How Outbreaks Can Contribute to Prevention of Nosocomial Infection: Analysis of 1,022 Outbreaks

2005 ◽  
Vol 26 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Petra Gastmeier ◽  
Sabine Stamm-Balderjahn ◽  
Sonja Hansen ◽  
Frauke Nitzschke-Tiemann ◽  
Irina Zuschneid ◽  
...  
Keyword(s):  
Case Reports ◽  
Transmission Risk ◽  
Invasive Technique ◽  
Case Control Studies ◽  
Source Of Infection ◽  
Time Period ◽  
Outbreak Investigations ◽  
Infection Source ◽  
Mode Of Transmission ◽  
Prevention Of Nosocomial Infection

AbstractObjective:To describe the epidemiology of nosocomial outbreaks published in the scientific literature.Design:Descriptive information was obtained from a sample of 1,022 published nosocomial outbreaks from 1966 to 2002.Methods:Published nosocomial outbreaks of the most important nosocomial pathogens were included in the database. A structured questionnaire was devised to extract information in a systematic manner on nosocomial outbreaks published in the literature. The following items were used: the reference, type of study (case reports or studies applying epidemiologic or fingerprinting methods), type of microorganism, setting, patients and personnel involved, type of infection, source of infection, mode of transmission, risk factors identified, and preventive measures applied.Results:Bloodstream infection was the most frequently identified type of infection (37.0%), followed by gastrointestinal infection (28.5%) and pneumonia (22.9%). In 37% of the outbreaks, the authors were not able to identify the sources. The most frequent sources were patients (25.7%), followed by medical equipment or devices (11.9%), the environment (11.6%), and the staff (10.9%). The mode of transmission remained unclear in 28.3% of the outbreaks. Transmission was by contact in 45.3%, by invasive technique in 16.1%, and through the air in 15.0%. The percentage of outbreaks investigated by case-control studies or cohort studies over the years was small (21% and 9%, respectively, for the whole time period).Conclusion:Outbreak reports in the literature are a valuable resource and should be used for educational purposes as well as for preparing outbreak investigations.

Source Attribution of Nontyphoid Salmonellosis in New Zealand Using Outbreak Surveillance Data

2011 ◽  
Vol 74 (3) ◽  
pp. 438-445 ◽  
Author(s):  
NICOLA KING ◽  
ROB LAKE ◽  
DONALD CAMPBELL
Keyword(s):  
New Zealand ◽  
Case Reports ◽  
Individual Case ◽  
Human Infection ◽  
Food Handler ◽  
Source Attribution ◽  
Multiple Sources ◽  
Source Of Infection ◽  
Waterborne Transmission ◽  
Mode Of Transmission

In this study, 204 New Zealand outbreaks of nontyphoid salmonellosis reported from 2000 to 2009 were analyzed for information on the sources of human infection. Data were extracted from the outbreak module of EpiSurv, New Zealand's notifiable diseases database, and augmented with information from individual case reports and separate investigation reports. The outbreaks involved 1,426 cases, representing an estimated 9% of the total salmonellosis cases reported for the study period. Salmonella Typhimurium was the causative serotype in 78% of 172 outbreaks for which a serotype was available, involving 71% of outbreak cases. The most commonly reported outbreak setting was the home (47% of outbreaks), followed by commercial food operations (31%). Foodborne transmission was reported for 63% of the 123 outbreaks for which only one mode of transmission was reported, followed by person-to-person transmission (32%), waterborne transmission (3%), and zoonotic transmission (2%). However, evidence for the mode of transmission was weak or absent for 107 (63%) of the 169 outbreaks for which a mode of transmission was reported. For only 22 outbreaks was laboratory evidence successfully used to identify a potential source of infection. Of these 22 outbreaks, 7 were foodborne, 11 involved an infected food handler, 2 were attributed to contact with animals, 1 was attributed to consumption of drinking water, and 1 was attributed to multiple sources. The laboratory-confirmed contaminated foods were diverse and included imported and domestically produced foods. The results of this analysis support the hypothesis that nontyphoid salmonellosis is primarily a foodborne disease in New Zealand, but there is insufficient evidence to confirm important food vehicles.

