Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidat...Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidate genes associated with host susceptibility to Aspergillus fumigatus(Af)using an RNAseq approach in CC lines and hepatic gene expression.Methods:We studied 31 male mice from 25 CC lines at 8 weeks old;the mice were infected with Af.Liver tissues were extracted from these mice 5 days post-infection,and next-generation RNA-sequencing(RNAseq)was performed.The GENE-E analysis platform was used to generate a clustered heat map matrix.Results:Significant variation in body weight changes between CC lines was ob-served.Hepatic gene expression revealed 12 top prioritized candidate genes differ-entially expressed in resistant versus susceptible mice based on body weight changes.Interestingly,three candidate genes are located within genomic intervals of the previ-ously mapped quantitative trait loci(QTL),including Gm16270 and Stox1 on chromo-some 10 and Gm11033 on chromosome 8.Conclusions:Our findings emphasize the CC mouse model's power in fine mapping the genetic components underlying susceptibility towards Af.As a next step,eQTL analysis will be performed for our RNA-Seq data.Suggested candidate genes from our study will be further assessed with a human cohort with aspergillosis.展开更多
INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefor...INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission展开更多
Hepatitis B virus(HBV) and hepatitis C virus(HCV) infections are the most common causes of chronic liver diseases and hepatocelluar carcinomas. Over the past few years, the liver-enriched micro RNA-122(mi R-122) has b...Hepatitis B virus(HBV) and hepatitis C virus(HCV) infections are the most common causes of chronic liver diseases and hepatocelluar carcinomas. Over the past few years, the liver-enriched micro RNA-122(mi R-122) has been shown to differentially regulate viral replication of HBV and HCV. It is notable that thelevel of mi R-122 is positively and negatively regulated by HCV and HBV, respectively. Consistent with the welldocumented phenomenon that mi R-122 promotes HCV accumulation, inhibition of mi R-122 has been shown as an effective therapy for the treatment of HCV infection in both chimpanzees and humans. On the other hand, mi R-122 is also known to block HBV replication, and HBV has recently been shown to inhibit mi R-122 expression; such a reciprocal inhibition between mi R-122 and HBV suggests an intriguing possibility that mi R-122 replacement may represent a potential therapy for treatment of HBV infection. As HBV and HCV have shared transmission routes, dual infection is not an uncommon scenario, which is associated with more advanced liver disease than either HBV or HCV mono-infection. Thus, there is a clear need to further understand the interaction between HBV and HCV and to delineate the role of mi R-122 in HBV/HCV dual infection in order to devise effective therapy. This review summarizes the current understanding of HBV/HCV dual infection, focusing on the pathobiological role and therapeutic potential of mi R-122.展开更多
BACKGROUND There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infe...BACKGROUND There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infection(NI) with SARS-CoV-2 is higher than that of the general infected population. In the early stage of the pandemic in Taiwan, as patients were not tested for SARS-CoV-2 at admission, NIs often go undetected. Strictly applying the systematic polymerase chain reaction(PCR) screening, as a standard infection control measure was subsequently implemented to reduce NI incidence. However, evidence on risk factors for SARS-CoV-2 NIs among healthcare workers(HCWs) and caregivers is limited.AIM To assess NI incidence of SARS-CoV-2 among hospital staff, hospitalized patients, and caregivers, and the transmission routes of clusters of infection.METHODS This descriptive retrospective analysis at our hospital from May 15 to August 15, 2021 included data on 132 SARS-CoV-2 NIs cases among hospital staff, inpatients, and caregivers who previously tested negative but subsequently identified with a positive SARS-CoV-2 reverse transcriptase-PCR(RT-PCR) test results, or a hospital staff who tested positive following routine SARS-CoV-2 RT-PCR test. Chi-square tests were performed to compare the