopeptides, MIC50 and MIC90 values of vancomycin were found to be lower than that of teicoplanin.

  20. Clinical and Microbiological Aspects of Linezolid Resistance Mediated by the cfr Gene Encoding a 23S rRNA Methyltransferase▿

    PubMed Central

    Arias, Cesar A.; Vallejo, Martha; Reyes, Jinnethe; Panesso, Diana; Moreno, Jaime; Castañeda, Elizabeth; Villegas, Maria V.; Murray, Barbara E.; Quinn, John P.

    2008-01-01

    The cfr (chloramphenicol-florfenicol resistance) gene encodes a 23S rRNA methyltransferase that confers resistance to linezolid. Detection of linezolid resistance was evaluated in the first cfr-carrying human hospital isolate of linezolid and methicillin-resistant Staphylococcus aureus (designated MRSA CM-05) by dilution and diffusion methods (including Etest). The presence of cfr was investigated in isolates of staphylococci colonizing the patient's household contacts and clinical isolates recovered from patients in the same unit where MRSA CM-05 was isolated. Additionally, 68 chloramphenicol-resistant Colombian MRSA isolates recovered from hospitals between 2001 and 2004 were screened for the presence of the cfr gene. In addition to erm(B), the erm(A) gene was also detected in CM-05. The isolate belonged to sequence type 5 and carried staphylococcal chromosomal cassette mec type I. We were unable to detect the cfr gene in any of the human staphylococci screened (either clinical or colonizing isolates). Agar and broth dilution methods detected linezolid resistance in CM-05. However, the Etest and disk diffusion methods failed to detect resistance after 24 h of incubation. Oxazolidinone resistance mediated by the cfr gene is rare, and acquisition by a human isolate appears to be a recent event in Colombia. The detection of cfr-mediated linezolid resistance might be compromised by the use of the disk diffusion or Etest method. PMID:18174304

  1. Heart sounds at home: feasibility of an ambulatory fetal heart rhythm surveillance program for anti-SSA-positive pregnancies.

    PubMed

    Cuneo, B F; Moon-Grady, A J; Sonesson, S-E; Levasseur, S; Hornberger, L; Donofrio, M T; Krishnan, A; Szwast, A; Howley, L; Benson, D W; Jaeggi, E

    2017-03-01

    Fetuses exposed to anti-SSA (Sjögren's) antibodies are at risk of developing irreversible complete atrioventricular block (CAVB), resulting in death or permanent cardiac pacing. Anti-inflammatory treatment during the transition period from normal heart rhythm (fetal heart rhythm (FHR)) to CAVB (emergent CAVB) can restore sinus rhythm, but detection of emergent CAVB is challenging, because it can develop in ⩽24 h. We tested the feasibility of a new technique that relies on home FHR monitoring by the mother, to surveil for emergent CAVB. We recruited anti-SSA-positive mothers at 16 to 18 weeks gestation (baseline) from 8 centers and instructed them to monitor FHR two times a day until 26 weeks, using a Doppler device at home. FHR was also surveilled by weekly or every other week fetal echo. If FHR was irregular, the mother underwent additional fetal echo. We compared maternal stress/anxiety before and after monitoring. Postnatally, infants underwent a 12-lead electrocardiogram. Among 133 recruited, 125 (94%) enrolled. Among those enrolled, 96% completed the study. Reasons for withdrawal (n=5) were as follows: termination of pregnancy, monitoring too time consuming or moved away. During home monitoring, 9 (7.5%) mothers detected irregular FHR diagnosed by fetal echo as normal (false positive, n=2) or benign atrial arrhythmia (n=7). No CAVB was undetected or developed after monitoring. Questionnaire analysis indicated mothers felt comforted by the experience and would monitor again in future pregnancies. These data suggest ambulatory FHR surveillance of anti-SSA-positive pregnancies is feasible, has a low false positive rate and is empowering to mothers.

  2. Vancomycin-resistant enterococci in Canada: results from the Canadian nosocomial infection surveillance program, 1999-2005.

    PubMed

    Ofner-Agostini, Marianna; Johnston, B Lynn; Simor, Andrew E; Embil, John; Matlow, Anne; Mulvey, Michael; Ormiston, Debbie; Conly, John

    2008-03-01

    Surveillance for vancomycin-resistant enterococci (VRE) in sentinel Canadian hospitals has been conducted since 1999. From 1999 to 2005, the rate of VRE detection increased from 0.37 to 1.32 cases per 1,000 patients admitted, and the rate of VRE infection increased from 0.02 to 0.05 cases per 1,000 patients admitted. Thirty-three percent of all patients with VRE detected that were reported during 1999-2005 were identified in 2005, with increases seen in all regions of Canada. Although the incidence rate of VRE carriage in Canada is increasing, it remains very low.

  3. Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: a Canadian Nosocomial Infection Surveillance Program Study.

    PubMed

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

    2009-03-01

    Clostridium difficile infection (CDI) is the most frequent cause of health care-associated infectious diarrhea in industrialized countries. The only previous report describing the incidence of health care-associated CDI (HA CDI) in Canada was conducted in 1997 by the Canadian Nosocomial Infection Surveillance Program. We re-examined the incidence of HA CDI with an emphasis on patient outcomes. A prospective surveillance was conducted from 1 November 2004 through 30 April 2005. Basic demographic data were collected, including age, sex, type of patient ward where the patient was hospitalized on the day HA CDI was identified, and patient comorbidities. Data regarding severe outcome were collected 30 days after the diagnosis of HA CDI; severe outcome was defined as an admission to the intensive care unit because of complications of CDI, colectomy due to CDI, and/or death attributable to CDI. A total of 1430 adults with HA CDI were identified in 29 hospitals during the 6-month surveillance period. The overall incidence rate of HA CDI for adult patients admitted to these hospitals was 4.6 cases per 1000 patient admissions and 65 per 100,000 patient-days. At 30 days after onset of HA CDI, 233 patients (16.3%) had died from all causes; 31 deaths (2.2%) were a direct result of CDI, and 51 deaths (3.6%) were indirectly related to CDI, for a total attributable mortality rate of 5.7%. The rates are remarkably similar to those found in our previous study; although we found wide variations in HA CDI among the participating hospitals. However, the attributable mortality increased almost 4-fold (5.7% vs. 1.5%; P<.001).

  4. The National Athletic Treatment, Injury and Outcomes Network (NATION): Methods of the Surveillance Program, 2011–2012 Through 2013–2014

    PubMed Central

    Dompier, Thomas P.; Marshall, Stephen W.; Kerr, Zachary Y.; Hayden, Ross

    2015-01-01

    Context Previous epidemiologic researchers have examined time-loss (TL) injuries in high school student-athletes, but little is known about the frequency of non–time-loss (NTL) injuries in these athletes. Objective To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) Surveillance Program and provide descriptive epidemiology of TL and NTL injuries across athletes in 27 high school sports. Design Descriptive epidemiology study. Setting Aggregate injury and exposure data collected from 147 high schools in 26 states. Patients or Other Participants High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011–2012 through 2013–2014 academic years. Main Outcome Measure(s) Athletic trainers documented injuries and exposures using commercially available injury-tracking software packages. Standard injury-tracking software was modified by the software vendors to conform to the surveillance needs of this project. The modified software exported a set of common data elements, stripped of personally identifiable information, to a centralized automated verification and validation system before they were included in the centralized research database. Dependent measures were injury and exposure frequencies and injury rates with 95% confidence intervals stratified by sport, sex, and injury type (TL or NTL). Results Over the 3-year period, a total of 2337 team seasons across 27 sports resulted in 47 014 injuries and 5 146 355 athlete-exposures. The NTL injuries accounted for 38 765 (82.45%) and TL injuries for 8249 (17.55%) of the total. Conclusions The NTL injuries accounted for a substantial amount of the total number of injuries sustained by high school student-athletes. This project demonstrates the feasibility of creating large-scale injury surveillance systems using commercially available injury-tracking software. PMID:26067620

  5. Can We Use Antibodies to Chlamydia trachomatis as a Surveillance Tool for National Trachoma Control Programs? Results from a District Survey

    PubMed Central

    West, Sheila K.; Munoz, Beatriz; Weaver, Jerusha; Mrango, Zakayo; Dize, Laura; Gaydos, Charlotte; Quinn, Thomas C.; Martin, Diana L.

    2016-01-01

    Background Trachoma is targeted for elimination by 2020. World Health Organization advises districts to undertake surveillance when follicular trachoma (TF) <5% in children 1–9 years and mass antibiotic administration has ceased. There is a question if other tools could be used for surveillance as well. We report data from a test for antibodies to C. trachomatis antigen pgp3 as a possible tool. Methodology We randomly sampled 30 hamlets in Kilosa district, Tanzania, and randomly selected 50 children ages 1–9 per hamlet. The tarsal conjunctivae were graded for trachoma (TF), tested for C. trachomatis infection (Aptima Combo2 assay: Hologic, San Diego, CA), and a dried blood spot processed for antibodies to C. trachomatis pgp3 using a multiplex bead assay on a Luminex 100 platform. Principal findings The prevalence of trachoma (TF) was 0.4%, well below the <5% indicator for re-starting a program. Infection was also low, 1.1%. Of the 30 hamlets, 22 had neither infection nor TF. Antibody positivity overall was low, 7.5% and increased with age from 5.2% in 1–3 year olds, to 9.3% in 7–9 year olds (p = 0.015). In 16 of the 30 hamlets, no children ages 1–3 years had antibodies to pgp3. Conclusions The antibody status of the 1–3 year olds indicates low cumulative exposure to infection during the surveillance period. Four years post MDA, there is no evidence for re-emergence of follicular trachoma. PMID:26771906

  6. Surveillance of Autism.

    ERIC Educational Resources Information Center

    Boyle, Coleen A.; Bertrand, Jacquelyn; Yeargin-Allsopp, Marshalyn

    1999-01-01

    This article describes the autism surveillance activities of the Center for Disease Control and Prevention. It considers why surveillance to track prevalence of autistic disorders is needed, how such surveillance is conducted, and the special challenges of autism surveillance. (DB)

  7. Postmarketing surveillance.

    PubMed

    Vlahović-Palčevski, Vera; Mentzer, Dirk

    2011-01-01

    Postmarketing drug surveillance refers to the monitoring of drugs once they reach the market after clinical trials. It evaluates drugs taken by individuals under a wide range of circumstances over an extended period of time. Such surveillance is much more likely to detect previously unrecognized positive or negative effects that may be associated with a drug. The majority of postmarketing surveillance concern adverse drug reactions (ADRs) monitoring and evaluation. Other important postmarketing surveillance components include unapproved or off-label drug use, problems with orphan drugs, and lack of paediatric formulations, as well as issues concerning international clinical trials in paediatric population. The process of evaluating and improving the safety of medicines used in paediatric practice is referred to as paediatric pharmacovigilance. It requires special attention. Childhood diseases and disorders may be qualitatively and quantitatively different from their adult equivalents. This may affect either benefit or risk of therapies (or both), with a resulting impact on the risk/benefit balance. In addition, chronic conditions may require chronic treatment and susceptibility to ADRs may change throughout the patient's lifetime according to age and stage of growth and development. Therefore, paediatric pharmacovigillance aspects need to be tailored to a number of variables based on heterogeneity of paediatric population. This chapter will summarize and discuss the key issues.

  8. Antistaphylococcal activity of DX-619 alone and in combination with vancomycin, teicoplanin, and linezolid assessed by time-kill synergy testing.

    PubMed

    Credito, Kim; Lin, Genrong; Appelbaum, Peter C

    2007-04-01

    Time-kill synergy studies testing in vitro activity of DX-619 alone and with added vancomycin, teicoplanin, or linezolid against 101 Staphylococcus aureus strains showed synergy between DX-619 and teicoplanin at 12 to 24 h in 72 strains and between DX-619 and vancomycin in 28 strains. No synergy was found with linezolid, and no antagonism was observed with any combination.