Herpetic Whitlow of the Hand in Infants

2020 ◽  
Author(s):  
Mohammad M. Al-Qattan ◽  
Nada G. AlQadri ◽  
Ghada AlHayaza
Keyword(s):  
Bacterial Infection ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Senior Author ◽  
Secondary Bacterial Infection ◽  
Clinical Appearance ◽  
History Of ◽  
Mode Of Transmission ◽  
Time Of Presentation

Abstract Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual case reports. We present a case series of six infants. Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following data were collected: age, sex, digit involved in the hand, mode of transmission, time of presentation to the author, clinical appearance, presence of secondary bacterial infection, presence of other lesions outside the hand, method of diagnosis, treatment, and outcome. Results All six infants initially presented with classic multiple vesicles of the digital pulp. In all cases, there was a history of active herpes labialis in the mother. Incision and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary bacterial infection. Conclusion The current report is the first series in the literature on herpetic whitlows in infants. We stress on the mode of transmission (from the mother) and establishing the diagnosis clinically. In these cases, no need for obtaining viral cultures or polymerase chain reaction; and no medications are required. Once the vesicles are disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir and intravenous antibiotics will be required.

scholarly journals COVID-19 Community Transmission among Healthcare Workers at a Tertiary Care Cardiac Center

2021 ◽  
Vol 9 (3) ◽  
pp. 49
Author(s):  
Mazin Barry ◽  
Asirvatham Alwin Robert ◽  
Mohamad-Hani Temsah ◽  
Syed Abdul Bari ◽  
Muhammad Yasin Akhtar ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Transmission Risk ◽  
Mitigation Measures ◽  
Age Group ◽  
Community Transmission ◽  
Mode Of Transmission ◽  
Healthcare Associated ◽  
Female Nurses ◽  
Cardiac Center

Aim: To determine the frequency, mode of transmission, and outcome of Coronavirus Disease 2019 (COVID-19) among healthcare workers (HCWs) in a tertiary care cardiac center in the Kingdom of Saudi Arabia (KSA). Methods: This is a retrospective study of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected HCWs and was conducted from 2 March to 31 December 2020. Data related to the presence of COVID-19 symptoms, mode of transmission, hospitalization, and mortality were collected from the patients’ medical records. Results: Of the 4462 patients tested for COVID-19 by real-time reverse transcriptase polymerase chain reaction (RT-PCR), 203 (4.5%) HCWs were positive; of these, 125 (61.6%) were males, and the most common age group was <40 years. The most commonly encountered health professionals were nurses (74, 36.4%), followed by therapists/technicians (48, 23.6%), housekeepers (25, 12.3%), and physicians (21, 10.4%). The majority (184, 90.6%) of the HCWs contracted COVID-19 in the community, and only 19 (9.4%) were healthcare-associated infections. Of the infected HCWs, 169 (83.3%) had mild symptoms and were managed in home isolation. The most common symptoms were fever (128, 63.1%), body ache (124, 61.8%), headache (113, 55.7%), dry cough (123, 60.6%), sore throat (97, 47.8%), body weakness (97, 47.8%), and fatigue (94, 46.3%). Comparing males and females, there was a significantly higher number of female nurses; in contrast, there was a higher number of male physicians, housekeepers, therapists/technicians, and other specialty HCWs. A significantly lower number of nurses, therapists/technicians were infected in the ≥40 years age group compared to <40 years. Furthermore, a significantly higher difference was observed among non-Saudi nurses compared to Saudi nurses. No mortality was documented among the included HCWs. Conclusions: In the largest tertiary cardiac center in KSA, most HCWs who contracted COVID-19 developed mild symptoms; nurses and those aged <40 years were most commonly infected, and most infections were acquired in the community. HCWs’ adherence to mitigation measures outside of the workplace is vital to curb the current pandemic and decrease nosocomial transmission risk.

scholarly journals Spatio-Temporal Distribution of Acinetobacter baumannii in Germany—A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000–2018)

2020 ◽  
Vol 8 (3) ◽  
pp. 375 ◽  
Author(s):  
Gamal Wareth ◽  
Christian Brandt ◽  
Lisa D. Sprague ◽  
Heinrich Neubauer ◽  
Mathias W. Pletz
Keyword(s):  
Case Reports ◽  
Temporal Distribution ◽  
Extensive Study ◽  
Multi Drug Resistance ◽  
Main Body ◽  
Resistance Development ◽  
Outbreak Investigations ◽  
Spatio Temporal ◽  
Specialized Institutions ◽  
Multiresistant Strains