differences between hospital staff and private caregivers, and between clusters and sporadic infections.RESULTS Overall, 9149 patients and 2005 hospital staff members underwent routine SARS-CoV-2 RT-PCR testing, resulting in 12 confirmed cluster and 23 sporadic infections. Among the index cases of the clusters, three(25%) cases were among hospital staff and nine(75%) cases were among other contacts. Among sporadic infections, 21(91%) cases were among hospital staff and two(9%) cases were among other contacts(P < 0.001). There was an average of 8.08 infections per cluster. The secondary cases of cluster infection were inpatients(45%), hospital staff(30%), and caregivers(25%). Private caregivers constituted 27% and 4% of the clusters and sporadic infections, respectively(P = 0.024);92.3% of them were infected in the clusters. The mortality rate was 0.0%.CONCLUSION The incidence of SARS-CoV-2 infection was relatively high among private caregivers, indicating a need for infection control education in this group, such as social distancing, frequent handwashing, and wearing PPE.展开更多
This documentary research aimed to describe the results of an epidemiological survey that sought to determine the prevalence of Infections Related to Health Care (IRHC) in newborns admitted to a Neonatal Intensive Car...This documentary research aimed to describe the results of an epidemiological survey that sought to determine the prevalence of Infections Related to Health Care (IRHC) in newborns admitted to a Neonatal Intensive Care Unit (NICU) at the city of Rio de Janeiro. For methodology, the existing data in the original research database were used as the primary source. The method used was the case study in a quantitative approach. The data have been statistically arranged by odds ratio, which measured the possibility of IRHC development at the 102 newborns, by exposition at the risk factors. Results: IRHC prevalence with pneumonias, sepsis, navel’s infection and ocular infections predominance rises. Prematures are 4.10 more susceptible. Twelve hours after amniotic rupture there are 1.77 more chances of infections. Babies with more than 10 days of hospitalization are 4.70 more susceptible than those with 10 days. The registers examined were incipient at the IRHC’s characterization, beginning and duration, which make the IRHC’s diagnostic/notification difficult.展开更多
To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with d...To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or "MAUDE"; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospi-tal X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including broncho-scopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endos-copy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind andnear the forceps elevator located at the distal end othe ERCP endoscope, are recommended. If the ERCPendoscope features a narrow and exposed channel thathouses a wire connecting the GI endoscope's controhead to this forceps elevator, then this channel's com-plete reprocessing, including its flushing with a deter-gent using a procedure validated for effectiveness, is also emphasized.展开更多
Background: Recently, the probable involvement of surfaces from the hospital environment as a disseminating source of resistant bacteria has been highlighted. The aim of the study was to compare resistant microorganis...Background: Recently, the probable involvement of surfaces from the hospital environment as a disseminating source of resistant bacteria has been highlighted. The aim of the study was to compare resistant microorganisms isolated from inanimate surfaces, equipments and patient blood culture samples in an Intensive Care Unit from Belo Horizonte, Brazil. Methods: A cross-sectional study was performed from July to October 2009. Data sources were microbiologic samples from environment and patient blood culture. Duplicate samples were obtained by swabs from up to seven different touch sites around two different patients in four different days. Jointly with the environmental samples, bacterial isolates from an adult ICU patients’ routine blood cultures were obtained from hospital laboratory. The samples were identified, tested for sensitivity and compared by rep-PCR test to verify similarity. Results: Difference among the averages of Colony Forming Units was found within the environment samples (p < 0.004). In the environment were identified antibiotic resistant microorganisms such as Vancomycin resistant Enterococcus faecalis, imipenem and ciprofloxacin Pseudomonas aeruginosa and multidrug-resistant Acinetobacter baumannii. Similarities (60% -80%) were established among environmental and blood culture samples. Conclusion: The environmental sampling showed different averages of contamination of the surfaces and equipment. The similarity among the bacterial isolates of patients’ blood cultures and environmental samples reinforces the hypothesis of the horizontal transference of pathogens.展开更多
