Suchergebnisse

Aim: Secondary bloodstream infections (SBSIs) are caused by another infection and differ from primary bloodstream infections (PBSIs) in terms of prevention and treatment strategies. The aim of this study was to determine the risk factors for bloodstream infections which were secondary to the most common healthcare-associated infections caused by the most common microorganisms in intensive care units (ICUs) and to examine whether extended-spectrum beta lactamase (ESBL) production and carbapenem resistance is related to the higher risk or not.Methods: The study population consisted of patients in ICUs with ventilator-associated pneumonia (VAP), ventilator-associated event (VAE) or catheter-associated urinary tract infection (CAUTI) caused by E. coli, K. pneumoniae, P. aeruginosa or A. baumannii between 2014 and 2019. The data were obtained through the National Healthcare-associated Infections Surveillance Network. Multivariate logistic regression analysis was performed separately for VAP/VAE and CAUTI to determine the risk factors for the development of SBSI.Results: Microorganism, ICU type, bed capasity and carbapenem resistance were found to be risk factors for SBSI for both types of infection. For VAPs/VAEs, female gender and hospital type were also identified as risk factors. The highest risk was in K.pneumoniae and in emergency ICUs. Among the hospitals, the highest risk in VAPs/VAEs was found in government education and research hospitals. ESBL production for K . pneumoniae and E. coli increased the risk in patients with VAP/VAE; however, it did not increase in patients with CAUTI.Discussion: By using the risk factors, it may be possible to recognize SBSIs earlier, especially in patients with CAUTIs or VAPs/VAEs caused by carbapenem-resistant or ESBL-producing K. pneumoniae . ; Hintergrund: Bei der sekundären Blutstrominfektion (SBI) gelangt der Erreger von einem anderen Infektionsort in die Blutbahn; daher unterscheidet sich die Präventions- und Behandlungsstrategie von der primären Blutstrominfektion ...

Infection is a major complication of military chest injuries. In a series of 142 wounded, infectious complications occurred in 7 (4.9%). Factors influencing the incidence of infection are evaluated. In this group of injuries, 81 patients were admitted soon after wounding. The intrathoracic damage was severe, due to penetration of metallic fragment. The hemothorax was treated by immediate intercostal drainage. Immediate thoracotomy was performed in 10 patients and late thoractomy in 15. One patient developed a lung abscess and 5 patients had infection following thoracotomy (7.4%). Another 61 wounded patients had been first managed in a forward hospital, including three with thoractomy for massive bleeding. Two, not in a forward hospital, had a bullet removed from the lung. Upon admission to this hospital, intercostal drains were inserted when needed and four patients underwent thoracotomy. Larger wounds were debrided in 24 patients. Late thoracotomy was perfromed in seven. Chronic empyema developed in one patient after pneumonectomy performed at the field hospital, resulting in a resuscitation or infection rate of less than 2%. Factors contributing to a low infection rate were: early drainage of hemothoraces and wide debridement of larger wounds with delayed closure and avoidance of thoracotomy as primary treatment. Resection of lung tissue was avoided. Thoraco-abdominal injuries were treated separately. The clotted hemothorax was immediately evacuated. Prolonged antibiotic therapy was usually indicated.

This study aims to determine the impact of COVID-19 on air connectivity in the Association of Southeast Asian Nations (ASEAN) region, specifically focusing on infection, vaccination and fatality rates. To examine the impact of COVID-19 on the ASEAN air transport industry, a panel data series was created. The panel covered data from 57 airlines with different business models in the 10 ASEAN member states from January 2019 to July 2022 (31 months). The results of the study have shown that there is a significant inverse linear relationship between full-service and low-cost international flight movements, passenger demand and vaccination rate, infection rate and fatality rate. At the country level, Brunei experienced the lowest drop in air passenger demand, followed by the Philippines, Thailand, Malaysia and Cambodia. Other countries (Indonesia, Lao PDR, Myanmar, Singapore and Vietnam) were not significant predictors of passenger demand. The study's results have indicated that an increase in infection rate has a greater impact on the international air travel market compared to the domestic market. The reduction rate of the domestic market is only half that of the international market, while the fatality rate demonstrated no differences. This study represents a valuable contribution to the existing knowledge of the pandemic's impact on the air transport industry, focusing on Southeast Asian countries. It provides evidence to help stakeholders in the aviation industry prepare for future related crises. The study concludes that fostering greater cooperation and coordination among ASEAN member states in managing health crises and facilitating the aviation industry can promote economic growth, enhance resilience and strengthen regional integration in the long run. JEL Classification: F02, I30

