Role of the hospital environment in disease transmission, with a focus on Clostridium difficile

2013 ◽  
Vol 18 (1) ◽  
pp. 14-22 ◽  
Author(s):  
William A. Rutala ◽  
David J. Weber
Keyword(s):  
Clostridium Difficile ◽  
Disease Transmission ◽  
Hospital Environment

scholarly journals Physicians` awareness level assessment of the epidemiology and diagnosis features of nosocomial infection caused by Clostridium difficile in a multidisciplinary hospitals

2021 ◽  
Author(s):  
Alla Lokotkova
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Clinical Manifestations ◽  
Low Frequency ◽  
Antibiotic Use ◽  
Hospital Environment ◽  
Laboratory Diagnostics ◽  
Important Place ◽  
Lack Of Physicians

Background. Clostridium difficile has an important place among healthcare associated infections pathogens , mainly due to the widespread and inappropriate antibiotics use. Over the past 10 years an incidence of this infection has increased in the USA and European countries. Unfortunately, Clostridium difficile infection cases in the Russian Federation are almost not register, probably due to the lack of physicians awareness and underestimation of the pathogen role in the etiology of nosocomial infections. The study purpose is to study the different specialties physicians awareness of patients` Clostridium difficile infections development in multidisciplinary hospitals. Materials and methods. A questionnaire survey of 115 physicians of two multidisciplinary hospitals in Kazan was carried out. The questionnaire included 15 questions related to etiology, transmission mechanism, risk factors, clinical presentation, diagnosis and prevention of C. difficile infection. Statistical data processing was carried out in MS Excel. Results. A low level of physicians` awareness on this issue was revealed. 92.2% of physicians did not have any Clostridium difficile infection cases in their practice. 31.3% of respondents underestimate the role of antibiotic use as the main risk factor for the development of the disease; at the same time, there are frequent cases of unreasonable prescription of antibiotics. 32.2% of the respondents are poorly informed about diagnosis methods of clostridiosis. 20% of physicians deny the role of bacteria carriers as a source of infection. 77.4% of respondents indicated the alimentary route as the main route of infection transmission. Only 38.2% of respondents noted the hospital environment objects as a possible factor in the transmission of Clostridium difficile. Conclusions. There is no alertness regarding antibiotic-associated diarrhea caused by Clostridium difficile infection among multidisciplinary hospital physicians. Insufficient knowledge of epidemiology, clinical manifestations, laboratory diagnostics of Clostridium difficile infection are factors that determine the low frequency of its detection and, accordingly, impede the implementation of required anti-epidemic measures. There is a need to include Clostridium difficile infection issues in professional development programs for medical workers. It is advisable to develop and implement Clostridium difficile infection control.

scholarly journals UnderstandingClostridium difficileColonization

2018 ◽  
Vol 31 (2) ◽  
Author(s):  
Monique J. T. Crobach ◽  
Jonathan J. Vernon ◽  
Vivian G. Loo ◽  
Ling Yuan Kong ◽  
Séverine Péchiné ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Hospital Environment ◽  
Clinical Implications ◽  
Comprehensive Overview ◽  
Content Type ◽  
Risk Of Progression ◽  
Alternative Sources ◽  
Associated Risk Factors

SUMMARYClostridium difficileis the main causative agent of antibiotic-associated and health care-associated infective diarrhea. Recently, there has been growing interest in alternative sources ofC. difficileother than patients withClostridium difficileinfection (CDI) and the hospital environment. Notably, the role ofC. difficile-colonized patients as a possible source of transmission has received attention. In this review, we present a comprehensive overview of the current understanding ofC. difficilecolonization. Findings from gut microbiota studies yield more insights into determinants that are important for acquiring or resisting colonization and progression to CDI. In discussions on the prevalence ofC. difficilecolonization among populations and its associated risk factors, colonized patients at hospital admission merit more attention, as findings from the literature have pointed to their role in both health care-associated transmission ofC. difficileand a higher risk of progression to CDI once admitted.C. difficilecolonization among patients at admission may have clinical implications, although further research is needed to identify if interventions are beneficial for preventing transmission or overcoming progression to CDI.

scholarly journals How does globalization affect COVID-19 responses?