Acinetobacter (A.) baumannii has gained global notoriety as a significant nosocomial pathogen because it is frequently associated with multi-drug resistance and hospital-based outbreaks. There is a substantial difference in the incidence of A. baumannii infections between different countries and within Germany. However, its continuous spread within Germany is a matter of concern. A systematic literature search and analysis of the literature published between 2000 and 2018 on A. baumannii in humans was performed. Forty-four studies out of 216 articles met the criteria for inclusion, and were selected and reviewed. The number of published articles is increasing over time gradually. Case reports and outbreak investigations are representing the main body of publications. North Rhine-Westphalia, Hesse and Baden-Wuerttemberg were states with frequent reports. Hospitals in Cologne and Frankfurt were often mentioned as specialized institutions. Multiresistant strains carrying diverse resistance genes were isolated in 13 of the 16 German states. The oxacillinase blaOXA-23-like, intrinsic blaOXA-51-like, blaOXA-58 variant, blaNDM-1, blaGES-11, blaCTX-M and blaTEM are the most predominant resistance traits found in German A. baumannii isolates. Five clonal lineages IC-2, IC-7, IC-1, IC-4 and IC-6 and six sequence types ST22, ST53, ST195, ST218, ST944/ST78 and ST348/ST2 have been reported. Due to multidrug resistance, colistin, tigecycline, aminoglycosides, fosfomycin, ceftazidime/avibactam and ceftolozan/tazobactam were often reported to be the only effective antibiotics left to treat quadruple multi-resistant Gram-negative (4MRGN) A. baumannii. Dissemination and infection rates of A. baumannii are on the rise nationwide. Hence, several aspects of resistance development and pathogenesis are not fully understood yet. Increased awareness, extensive study of mechanisms of resistance and development of alternative strategies for treatment are required. One-Health genomic surveillance is needed to understand the dynamics of spread, to identify the main reservoirs and routes of transmission and to develop targeted intervention strategies.

scholarly journals Review of literature of attention-deficit/hyperactivity disorder with comorbid eating disorders

2008 ◽  
Vol 30 (4) ◽  
pp. 384-389 ◽  
Author(s):  
Bruno Palazzo Nazar ◽  
Camilla Moreira de Sousa Pinna ◽  
Gabriel Coutinho ◽  
Daniel Segenreich ◽  
Monica Duchesne ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Eating Disorders ◽  
Bulimia Nervosa ◽  
Attention Deficit ◽  
Case Reports ◽  
Small Sample ◽  
Adult Women ◽  
Case Control Studies ◽  
Prevalence Studies ◽  
Hyperactivity Disorder

OBJECTIVE: According to studies of prevalence, up to 70% of adults with attention deficit/hyperactivity disorder have at least one psychiatric comorbidity, which leads to diagnostic and therapeutic difficulties as well as more severe functional impairment. There is a paucity of data on the comorbidity of attention deficit/hyperactivity disorder and eating disorders. The objective of this study was to review the literature regarding the attention deficit/hyperactivity disorder/eating disorders comorbidity, performing a critical analysis of relevant data. METHOD: Articles in Medline, Lilacs, SciELO, ISI and PsycINFO databases from 1980 up to 2008, were searched. The references from the articles were used as additional sources of data. RESULTS: Fourteen articles were found: five prevalence studies, four case reports, three case-control studies, one symptom-assessment study of attention deficit/hyperactivity disorder and eating disorders, and one article regarding possible causes of the association between attention deficit/hyperactivity disorder and eating disorders. These articles suggested that adult women with attention deficit/hyperactivity disorder are at higher risk of developing eating disorders, especially bulimia nervosa. Bulimia Nervosa rates found in attention deficit/hyperactivity disorder groups ranged from 1% to 12%, versus 0% to 2% in control groups. CONCLUSIONS: Although there seems to be a relationship between attention deficit/hyperactivity disorder and eating disorders, the reduced number of studies available, with various methodologies, and small sample sizes limit the generalization of the findings.

scholarly journals Probable Neuropsychological & Cognitive Complications due to Cytokine Storm in Patients With COVID-19