The determination of infection rate parameter from in vitro macrophages infected by Leishmania amastigotes is fundamental in the study of vaccine candidates and new drugs for the treatment of leishmaniasis. The conventional method that consists in the amastigotes count inside macrophages, normally is done by a trained microscope technician, which is liable to misinterpretation and sampling. The objective of this work is to develop a method for the segmentation of images to enable the automatic calculation of the infection rate by amastigotes. Segmentation is based on mathematical morphology in the context of a computer vision system. The results obtained by computer vision system presents a 95% accuracy in comparison to the conventional method. Therefore, the proposed method can contribute to the speed and accuracy of analysis of infection rate, minimizing errors from the traditional methods, especially in situations where exhaustive repetitions of the procedure are required from the technician.

OBJECTIVE: This paper reports perioperative mortality and postoperative infection rates of surgical patients who underwent operations at district-level hospitals in Malawi and Zambia, and the associations of these outcomes with patient characteristics based on routinely available data. DESIGN: Prospective cohort study. SETTING: Eight government district hospitals in Malawi and nine mission and government district hospitals in Zambia. OUTCOME MEASURES: Perioperative mortality and postoperative infection were used as primary outcome measures in this study. Logistic regression and penalised maximum likelihood logistic regression were used to examine the factors correlated with surgical outcomes. RESULTS: The average perioperative mortality rates were 0.19% and 0.43% in Malawi and Zambia, respectively. Penalised maximum likelihood logistic regression showed that age (OR=1.046, 95% CI 1.016 to 1.078) and American Society of Anesthesiologists physical status score II (OR=6.658, 95% CI 2.363 to 18.762) were significantly associated with perioperative deaths. General surgery procedures were significantly more likely than obstetrical procedures to result in perioperative deaths (OR=3.821, 95% CI 1.226 to 11.908). The average rates of postoperative infections in Malawi and Zambia were 2.69% and 2.24%, respectively. Age (OR=1.010, 95% CI 1.000 to 1.020) and male sex (OR=0.407, 95% CI 0.260 to 0.637) were significantly associated with postoperative infections. Additional factors, general procedures (OR=2.319, 95% CI 1.397 to 3.850) and trauma-related procedure (OR=5.490, 95% CI 2.632 to 11.449) were significantly associated with infection rates. There was no significant correlation between surgical outcomes and cadre of lead surgeon (a non-physician clinician or doctor). CONCLUSION: Rates of mortality and postoperative infections in this sample of district-level hospitals in Malawi and Zambia were relatively low, with poorer preoperative physical status as the main predictor of both greater postoperative infection and ...

Abstract Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control challenges between Turkey, a country with "limited" resources, and the Netherlands, a country with "reasonable" resources. Infrastructure of hospitals, low compliance of hand hygiene, understaffing, overcrowding, heavy workload, misuse of personal protective equipments, late establishment of infection control programme are major problems in limited-resources countries. These problems cause high infection rates and spread of multi-drug resistant pathogens. To improve the control and prevention of infections in countries with limited resources, a multi-facet approach is needed.

Doganay, Mehmet/0000-0003-3922-4901; Leblebicioglu, Hakan/0000-0002-6033-8543 ; WOS: 000208655000036 ; PubMed: 22018286 ; Nosocomial infections and their control are a world-wide challenge. The prevalence of nosocomial infections is generally higher in developing countries with limited resources than industrialized countries. In this paper we aimed to further explain the differences with regard to infection control challenges between Turkey, a country with "limited" resources, and the Netherlands, a country with "reasonable" resources. Infrastructure of hospitals, low compliance of hand hygiene, understaffing, overcrowding, heavy workload, misuse of personal protective equipments, late establishment of infection control programme are major problems in limited-resources countries. These problems cause high infection rates and spread of multi-drug resistant pathogens. To improve the control and prevention of infections in countries with limited resources, a multi-facet approach is needed.

The outbreak of COVID-19 has constantly exposed health care workers (HCWs) around the world to a high risk of infection. To more accurately discover the infection differences among high-risk occupations and institutions, Hubei Province was taken as an example to explore the spatiotemporal characteristics of HCWs at different scales by employing the chi-square test and fitting distribution. The results indicate (1) the units around the epicenter of the epidemic present lognormal distribution, and the periphery is Poisson distribution. There is a clear dividing line between lognormal and Poisson distribution in terms of the number of HCWs infections. (2) The infection rates of different types of HCWs at multiple geospatial scales are significantly different, caused by the spatial heterogeneity of the number of HCWs. (3) With the increase of HCWs infection rate, the infection difference among various HCWs also gradually increases and the infection difference becomes more evident on a larger scale. The analysis of the multi-scale infection rate and statistical distribution characteristics of HCWs can help government departments rationally allocate the number of HCWs and personal protective equipment to achieve distribution on demand, thereby reducing the mental and physical pressure and infection rate of HCWs.