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Steve J. Bickley ◽  
Ho Fai Chan ◽  
Ahmed Skali ◽  
David Stadelmann ◽  
Benno Torgler
Keyword(s):  
Infectious Disease ◽  
Disease Transmission ◽  
State Capacity ◽  
International Travel ◽  
Health Crisis ◽  
Government Effectiveness ◽  
Policy Responses ◽  
Travel Restrictions ◽  
High Government

Abstract Background The ongoing COVID-19 pandemic has highlighted the vast differences in approaches to the control and containment of coronavirus across the world and has demonstrated the varied success of such approaches in minimizing the transmission of coronavirus. While previous studies have demonstrated high predictive power of incorporating air travel data and governmental policy responses in global disease transmission modelling, factors influencing the decision to implement travel and border restriction policies have attracted relatively less attention. This paper examines the role of globalization on the pace of adoption of international travel-related non-pharmaceutical interventions (NPIs) during the coronavirus pandemic. This study aims to offer advice on how to improve the global planning, preparation, and coordination of actions and policy responses during future infectious disease outbreaks with empirical evidence. Methods and data We analyzed data on international travel restrictions in response to COVID-19 of 185 countries from January to October 2020. We applied time-to-event analysis to examine the relationship between globalization and the timing of travel restrictions implementation. Results The results of our survival analysis suggest that, in general, more globalized countries, accounting for the country-specific timing of the virus outbreak and other factors, are more likely to adopt international travel restrictions policies. However, countries with high government effectiveness and globalization were more cautious in implementing travel restrictions, particularly if through formal political and trade policy integration. This finding is supported by a placebo analysis of domestic NPIs, where such a relationship is absent. Additionally, we find that globalized countries with high state capacity are more likely to have higher numbers of confirmed cases by the time a first restriction policy measure was taken. Conclusions The findings highlight the dynamic relationship between globalization and protectionism when governments respond to significant global events such as a public health crisis. We suggest that the observed caution of policy implementation by countries with high government efficiency and globalization is a by-product of commitment to existing trade agreements, a greater desire to ‘learn from others’ and also perhaps of ‘confidence’ in a government’s ability to deal with a pandemic through its health system and state capacity. Our results suggest further research is warranted to explore whether global infectious disease forecasting could be improved by including the globalization index and in particular, the de jure economic and political, and de facto social dimensions of globalization, while accounting for the mediating role of government effectiveness. By acting as proxies for a countries’ likelihood and speed of implementation for international travel restriction policies, such measures may predict the likely time delays in disease emergence and transmission across national borders.

The role of pathogen genomics in assessing disease transmission

BMJ ◽  
2015 ◽  
Vol 350 (may11 1) ◽  
pp. h1314-h1314 ◽  
Author(s):  
V. Sintchenko ◽  
E. C. Holmes
Keyword(s):  
Disease Transmission

Arthrocladiella mougeotii. [Descriptions of Fungi and Bacteria].

1998 ◽  
Author(s):  
V. P. Heluta
Keyword(s):  
Czech Republic ◽  
Geographical Distribution ◽  
Disease Transmission ◽  
Russian Far East ◽  
Far East ◽  
Republic Of Georgia ◽  
Lycium Barbarum ◽  
Initial Stage ◽  
High Infection