Objective: Infection control protocols dictate the disinfection of dentures. There are no products available which are designed for the specific use of disinfecting dentures. The objective of this study was to investi...Objective: Infection control protocols dictate the disinfection of dentures. There are no products available which are designed for the specific use of disinfecting dentures. The objective of this study was to investigate the impact of chemical disinfectants on elastic modulus, flexural strength and color stability of denture base resins. Methods: 256 specimens from four acrylic denture base resins were manufactured. Two cold-curing denture base resins: PalaXpress (Heraeus Kulzer, Hanau, Germany), Futura Gen (Schuetz Dental, Roßbach, Germany) and two heat-curing denture base resins: Paladon 65 (Heraeus Kulzer, Hanau, Germany), FuturAcryl 2000 (Schuetz Dental, Roßbach, Germany) were used. Three chemical disinfecting agents were tested: Impresept, D050 Instru-Gen, Stammopur DR. Specimens were stored in distilled water and in chemical disinfecting agents. They were divided randomly into groups. E-Modulus and flexural strength were measured using the three-point bending test. Color changes (ΔE) were determined spectrophotometrically. Results: The disinfection agents showed no significant influence on the E-modulus compared to distilled water (Acrylic vs. distilled water from (Futura Gen) 2688.80 ± 230.78 vs. 2766.60 ± 91.22 MPa to (PalaXpress) 3004.20 ± 26.40 vs. 2851.00 ± 95.23 MPa). Flexural strength after storage in distilled water and disinfection did not differ significantly (Acrylic vs. distilled water from (Paladon65) 27.28 ± 1.30 vs. 28.42 ± 0.84 N/mm2, (p > 0.05) to (PalaXpress) 30.88 ± 0.25 vs. 29.68 ± 0.79 N/mm2, p < 0.001). Disinfection caused a significant color change with Impresept of Paladon 65 (p ≤ 0.001), FuturaAcryl 2000 with Stammopur DR and D 050 Instru-Gen (p ≤ 0.001). Conclusions: The investigated disinfection agents did not influence elastic modulus and flexural strength of denture base resins negatively. ΔE-values were in a range of 1 to 2. Thus, the detected color changes may be marginal. Clinical relevance: Single use disinfections are feasible for acrylic dentures regarding to elastic modulus and flexural strength.展开更多
<b>Introduction:</b> <i>Burkholderia cepacia</i> is a non-fermenting emergent bacterium common in nosocomial infections and can cause life-threatening infections whose multidrug resistance make...<b>Introduction:</b> <i>Burkholderia cepacia</i> is a non-fermenting emergent bacterium common in nosocomial infections and can cause life-threatening infections whose multidrug resistance makes them a serious threat in hospitals. The aim of this study was to determine the prevalence of <i>B. cepacia</i> infections during nosocomial infections at Libreville University teaching hospital. <b>Methodology:</b> In this cross-sectional study, lasting 19 months, 412 blood cultures were analyzed. The BacT/ALERT 3D (Biomerieux, France) was used to detect the positivity of blood culture flasks and the Viteck 2 compact (Biomerieux, France) for the identification of germs and the study of their susceptibility to antibiotics. <b>Results:</b> Our study population consisted of 412 patients. The sex-ratio M/F was 1.06 in favor of the male gender (n = 201, 51%). The age of the patients varied between 0 and 82 years. The bacteremia of <i>B. cepacia</i> mainly affected children under 15 years of age with a prevalence of 7% (n = 28). The pediatric ward was more represented with a frequency of 36% (n = 10). The antibiotic sensitivity profile showed high resistance of 100% for aminoglycosides (amikacin, tobramycin, and gentamycin), tetracycline, beta-lactams (Amoxicillin, Imipenem, Ticarcillin, Cefoxitin and Cefotaxime), and ciprofloxacin. However, four molecules were active on <i>B. cepacia</i> (Levofloxacin 100%, Trimethoprim + sulfamethoxazole 92.3%, ceftazidime 80% and cefepime 35%). <b>Conclusion:</b> Ultimately, infection and multi-resistance due to <i>Burkholderia cepacia</i> calls for a review of hospital hygiene in the pediatric ward and a review of antibiotic therapy in young children.展开更多
Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and ...Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.展开更多
Background Nosocomial infection in early post-transplantation period is a tough problem for kidney transplantation. Few reports have explored the relations between biochemical parameters and nosocomial infection in ki...Background Nosocomial infection in early post-transplantation period is a tough problem for kidney transplantation. Few reports have explored the relations between biochemical parameters and nosocomial infection in kidney transplantation. This retrospective study was carried out to describe the characteristics of nosocomial infection in the very early period of kidney transplantation and to determine the risk factors in biochemical parameters and their alterations. Methods Patients who underwent their first kidney transplantation from January 2001 to March 2009 in Beijing Chao-Yang Hospital were recruited and the nosocomial infectious episodes were collected for this study. Gender, age, donor type, delayed graft function (DGF) and biochemical parameters such as serum uric acid, lipids files and albumin on day 0 (before transplantation) and day 1 (24 hours after transplantation) and their changes were analyzed with Logistic regression models for nosocomial infection. Results A total of 405 patients (315 men and 90 women) were involved in this study. There were 80 patients experiencing 113 infection episodes and 105 strains of microorganism were indentified. In univariate analysis, there were significant differences in DGF, albumin on day 0, lipoprotein (a) (Lp(a)) on day 1, change in low density lipoprotein-cholesterol (LDL-C, day 1-day 0) and change in uric acid (day 1-day 0) between nosocomial infection patients and noninfectious patients (P 〈0.05). In multivariate analysis, change in uric acid (day 1-day 0) (OR 5.139, 95% CI 1.176-22.465, P 〈0.05), change in LDL-C (day 1-day 0) (OR4.179, 95% CI 1.375-12.703, P 〈0.05) and DGF (OR 14.409, 95% CI 1.603-129.522, P 〈0.05) were identified as independent risk factors for nosocomial infection in kidney transplantation. Conclusions Most nosocomial infections in early postoperative period of kidney transplantation are bacterial, especially with Gram-negative bacteria. The most common infection sites are respiratory tract, urinary tract and surgical site. DGF, decrease of LDL-C and increase of uric acid could increase the risk for nosocomial infections.展开更多
基金European Sequencing and Genotyping Institutes(ESGI),Grant/Award Number:075491/Z/04,085906/Z/08/Z and 090532/Z/09/ZTel-Aviv University(TAU)。
文摘Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidate genes associated with host susceptibility to Aspergillus fumigatus(Af)using an RNAseq approach in CC lines and hepatic gene expression.Methods:We studied 31 male mice from 25 CC lines at 8 weeks old;the mice were infected with Af.Liver tissues were extracted from these mice 5 days post-infection,and next-generation RNA-sequencing(RNAseq)was performed.The GENE-E analysis platform was used to generate a clustered heat map matrix.Results:Significant variation in body weight changes between CC lines was ob-served.Hepatic gene expression revealed 12 top prioritized candidate genes differ-entially expressed in resistant versus susceptible mice based on body weight changes.Interestingly,three candidate genes are located within genomic intervals of the previ-ously mapped quantitative trait loci(QTL),including Gm16270 and Stox1 on chromo-some 10 and Gm11033 on chromosome 8.Conclusions:Our findings emphasize the CC mouse model's power in fine mapping the genetic components underlying susceptibility towards Af.As a next step,eQTL analysis will be performed for our RNA-Seq data.Suggested candidate genes from our study will be further assessed with a human cohort with aspergillosis.