  9. Ocean surveillance satellites

    NASA Astrophysics Data System (ADS)

    Laurent, D.

    Soviet and U.S. programs involving satellites for surveillance of ships and submarines are discussed, considering differences in approaches. The Soviet program began with the Cosmos 198 in 1967 and the latest, the Cosmos 1400 series, 15 m long and weighing 5 tons, carry radar for monitoring ships and a nuclear reactor for a power supply. Other Soviet spacecraft carrying passive microwave sensors and ion drives powered by solar panels have recently been detonated in orbit for unknown reasons. It has also been observed that the Soviet satellites are controlled in pairs, with sequential orbital changes for one following the other, and both satellites then overflying the same points. In contrast, U.S. surveillance satellites have been placed in higher orbits, thus placing greater demands on the capabilities of the on-board radar and camera systems. Project White Cloud and the Clipper Bow program are described, noting the continued operation of the White Cloud spacecraft, which are equipped to intercept radio signals from surface ships. Currently, the integrated tactical surveillance system program has completed its study and a decision is expected soon.

  10. Break-even analysis of costs for controlling Toxoplasma gondii infections in slaughter pigs via a serological surveillance program in the Netherlands.

    PubMed

    van Asseldonk, M; van Wagenberg, C P A; Wisselink, H J

    2017-03-01

    Toxoplasma gondii (T. gondii) is a food safety hazard which causes a substantial human disease burden and cost-of-illness. Infected pig meat is a common source of toxoplasmosis. A break-even analysis was conducted to estimate the point for which the intervention cost at fattening pig farms equaled the cost of averted human disease burden and cost-of-illness minus the costs of a T. gondii surveillance program. The surveillance program comprised serological testing of blood samples taken at slaughter. Break-even points were determined given alternative levels of the effectiveness of the intervention program (10% up to 90% in steps of 10%), the value of an averted DALY (20,000, 50,000 and 80,000 Euro), and threshold of sample prevalence for a farm to be under intervention (5% up to 50% out of 20 samples in steps of 5%). Since test characteristics are a determining factor in the break-even analysis, and literature is inconclusive concerning sensitivity (se) and specificity (sp) of the serological test kit used, two alternative sets of assumptions were analysed. The estimated maximum costs of an intervention if only benefits for domestic consumers were accounted amounted approximately 2981 Euro (se=98.9% and sp=92.7%) versus 4389 Euro (se=65.2% and sp=97.4%) per year per fattening pig farm under intervention assuming an effectiveness of 50%, 50,000 Euro per averted DALY and threshold T. gondii sample prevalence of 5% for a farm to be under intervention. Since almost 80% of the gross domestic production is exported corresponding break-even values increased up to 12,034 Euro and 18,366 Euro if benefits for consumers abroad were included as well. Empirical research to strengthen the knowledge about the efficacy of a farm intervention measures is recommended.

  11. [Surgical site infection (SSI) surveillance].

    PubMed

    Harihara, Yasushi; Konishi, Toshiro

    2006-09-01

    Surgical site infections (SSI) are major complications after surgery. SSI leads to the longer hospital stay, higher costs and patients' dissatisfaction to the surgical treatment. SSI surveillance is not only an activity to investigate the incidence and causes of SSI but also an infection control activity to reduce SSI rates. The Japanese Society of Environmental Infections established the Japanese nosocomial infection surveillance UNIS) system and initiated SSI surveillance in Japan in 1999. The Japanese Ministry of Health and Welfare started a nation-wide SSI surveillance program in July 2002, and the SSI surveillance study group was founded in October 2002 to support the Ministry's SSI surveillance and to make activities aiming at a further spread and quality enhancement of SSI surveillance in Japan. Up to December 2004, 31, 436 cases from 50 institutions have been registered. SSI occurred in 2,346 cases (7.7%). With regard to surgical procedures, SSI rates are far much higher in gastrointestinal surgery than in other procedures. It is important for all Japanese surgeons to continue highly precise SSI surveillance and make efforts to reduce SSI rates, to provide safe medical practice of high-quality and adequate costs.

  12. Emergency department surveillance of injuries associated with bunk beds: the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990-2009.

    PubMed

    McFaull, S R; Fréchette, M; Skinner, R

    2012-12-01

    Due to space constraints, bunk beds are a common sleeping arrangement in many homes. The height and design of the structure can present a fall and strangulation hazard, especially for young children. The primary purpose of this study was to describe bunk bed-related injuries reported to the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990-2009. CHIRPP is an injury and poisoning surveillance system operating in 11 pediatric and 4 general emergency departments across Canada. Records were extracted using CHIRPP product codes and narratives. Over the 20-year surveillance period, 6002 individuals presented to Canadian emergency departments for an injury associated with a bunk bed. Overall, the frequency of bunk bed-related injuries in CHIRPP has remained relatively stable with an average annual percent change of 21.2% (21.8% to 20.5%). Over 90% of upper bunk-related injuries were due to falls and children 3-5 years of age were most frequently injured (471.2/100 000 CHIRPP cases). Children with bunk bed-related injuries continue to present to Canadian emergency departments, many with significant injuries. Injury prevention efforts should focus on children under 6 years of age.

  13. ProPSA and Diagnostic Biopsy Tissue DNA Content Combination Improves Accuracy to Predict Need for Prostate Cancer Treatment Among Men Enrolled in an Active Surveillance Program

    PubMed Central

    Isharwal, Sumit; Makarov, Danil V.; Sokoll, Lori J.; Landis, Patricia; Marlow, Cameron; Epstein, Jonathan I.; Partin, Alan W.; Carter, H. Ballentine; Veltri, Robert W.

    2015-01-01

    Surveillance program. PMID:21216447

  14. Emergence of extensively drug-resistant Acinetobacter baumannii complex over 10 years: nationwide data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program.

    PubMed

    Kuo, Shu-Chen; Chang, Shan-Chwen; Wang, Hui-Ying; Lai, Jui-Fen; Chen, Pei-Chen; Shiau, Yih-Ru; Huang, I-Wen; Lauderdale, Tsai-Ling Yang

    2012-08-28

    Acinetobacter baumannii complex (ABC) has emerged as an important pathogen causing a variety of infections. Longitudinal multicenter surveillance data on ABC from different sources in Taiwan have not been published. Using data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) conducted biennially, we investigated the secular change in resistance of 1640 ABC from 2002 to 2010 (TSAR period III to VII) to different antimicrobial agents and identified factors associated with imipenem-resistant and extensively drug-resistant ABC (IRABC and XDRABC). Isolates were collected by TSAR from the same 26 hospitals located in all 4 regions of Taiwan. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. Isolates nonsusceptible to all tested aminoglycosides, fluoroquinolones, β-lactam, β-lactam/β-lactam inhibitors, and carbapenems were defined as extensively drug-resistant (XDR). Multivariate logistic regression analysis was performed to assess the relationship between predictor variables among patients with resistant ABC and patients with non-resistant ABC. The prevalence of IRABC increased from 3.4% in 2002 to 58.7% in 2010 (P < 0.001; odds ratio [OR], 2.138; 95% confidence interval [CI], 1.947 to 2.347) and that of XDRABC increased from 1.3% in 2002 to 41.0% in 2010 (P < 0.001; OR, 1.970; 95% CI, 1.773-2.189). The rates of non-susceptibility to other antimicrobial agents remained high (>55%) over the years with some fluctuations before and after TSAR V (2006) on some agents. Multivariate analysis revealed that recovery from elderly patients, origins other than blood, from ICU settings, or geographic regions are independent factors associated with IRABC and XDRABC. Although the prevalence of XDRABC increased in all four regions of Taiwan over the years, central Taiwan had higher prevalence of XDRABC starting in 2008. Susceptibility to polymyxin remained high (99.8%). This longitudinal multicenter surveillance program

  15. Pharmacokinetics of unbound linezolid in plasma and tissue interstitium of critically ill patients after multiple dosing using microdialysis.

    PubMed

    Buerger, Cornelia; Plock, Nele; Dehghanyar, Pejman; Joukhadar, Christian; Kloft, Charlotte

    2006-07-01

    The antimicrobial agent linezolid is approved for the treatment of severe infections caused by, e.g., methicillin-resistant Staphylococcus strains. In order to evaluate the penetration of linezolid into the interstitial space fluid (ISF) of subcutaneous adipose tissue and skeletal muscle of the target population, a microdialysis study was performed with 12 patients with sepsis or septic shock after multiple intravenous infusions. Unbound linezolid concentrations were determined for plasma and microdialysates by use of a validated high-performance liquid chromatography method. Individual compartmental pharmacokinetic (PK) analysis was performed using WinNonlin. In vivo microdialysis was found to be feasible for the determination of unbound linezolid concentrations at steady state in the ISF of critically ill patients. On average, linezolid showed good distribution into ISF but with high interindividual variability. A two-compartment model was fitted to unbound concentrations in plasma with a geometric mean distribution volume of 62.9 liters and a mean clearance of 9.18 liters/h at steady state. However, disposition characteristics changed intraindividually within the time course. In addition, an integrated model for simultaneous prediction of concentrations in all matrices was developed and revealed similar results. Based on the model-predicted unbound concentrations in ISF, a scheme of more-frequent daily dosing of linezolid for some critically ill patients might be taken into consideration to avoid subinhibitory unbound concentrations in the infected tissue. The developed integrated model will be a valuable basis for further PK data analysis to explore refined dosing guidelines that achieve effective antimicrobial therapy in all patients by use of the population PK approach.

  16. Bacteriophage Mediated Killing of Staphylococcus aureus In Vitro on Orthopaedic K Wires in Presence of Linezolid Prevents Implant Colonization

    PubMed Central

    Kaur, Sandeep; Harjai, Kusum; Chhibber, Sanjay

    2014-01-01

    Background Infections of bone and joint tissues following arthroplasty surgeries remain a major challenge in orthopaedic settings. Methicillin resistant Staphylococcus aureus (MRSA) is recognised as an established pathogen in such infections. Combination therapy using linezolid and bacteriophage impregnated in biopolymer was investigated in the present study as an alternative strategy to prevent MRSA colonisation on the orthopaedic implant surface. Methodology Coating of stainless steel orthopaedic grade K-wires was achieved using hydroxypropylmethlycellulose (HPMC) mixed with phage alone, linezolid alone and phage and linezolid together. The potential of these agents to inhibit adhesion of S.aureus (MRSA) 43300 on K-wires was assessed. Coated and naked wires were analysed by scanning electron microscopy (SEM) and fluorescent staining. Result Significant reduction in bacterial adhesion was achieved on phage/linezolid wires in comparison to naked as well as HPMC coated wires. However, maximum reduction in bacterial adherence (∼4 log cycles) was observed on the wires coated with phage-linezolid combination. The frequency of emergence of resistant mutants was also negligible in presence of both the agents. Conclusion This study provides evidence to confirm that local delivery system employing linezolid (a potent protein synthesis inhibitor) along with a broad spectrum lytic bacteriophage (capable of self-multiplication) is able to attack the adhered as well as surrounding bacteria present near the implant site. Unlike other antibiotic based therapies, this combination has the potential to significantly restrict the emergence of resistant mutants, thus paving the way for effective treatment of MRSA associated infection of medical implants. PMID:24594764

  17. Target site pharmacokinetics of linezolid after single and multiple doses in diabetic patients with soft tissue infection.

