scholarly journals The Influence of Infectious Diseases on Dentistry

2010 ◽  
Vol 1 (3) ◽  
pp. 225-231
Author(s):  
Anil Reddy ◽  
Shankar Gouda Patil ◽  
Raghunath Puttaiah

ABSTRACT Dentistry, predominantly a surgical field with frequent exposure to blood and body fluids, is a high-risk occupation with respect to occupationally acquiring infectious diseases. On the same note, patients are also at risk of being infected, if adequate infection control measures are not strictly followed. Traditionally, based on the routes of disease transmission, we can categorize diseases that are bloodborne, airborne and also through fomites. Within these traditional categories also fall the new and emerging diseases that have had serious public health consequences of morbidity and mortality. As a health care provider, dentists must understand the impact of these diseases, and strictly implement practical disease control measures during provision of dental care and reduce the spread within the clinical arena. Common diseases of public health concern that need to be addressed are bloodborne diseases, such as hepatitis A, E, B, C, D and G, HIV; respiratory diseases such as tuberculosis, influenza, severe acute respiratory syndrome (SARS), AH1N1 influenza and immunizable childhood diseases. Apart from infection control measures, we must implement public health policy measures, such as immunization of current and prospective health care personnel (students in the dental profession) against immunizable diseases, utilize disease screening measures, postexposure disease control measures and utilize standard and additional precautions, the latter as required in certain instances.

2014 ◽  
Vol 35 (7) ◽  
pp. 810-817 ◽  
Author(s):  
Kyle B. Enfield ◽  
Nujhat N. Huq ◽  
Megan F. Gosseling ◽  
Darla J. Low ◽  
Kevin C. Hazen ◽  
...  

ObjectiveWe describe the efficacy of enhanced infection control measures, including those recommended in the Centers for Disease Control and Prevention’s 2012 carbapenem-resistant Enterobacteriaceae (CRE) toolkit, to control concurrent outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) and extensively drug-resistantAcinetobacter baumannii(XDR-AB).DesignBefore-after intervention study.SettingFifteen-bed surgical trauma intensive care unit (ICU).MethodsWe investigated the impact of enhanced infection control measures in response to clusters of CPE and XDR-AB infections in an ICU from April 2009 to March 2010. Polymerase chain reaction was used to detect the presence ofblaKPCand resistance plasmids in CRE. Pulsed-field gel electrophoresis was performed to assess XDR-AB clonality. Enhanced infection-control measures were implemented in response to ongoing transmission of CPE and a new outbreak of XDR-AB. Efficacy was evaluated by comparing the incidence rate (IR) of CPE and XDR-AB before and after the implementation of these measures.ResultsThe IR of CPE for the 12 months before the implementation of enhanced measures was 7.77 cases per 1,000 patient-days, whereas the IR of XDR-AB for the 3 months before implementation was 6.79 cases per 1,000 patient-days. All examined CPE shared endemicblaKPCresistance plasmids, and 6 of the 7 XDR-AB isolates were clonal. Following institution of enhanced infection control measures, the CPE IR decreased to 1.22 cases per 1,000 patient-days (P= .001), and no more cases of XDR-AB were identified.ConclusionsUse of infection control measures described in the Centers for Disease Control and Prevention’s 2012 CRE toolkit was associated with a reduction in the IR of CPE and an interruption in XDR-AB transmission.


2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Mary J Choi ◽  
Shewangizaw Worku ◽  
Barbara Knust ◽  
Arnold Vang ◽  
Ruth Lynfield ◽  
...  

Abstract Background In April 2014, a 46-year-old returning traveler from Liberia was transported by emergency medical services to a community hospital in Minnesota with fever and altered mental status. Twenty-four hours later, he developed gingival bleeding. Blood samples tested positive for Lassa fever RNA by reverse transcriptase polymerase chain reaction. Methods Blood and urine samples were obtained from the patient and tested for evidence of Lassa fever virus infection. Hospital infection control personnel and health department personnel reviewed infection control practices with health care personnel. In addition to standard precautions, infection control measures were upgraded to include contact, droplet, and airborne precautions. State and federal public health officials conducted contract tracing activities among family contacts, health care personnel, and fellow airline travelers. Results The patient was discharged from the hospital after 14 days. However, his recovery was complicated by the development of near complete bilateral sensorineural hearing loss. Lassa virus RNA continued to be detected in his urine for several weeks after hospital discharge. State and federal public health authorities identified and monitored individuals who had contact with the patient while he was ill. No secondary cases of Lassa fever were identified among 75 contacts. Conclusions Given the nonspecific presentation of viral hemorrhagic fevers, isolation of ill travelers and consistent implementation of basic infection control measures are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral hemorrhagic fever is delayed.