基金Scientific Research Foundation,State Health Commission,No.96-2-128
文摘INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission
文摘Hepatitis B virus(HBV) and hepatitis C virus(HCV) infections are the most common causes of chronic liver diseases and hepatocelluar carcinomas. Over the past few years, the liver-enriched micro RNA-122(mi R-122) has been shown to differentially regulate viral replication of HBV and HCV. It is notable that thelevel of mi R-122 is positively and negatively regulated by HCV and HBV, respectively. Consistent with the welldocumented phenomenon that mi R-122 promotes HCV accumulation, inhibition of mi R-122 has been shown as an effective therapy for the treatment of HCV infection in both chimpanzees and humans. On the other hand, mi R-122 is also known to block HBV replication, and HBV has recently been shown to inhibit mi R-122 expression; such a reciprocal inhibition between mi R-122 and HBV suggests an intriguing possibility that mi R-122 replacement may represent a potential therapy for treatment of HBV infection. As HBV and HCV have shared transmission routes, dual infection is not an uncommon scenario, which is associated with more advanced liver disease than either HBV or HCV mono-infection. Thus, there is a clear need to further understand the interaction between HBV and HCV and to delineate the role of mi R-122 in HBV/HCV dual infection in order to devise effective therapy. This review summarizes the current understanding of HBV/HCV dual infection, focusing on the pathobiological role and therapeutic potential of mi R-122.
文摘BACKGROUND There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infection(NI) with SARS-CoV-2 is higher than that of the general infected population. In the early stage of the pandemic in Taiwan, as patients were not tested for SARS-CoV-2 at admission, NIs often go undetected. Strictly applying the systematic polymerase chain reaction(PCR) screening, as a standard infection control measure was subsequently implemented to reduce NI incidence. However, evidence on risk factors for SARS-CoV-2 NIs among healthcare workers(HCWs) and caregivers is limited.AIM To assess NI incidence of SARS-CoV-2 among hospital staff, hospitalized patients, and caregivers, and the transmission routes of clusters of infection.METHODS This descriptive retrospective analysis at our hospital from May 15 to August 15, 2021 included data on 132 SARS-CoV-2 NIs cases among hospital staff, inpatients, and caregivers who previously tested negative but subsequently identified with a positive SARS-CoV-2 reverse transcriptase-PCR(RT-PCR) test results, or a hospital staff who tested positive following routine SARS-CoV-2 RT-PCR test. Chi-square tests were performed to compare the differences between hospital staff and private caregivers, and between clusters and sporadic infections.RESULTS Overall, 9149 patients and 2005 hospital staff members underwent routine SARS-CoV-2 RT-PCR testing, resulting in 12 confirmed cluster and 23 sporadic infections. Among the index cases of the clusters, three(25%) cases were among hospital staff and nine(75%) cases were among other contacts. Among sporadic infections, 21(91%) cases were among hospital staff and two(9%) cases were among other contacts(P < 0.001). There was an average of 8.08 infections per cluster. The secondary cases of cluster infection were inpatients(45%), hospital staff(30%), and caregivers(25%). Private caregivers constituted 27% and 4% of the clusters and sporadic infections, respectively(P = 0.024);92.3% of them were infected in the clusters. The mortality rate was 0.0%.CONCLUSION The incidence of SARS-CoV-2 infection was relatively high among private caregivers, indicating a need for infection control education in this group, such as social distancing, frequent handwashing, and wearing PPE.
文摘This documentary research aimed to describe the results of an epidemiological survey that sought to determine the prevalence of Infections Related to Health Care (IRHC) in newborns admitted to a Neonatal Intensive Care Unit (NICU) at the city of Rio de Janeiro. For methodology, the existing data in the original research database were used as the primary source. The method used was the case study in a quantitative approach. The data have been statistically arranged by odds ratio, which measured the possibility of IRHC development at the 102 newborns, by exposition at the risk factors. Results: IRHC prevalence with pneumonias, sepsis, navel’s infection and ocular infections predominance rises. Prematures are 4.10 more susceptible. Twelve hours after amniotic rupture there are 1.77 more chances of infections. Babies with more than 10 days of hospitalization are 4.70 more susceptible than those with 10 days. The registers examined were incipient at the IRHC’s characterization, beginning and duration, which make the IRHC’s diagnostic/notification difficult.