    PubMed

    Eslam, Roza Badr; Burian, Angela; Vila, Greisa; Sauermann, Robert; Hammer, Alexandra; Frenzel, Dorothea; Minichmayr, Iris K; Kloft, Charlotte; Matzneller, Peter; Oesterreicher, Zoe; Zeitlinger, Markus

    2014-09-01

    The underlying pathology of diabetic wounds, i.e. impairment of macro- and microcirculation, might also impact target site penetration of antibacterial drugs. To compare tissue concentrations of linezolid in infected and not infected tissue 10 patients suffering from type 2 diabetes with foot infection were included in the study. Tissue penetration of linezolid was assessed using in vivo microdialysis at the site of infection as well as in non-inflamed subcutaneous adipose tissue. All patients were investigated after receiving a single dose of linezolid and five patients in addition at steady state. After a single dose of linezolid significantly higher area under the concentration vs. time curve over 8 hours (AUC0-8 ) and maximum concentrations (Cmax )-values were observed in plasma (65.5 ± 21.2 mg*h/L and 16.4 ± 4.6 mg/L) as compared to inflamed (36.3 ± 22.9  mg*h/L and 6.6 ± 3.6 mg/L) and non-inflamed tissue (33.0 ± 17.7 mg*h/L and 6.7 ± 3.6 mg/L). Multiple administrations of linezolid led to disappearance of significant differences in Cmax and AUC0-8 between plasma, inflamed, and non-inflamed tissue. Approximately 2-fold increase of Cmax and AUC0-8 -values in tissue was observed at steady state as compared to the first administration. Penetration of linezolid is not impaired in diabetic foot infection but equilibrium between plasma and tissue might be delayed.

  18. Economic evaluation of linezolid versus teicoplanin for the treatment of infections caused by gram-positive microorganisms in Spain.

    PubMed

    Grau, S; Aguado, J M; Mateu-de Antonio, J; Gonzalez, P; Del Castillo, A

    2007-08-01

    The aim of this study was to perform a comparative cost-effectiveness analysis of linezolid vs teicoplanin (i.v., switching to oral/i.m. respectively) in Spain. A decision tree model was used with the results of a randomized, comparative, controlled clinical trial with linezolid vs teicoplanin in the treatment of infections caused by Gram-positive microorganisms, with a timeline of 31 days. The efficacy endpoint was the percentage of patients with clinical healing or improvement in their infection. Direct medical costs were included using Spanish 2005 prices. Average cost per patient, average cost-effectiveness ratio and several sensitivity analyses were carried out. In the intent-to-treat (ITT) analysis linezolid obtained a higher percentage of therapeutic success than teicoplanin (95.5% vs 87.6% respectively, p = 0.005), both with similar tolerability. The average cost per treated patient was euro 8,064.76 for linezolid vs euro 8,727.36 for teicoplanin, with an incremental cost of euro 622.59 (-7,6%). Linezolid yielded a lower average cost-effectiveness ratio, euro 8,444.78 (8,195.90 - 8,709.25) than teicoplanin, euro 9,962.74 (9,465.68 - 10,502.23), with a slight reduction in average cost per successfully treated patient of 15.2% ( euro 1,517.96). The results were robust to the sensitivity analysis. In conclusion, linezolid is a more cost-effective option than teicoplanin in the treatment of infections caused by Gram-positive microorganisms, since it offers superior clinical benefits with a lower use of associated resources.

  19. Nosocomial spondylodiskitis with epidural abscess and CSF fistula cured with quinupristin/dalfopristin and linezolid.

    PubMed

    Marroni, M; Tinca, M; Belfiori, B; Altobelli, G; Malincarne, L; Papili, R; Stagni, G

    2006-06-01

    Nosocomial infections after spinal surgery are relatively uncommon but potentially serious. The goal of diagnostic evaluation is to determine the extent of infection and identify the microorganism involved. Neuroimaging provides accurate information on correct topography, localization and propagation of the infection. Microbiological data are able to give aetiological causes. In this patient with severe, chronic polymicrobial spine infection with epidural abscess and CSF fistula due to multidrug-resistant organisms, the cure was achieved with long-term antimicrobial specific therapy with quinupristin-dalfopristin (50 days) and linezolid (100 days) with mild side effects. This positive result was due to combined medical and surgical treatment.

  20. Linezolid-Induced Near-Fatal Serotonin Syndrome During Escitalopram Therapy: Case Report and Review of Literature

    PubMed Central

    Kulkarni, Ranganath R.; Kulkarni, Pratibha R.

    2013-01-01

    Linezolid is a synthetic antimicrobial agent of the oxazolidinone class with weak, nonspecific inhibitor of monoamine oxidase enzymes. Concomitant therapy with an adrenergic or serotonergic agent or consuming tyramine (>100 mg/day) may induce serotonin syndrome (SS). We present a case report of near-fatal adverse interaction between linezolid and escitalopram inducing SS in a 65-year-old woman with sepsis, under empirical antibiotic treatment. This report also summarizes the current relevant literature as identified via PubMed, EMBASE, and PsycINFO, supplemented with a manual search of cross references. PMID:24379509

  1. Surveillance of Anal Canal Cancers.

    PubMed

    Adams, Richard

    2017-01-01

    Anal squamous cell cancer is most frequently a locoregional disease that is amenable to curative therapy in a majority of fit patients. Complete response rates after chemoradiotherapy (CRT) are good, with up to 75% of patients with no evidence of relapse on surveillance. Relapse is most frequently locoregional and is often amendable to salvage surgery with curative intent. Effective surveillance attempts to improve outcomes by identifying recurrent or persistent disease early, managing both acute and late toxicities, and offering reassurance to patients. This article explores the rationale and evidence for surveillance programs after definitive CRT. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Lessons learned in using hospital discharge data for state and national public health surveillance: implications for Centers for Disease Control and prevention tracking program.

    PubMed

    Love, Denise; Rudolph, Barbara; Shah, Gulzar H

    2008-01-01

    The goal of the Centers for Disease Control and Prevention Environmental Public Health Tracking (EPHT) Program is to build a nationwide network of integrated health and environmental data to measure impact of environmental factors on public health. This article describes how hospital discharge data can provide essential information for public health programs, including EPHT. The state inpatient hospital discharge data systems have properties that are highly desirable for surveillance and multistate initiatives, like EPHT, yet accessing and using the data can create challenges for the end user. This article highlights the strengths and limitations of hospital discharge data and references crash outcome data and evaluation system and Healthcare Cost and Utilization Project as models for accessing, linking, and aggregating hospital discharge data. These federal-state data partnerships have overcome many of these challenges and have the potential to serve as models for the EPHT Program. The lessons learned from these "early adopters" can shortcut the implementation period for the Centers for Disease Control and Prevention EPHT Program.

  3. A simple method to identify triatomine (Hemiptera: Reduviidae) feces in sensing devices used in vector surveillance programs.

    PubMed

    Gürtler, R E; Oneto, M L; Cecere, M C; Castañera, M B; Canale, D M

    2001-03-01

    We successfully applied the phenolphthalin (Kastle-Meyer) test used in forensic chemistry to distinguish between feces from triatomines and other domestic arthropods in sensing devices used for vector surveillance. All black or dark brown, but not white or yellow, fecal smears from laboratory-reared or field-collected Triatoma infestans Klug, Triatoma guasayana Wydgozinsky & Abalos, Triatoma sordida Ståhl (recently revalidated as Triatoma garciabesi Carcavallo, Cichero, Martínez, Prosen & Ronderos) tested positive, whereas dejecta from cockroaches and spiders, crickets, beetles, predatory bugs, and domestic flies tested negative. Black or dark brown dejecta from female Aedes aegypti L. and Cimex lectularius L. bedbugs also tested positive. In sellsing devices installed in bedrooms of 11 houses in Amamá, rural northwestern Argentina, where neither cimicid bedbugs nor argasid ticks had been found over the years, only 62% of the black or dark brown fecal smears attributed to triatomines by a skilled observer tested phenolphthalin-positive. After insecticidal spraying, when bedroom areas were not colonized by triatomines, only 33-40% of the black or dark brown fecal smears in sensor boxes attributed to triatomines by another skilled observer tested phenolphthalin-positive. Eleven (79%) ofthe 14 houses with dubious or nontypical triatomine feces tested phenolphthalin-positive at least once during 1993-1995. Our study introduces a low-cost, simple and effective procedure for the identification of triatomine feces. The test, as a helpful adjunct to sensing devices used in triatomine surveillance, will aid in the accurate detection of infestations and the determination of the need for insecticide application.

  4. Molecular analysis of population structure and antibiotic resistance of Klebsiella isolates from a three-year surveillance program in Florence hospitals, Italy.

    PubMed

    Donnarumma, F; Indorato, C; Mastromei, G; Goti, E; Nicoletti, P; Pecile, P; Fanci, R; Bosi, A; Casalone, E

    2012-03-01

    We report the results of a three-year surveillance program of Klebsiella spp. in six hospitals in Florence (Italy). A total of 172 Klebsiella isolates were identified and typed by AFLP: 122 were K. pneumoniae and 50 were K. oxytoca. Most K. pneumoniae (80%) and K. oxytoca (93%) showed unrelated AFLP profiles. Beside this heterogeneous population structure, we found five small epidemic clonal groups of K. pneumoniae. Four of these groups were involved in outbreak events, three of which occurred in neonatal ICUs. The fifth clonal group spread in three different wards of two hospitals. Only one non-epidemic clonal group of K. oxytoca was detected. The frequencies of isolates with multiple antibiotic resistances increased with time; at the end of the study period, most K. pneumoniae were resistant to all the antibiotics tested. A PCR analysis of seven ertapenem resistant isolates was unable to detect any of the major genes known to underlie carbapenem resistance in K. pneumoniae.

  5. Contemporary prevalence of BRO beta-lactamases in Moraxella catarrhalis: report from the SENTRY antimicrobial surveillance program (North America, 1997 to 2004).

    PubMed

    Deshpande, Lalitagauri M; Sader, Helio S; Fritsche, Thomas R; Jones, Ronald N

    2006-10-01

    A total of 7,860 community-acquired Moraxella catarrhalis isolates (SENTRY Antimicrobial Surveillance Program, 1997 to 2004) were tested by broth microdilution methods, and 399 randomly selected strains from North American sites were tested for BRO-1 and BRO-2 by PCR methods. Several antimicrobials remained very active, including amoxicillin-clavulanate (MIC90s, < or =0.25 microg/ml), azithromycin (MIC90s, < or =0.12 microg/ml), ceftriaxone (MIC90s, 0.5 microg/ml), and levofloxacin (MIC90s, < or =0.03 to 0.06 microg/ml). The BRO-2 incidence rates by year were 3 to 4% overall (96 to 97% for BRO-1) and were the highest in Canada (7.9%), with the incidence in the United States being only 2.0%.

  6. Antimicrobial Susceptibility and Epidemiology of a Worldwide Collection of Chryseobacterium spp.: Report from the SENTRY Antimicrobial Surveillance Program (1997-2001)

    PubMed Central

    Kirby, Jeffrey T.; Sader, Helio S.; Walsh, Timothy R.; Jones, Ronald N.

    2004-01-01

    Limited data are available on Chryseobacterium spp. leading to an evaluation of the patient demographics and susceptibility patterns for Chryseobacterium spp. collected in the first 5 years of the SENTRY Antimicrobial Surveillance Program (1997 to 2001). Fifty isolates (24 Chryseobacterium meningosepticum, 20 Chryseobacterium indologenes, two Chryseobacterium gleum, and 4 Chryseobacterium spp. isolates) were collected. The highest Chryseobacterium prevalence was detected among the elderly. The most active antimicrobials were the newer quinolones (garenoxacin, gatifloxacin, and levofloxacin, each with a MIC at which 90 percent of the isolates are inhibited [MIC90] of 1 μg/ml and 98.0% susceptibility) followed by rifampin (MIC90, 2 μg/ml and 85.7% susceptibility). Trimethoprim-sulfamethoxazole, ciprofloxacin, and piperacillin-tazobactam also showed reasonable activity; vancomycin showed poor potency. PMID:14715802

  7. Hospital discharge data: can it serve as the sole source of case ascertainment for population-based birth defects surveillance programs?

