2,955,432 research outputs found
Heterogeneous and tissue-specific regulation of effector T cell responses by IFN-gamma during Plasmodium berghei ANKA infection.
Get PDFIFN-γ and T cells are both required for the development of experimental cerebral malaria during Plasmodium berghei ANKA infection. Surprisingly, however, the role of IFN-γ in shaping the effector CD4(+) and CD8(+) T cell response during this infection has not been examined in detail. To address this, we have compared the effector T cell responses in wild-type and IFN-γ(-/-) mice during P. berghei ANKA infection. The expansion of splenic CD4(+) and CD8(+) T cells during P. berghei ANKA infection was unaffected by the absence of IFN-γ, but the contraction phase of the T cell response was significantly attenuated. Splenic T cell activation and effector function were essentially normal in IFN-γ(-/-) mice; however, the migration to, and accumulation of, effector CD4(+) and CD8(+) T cells in the lung, liver, and brain was altered in IFN-γ(-/-) mice. Interestingly, activation and accumulation of T cells in various nonlymphoid organs was differently affected by lack of IFN-γ, suggesting that IFN-γ influences T cell effector function to varying levels in different anatomical locations. Importantly, control of splenic T cell numbers during P. berghei ANKA infection depended on active IFN-γ-dependent environmental signals--leading to T cell apoptosis--rather than upon intrinsic alterations in T cell programming. To our knowledge, this is the first study to fully investigate the role of IFN-γ in modulating T cell function during P. berghei ANKA infection and reveals that IFN-γ is required for efficient contraction of the pool of activated T cells
The use of behaviour change theory for infection prevention and control practices in healthcare settings: a scoping review
Get PDFBackground
Infection prevention and control (IPC) practices performed by healthcare workers are key to the prevention and management of infections. Compliance with IPC practice is often low, they are therefore commonly the focus of improvement interventions. Designing interventions that are based on behaviour change theories may help to improve compliance to practice. The aim of this review is to synthesise the evidence on the application of behaviour change theories to interventions to improve IPC practice in healthcare settings.
Methods
A scoping review was conducted following the Joanna Briggs Institute (JBI) methodological framework. The theories of focus were the Theoretical Domains Framework (TDF), Capability, Opportunity, Motivation, Behaviour (COM-B) and Behaviour Change Wheel (BCW). Studies which applied these theories to any IPC practice were included.
Results
Eleven studies were identified which met the inclusion criteria. The IPC behaviours investigated were hand hygiene (7), antimicrobial stewardship (3), and MRSA screening (1). Nine studies explored barriers and facilitators to existing IPC practice; three used their findings to design a behaviour change intervention or tool. Domains of ‘beliefs about consequences’, ‘environmental context/resources’, and ‘social/professional role and identity’ were identified as key across all three IPC behaviours.
Discussion
This review has demonstrated the use of behavioural theories to understand determinants of behaviour related to IPC practice. Currently there are few published examples of interventions to improve IPC practice that have been underpinned by behavioural theory. Practitioners in IPC should consider the use of these methods to enhance the efficacy of strategies to change healthcare worker behaviour
Low incidence of toxoplasma infection during pregnancy and in newborns in Sweden
No full textTo estimate the burden of disease due to congenital toxoplasmosis in Sweden the incidence of primary infections during pregnancy and birth prevalence of congenital toxoplasmosis in 40978 children born in two regions in Sweden was determined. Women possibly infected during pregnancy were identified based on: 1, detection of specific IgG based on neonatal screening of the phenylketonuria (PKU) card blood spot followed by retrospective testing of stored prenatal samples to detect women who acquired infection during pregnancy and follow up of their children to 12 months; 2, detection of specific IgM on the PKU blood spot. The birth prevalence of congenital toxoplasmosis was 0·73/10000 (95% CI 0·15–2·14) (3/40978). The incidence of primary infection during pregnancy was 5·1/10000 (95% CI 2·6–8·9) susceptible pregnant women. The seroprevalence in the southern part was 25·7% and in the Stockholm area 14·0%. The incidence of infection during pregnancy was low, as the birth prevalence of congenital toxoplasmosis. Neonatal screening warrants consideration in view of the low cost and feasibility
One-year infection control rates of a DAIR (debridement, antibiotics and implant retention) procedure after primary and prosthetic-joint-infection-related revision arthroplasty - A retrospective cohort study
Get PDFIntroduction: Debridement, antibiotics and implant retention (DAIR) procedures are effective treatments for acute postoperative or acute hematogenous periprosthetic joint infections. However, literature reporting on the effectiveness of DAIR procedures performed after a one- or two-stage revision because of a prosthetic joint infection (PJI) (PJI-related revision arthroplasty) is scarce. The aim of this study is to retrospectively evaluate the infection control after 1 year of a DAIR procedure in the case of an early postoperative infection either after primary arthroplasty or after PJI-related revision arthroplasty. Materials and methods: All patients treated with a DAIR procedure within 3 months after onset of PJI between 2009 and 2017 were retrospectively included. Data were collected on patient and infection characteristics. All infections were confirmed by applying the Musculoskeletal Infection Society (MSIS) 2014 criteria. The primary outcome was successful control of infection at 1 year after a DAIR procedure, which was defined as the absence of clinical signs, such as pain, swelling, and erythema; radiological signs, such as protheses loosening; or laboratory signs, such as C-reactive protein (CRP) (<10) with no use of antibiotic therapy. Results: Sixty-seven patients were treated with a DAIR procedure (41 hips and 26 knees). Successful infection control rates of a DAIR procedure after primary arthroplasty (n=51) and after prior PJI-related revision arthroplasty (n=16) were 69 % and 56 %, respectively (p=0.38). The successful infection control rates of a DAIR procedure after an early acute infection (n=35) and after a hematogenous infection (n=16) following primary arthroplasty were both 69 % (p=1.00). Conclusion: In this limited study population, no statistically significant difference is found in infection control after 1 year between DAIR procedures after primary arthroplasty and PJI-related revision arthroplasty.Biomaterials & Tissue Biomechanic