基金Supported by An educational grant provided by FUJIFILM Medical Systems,USA,Inc.,Endoscopy Division(Wayne,NJUnited States)
文摘To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or "MAUDE"; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospi-tal X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including broncho-scopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endos-copy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind andnear the forceps elevator located at the distal end othe ERCP endoscope, are recommended. If the ERCPendoscope features a narrow and exposed channel thathouses a wire connecting the GI endoscope's controhead to this forceps elevator, then this channel's com-plete reprocessing, including its flushing with a deter-gent using a procedure validated for effectiveness, is also emphasized.
文摘Background: Recently, the probable involvement of surfaces from the hospital environment as a disseminating source of resistant bacteria has been highlighted. The aim of the study was to compare resistant microorganisms isolated from inanimate surfaces, equipments and patient blood culture samples in an Intensive Care Unit from Belo Horizonte, Brazil. Methods: A cross-sectional study was performed from July to October 2009. Data sources were microbiologic samples from environment and patient blood culture. Duplicate samples were obtained by swabs from up to seven different touch sites around two different patients in four different days. Jointly with the environmental samples, bacterial isolates from an adult ICU patients’ routine blood cultures were obtained from hospital laboratory. The samples were identified, tested for sensitivity and compared by rep-PCR test to verify similarity. Results: Difference among the averages of Colony Forming Units was found within the environment samples (p < 0.004). In the environment were identified antibiotic resistant microorganisms such as Vancomycin resistant Enterococcus faecalis, imipenem and ciprofloxacin Pseudomonas aeruginosa and multidrug-resistant Acinetobacter baumannii. Similarities (60% -80%) were established among environmental and blood culture samples. Conclusion: The environmental sampling showed different averages of contamination of the surfaces and equipment. The similarity among the bacterial isolates of patients’ blood cultures and environmental samples reinforces the hypothesis of the horizontal transference of pathogens.
文摘Objective: Infection control protocols dictate the disinfection of dentures. There are no products available which are designed for the specific use of disinfecting dentures. The objective of this study was to investigate the impact of chemical disinfectants on elastic modulus, flexural strength and color stability of denture base resins. Methods: 256 specimens from four acrylic denture base resins were manufactured. Two cold-curing denture base resins: PalaXpress (Heraeus Kulzer, Hanau, Germany), Futura Gen (Schuetz Dental, Roßbach, Germany) and two heat-curing denture base resins: Paladon 65 (Heraeus Kulzer, Hanau, Germany), FuturAcryl 2000 (Schuetz Dental, Roßbach, Germany) were used. Three chemical disinfecting agents were tested: Impresept, D050 Instru-Gen, Stammopur DR. Specimens were stored in distilled water and in chemical disinfecting agents. They were divided randomly into groups. E-Modulus and flexural strength were measured using the three-point bending test. Color changes (ΔE) were determined spectrophotometrically. Results: The disinfection agents showed no significant influence on the E-modulus compared to distilled water (Acrylic vs. distilled water from (Futura Gen) 2688.80 ± 230.78 vs. 2766.60 ± 91.22 MPa to (PalaXpress) 3004.20 ± 26.40 vs. 2851.00 ± 95.23 MPa). Flexural strength after storage in distilled water and disinfection did not differ significantly (Acrylic vs. distilled water from (Paladon65) 27.28 ± 1.30 vs. 28.42 ± 0.84 N/mm2, (p > 0.05) to (PalaXpress) 30.88 ± 0.25 vs. 29.68 ± 0.79 N/mm2, p < 0.001). Disinfection caused a significant color change with Impresept of Paladon 65 (p ≤ 0.001), FuturaAcryl 2000 with Stammopur DR and D 050 Instru-Gen (p ≤ 0.001). Conclusions: The investigated disinfection agents did not influence elastic modulus and flexural strength of denture base resins negatively. ΔE-values were in a range of 1 to 2. Thus, the detected color changes may be marginal. Clinical relevance: Single use disinfections are feasible for acrylic dentures regarding to elastic modulus and flexural strength.