    PubMed

    Wang, Ying; Cross, Philip K; Druschel, Charlotte M

    2010-01-01

    Because of the relatively high expense of collecting primary data and limited resources, electronically available, population-based hospital discharge data have been increasingly used for disease surveillance by public health researchers. The objective of this study was to compare the New York State Congenital Malformations Registry (CMR) data, which relies on hospital reports, with the hospital discharge files to identify cases in the CMR that were missed in the hospital discharge data files. The ultimate goal was to evaluate whether hospital discharge data can serve as the sole source of case ascertainment for a population-based birth defects surveillance program. CMR cases that were born to the New York State residents for the years 2000 to 2005 were selected and matched to the hospital discharge files from the New York Statewide Planning and Research Cooperative System (SPARCS) for the same birth year period. Since the SPARCS database does not contain patient's name, extensive database matching and manual review by staff members were performed using identifying variables such as the hospital's permanent facility identifier, child's date of birth and medical record number, and mother's medical record number and residential address. Out of 66 757 CMR cases selected for the study period, 62 118 cases (93.1%) were matched to SPARCS hospital discharge records with International Classification of Diseases, Ninth Revision (ICD-9) codes that were reportable to the CMR, 3 444 cases (5.2%) were matched to SPARCS records with ICD-9 codes that were not reportable to the CMR, and 1 195 cases (1.8%) were not matched. The percentage of cases with multiple congenital malformations was significantly higher (21.3%) for the matched cases that had reportable ICD-9 codes in SPARCS, compared with that for matched CMR cases that had no reportable ICD-9 codes in SPARCS (10.2%). The study found that 93% of CMR infants selected for the study were matched to hospital discharge records

  8. Pharmacologic concentrations of linezolid modify oxidative phosphorylation function and adipocyte secretome.

    PubMed

    Llobet, Laura; Bayona-Bafaluy, M Pilar; Pacheu-Grau, David; Torres-Pérez, Elena; Arbones-Mainar, José M; Navarro, M Ángeles; Gómez-Díaz, Covadonga; Montoya, Julio; López-Gallardo, Ester; Ruiz-Pesini, Eduardo

    2017-10-01

    The oxidative phosphorylation system is important for adipocyte differentiation. Therefore, xenobiotics inhibitors of the oxidative phosphorylation system could affect adipocyte differentiation and adipokine secretion. As adipokines impact the overall health status, these xenobiotics may have wide effects on human health. Some of these xenobiotics are widely used therapeutic drugs, such as ribosomal antibiotics. Because of its similarity to the bacterial one, mitochondrial translation system is an off-target for these compounds. To study the influence of the ribosomal antibiotic linezolid on adipokine production, we analyzed its effects on adipocyte secretome. Linezolid, at therapeutic concentrations, modifies the levels of apolipoprotein E and several adipokines and proteins related with the extracellular matrix. This antibiotic also alters the global methylation status of human adipose tissue-derived stem cells and, therefore, its effects are not limited to the exposure period. Besides their consequences on other tissues, xenobiotics acting on the adipocyte oxidative phosphorylation system alter apolipoprotein E and adipokine production, secondarily contributing to their systemic effects. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  9. A cfr-like gene cfr(C) conferring linezolid resistance is common in Clostridium difficile.

    PubMed

    Candela, Thomas; Marvaud, Jean-Christophe; Nguyen, Tiep Khac; Lambert, Thierry

    2017-09-01

    Clostridium difficile T10 and Clostridium bolteae 90B3 were co-resistant to phenicols, lincosamides, oxazolidinones, pleuromutilins and streptogramin A (PhLOPSA) and harbored an unreported cfr-like determinant that may alter the 23S rRNA by m(8)A2503 methylation. The cfr-like cfr(C) gene was cloned in C. difficile 630Δerm in which it conferred PhLOPSA resistance. In C. bolteae 90B3: (i) qRT-PCR analysis indicated that cfr(C) was similarly expressed in the absence or presence of either chloramphenicol or clindamycin or linezolid; and (ii) cfr(C) was part of a putative 24 kb-transposon, which generated a detectable circular intermediate. An element differing by a single nucleotide was found in C. difficile DA00203 from GenBank data, consistent with a recent horizontal transfer. In silico analysis showed cfr(C) in 19 out of 274 C. difficile genomes. This gene was also detected by PCR analysis in 9 out of 80 C. difficile from our laboratory strain collection according to resistance to linezolid and florfenicol. The fact that cfr(C) was mainly confined in C. difficile within polymorphic environments indicates this microorganism is a reservoir for PhLOPSA resistance. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  10. [Total eclipse of the sun in August 11, 1999: a program of prevention and surveillance of ocular complications].

    PubMed

    Dixsaut, G; Coulombier, D; Malfait, P; Bodaghi, B; Espinoza, P

    2000-01-01

    Watching directly at the sun without appropriate protection, particularly during a solar eclipse, can cause severe retinal injuries. On 11 August 1999, a total solar eclipse crossed France. The Direction Générale de la Santé implemented a prevention strategy. A formal agreement was developed with manufacturers and importers of protective glasses and more than 30 million glasses, conformed with safety standards, were distributed in France. Information campaign reach the whole population in France. In order to evaluate the impact of this campaign, The National Institute of Public Health in France implemented a nation-wide surveillance of ocular complications related to the eclipse. Information on patients was collected using a standardised questionnaire. The questionnaire was sent to the 5,600 private and public sector ophthalmologists practising in France and to five hundred hospital emergency units. A total of 147 patients were reported to have had a retinal injury associated with viewing the eclipse. Seventeen cases were severe (visual acuity < 2/10th) of whom 7 had bilateral injury. Forty-four per cent of patients were aged 15 to 29 years and 46% viewed the eclipse in three regions in the south of France which were sunny on 11th August. One hundred and six patients (67% aged 30 years and more) presented with keratitis. Thirty-six per cent occurred in 2 northern regions of France, which were overcast on the day. A hundred patients watched the whole eclipse without any protection, 74 reported to have removed their EC glasses, and 32 used non-appropriate devices. Only 4 patients presenting with retinal injury reported having used the EC glasses the whole time whilst viewing the eclipse. France is the only country in Europe to have implemented an exhaustive prospective surveillance of ocular injuries related to the solar eclipse. According to current data, the quality and availability of EC glasses did not contribute significantly to ocular injuries. Clinical and

  11. 14 CFR 91.1431 - CAMP: Continuing analysis and surveillance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false CAMP: Continuing analysis and surveillance... Ownership Operations Program Management § 91.1431 CAMP: Continuing analysis and surveillance. (a) Each... continuing analysis and surveillance of the performance and effectiveness of its inspection program and the...

  12. 14 CFR 91.1431 - CAMP: Continuing analysis and surveillance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false CAMP: Continuing analysis and surveillance... Ownership Operations Program Management § 91.1431 CAMP: Continuing analysis and surveillance. (a) Each... continuing analysis and surveillance of the performance and effectiveness of its inspection program and the...

  13. 14 CFR 91.1431 - CAMP: Continuing analysis and surveillance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false CAMP: Continuing analysis and surveillance... Ownership Operations Program Management § 91.1431 CAMP: Continuing analysis and surveillance. (a) Each... continuing analysis and surveillance of the performance and effectiveness of its inspection program and the...

  14. 14 CFR 91.1431 - CAMP: Continuing analysis and surveillance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false CAMP: Continuing analysis and surveillance... Ownership Operations Program Management § 91.1431 CAMP: Continuing analysis and surveillance. (a) Each... continuing analysis and surveillance of the performance and effectiveness of its inspection program and the...

  15. Assessing the Impact of a Pertussis Active Surveillance Program on Provider Testing Behavior, Minnesota 2005–2009

    PubMed Central

    Banerjee, Emily; Sweet, Kristin; Miller, Claudia; Ehresmann, Kristen

    2014-01-01

    Objectives. The Minnesota Department of Health, in collaboration with the Centers for Disease Control and Prevention, implemented the Pertussis Active Surveillance Project to better understand pertussis epidemiology. We evaluated the program’s impact. Methods. Clinics in 2 counties were offered free diagnostic testing and an educational presentation covering pertussis epidemiology. Clinics were identified as either active or intermittent, with active clinics testing 33% or more of the total number of months enrolled. We used generalized estimating equations to assess changes in provider testing behavior over the project period. Results. Ninety-seven clinics enrolled, with 38% classified as active. Active clinics were more likely to use the state lab for diagnostic testing and had a larger staff. During the project period, a decline in days coughing at the time of visit occurred in both jurisdictions. Conclusions. Providing clinics with free diagnostic testing influenced their participation levels. Among active clinics, results suggest changes in provider testing behavior over the course of the project. However, given the lack of robust participation, this resource-intensive strategy may not be a cost-effective approach to evaluating trends in pertussis epidemiology. PMID:24524507

  16. Implementing an early childhood developmental screening and surveillance program in primary care settings: lessons learned from a project in Illinois.

    PubMed

    Berry, Anita D; Garzon, Dawn Lee; Mack, Patricia; Kanwischer, Katelyn Z; Beck, Deborah Guzzo

    2014-01-01

    Enhancing Developmentally Oriented Primary Care (EDOPC) is a project with a goal to increase the financing and delivery of preventive developmental services for children birth to age 3 years in the state of Illinois. Primary care providers have more opportunities to screen and observe infants and toddlers than any other professional, because they see them up to 13 times in the first 3 years of life for well-child visits. The project focused on using a 1-hour, on-site training for primary care providers and their entire office staff as the method of increasing knowledge, focusing on intent to change practice and implementation of routine early childhood developmental screening. Although many primary care providers routinely use only developmental surveillance in their practices, clinical practice guidelines recommend routine use of standardized developmental screening, using validated developmental screening tools. This article includes lessons learned and recommendations based on clinical practice guidelines and experiences of the team members during implementation of the EDOPC project. Primary care providers are critical to this process because children with developmental disorders have the best long-term outcomes and opportunities for improved family functioning with early detection, diagnosis, and treatment. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  17. In vitro susceptibilities of bloodstream isolates of Candida spp.: results from a multicenter active surveillance program in Andalusia.

    PubMed

    Flórez, Carmen; Martín-Mazuelos, Estrella; Ruiz, Maite; Cisneros, José Miguel; Herrero, Marta; García, M Victoria; García, Ma Victoria; Márquez, Manuel; Porras, José; Martín, Patricia; Gamero, Carmen; Castón, Juan José

    2009-11-01

    The aim of this study was to determine the antifungal drug susceptibilities of Candida bloodstream isolates in Andalusia, obtained through a multicenter active laboratory-based surveillance between October 2005 and September 2006. One hundred and ninety-seven Candida isolates were collected. The MICs of amphotericin B, fluconazole, itraconazole and voriconazole were established using the Sensititre YeastOne panel. The MICs of posaconazole and caspofungin were determined by Etest. C. albicans was the most frequently isolated species (49.2%), followed by C. parapsilosis (17.3%), C. tropicalis (15.2%), C. glabrata (13.7%) and C. krusei (3.6%). All strains were inhibited at MICs of or = 64 mg/L) and 7 (3.6%) were considered resistant to itraconazole (MIC > or = 1 mg/L). All the isolates were susceptible to voriconazole and caspofungin. In our study C. krusei and C. glabrata were identified in over 18% of cases of candidemia. Most clinical isolates of these species are resistant or susceptible-dose-dependent to fluconazole but susceptible to voriconazole and caspofungin. These agents must be used in the empiric treatment of candidemia rather than fluconazole.