2021 ◽  
Vol 0 (0) ◽  
pp. 1-37
Author(s):  
Zahra Keshtgar ◽  
◽  
GH. Reza Chalabianloo ◽  
Niloofar Esmaeili ◽  
◽  
...  
Keyword(s):  
Nervous System ◽  
Case Reports ◽  
Case Series ◽  
Executive Dysfunction ◽  
Inflammatory Factors ◽  
Cytokine Storm ◽  
Case Control Studies ◽  
Necrosis Factor Alpha ◽  
Cross Sectional ◽  
Tnf Α

Introduction: COVID-19 (coronavirus disease 2019) was identified in China in December 2019 for the first time and is rapidly spreading throughout the world as a pandemic. As COVID-19 causes mild to severe acute respiratory syndrome, most studies in this context have focused on pathogenesis primarily in the respiratory system. However, evidence shows that the central nervous system (CNS) may also be affected by COVID-19. Since COVID-19 is spreading, it is imperative to study its possible cognitive effects in patients suffering and recovering from COVID-19. Methods: The articles used in this study were searched by keywords such as Cytokine storm and covid-19, covid-19 and executive dysfunction, cognitive disorder and covid-19, CNS and covid 19, Coronavirus, Neuroinvasion in science direct, Scopus, PubMed, Embase, and Web of Science databases based on Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. The study will assess all observational studies published between December 2019 and April 2021 in peer-reviewed journals, including cross-sectional, cohort, case-control studies, case reports and case series. The search result was 106 articles, of which 73 articles related to Covid-19, the stages of infection by this virus, its effect on the nervous system and neurological symptoms, the cytokine storm caused by this infection, and the possible cognitive consequences caused by this virus in patients, has been reviewed. Other articles were not checked due to their limited relevance to the topic under discussion. Results: Studies show that neurons may be directly affected by SARS-CoV-1 and SARS-CoV-2. Furthermore, various studies indicate that systemic inflammation (so-called "cytokine storm") is also responsible for brain damage induced by infection with SARS-CoV-1 and SARS-CoV-2. Such a way that this patients showed elevated levels of interleukin (IL-), 6, 8, and 10 and of tumor necrosis factor-alpha (TNF- α) in their blood. Conclusion: Various cognitive defects following an increase level of cytokines such as TNF-α and IL-6,8 have been observed. Therefore, due to the increase level of these pro-inflammatory factors in the brains of these patients, cognitive deficits can be expected, which need further investigation.

Molecular Analysis of Hepatitis B Virus in Mothers-Children Pairs

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Chatzidaki V ◽  
◽  
Perdikogianni C ◽  
Galanakis E ◽  
Paraskevis D ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Phylogenetic Tree ◽  
Surface Glycoprotein ◽  
Phylogenetic Tree Analysis ◽  
Source Of Infection ◽  
B Virus ◽  
Maximum Likelihood Methods ◽  
Infection Source ◽  
Relationship Of

ackground: Vertical transmission of Hepatitis B Virus (HBV) is the primary infection source for infants, but little is known on the proportion of children that have acquired HBV from their mothers. Objective: We investigated the relationship of HBV sequencing in HBVpositive children and their mothers and explored the HBV phylogenetic tree. Methods: Serum-extracted HBV-DNA from 38 individuals (13 children paired to nine mothers, 16 unpaired infected children) was amplified by polymerase chain reaction and the target region HBV surface glycoprotein (amino acids 40-171) was directly sequenced. Following editing and alignment of these sequences, phylogenetic tree analysis was performed using the neighbourjoining and maximum-likelihood methods. Results: Analysis was successfully performed in 29 subjects (23 children and six mothers), including six mother-child pairs. All individuals were infected by genotype D. Subgenotype adw3 prevailed (21, 72.4%), followed by ayw2 (4, 13.8%) and ayw3 (4, 13.8%). Among six mother-child pairs, three had identical and three had different subgenotypes. Phylogenetic analysis revealed that HBV sequences from three children did not cluster with their siblings suggesting a different source of infection. Conclusion: Our findings suggest that HBV subgenotypes in infected children may not be identical to their mothers’ and point to non-vertical HBV transmission in childhood.