2019 ◽  
Vol 147 ◽  
Author(s):  
A. P. J. Haenen ◽  
L. P. Verhoef ◽  
A. Beckers ◽  
E. F. Gijsbers ◽  
J. Alblas ◽  
...  

Abstract We studied trends in the incidence of health care-associated infections (HAIs) in LTCFs between 2009 and 2015 and determined the effect of participation in our network. Elder-care physicians reported weekly the number of cases of influenza-like illness, gastroenteritis, (probable) pneumonia, urinary tract infections (UTIs) and all-cause mortality. Trends in the incidence of infection and mortality in relation to LTCF characteristics were calculated using multilevel univariate and multivariate logistic regression. Thirty LTCF participated for 3 years or more, 16 for 2 years and the remaining 12 LTCF for 1 year. During the study period, the median number of beds decreased from 158 to 139, whereas the percentage of residents with private bedrooms increased from 14% to 87%. UTIs were the most frequently reported infections, followed by (probable) pneumonia and gastroenteritis. Adjusted for calendar year and season, we observed a statistically significant decrease in the incidence of influenza-like illness (odds ratio (OR) = 0.8, P < 0.01) and (probable) pneumonia (OR = 0.8, P < 0.01) for each extra year an LTCF participated. Although there are other likely contributors, such as more private rooms and enhanced infection control measures, the decreasing trend of HAI in LTCFs participating in surveillance implies that surveillance is a valuable addition to current strategies to optimise infection control.


2020 ◽  
Vol 68 (11) ◽  
pp. 519-525
Author(s):  
Ana Cláudia Vasconcellos Azeredo ◽  
Sizuane Rieger Holler ◽  
Ellis Gabriela Correa de Almeida ◽  
Otávio Augusto Gonçalves Dias Cionek ◽  
Marcelle Martinez Loureiro ◽  
...  

Background: Most studies that have evaluated the impact of infection-control measures (ICM) reported a decrease in latent tuberculosis (TB) and not in TB. The objective of this study was to evaluate the impact of ICM on TB incidence among Health Care Workers (HCW’s). Methods: We conducted a retrospective record review study in a general, tertiary care, university-affiliated hospital. All TB case reports among HCWs in the hospital from 2005 to 2018 were reviewed. The TB incidence was measured before and after 2012 to evaluate the impact of ICM implemented. Findings: In total, there were 53 TB cases. The number of TB cases before and after the implementation of ICM was 42 (incidence: 100.0 cases/100,000 HCWs/year) and 11 (incidence: 26.2 cases/100,000 HCWs/year), respectively ( p < .0001). Conclusions/Application to Practice: TB incidence among HCWs reduced significantly after the implementation of ICM. The establishment of ICM, such as written TB infection control plan, monitoring, screening, training, and education, can reduce TB incidence.


2013 ◽  
Vol 6 (4) ◽  
pp. 27-52 ◽  
Author(s):  
Torsten Holmdahl ◽  
Peter Lanbeck

OBJECTIVE: To describe the experience of planning and designing a new facility for infectious diseases in Sweden and to discuss underlying theories relating to infection prevention and evidence-based design. BACKGROUND: Departments of Infectious Diseases are common in healthcare facililties in Sweden. In 2005, a decision was made to build a new facility. The program required spacious single rooms, with a high ventilation standard, and anterooms. METHODS: In this article we present an analysis of the future of infectious diseases. Underlying theories are discussed. We also describe how a program was outlined using literature studies, including evidence-based healthcare design, focus groups of staff, and study visits. RESULTS: Active involvement of users and infection control specialists was important in the building process. A full-scale patient room mock-up was built with ventilation, electrical, and other systems. The mock-up was cost effective because it avoided costly mistakes during the building process. The mock-up also was a place where staff could assess and begin adapting to their future work environment. Separate ventilation and separate entrances to patient rooms from the building exterior allowed placement of isolation units in the main hospital area. CONCLUSIONS: Antimicrobial resistance, emerging diseases, healthcare associated infections, and outbreaks highlight the need for infection control measures in all hospital design. Infection control should be integrated in all hospital planning and be part of contracts. In this study we describe a specialized unit where a high degree of standardization and flexibility has made it possible to have a unique standard of preparedness for the post-antibiotic era.