Abstract
Strains of Rocahepevirus ratti, an emerging hepatitis E virus (HEV), have recently been found to be infectious to humans. Rats are a primary reservoir of the virus; thus, it is referred to as "rat HEV". Rats are often found on swine farms in close contact with pigs. Our goal was to determine whether swine may serve as a transmission host for zoonotic rat HEV by characterizing an infectious cDNA clone of a zoonotic rat HEV, strain LCK-3110, in vitro and in vivo. RNA transcripts of LCK-3110 were constructed and assessed for their replicative capacity in cell culture and in gnotobiotic pigs. Fecal suspension from rat HEV-positive gnotobiotic pigs was inoculated into conventional pigs co-housed with naïve pigs. Our results demonstrated that capped RNA transcripts of LCK-3110 rat HEV replicated in vitro and successfully infected conventional pigs that transmit the virus to co-housed animals. The infectious clone of rat HEV may afford an opportunity to study the genetic mechanisms of rat HEV cross-species infection and tissue tropism.

Autochthonous outbreaks of chikungunya have occurred in the European Union (EU) after virus introduction by infected travelers. We reviewed the surveillance data of travel-related cases reported in the EU during 2012-2018 to document factors associated with increased infection rates among travelers and to assess how surveillance data could support preparedness against secondary transmission and timely control of outbreaks. Thirteen EU countries reported 2,616 travel-related chikungunya cases. We observed 3 successive epidemiologic periods; the highest number of cases (75%) occurred during 2014-2015, when most cases were associated with the Caribbean and South America. The highest infection rates among travelers were observed during the same phase. Although surveillance of travel-related cases is relevant for estimating the infection risk for travelers, we could not identify a relationship between the number of infected travelers and a higher likelihood of secondary transmission in the EU. ; Sí

ObjectivesData linkage was conducted between the Office for National Statistics' Covid Infection Survey (CIS), the Department of Health and Social Care's Test and Trace (T&T) and NHS' Personal Demographics Service (PDS) datasets. Linked data was required to provide reliable estimates of rates of COVID-19 transmission and infection used to inform policy regarding the ongoing pandemic.
ApproachThe CIS was created to track infection rates in the UK population. Linking CIS participants to positive tests in T&T helped improve these estimates. Linkage to PDS was required to attach NHS number to these datasets to facilitate further linkages that could also be used to inform Government about the spread of the virus. Multiple approaches were used to link the data. Initially, T&T was linked to itself via a series of strict matchkeys to cluster records belonging to the same individual, to create a person level identifier. Subsequent linkage of CIS-PDS, T&T-PDS and CIS-T&T involved deterministic linkages with matchkeys designed and applied independently. A probabilistic (Fellegi-Sunter scoring) method was used to link CIS-PDS and CIS-T&T. Additional, associative links were created between CIS and T&T records that had matched to the same PDS record but had not matched to each other.
ResultsThe accuracy of CIS-PDS and CIS-T&T linkages was high (recall and precision >98%; all 95% lower confidence intervals >93%). A quality assessment of T&T-PDS is underway, as are relevant bias analyses.
ConclusionAs a result of this linkage, COVID-19 analysts have access to enriched datasets linked to compare previously separated variables, with confidence that the linkage method used was to required quality standards. The linked data has been used to provide crucial evidence to Government on infection and re-infection rates. Subsequent linkages have enabled analysts to explore risk factors associated with different variants of the virus, vaccination status and hospital episodes. Improvements continue to be made.

Autochthonous outbreaks of chikungunya have occurred in the European Union (EU) after virus introduction by infected travelers. We reviewed the surveillance data of travel-related cases reported in the EU during 2012–2018 to document factors associated with increased infection rates among travelers and to assess how surveillance data could support preparedness against secondary transmission and timely control of outbreaks. Thirteen EU countries reported 2,616 travel-related chikungunya cases. We observed 3 successive epidemiologic periods; the highest number of cases (75%) occurred during 2014–2015, when most cases were associated with the Caribbean and South America. The highest infection rates among travelers were observed during the same phase. Although surveillance of travel-related cases is relevant for estimating the infection risk for travelers, we could not identify a relationship between the number of infected travelers and a higher likelihood of secondary transmission in the EU.