文摘<b>Introduction:</b> <i>Burkholderia cepacia</i> is a non-fermenting emergent bacterium common in nosocomial infections and can cause life-threatening infections whose multidrug resistance makes them a serious threat in hospitals. The aim of this study was to determine the prevalence of <i>B. cepacia</i> infections during nosocomial infections at Libreville University teaching hospital. <b>Methodology:</b> In this cross-sectional study, lasting 19 months, 412 blood cultures were analyzed. The BacT/ALERT 3D (Biomerieux, France) was used to detect the positivity of blood culture flasks and the Viteck 2 compact (Biomerieux, France) for the identification of germs and the study of their susceptibility to antibiotics. <b>Results:</b> Our study population consisted of 412 patients. The sex-ratio M/F was 1.06 in favor of the male gender (n = 201, 51%). The age of the patients varied between 0 and 82 years. The bacteremia of <i>B. cepacia</i> mainly affected children under 15 years of age with a prevalence of 7% (n = 28). The pediatric ward was more represented with a frequency of 36% (n = 10). The antibiotic sensitivity profile showed high resistance of 100% for aminoglycosides (amikacin, tobramycin, and gentamycin), tetracycline, beta-lactams (Amoxicillin, Imipenem, Ticarcillin, Cefoxitin and Cefotaxime), and ciprofloxacin. However, four molecules were active on <i>B. cepacia</i> (Levofloxacin 100%, Trimethoprim + sulfamethoxazole 92.3%, ceftazidime 80% and cefepime 35%). <b>Conclusion:</b> Ultimately, infection and multi-resistance due to <i>Burkholderia cepacia</i> calls for a review of hospital hygiene in the pediatric ward and a review of antibiotic therapy in young children.
文摘Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.
文摘Background Nosocomial infection in early post-transplantation period is a tough problem for kidney transplantation. Few reports have explored the relations between biochemical parameters and nosocomial infection in kidney transplantation. This retrospective study was carried out to describe the characteristics of nosocomial infection in the very early period of kidney transplantation and to determine the risk factors in biochemical parameters and their alterations. Methods Patients who underwent their first kidney transplantation from January 2001 to March 2009 in Beijing Chao-Yang Hospital were recruited and the nosocomial infectious episodes were collected for this study. Gender, age, donor type, delayed graft function (DGF) and biochemical parameters such as serum uric acid, lipids files and albumin on day 0 (before transplantation) and day 1 (24 hours after transplantation) and their changes were analyzed with Logistic regression models for nosocomial infection. Results A total of 405 patients (315 men and 90 women) were involved in this study. There were 80 patients experiencing 113 infection episodes and 105 strains of microorganism were indentified. In univariate analysis, there were significant differences in DGF, albumin on day 0, lipoprotein (a) (Lp(a)) on day 1, change in low density lipoprotein-cholesterol (LDL-C, day 1-day 0) and change in uric acid (day 1-day 0) between nosocomial infection patients and noninfectious patients (P 〈0.05). In multivariate analysis, change in uric acid (day 1-day 0) (OR 5.139, 95% CI 1.176-22.465, P 〈0.05), change in LDL-C (day 1-day 0) (OR4.179, 95% CI 1.375-12.703, P 〈0.05) and DGF (OR 14.409, 95% CI 1.603-129.522, P 〈0.05) were identified as independent risk factors for nosocomial infection in kidney transplantation. Conclusions Most nosocomial infections in early postoperative period of kidney transplantation are bacterial, especially with Gram-negative bacteria. The most common infection sites are respiratory tract, urinary tract and surgical site. DGF, decrease of LDL-C and increase of uric acid could increase the risk for nosocomial infections.