  18. Immunoglobulin D enhances immune surveillance by activating antimicrobial, proinflammatory and B cell-stimulating programs in basophils.

    PubMed

    Chen, Kang; Xu, Weifeng; Wilson, Melanie; He, Bing; Miller, Norman W; Bengtén, Eva; Edholm, Eva-Stina; Santini, Paul A; Rath, Poonam; Chiu, April; Cattalini, Marco; Litzman, Jiri; B Bussel, James; Huang, Bihui; Meini, Antonella; Riesbeck, Kristian; Cunningham-Rundles, Charlotte; Plebani, Alessandro; Cerutti, Andrea

    2009-08-01

    Immunoglobulin D (IgD) is an enigmatic antibody isotype that mature B cells express together with IgM through alternative RNA splicing. Here we report active T cell-dependent and T cell-independent IgM-to-IgD class switching in B cells of the human upper respiratory mucosa. This process required activation-induced cytidine deaminase (AID) and generated local and circulating IgD-producing plasmablasts reactive to respiratory bacteria. Circulating IgD bound to basophils through a calcium-mobilizing receptor that induced antimicrobial, opsonizing, inflammatory and B cell-stimulating factors, including cathelicidin, interleukin 1 (IL-1), IL-4 and B cell-activating factor (BAFF), after IgD crosslinking. By showing dysregulation of IgD class-switched B cells and 'IgD-armed' basophils in autoinflammatory syndromes with periodic fever, our data indicate that IgD orchestrates an ancestral surveillance system at the interface between immunity and inflammation.

  19. Ribosomal protein L3 mutations are associated with cfr-mediated linezolid resistance in clinical isolates of Staphylococcus cohnii.

    PubMed

    Xu, Hongtao; Tian, Rui; Li, Yanming; Chen, Dongke; Liu, Yalin; Hu, Yunjian; Xiao, Fei

    2015-06-01

    From June, 2012 to November, 2013 five linezolid-resistant Staphylococcus cohnii isolates were identified in our hospital in Beijing, China. The investigation of the resistance mechanisms confirmed that the cfr-carrying plasmids were the main cause of linezolid resistance in those clinical isolates. Moreover, all the five isolates had ribosomal protein L3 mutations, which had different coordinate effect on cfr-mediated linezolid resistance directly through the substitution of serine 158 by phenylalanine or tyrosine in L3 protein. In this study, two types of plasmids (p432, p438) (Accession No. KM114207) were found, which share high sequence identity with previously reported cfr-carrying pRM01 and pMHZ plasmids originated from northern and southern China, showing wide regional dissemination in China. The stability of linezolid resistance was studied by passaging single colonies serially on antibiotic-free blood medium, which showed that the susceptible derivatives emerged until the passages 39-42 with the elimination of cfr-carrying plasmid. Thus the high stability of this plasmid may pose a risk for the transmission among patients or even cause an outbreak in clinical settings.

  20. Promising in vitro and in vivo inhibition of multidrug-resistant Helicobacter pylori by linezolid and novel oxazolidinone analogues.

    PubMed

    Shi, Jingdong; Jiang, Ying; Zhao, Yanfang

    2016-12-01

    The objective of this study was to investigate the prevalence of drug-resistant Helicobacter pylori in Beijing Tian Tan Hospital (Beijing, China) and to determine the susceptibility of H. pylori to linezolid and novel oxazolidinone analogues. Minimum inhibitory concentrations (MICs) of amoxicillin, clarithromycin, metronidazole, ciprofloxacin, tetracycline and levofloxacin against H. pylori were determined by Etest. The in vitro antibacterial activities of linezolid and novel oxazolidinone analogues were assessed by the disk diffusion method. In vivo antibacterial activities were determined by intragastric administration and stomach CFU counting. Drug resistance patterns were serious among clinical H. pylori isolates, with a rate of multidrug-resistant H. pylori of 10.1%. Linezolid was observed to exhibit in vitro activity, with MICs ranging from ≤0.25mg/L to 32mg/L against clinical H. pylori isolates (MIC50, 2mg/L; MIC90, 8mg/L). The oxazolidinone analogue sy142 demonstrated better antimicrobial activity than linezolid in vitro. These results indicate that oxazolidinones may be appropriate agents to treat drug-resistant H. pylori. Further clinical trials should be performed to confirm this.

  1. Vancomycin-resistant Enterococcus spp.: validation of susceptibility testing and in vitro activity of vancomycin, linezolid, tigecycline and daptomycin.

    PubMed

    Rathe, Mathias; Kristensen, Lise; Ellermann-Eriksen, Svend; Thomsen, Marianne Kragh; Schumacher, Helga

    2010-01-01

    Vancomycin-resistant enterococci (VRE) have emerged to become a significant nosocomial pathogen. However, detection may be challenging and treatment possibilities are limited. Reports of resistance to linezolide, daptomycin and tigecycline underline the need for reliable susceptibility testing with respect to these compounds. We evaluated the in vitro activity of vancomycin, linezolid, daptomycin and tigecycline against a panel of VRE and vancomycin-susceptible enterococci by broth microdilution (BMD). Etest for determination of minimum inhibitory concentration of these four antibiotics and two disc diffusion assays for detecting VRE and for susceptibility testing against tigecycline and linezolid were evaluated. Before susceptibility testing, all isolates were classified by polymerase chain reaction as vanA or vanB gene positive or vanA/B gene negative. Linezolid, daptomycin and tigecycline had excellent in vitro activity towards all isolates. For daptomycin and tigecycline, the overall agreement between BMD and Etest was suboptimal. For both disc diffusion assays, use of current break points was inadequate to detect vancomycin resistance for isolates carrying the vanB gene. Inspection of the inhibition zone for a diffuse edge, as recommended, accurately predicted presence of the vanB gene.

  2. Linezolid in the Starter Combination for Multidrug-Resistant Tuberculosis: Time to Move on to Group Four?

    PubMed Central

    Grard, Soazic; Catho, Gaud; Valour, Florent; Bouaziz, Anissa; Perpoint, Thomas; Braun, Evelyne; Biron, François; Miailhes, Patrick; Ferry, Tristan; Chidiac, Christian; Souquet, Pierre-Jean; Couraud, Sébastien; Lina, Gérard; Goutelle, Sylvain; Veziris, Nicolas; Dumitrescu, Oana; Ader, Florence

    2015-01-01

    Linezolid (LNZ), a group 5 antituberculous drug (unclear efficacy), was used in the starter regimens of 23 adults with multidrug-resistant tuberculosis. The LNZ-containing regimens were effective in achieving culture conversions and relapse-free outcomes. The most frequent LNZ-related side effect was neuropathy. We propose that LNZ should be reclassified among bactericidal second-line drugs. PMID:26719846

  3. Decrease in Staphylococcus aureus colonization and hospital-acquired infection in a medical intensive care unit after institution of an active surveillance and decolonization program.

    PubMed

    Fraser, Thomas G; Fatica, Cynthia; Scarpelli, Michele; Arroliga, Alejandro C; Guzman, Jorge; Shrestha, Nabin K; Hixson, Eric; Rosenblatt, Miriam; Gordon, Steven M; Procop, Gary W

    2010-08-01

    To evaluate the effects of an active surveillance program for Staphylococcus aureus linked to a decolonization protocol on the incidence of healthcare-associated infection and new nasal colonization due to S. aureus. Retrospective quasi-experimental study. An 18-bed medical intensive care unit at a tertiary care center in Cleveland, Ohio. From January 1, 2006, through December 31, 2007, all patients in the medical intensive care unit were screened for S. aureus nasal carriage at admission and weekly thereafter. During the preintervention period, January 1 through September 30, 2006, only surveillance occurred. During the intervention period, January 1 through December 31, 2007, S. aureus carriers received mupirocin intranasally. Beginning in February 2007, carriers also received chlorhexidine gluconate baths. During the preintervention period, 604 (73.7%) of 819 patients were screened for S. aureus nasal carriage, yielding 248 prevalent carriers (30.3%). During the intervention period, 752 (78.3%) of 960 patients were screened, yielding 276 carriers (28.8%). The incidence of S. aureus carriage decreased from 25 cases in 3,982 patient-days (6.28 cases per 1,000 patient-days) before intervention to 18 cases in 5,415 patient-days (3.32 cases per 1,000 patient-days) (P=.04; relative risk [RR], 0.53 [95% confidence interval {CI}, 0.28-0.97]) and from 9.57 to 4.77 cases per 1,000 at-risk patient-days (P=.02; RR, 0.50 [95% CI, 0.27-0.91]). The incidence of S. aureus hospital-acquired bloodstream infection during the 2 periods was 2.01 and 1.11 cases per 1,000 patient-days, respectively (P=.28). The incidence of S. aureus ventilator-associated pneumonia decreased from 1.51 to 0.18 cases per 1,000 patient-days (P=.03; RR, 0.12 [95% CI, 0.01-0.83]). The total incidence of S. aureus hospital-acquired infection decreased from 3.52 to 1.29 cases per 1,000 patient-days (P=.03; RR, 0.37 [95% CI, 0.14-0.90]). Active surveillance for S. aureus nasal carriage combined with

  4. Linezolid-resistant clinical isolates of enterococci and Staphylococcus cohnii from a multicentre study in China: molecular epidemiology and resistance mechanisms.

    PubMed

    Chen, Hongbin; Wu, Weiyuan; Ni, Ming; Liu, Yingmei; Zhang, Jixia; Xia, Fei; He, Wenqiang; Wang, Qi; Wang, Zhanwei; Cao, Bin; Wang, Hui

    2013-10-01

    Genetic characterisation of linezolid-resistant Gram-positive cocci in a multicentre study in China has not been reported previously. To study the mechanism underlying the resistance of linezolid-resistant isolates, nine Enterococcus faecalis, one Enterococcus faecium and three Staphylococcus cohnii isolates with various levels of resistance were collected from five hospitals across China in 2009-2012. The nine E. faecalis isolates were classified into seven sequence types, indicating that these linezolid-resistant E. faecalis isolates were polyclonal. Enterococci isolates had reduced susceptibility to linezolid (MICs of 4-8 mg/L) and had mutation of ribosomal protein L3, with three also having mutation of L4, but without the multidrug resistance gene cfr or the 23S rRNA mutation G2576T. The three S. cohnii isolates were highly resistant to linezolid (MICs of 64 mg/L to >256 mg/L), harboured the cfr gene and had the 23S rRNA mutation G2576T. Southern blotting indicated that the cfr gene of these three isolates resided on different plasmids (pHK01, pRM01 and pRA01). In plasmid pHK01, IS21-558 and the cfr gene were integrated into transposon Tn558. In plasmids pRM01 and pRA01, the cfr gene was flanked by two copies of an IS256-like insertion sequence, indicating that the transferable form of linezolid resistance is conferred by the cfr gene. In conclusion, the emergence of linezolid-resistant Gram-positive cocci in different regions of China is of concern. The cfr gene and the 23S rRNA mutation contribute to high-level linezolid resistance in S. cohnii, and the L3 and L4 mutations are associated with low-level linezolid resistance in enterococci.

  5. Radiographic features of importance in the National Institute for Occupational Safety and Health-administered Coal Workers' Health Surveillance Program: characterising the use of the 'other symbols'.