Timely Revisit of Proprioceptive Deficits in Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110668
Author(s):  
Kenney K. L. Lau ◽  
Karlen K. P. Law ◽  
Kenny Y. H. Kwan ◽  
Jason P. Y. Cheung ◽  
Kenneth M. C. Cheung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Case Reports ◽  
Data Extraction ◽  
Meta Analysis ◽  
Detection Threshold ◽  
Mean Difference ◽  
Case Control Studies ◽  
Meta Analyses

Study Design Systematic review and meta-analysis Objectives The present review aimed to summarize the evidence regarding differences in proprioception between children with and without adolescent idiopathic scoliosis (AIS). Methods Seven electronic databases were searched from their inception to April 10, 2021. Articles were included if they involved: (1) AIS patients aged between 10 and 18 years, (2) measurements of proprioceptive abilities, and (3) comparisons with non-AIS controls. Animal studies, case reports, commentaries, conference proceedings, research protocols, and reviews were excluded. Two reviewers independently conducted literature screening, data extraction, risks of bias assessments, and quality of evidence evaluations. Relevant information was pooled for meta-analyses. Results From 432 identified citations, 11 case-control studies comprising 1121 participants were included. The meta-analyses showed that AIS participants displayed proprioceptive deficits as compared to non-AIS controls. Moderate evidence supported that AIS participants showed significantly larger repositioning errors than healthy controls (pooled mean difference = 1.27 degrees, P < .01). Low evidence substantiated that AIS participants had significantly greater motion detection threshold (pooled mean difference = 1.60 degrees, P < .01) and abnormal somatosensory evoked potentials (pooled mean difference = .36 milliseconds, P = .01) than non-AIS counterparts. Conclusions Consistent findings revealed that proprioceptive deficits occurred in AIS patients. Further investigations on the causal relationship between AIS and proprioception, and the identification of the subgroup of AIS patients with proprioceptive deficit are needed.

Healthcare Settings

2019 ◽  
pp. 341-362 ◽  
Author(s):  
Bryan E. Christensen ◽  
Ryan P. Fagan
Keyword(s):  
Urinary Tract ◽  
Respiratory Tract ◽  
Medical Devices ◽  
Disease Transmission ◽  
Healthcare Setting ◽  
Healthcare Settings ◽  
Outbreak Investigations ◽  
Mode Of Transmission ◽  
Healthcare Associated ◽  
General Community

Healthcare-associated infections (e.g., bloodstream, respiratory tract, urinary tract, or surgical site) can be common in patients. Patients receiving acute and chronic healthcare across various settings, such as hospitals, dialysis clinics, and nursing homes, tend to have comorbidities that make them more susceptible to infection than their counterparts in the general community. Also, some pathogens may be more likely to cause infection in healthcare settings because of the unique exposures that patients can experience, such as invasive procedures or indwelling medical devices. Similar to community outbreak investigations, the primary purpose of an investigation in a healthcare setting is to determine the source of the outbreak, define mode of transmission, disrupt disease transmission, and prevent further transmission.

scholarly journals High Exposure to Toxoplasma gondii and Neospora Spp. in Donkeys in Israel: Serological Survey and Case Reports

Animals ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 1921
Author(s):  
Sharon Tirosh-Levy ◽  
Amir Steinman ◽  
Avital Minderigiu ◽  
Ori Arieli ◽  
Igor Savitski ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Case Reports ◽  
Palestinian Authority ◽  
Serum Samples ◽  
High Exposure ◽  
Economic Implications ◽  
Animal Shelters ◽  
Source Of Infection ◽  
High Prevalence ◽  
Coccidian Parasites

Toxoplasma gondii and Neospora spp. are closely related cyst-forming coccidian parasites, which infect various animal species and have considerable zoonotic and economic implications, respectively. Both parasites are endemic in Israel and have been reported to infect wild and domestic animals. This study was conceived to evaluate the serologic exposure of donkeys to these parasites. Serum samples were collected from 98 donkeys. Half of them (n = 49) were from animal shelters in Israel, and the rest (n = 49) were working donkeys from the Palestinian Authority. The donkeys were screened for the presence of anti-Toxoplasma and anti-Neospora antibodies by immunofluorescence antibody tests (IFATs). The seroprevalence of T. gondii and Neospora spp. was 94% and 70%, respectively, and 69% of the donkeys were exposed to both parasites. In addition, N. caninum tissue cysts were documented in two donkeys during post-mortem examination. This is the first report of the exposure of donkeys to T. gondii and Neospora spp. in the area. The high prevalence found in this study suggests that donkeys may have a role in the maintenance of these parasites in the area, thus serving as a source of infection for the definitive hosts.

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