Abstract A description is provided for Arthrocladiella mougeotii. Information is included on the disease caused by the organism, its transmission, geographical distribution, and hosts. DISEASE: Powdery mildew of Lycium species only. The mycelium, conidiophores, conidia and ascomata form first white, then dirty-grey patches on damaged green parts of the host. Infected parts are deformed slightly and, in cases of high infection, plants can lose their ornamental qualities. Damaged leaves can fall prematurely. HOSTS: Lycium barbarum (= L. europaeum), L. chinense, L. dasystemum, L. halimifolium, L. ovatum, L. potaninii, L. rhombifolium, L. ruthenicum. [Type host - Lycium barbarum] GEOGRAPHICAL DISTRIBUTION: Africa: Canary Islands. Asia (temperate areas only): Armenia, Azerbaijan, China, Republic of Georgia, Israel, Japan, Kazakhstan, Kirghizistan, Korea, Russia (Russian far east), Tadzhikistan, Taiwan, Turkey, Turkmenistan, Uzbekistan. Australasia: New Zealand (introduced). Europe: Austria, Belgium, Bulgaria, Czech Republic, Estonia, France, Germany, Hungary, Italy, Netherlands, Norway, Poland, Rumania, Slovakia, Sweden, Switzerland, UK, Ukraine (southern), former Yugoslavia. North America: USA (introduced). TRANSMISSION: By wind-dispersed conidia. The rôle of ascospores in disease transmission is unknown, although it has been supposed that they can cause the initial stage of the disease.

scholarly journals Cyclic Diguanylate Regulates Virulence Factor Genes via Multiple Riboswitches inClostridium difficile

mSphere ◽  
2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Robert W. McKee ◽  
Carissa K. Harvest ◽  
Rita Tamayo
Keyword(s):  
Gene Expression ◽  
Clostridium Difficile ◽  
Biofilm Formation ◽  
Toxin Production ◽  
Intestinal Colonization ◽  
Cyclic Diguanylate ◽  
Signaling Molecule ◽  
Content Type ◽  
Surface Motility

ABSTRACTThe intracellular signaling molecule cyclic diguanylate (c-di-GMP) regulates many processes in bacteria, with a central role in controlling the switch between motile and nonmotile lifestyles. Recent work has shown that inClostridium difficile(also calledClostridioides difficile), c-di-GMP regulates swimming and surface motility, biofilm formation, toxin production, and intestinal colonization. In this study, we determined the transcriptional regulon of c-di-GMP inC. difficile,employing overexpression of a diguanylate cyclase gene to artificially manipulate intracellular c-di-GMP. Consistent with prior work, c-di-GMP regulated the expression of genes involved in swimming and surface motility. c-di-GMP also affected the expression of multiple genes encoding cell envelope proteins, several of which affected biofilm formationin vitro. A substantial proportion of the c-di-GMP regulon appears to be controlled either directly or indirectly via riboswitches. We confirmed the functionality of 11 c-di-GMP riboswitches, demonstrating their effects on downstream gene expression independent of the upstream promoters. The class I riboswitches uniformly functioned as “off” switches in response to c-di-GMP, while class II riboswitches acted as “on” switches. Transcriptional analyses of genes 3′ of c-di-GMP riboswitches over a broad range of c-di-GMP levels showed that relatively modest changes in c-di-GMP levels are capable of altering gene transcription, with concomitant effects on microbial behavior. This work expands the known c-di-GMP signaling network inC. difficileand emphasizes the role of the riboswitches in controlling known and putative virulence factors inC. difficile.IMPORTANCEInClostridium difficile, the signaling molecule c-di-GMP regulates multiple processes affecting its ability to cause disease, including swimming and surface motility, biofilm formation, toxin production, and intestinal colonization. In this study, we used RNA-seq to define the transcriptional regulon of c-di-GMP inC. difficile. Many new targets of c-di-GMP regulation were identified, including multiple putative colonization factors. Transcriptional analyses revealed a prominent role for riboswitches in c-di-GMP signaling. Only a subset of the 16 previously predicted c-di-GMP riboswitches were functionalin vivoand displayed potential variability in their response kinetics to c-di-GMP. This work underscores the importance of studying c-di-GMP riboswitches in a relevant biological context and highlights the role of the riboswitches in controlling gene expression inC. difficile.

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