    PubMed

    Halldin, Cara N; Hale, Janet M; Blackley, David J; Laney, A Scott

    2017-08-11

    The National Institute for Occupation Safety and Health-administered Coal Workers' Health Surveillance Program (CWHSP) provides radiographic pneumoconiosis screening for US coal miners. Radiographs are classified by readers according to International Labour Office criteria. In addition to pneumoconiotic parenchymal and pleural lung abnormalities, readers document radiographic features of importance (other symbols). Other symbols are not meant to imply a diagnosis or interpretation but are relevant as they provide information beyond a pneumoconiosis classification for features related to dust exposure and other aetiologies. Our objective was to summarise other symbol data from 48 years of CWHSP participants. Chest radiograph classifications obtained from CWHSP participants between July 1968 and July 2016 were analysed. Any 'other symbol' indication from any of the readings were counted. Frequencies were tabulated by individual reader and those identified by any reader. Of the 469 922 radiographs included in this study, nearly 15% had at least one reader identify a radiographic feature of importance. The most commonly identified other symbol was cancer (excluding mesothelioma) (6.83%), followed by emphysema (1.68%). Some features were rarely identified over the 48 years of data collection such as rheumatoid pneumoconiosis (n=46), pneumothorax (n=32), mesothelioma (n=12) and rounded atelectasis (n=4). This is the largest study to date describing radiographic features of importance as part of routine chest radiographic surveillance. While these symbols are not diagnostic they can be used to describe features associated with dust exposure. One of the most commonly identified radiographic features in our population is emphysema which is associated with respirable dust exposure. These results can be compared with other dust exposed populations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  6. Trends in Antifungal Susceptibility of Candida spp. Isolated from Pediatric and Adult Patients with Bloodstream Infections: SENTRY Antimicrobial Surveillance Program, 1997 to 2000

    PubMed Central

    Pfaller, M. A.; Diekema, D. J.; Jones, R. N.; Messer, S. A.; Hollis, R. J.

    2002-01-01

    From 1 January 1997 through 31 December 2000, 2,047 bloodstream infections (BSIs) due to Candida spp. were reported from hospitals in the United States, Canada, Latin America, and Europe participating in the SENTRY Antifungal Surveillance Program. Among individuals in four age groups (≤1, 2 to 15, 16 to 64, and ≥65 years) Candida albicans was the most common species, causing 60, 55, 55, and 50% of infections, respectively. C. glabrata caused 17 to 23% of BSIs in those ages 16 to 64 and ≥65 years, whereas it caused only 3% of BSIs in the individuals in the two younger age groups (P < 0.001). C. parapsilosis (which caused 21 to 24% of BSIs) and C. tropicalis (which caused 7 to 10% of BSIs) were more common than C. glabrata in individuals ages ≤1 year and 2 to 15 years. Isolates of Candida spp. showed a trend of decreasing susceptibility to fluconazole, itraconazole, and amphotericin B with increasing patient age (P ≤ 0.01). None of the C. glabrata isolates from individuals ≤1 year old were resistant to fluconazole, whereas they made up 5 to 9% of isolates from individuals ages 16 to 64 and ≥65 years. Isolates of C. tropicalis from patients ≤1 year old were more susceptible to flucytosine (MIC at which 90% of isolates are inhibited [MIC90], 0.5 μg/ml; 0% resistant isolates) than those from patients ≥65 years old (MIC90, 32 μg/ml; 11% resistant isolates). The investigational triazoles posaconazole, ravuconazole, and voriconazole were all highly active against all species of Candida from individuals in all age groups. These data demonstrate differences in the species distributions of pathogens and differences in antifungal resistance among isolates from individuals in the pediatric and adult age groups. Ongoing surveillance will enhance efforts to limit the extent of antifungal resistance in individuals in various age groups. PMID:11880404

  7. Air toxics in Canada measured by the National Air Pollution Surveillance (NAPS) program and their relation to ambient air quality guidelines.

    PubMed

    Galarneau, Elisabeth; Wang, Daniel; Dabek-Zlotorzynska, Ewa; Siu, May; Celo, Valbona; Tardif, Mylaine; Harnish, David; Jiang, Ying

    2016-02-01

    This study reports ambient concentrations of 63 air toxics that were measured in Canada by the National Air Pollution Surveillance (NAPS) program over the period 2009-2013. Measured concentrations are compared with ambient air quality guidelines from Canadian jurisdictions, and compounds that exceeded guidelines are identified and discussed. Although this study does not assess risk or cumulative effects, air toxics that approached guidelines are also identified so that their potential contribution to ambient air toxics pollution can be considered. Eleven air toxics exceeded at least one guideline, and an additional 16 approached guidelines during the study period. Four compounds were measured using methods whose detection limits exceeded a guideline value, three of which could not be compared with guidelines, since they were not detected in any samples. The assessment of several metal(loid) concentrations is tentative, since they were measured only in fine particulate matter (PM) but compared with guidelines based on coarse or total PM. Improvements to sampling and analysis techniques for the latter compounds as well as for those whose methods are subject to known uncertainties would improve confidence in reported concentrations and their relation to applicable guidelines. Analysis of sampling strategies for all compounds found to exceed or approach guidelines would contribute to ensuring that their spatiotemporal coverage is adequate. Examination of the air toxics not measured by NAPS but having guidelines in Canadian jurisdictions or being included in other programs such as the U.S. National-Scale Air Toxics Assessment (NATA) would contribute to ensuring that the full suite of pollutants relevant to ambient air quality in Canada is subject to adequate study. The results of this study can be applied to evaluating the effectiveness of toxic substances management in Canada. Recent measurements of 63 air toxics in Canada by the National Air Pollution Surveillance

  8. Rapid surveillance for health events following a mass meningococcal B vaccine program in a university setting: A Canadian Immunization Research Network study.

    PubMed

    Langley, J M; MacDougall, D M; Halperin, B A; Swain, A; Halperin, S A; Top, K A; McNeil, S A; MacKinnon-Cameron, D; Marty, K; De Serres, G; Dubé, E; Bettinger, J A

    2016-07-25

    An outbreak of Neisseria meningitidis serotype B infection occurred at a small residential university; public health announced an organizational vaccination program with the 4-component Meningococcal B (4CMenB) vaccine (Bexsero(TM), Novartis/GlaxoSmithKline Inc.) several days later. Since there were limited published data on reactogenicity of 4CMenB in persons over 17years of age, this study sought to conduct rapid surveillance of health events in vaccinees and controls using an online survey. Vaccine uptake was 84.7% for dose 1 (2967/3500) and 70% (2456/3500) for dose 2; the survey response rates were 33.0% (987/2967) and 18.7% (459/2456) in dose 1 and dose 1 recipients respectively, and 12% in unvaccinated individuals (63/533). Most students were 20-29years of age (vaccinees, 64.0%; controls, 74.0). A new health problem or worsening of an existing health problem was reported by 30.0% and 30.3% of vaccine recipients after doses 1 and 2 respectively; and by 15.9% of controls. These health problems interfered with the ability to perform normal activities in most vaccinees reporting these events (74.7% post dose 1; 62.6% post dose 2), and in 60% of controls. The health problems led to a health care provider visit (including emergency room) in 12.8% and 14.4% of vaccinees post doses 1 and 2, respectively and in 40% of controls. The most common reactions in vaccinees were injection site reactions (20.6% post dose 1, 16.1% post dose 20 and non-specific systemic complaints (22.6% post dose 1, 17.6% post dose 2). No hospitalizations were reported. An online surveillance program during an emergency meningococcal B vaccine program was successfully implemented, and detected higher rates of health events in vaccinees compared to controls, and high rates of both vaccinees and controls seeking medical attention. The types of adverse events reported by young adult vaccinees were consistent with those previously.

  9. Severe morbidity after antiretroviral (ART) initiation: active surveillance in HIV care programs, the IeDEA West Africa collaboration.

    PubMed

    Abo, Yao; Zannou Djimon, Marcel; Messou, Eugène; Balestre, Eric; Kouakou, Martial; Akakpo, Jocelyn; Ahouada, Carin; de Rekeneire, Nathalie; Dabis, François; Lewden, Charlotte; Minga, Albert

    2015-04-09

    The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance system established within a network of specialized care facilities in West African cities. Within the International epidemiological Database to Evaluate AIDS (IeDEA)--West Africa collaboration, we conducted a prospective, multicenter data collection that involved two facilities in Abidjan, Côte d'Ivoire and one in Cotonou, Benin. Among HIV-infected adults receiving ART, events were recorded using a standardized form. A simple case-definition of severe morbidity (death, hospitalization, fever>38°5C, Karnofsky index<70%) was used at any patient contact point. Then a physician confirmed and classified the event as WHO stage 3 or 4 according to the WHO clinical classification or as degree 3 or 4 of the ANRS scale. From December 2009 to December 2011, 978 adults (71% women, median age 39 years) presented with 1449 severe events. The main diagnoses were: non-AIDS-defining infections (33%), AIDS-defining illnesses (33%), suspected adverse drug reactions (7%), other illnesses (4%) and syndromic diagnoses (16%). The most common specific diagnoses were: malaria (25%), pneumonia (13%) and tuberculosis (8%). The diagnoses were reported as syndromic in one out of five events recorded during this study. This study highlights the ongoing importance of conventional infectious diseases among severe morbid events occurring in patients on ART in ambulatory HIV care facilities in West Africa. Meanwhile, additional studies are needed due to the undiagnosed aspect of severe morbidity in substantial proportion.

  10. Vancomycin, teicoplanin, daptomycin, and linezolid MIC creep in methicillin-resistant Staphylococcus aureus is associated with clonality

    PubMed Central

    Hsieh, Yu-Chia; Lin, Yu-Chun; Huang, Yhu-Chering

    2016-01-01

    Abstract The purpose of this study is to evaluate the susceptibility trend of vancomycin, teicoplanin, daptomycin, and linezolid against methicillin-resistant Staphylococcus aureus (MRSA) blood isolates of different clones over an 11-year period. From 2000 to 2010, all bloodstream MRSA isolates from Chang Gung Memorial Hospital in Taiwan were prospectively collected. Three periods, namely 2000 to 2001, 2004 to 2005, and 2010, were included and 124 MRSA isolates were selected from each period. Minimum inhibitory concentrations (MICs) were determined by E-test. All the isolates were molecularly characterized. MRSA molecular epidemiology evolved from 1 predominant pulsotype (type A) to 5 major pulsotypes of 3 clonal complexes (CC). Vancomycin, teicoplanin, and daptomycin MICs creep were observed, particularly for pulsotype A-CC 239-staphylococcal cassette chromosome mec (SCCmec) III though its prevalence dramatically decreased since 2004 to 2005. Throughout the study period, the overall vancomycin modal MIC was stable at 1.5 mg/L, but teicoplanin and linezolid modal MIC increased to 2 and 2 mg/L, respectively. Isolates with teicoplanin and linezolid ≧ 2 ug/mL belonged to multiple clones. Pulsotype F-ST5-SCCmec II with a high rate of teicoplanin MIC ≧ 2 ug/mL continued clonal spread. Teicoplanin MIC had a high correlation with linezolid MIC. Molecular epidemiology MRSA bloodstream isolates in northern Taiwan evolved from 2000 throughout 2010, which was subsequently associated with the changing distribution of antibiotic MICs. While vancomycin MIC level remained unchanged, teicoplanin, daptomycin, and linezolid MIC levels increased. The impact of these changes on clinical treatment response deserves further investigations. PMID:27741120

  11. Vancomycin, teicoplanin, daptomycin, and linezolid MIC creep in methicillin-resistant Staphylococcus aureus is associated with clonality.