Science ◽  
2021 ◽  
pp. eabf9648
Author(s):  
Martin Pavelka ◽  
Kevin Van-Zandvoort ◽  
Sam Abbott ◽  
Katharine Sherratt ◽  
Marek Majdan ◽  
...  

Slovakia conducted multiple rounds of population-wide rapid antigen testing for SARS-CoV-2 in late 2020, combined with a period of additional contact restrictions. Observed prevalence decreased by 58% (95% CI: 57-58%) within one week in the 45 counties that were subject to two rounds of mass testing, an estimate that remained robust when adjusting for multiple potential confounders. Adjusting for epidemic growth of 4.4% (1.1-6.9%) per day preceding the mass testing campaign, the estimated decrease in prevalence compared to a scenario of unmitigated growth was 70% (67-73%). Modelling indicated that this decrease could not be explained solely by infection control measures, but required the additional impact of isolation and quarantine of household members of those testing positive.


2011 ◽  
Vol 32 (3) ◽  
pp. 210-219 ◽  
Author(s):  
Mamoon A. Aldeyab ◽  
Michael J. Devine ◽  
Peter Flanagan ◽  
Michael Mannion ◽  
Avril Craig ◽  
...  

Objective.To report a large outbreak ofClostridium difficileinfection (CDI; ribotype 027) between June 2007 and August 2008, describe infection control measures, and evaluate the impact of restricting the use of fluoroquinolones in controlling the outbreak.Design.Outbreak investigation in 3 acute care hospitals of the Northern Health and Social Care Trust in Northern Ireland.Interventions.Implementation of a series of CDI control measures that targeted high-risk antibiotic agents (ie, restriction of fluoroquinolones), infection control practices, and environmental hygiene.Results.A total of 318 cases of CDI were identified during the outbreak, which was the result of the interaction betweenC. difficileribotype 027 being introduced into the affected hospitals for the first time and other predisposing risk factors (ranging from host factors to suboptimal compliance with antibiotic guidelines and infection control policies). The 30-day all-cause mortality rate was 24.5%; however, CDI was the attributable cause of death for only 2.5% of the infected patients. Time series analysis showed that restricting the use of fluoroquinolones was associated with a significant reduction in the incidence of CDI (coefficient, —0.054; lag time, 4 months;P= .003).Conclusion.These findings provide additional evidence to support the value of antimicrobial stewardship as an essential element of multifaceted interventions to control CDI outbreaks. The present CDI outbreak was ended following the implementation of an action plan improving communication, antibiotic stewardship, infection control practices, environmental hygiene, and surveillance.


2020 ◽  
Vol 99 (5) ◽  
pp. 481-487 ◽  
Author(s):  
L. Meng ◽  
F. Hua ◽  
Z. Bian

The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.


2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1593
Author(s):  
Kyoko Yoshioka-Maeda ◽  
Yuka Sumikawa ◽  
Noriha Tanaka ◽  
Chikako Honda ◽  
Riho Iwasaki-Motegi ◽  
...  

This cross-sectional study aimed to (1) describe the unclassified contents of telephone consultation services provided by a public health center during the first wave of COVID-19 in Japan and (2) examine whether the contents required assistance from public health nurses (PHNs). We analyzed a total of 207 calls in which the purpose of the call was unclassified into pre-set categories. PHNs transcribed the exact text of the consultation conversations recorded from 25 March to 20 April 2020 in City A. Approximately half of the calls were from residents. Seven categories were extracted through a qualitative content analysis. The most common topic was infection control measures, where the presence of COVID-19 infection was assumed (n = 62); the second most common was extreme anxiety and fear of infection (n = 50). Questions about the COVID-19 response system (n = 30), discrimination and misunderstandings about COVID-19 (n = 24), and response measures for COVID-19 outbreaks within organizations (n = 18) were also included. The unclassified consultations included various topics, several of which required the expertise of a PHN. Each local government should consider sharing and task-shifting telephone consultation services among PHNs and other staff to reduce their burden and allow them to concentrate on conducting infection control more effectively.


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