    PubMed

    Hsieh, Yu-Chia; Lin, Yu-Chun; Huang, Yhu-Chering

    2016-10-01

    The purpose of this study is to evaluate the susceptibility trend of vancomycin, teicoplanin, daptomycin, and linezolid against methicillin-resistant Staphylococcus aureus (MRSA) blood isolates of different clones over an 11-year period.From 2000 to 2010, all bloodstream MRSA isolates from Chang Gung Memorial Hospital in Taiwan were prospectively collected. Three periods, namely 2000 to 2001, 2004 to 2005, and 2010, were included and 124 MRSA isolates were selected from each period. Minimum inhibitory concentrations (MICs) were determined by E-test. All the isolates were molecularly characterized.MRSA molecular epidemiology evolved from 1 predominant pulsotype (type A) to 5 major pulsotypes of 3 clonal complexes (CC). Vancomycin, teicoplanin, and daptomycin MICs creep were observed, particularly for pulsotype A-CC 239-staphylococcal cassette chromosome mec (SCCmec) III though its prevalence dramatically decreased since 2004 to 2005. Throughout the study period, the overall vancomycin modal MIC was stable at 1.5 mg/L, but teicoplanin and linezolid modal MIC increased to 2 and 2 mg/L, respectively. Isolates with teicoplanin and linezolid ≧ 2 ug/mL belonged to multiple clones. Pulsotype F-ST5-SCCmec II with a high rate of teicoplanin MIC ≧ 2 ug/mL continued clonal spread. Teicoplanin MIC had a high correlation with linezolid MIC.Molecular epidemiology MRSA bloodstream isolates in northern Taiwan evolved from 2000 throughout 2010, which was subsequently associated with the changing distribution of antibiotic MICs. While vancomycin MIC level remained unchanged, teicoplanin, daptomycin, and linezolid MIC levels increased. The impact of these changes on clinical treatment response deserves further investigations.

  12. Front-loaded linezolid regimens result in increased killing and suppression of the accessory gene regulator system of Staphylococcus aureus.

    PubMed

    Tsuji, Brian T; Brown, Tanya; Parasrampuria, Ridhi; Brazeau, Daniel A; Forrest, Alan; Kelchlin, Pamela A; Holden, Patricia N; Peloquin, Charles A; Hanna, Debra; Bulitta, Jurgen B

    2012-07-01

    Front loading is a strategy used to optimize the pharmacodynamic profile of an antibiotic through the administration of high doses early in therapy for a short duration. Our aims were to evaluate the impact of front loading of linezolid regimens on bacterial killing and suppression of resistance and on RNAIII, the effector molecule of the accessory gene regulator system (encoded by agr) in methicillin-resistant Staphylococcus aureus (MRSA). Time-killing experiments over 48 h were utilized for linezolid against four strains of MRSA: USA100, USA300, USA400, and ATCC 29213. A hollow-fiber infection model simulated traditional and front-loaded human therapeutic regimens of linezolid versus USA300 at 10(6) CFU/ml over 240 h. Over 48 h in time-kill experiments, linezolid displayed bacteriostatic activity, with reductions of >1 log(10) CFU/ml for all strains. Front-loaded regimens that were administered over 5 days, 1,200 mg every 12 h (q12h) (total, 10 doses) and 2,400 mg q12h (total, 10 doses) followed by 300 mg q12h thereafter, resulted in sustained bactericidal activity, with reductions of the area under the CFU curve of -6.15 and -6.03, respectively, reaching undetectable limits at the 10-day study endpoint. All regimens displayed a reduction in RNAIII relative expression at 24 h and 240 h compared with that of the growth control. Monte Carlo simulations predicted a <1.27× increase in the fractional decreases in platelets for all front-loaded regimens versus the 600 mg q12h regimen, except for the highest-dose front-loaded regimen. Front-loading strategies for linezolid are promising and may be of utility in severe MRSA infections, where early aggressive therapy is necessary.

  13. Linezolid minimum inhibitory concentration (MIC) creep in methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates at a single Japanese center.

    PubMed

    Miyazaki, Motoyasu; Nagata, Nobuhiko; Miyazaki, Hiroyuki; Matsuo, Koichi; Takata, Tohru; Tanihara, Shinichi; Kamimura, Hidetoshi

    2014-01-01

    The aim of this study was to evaluate whether linezolid minimum inhibitory concentration (MIC) creep occurred in Staphylococcus aureus clinical isolates, including methicillin-resistant S. aureus (MRSA), over a recent 5-year period at a single Japanese center. A total of 453 MRSA and 195 methicillin-susceptible S. aureus (MSSA) isolates recovered from inpatients from April 1, 2008 to March 31, 2013 were analyzed. The MIC of linezolid was determined by automated Vitek-2 system. The modal MIC, MIC range, MIC50 and MIC90 (MICs required to inhibit the growth of 50% and 90% of organisms, respectively), geometric mean MIC and percentages of susceptible and resistant isolates were evaluated for each fiscal year. None of the S. aureus isolates were resistant to linezolid. Isolates with an MIC of >1 µg/mL were more common in the MSSA samples than in the MRSA samples (91.3% versus 38.2%, p<0.001). The linezolid geometric mean MIC increased by 0.403 µg/mL (from 1.178 in 2008 to 1.582 in 2012) in the MRSA isolates (p=0.006, r(2)=0.945 according to a linear regression analysis) over the 5-year period; however, no increase was observed in the MSSA isolates. The frequency of MRSA isolates with an MIC of 1 µg/mL decreased (from 76.3% in 2008 to 35.4% in 2012) and the isolates with MICs of >1 µg/mL increased over time (from 23.7% in 2008 to 64.6% in 2012). This report demonstrates the occurrence of linezolid MIC creep, as determined using the geometric mean MIC, in MRSA clinical isolates at a single Japanese center.

  14. Activity of linezolid and daptomycin against methicillin-resistant coagulase-negative staphylococci with increased MIC for vancomycin isolated from blood cultures in pediatric patients.

    PubMed

    Castagnola, Elio; Amoroso, Loredana; Banov, Laura; Faraci, Maura; Loy, Anna; Moscatelli, Andrea; Risso, Francesco; Barabino, Paola; Ciucci, Antonella; Bandettini, Roberto

    2014-10-01

    We evaluated minimal inhibitory concentration (MIC) for vancomycin, daptomycin, and linezolid in methicillin-resistant coagulase-negative staphylococci (MR-CoNS). Minimal inhibitory concentration of 2-4 mg/l for vancomycin was observed in 16% of strains, and among them 19% had MIC at breakpoint for daptomycin or linezolid. Among strains completely susceptible to vancomycin, 16% had MIC at breakpoint for daptomycin and 11% had for linezolid. This large proportion of pathogens with MIC around the breakpoint suggests a possible risk of treatment failure with these drugs. This phenomenon is worth further and constant monitoring.

  15. Observed Antagonistic Effect of Linezolid on Daptomycin or Vancomycin Activity against Biofilm-Forming Methicillin-Resistant Staphylococcus aureus in an In Vitro Pharmacodynamic Model.

    PubMed

    Luther, Megan K; LaPlante, Kerry L

    2015-12-01

    Pharmacodynamic activity in antibiotic combinations of daptomycin, vancomycin, and linezolid was investigated in a 48-h in vitro pharmacodynamic model. Using human-simulated free drug concentrations, activity against clinical biofilm-forming methicillin-resistant Staphylococcus aureus isolates was evaluated. Linezolid antagonized vancomycin activity at 24 and 48 h. Linezolid antagonized daptomycin at 24 and 48 h depending on dose and strain. Adding daptomycin increased vancomycin activity at 48 h (P < 0.03). These results may be strain dependent and require further clinical investigation.

  16. Should quality goals be defined for multicenter laboratory testing? Lessons learned from a pilot survey on a national surveillance program for diabetes.

    PubMed

    Wang, Limin; Mo, Nanxun; Pang, Richard; Deng, Qian; Liu, Yong; Hu, Yan; Hu, Chaohui; Wang, Linhong

    2016-04-01

    Robust laboratory protocols and stringent quality control (QC) procedures are essential for meaningful collection of data from multiple sites in large-scale population-based studies. Failure to design and implement an effective QC program not only adversely affects the scientific outcome, but also affects public confidence in the acceptability of the data. A pilot survey was conducted to assess the analytical performance of multicenter plasma glucose measurements in a national surveillance program for diabetes in China. Quality goals of the imprecision in terms of coefficient of variation (CV) and total analytical error (TEa) were defined based on the Clinical Laboratory Improvement Amendments (CLIA) criteria for acceptable performance of proficiency testing (PT) for plasma glucose using commercial QC preparations. A web-based internal QC (IQC) program was established to monitor the analytical performance of the 302 centers participating in the survey. The participation rate was 96% (289/302). Statistical analysis showed that the percentage of centers meeting the acceptable specifications of CV ≤5.0% and TEa ≤10% using the CLIA PT criteria was 91.7% while 76.4% of laboratories achieved the goals for desirable performance of CV ≤2.9% and TEa ≤6.9%, as proposed by the Laboratory Medicine Practice Guidelines for the management of diabetes mellitus based on biological criteria. Communications and training are important in ensuring the data integrity of multicenter population-based studies. Performance verification and IQC programs should be implemented to help identify centers that can fulfill the eligibility criteria to perform laboratory analyses. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  17. National status and trends program for National Benthic Surveillance Project: Northeast coast. Fish histopathology and relationships between lesions and chemical contaminants (1987-89). Technical memo

    SciTech Connect

    Johnson, L.L.; Stehr, C.M.; Olson, O.P.; Myers, M.S.; Pierce, S.M.

    1992-12-01

    The report presents and interprets the results of pathology studies conducted on winter flounder (Pleuronectes americanus) between 1987 and 1989 in conjunction with NOAA's National Status and Trends (NS T) Program. In these studies, a variety of potentially contaminant-associated disease conditions were monitored in winter flounder collected from 22 Northeast Coast sites, and the relationship between disease occurrence and levels of organic chemical contaminants in sediment, stomach contents, and tissues was examined. Sampling was conducted primarily in spring of 1988 and 1989 (Cycles 5 and 6) as part of the National Benthic Surveillance Project (NBSP) of the NS T Program, but to provide a more comprehensive view of pathological conditions in winter flounder from the Northeast Coast, data on winter flounder collected in Long Island Sound during 1987 and in Boston Harbor and adjacent embayments during the winter of 1988 were also included in the memorandum. In the three studies combined, a total of more than 1,500 fish were examined.

  18. Principles in sampling design, lessons, and recommendations from a multi-year, multi-port surveillance program in Lake Superior

    EPA Science Inventory

    We evaluated a pilot aquatic invasive species (AIS) early detection monitoring program in Lake Superior that was designed to detect newly-introduced fishes. We established survey protocols for three major ports (Duluth-Superior, Sault Ste. Marie, Thunder Bay), and designed an ada...

  19. Principles in sampling design, lessons, and recommendations from a multi-year, multi-port surveillance program in Lake Superior

    EPA Science Inventory

    We evaluated a pilot aquatic invasive species (AIS) early detection monitoring program in Lake Superior that was designed to detect newly-introduced fishes. We established survey protocols for three major ports (Duluth-Superior, Sault Ste. Marie, Thunder Bay), and designed an ada...

  20. Public participation in radiological surveillance.

    PubMed

    Hanf, R W; Schreckhise, R G; Patton, G W; Poston, T M; Jaquish, R E

    1997-10-01

    In 1989, Pacific Northwest National Laboratory developed a program, for the U.S. Department of Energy, to involve local citizens in environmental surveillance at the Hanford Site. The Community-Operated Environmental Surveillance Program was patterned after similar community-involvement efforts at the Nevada Test Site and the Three Mile Island nuclear facility. Its purpose is to increase the flow of information to the public, thereby enhancing the public's awareness and understanding of surveillance activities. The program consists of two components: radiological air monitoring at nine offsite locations and agricultural product sampling at selected locations near the site. At each air-monitoring station, two local school teachers collect air particulate samples and operate equipment to monitor ambient radiation levels. Atmospheric tritium samples (as water vapor) are also collected at some locations. Four of the air-monitoring stations include large, colorful informational displays for public viewing. These displays provide details on station equipment, sample types, and sampling purposes. Instruments in the displays also monitor, record, and show real-time ambient radiation readings (measured with a pressurized ionization chamber) and meteorological conditions. Agricultural products, grown primarily by middle-school-aged students, are obtained from areas downwind of the site. Following analysis of these samples, environmental surveillance staff visit the schools to discuss the results with the students and their teachers. The data collected by these air and agricultural sampling efforts are summarized with other routinely collected sitewide surveillance data and reported annually in the Hanford Site environmental report.

  1. Surveillance of tedizolid activity and resistance: In vitro susceptibility of Gram-positive pathogens collected over 5 years from the United States and Europe.

    PubMed

    Bensaci, Mekki; Sahm, Daniel

    2017-02-01

    In vitro activity of tedizolid and comparators against 11,231 Gram-positive clinical isolates from the United States (84 centers) and Europe (115 centers) were summarized as part of the Surveillance of Tedizolid Activity and Resistance program between 2009 and 2013. Susceptibility testing was performed according to Clinical Laboratory and Standards Institute (CLSI) guidelines. Minimum inhibitory concentration (MIC) interpretations were based on CLSI and European Committee on Antimicrobial Susceptibility Testing criteria. Tedizolid inhibited 99.7% of all isolates at MIC ≤0.5 mg/L; activity was similar regardless of methicillin or vancomycin resistance phenotypes of Staphylococcus aureus and enterococci, respectively. Tedizolid MIC >1 mg/L was reported for 3 S. aureus, 4 coagulase-negative staphylococci, and 2 enterococcal isolates; all streptococci were inhibited at MIC ≤0.5 mg/L. Tedizolid was ≥4-fold more potent than linezolid against all groups, including resistant phenotypes. Tedizolid had potent/stable activity against a large, contemporary collection of Gram-positive clinical isolates, with low rates of resistance.

  2. Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

    PubMed

    Fraser, Melissa A; Grooms, Dustin R; Guskiewicz, Kevin M; Kerr, Zachary Y

    2017-07-01

    Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries.   To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009-2010 through 2014-2015 academic years.   Descriptive epidemiology study.   Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009-2010 through 2014-2015 academic years.   Collegiate student-athletes participating in 11 sports.   Ball-contact-injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years.   During the 2009-2010 through 2014-2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were non-time loss (ie, participation-restriction time <24 hours), and 6.6% were severe (ie, participation-restriction time ≥21 days). The most common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10).   Ball-contact-injury rates

  3. Coding completeness and quality of relative survival-related variables in the National Program of Cancer Registries Cancer Surveillance System, 1995-2008.

    PubMed

    Wilson, Reda J; O'Neil, M E; Ntekop, E; Zhang, Kevin; Ren, Y

    2014-01-01

    Calculating accurate estimates of cancer survival is important for various analyses of cancer patient care and prognosis. Current US survival rates are estimated based on data from the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End RESULTS (SEER) program, covering approximately 28 percent of the US population. The National Program of Cancer Registries (NPCR) covers about 96 percent of the US population. Using a population-based database with greater US population coverage to calculate survival rates at the national, state, and regional levels can further enhance the effective monitoring of cancer patient care and prognosis in the United States. The first step is to establish the coding completeness and coding quality of the NPCR data needed for calculating survival rates and conducting related validation analyses. Using data from the NPCR-Cancer Surveillance System (CSS) from 1995 through 2008, we assessed coding completeness and quality on 26 data elements that are needed to calculate cancer relative survival estimates and conduct related analyses. Data elements evaluated consisted of demographic, follow-up, prognostic, and cancer identification variables. Analyses were performed showing trends of these variables by diagnostic year, state of residence at diagnosis, and cancer site. Mean overall percent coding completeness by each NPCR central cancer registry averaged across all data elements and diagnosis years ranged from 92.3 percent to 100 percent. RESULTS showing the mean percent coding completeness for the relative survival-related variables in NPCR data are presented. All data elements but 1 have a mean coding completeness greater than 90 percent as was the mean completeness by data item group type. Statistically significant differences in coding completeness were found in the ICD revision number, cause of death, vital status, and date of last contact variables when comparing diagnosis years. The majority of data items had a coding

  4. Antimicrobial susceptibility among Gram-positive organisms collected from pediatric patients globally between 2004 and 2011: results from the Tigecycline Evaluation and Surveillance Trial.

    PubMed

    Brandon, Michael; Dowzicky, Michael J

    2013-07-01

    The Tigecycline Evaluation and Surveillance Trial (TEST) was designed to monitor global longitudinal changes in bacterial susceptibility to a panel of antimicrobial agents, including tigecycline. In this study, we examine susceptibility among Gram-positive isolates collected from pediatric patients globally between 2004 and 2011. A total of 9,422 Gram-positive isolates were contributed by 1,255 centers, predominantly from Europe and North America. One-third of Staphylococcus aureus isolates were methicillin resistant, peaking in prevalence in 2007. All S. aureus isolates (n = 3,614) were susceptible to linezolid, tigecycline, and vancomycin; minocycline, imipenem, and meropenem were also highly active (>92% susceptibility). Ampicillin and penicillin susceptibility increased significantly during the study period (P < 0.0001 for both). Streptococcus pneumoniae isolates (n = 3,373) were highly susceptible to vancomycin (100%), linezolid (>99%), and levofloxacin and tigecycline (both >96%); imipenem susceptibility was low (32%) in Africa while minocycline susceptibility was low in Asia-Pacific Rim (38%). Penicillin resistance occurred in one-fifth of all S. pneumoniae isolates, with penicillin susceptibility ranging from 14% in Africa to 65% in Europe. Streptococcus agalactiae isolates (n = 1,056) were highly susceptible to most antimicrobials, although only 16% were susceptible to minocycline. Enterococcus faecalis isolates (n = 1,112) were highly susceptible (>97%) to ampicillin, linezolid, penicillin, tigecycline, and vancomycin globally, but only 34% were minocycline susceptible; minocycline susceptibility decreased significantly from 2004 to 2011 (P < 0.001). Tigecycline and linezolid were highly active against Enterococcus faecium (n = 267) globally (100% and 98% susceptible, respectively). Tigecycline and linezolid were highly active against Gram-positive pathogens from pediatric patients in TEST 2004 to 2011, with vancomycin and the carbapenems performing well

  5. Economic evaluation of linezolid, flucloxacillin and vancomycin in the empirical treatment of cellulitis in UK hospitals: a decision analytical model.

    PubMed

    Vinken, A; Li, Z; Balan, D; Rittenhouse, B; Wilike, R; Nathwani, D

    2001-12-01

    Standard antibiotic treatment of infections has become more difficult and costly due to treatment failure associated with the rise in bacterial resistance. New antibiotics that can overcome such resistant pathogens have the potential for great clinical and economic impact. Linezolid is a new antibiotic that is effective in the treatment of both antibiotic-susceptible and antibiotic-resistant Gram-positive bacterial infections, including those resistant to other available antibiotics. This breadth of activity is unique in existing antibiotics for Gram-positive bacteria and serves as the rationale for exploring the hypothesis that linezolid is an appropriate choice when considering empirical treatment of cellulitis in complicated or compromised patients in the nosocomial setting. A decision-modelling approach was used to compare the predicted first-line treatment efficacy and direct medical costs of linezolid with standard treatment of cellulitis among hospitalized patients. For the purposes of this analysis, standard care is defined along two main pathways: (1) initiating care with intravenous (iv) flucloxacillin, switching to vancomycin if the pathogen is found to be resistant to flucloxacillin, or maintaining flucloxacillin if the pathogen is found susceptible, or when culture and sensitivity analysis is inconclusive; or (2) initiating care with vancomycin, switching to iv flucloxacillin if the pathogen is found susceptible to flucloxacillin, maintaining vancomycin if the infection is found resistant, or when culture and sensitivity are inconclusive. For those patients taking iv flucloxacillin, a switch to oral flucloxacillin was allowed when clinically appropriate. We hypothesized that the cost of care of initiating treatment with linezolid would be less than that for both vancomycin and flucloxacillin in resistance risk ranges typically encountered in UK hospitals. In addition, while the registration trials showed equivalence of linezolid with the comparators in

  6. The importance of monitoring adverse drug reactions in pediatric patients: the results of a national surveillance program in Italy.

    PubMed

    Carnovale, Carla; Brusadelli, Tatiana; Zuccotti, GianVincenzo; Beretta, Silvia; Sullo, Maria Giuseppa; Capuano, Annalisa; Rossi, Francesco; Moschini, Martina; Mugelli, Alessandro; Vannacci, Alfredo; Laterza, Marcella; Clementi, Emilio; Radice, Sonia

    2014-09-01

    To gain information on safety of drugs used in pediatrics through a 4-year post-marketing active pharmacovigilance program. The program sampled the Italian population and was termed 'Monitoring of the Adverse Effects in Pediatric population' (MEAP). Adverse drug reactions (ADRs) were collected for individuals aged 0 - 17 years treated in hospitals and territorial health services in Lombardy, Tuscany, Apulia and Campania; located to gain an appropriate sampling of the population. ADRs were evaluated using the Adverse Drug Reaction Probability Scale (Naranjo) and analyzed with respect to time, age, sex, category of ADR, seriousness, suspected medicines, type of reporter and off-label use. We collected and analyzed reports from 3539 ADRs. Vaccines, antineoplastic and psychotropic drugs were the most frequently pharmacotherapeutic subgroups involved. Seventeen percent of reported ADRs were serious; of them fever, vomiting and angioedema were the most frequently reported. Eight percent of ADRs were associated with off-label use, and 10% were unknown ADRs. Analysis of these revealed possible strategies of therapy optimization. The MEAP project demonstrated that active post-marketing pharmacovigilance programs are a valid strategy to increase awareness on pediatric pharmacology, reduce underreporting and provide information on drug actions in pediatrics. This information enhances drug therapy optimization in the pediatric patients.

  7. 40 CFR 52.2684 - Source surveillance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Source surveillance. 52.2684 Section 52.2684 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2684 Source surveillance. (a) The...

  8. 40 CFR 52.2684 - Source surveillance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Source surveillance. 52.2684 Section 52.2684 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2684 Source surveillance. (a) The...

  9. 40 CFR 52.1077 - Source surveillance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Source surveillance. 52.1077 Section 52.1077 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Maryland § 52.1077 Source surveillance. (a...

  10. 40 CFR 52.2030 - Source surveillance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Source surveillance. 52.2030 Section 52.2030 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Pennsylvania § 52.2030 Source surveillance...

  11. 40 CFR 52.2075 - Source surveillance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Source surveillance. 52.2075 Section 52.2075 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Rhode Island § 52.2075 Source surveillance...

  12. 40 CFR 52.2075 - Source surveillance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Source surveillance. 52.2075 Section 52.2075 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Rhode Island § 52.2075 Source surveillance...

  13. 40 CFR 52.1077 - Source surveillance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Source surveillance. 52.1077 Section 52.1077 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Maryland § 52.1077 Source surveillance. (a...

  14. 40 CFR 52.479 - Source surveillance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Source surveillance. 52.479 Section 52.479 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.479 Source surveillance. (a) (b...

  15. 40 CFR 52.479 - Source surveillance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Source surveillance. 52.479 Section 52.479 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS District of Columbia § 52.479 Source surveillance. (a) (b...

  16. 40 CFR 52.2075 - Source surveillance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Source surveillance. 52.2075 Section 52.2075 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Rhode Island § 52.2075 Source surveillance...

  17. 40 CFR 52.1077 - Source surveillance.<