Cowpox virus infection in natural field vole Microtus agrestispopulations: significant negative impacts on survival
Get PDF1. Cowpox virus is an endemic virus circulating in populations of wild rodents. It has been implicated as a potential cause of population cycles in field voles Microtus agrestis L., in Britain, owing to a delayed density-dependent pattern in prevalence, but its impact on field vole demographic parameters is unknown. This study tests the hypothesis that wild field voles infected with cowpox virus have a lower probability of survival than uninfected individuals. 2. The effect of cowpox virus infection on the probability of an individual surviving to the next month was investigated using longitudinal data collected over 2 years from four grassland sites in Kielder Forest, UK. This effect was also investigated at the population level, by examining whether infection prevalence explained temporal variation in survival rates, once other factors influencing survival had been controlled for. 3. Individuals with a probability of infection, P(I), of 1 at a time when base survival rate was at median levels had a 22.4% lower estimated probability of survival than uninfected individuals, whereas those with a P(I) of 0.5 had a 10.4% lower survival. 4. At the population level, survival rates also decreased with increasing cowpox prevalence, with lower survival rates in months of higher cowpox prevalence. 5. Simple matrix projection models with 28 day time steps and two stages, with 71% of voles experiencing cowpox infection in their second month of life (the average observed seroprevalence at the end of the breeding season) predict a reduction in 28-day population growth rate during the breeding season from λ = 1.62 to 1.53 for populations with no cowpox infection compared with infected populations. 6. This negative correlation between cowpox virus infection and field vole survival, with its potentially significant effect on population growth rate, is the first for an endemic pathogen in a cyclic population of wild rodents
The Relation between Treated Maternal Urinary Tract Infection and Adverse Maternal, Prenatal Outcomes in Pregnant Women of Ardabil, Iran
Get PDFBackground and Objective: Urinary tract infection is one of the most common bacterial infections during pregnancy and has also been implicated as a risk factor for adverse maternal and prenatal outcomes. The aim of our study was to determine the relation between maternal urinary tract infection and adverse maternal, prenatal outcomes in pregnant women of Ardabil, Iran.
Material and Methods: This retrospective-case-control study was conducted on prenatal file records of pregnant women in Ardabil (2011). The pregnant women who had a positive urine culture in their prenatal files (N= 211) were considered as a case group and 232 ones without urinary tract infection as a control. Using a research- made questionnaire, the data related to present pregnancy and prenatal information was collected and analyzed by KrusKal Wallis, Chi- Square and Fisher statistical tests.
Results: Maternal age of under 25 (%61.6 vs. 56.5), body mass index of more than 30 (%18.3 vs. 15.6), primigravida (%55 vs. 48.8), hypertension (%2.4 vs. 1.3), hyperemesis Gravidarum (%14.8 vs. 12.6), frequency and dysuria (%1.9 vs. 0.9), low birth weight (%95.4 vs. 93.2), congenital malformation (%3.5 vs. 1.8), artificial milk feeding (%6.5 vs. 2.7), neonatal death (%0.9 vs. 0.0) are higher in urinary infection group, however the differences are not statistically significant. Other maternal and prenatal adverse outcomes such as diabetes, pre-eclampsia , hemoglobin level, prematurity, abortion and stillbirth have not significant relation with urinary infection.
Conclusion: Because of low level of adverse maternal or prenatal outcomes reported in our study, we conclude that screening and treatment of urinary tract infection in Ardabil health service is appropriate; therefore, no change is needed for present screening or treatment processes
Cryptococcosis and Tuberculosis Co-Infection at a University Hospital in Taiwan, 1993-2006
No full textThe human immunodeficiency virus (HIV) epidemic and increasing use of immunosuppressive agents have increased the prevalence of both cryptococcosis and tuberculosis (TB). However, the status of co-infection with both pathogens remains unknown. This study retrospectively reviewed patient records of cryptococcosis and TB co-infection from 1993 to 2006. The temporal sequence of co-infection was defined as either concurrent or sequential. Data collected included patient demographics, HIV status, co- morbidities, clinical manifestations, treatment strategies, and outcome at 1-year follow-up. There were 23 patients with cryptococcosis and TB co- infection, representing 5.4% of cryptococcosis or 0.6% of TB cases. Eleven (48%) patients were HIV-infected, and no underlying disease or immunocompromised state could be identified in six (26%) patients. Twelve (52%) patients presented with concurrent infection, but diagnosis of co- infection could be achieved simultaneously in only three (13 %). Constitutional symptoms, particularly fever and weight loss, were the most common presenting symptoms, developing in more than two-thirds of the patients. The majority (83%) of the patients made a good recovery following dual antifungal and anti-TB therapy. There were three mortalities at the 1-year follow-up, which might be attributable to a delay in diagnosis and treatment of co-infection. The outcomes of HIV- infected and non-HIV-infected patients were not significantly different. Cryptococcosis and TB co- infection, although rare, develops in both immunocompromised and healthy individuals. Early diagnosis and treatment may improve patient prognosis. There should be a high index of suspicion in order to achieve a timely diagnosis in a TB endemic area
For the good of many: an infection control perspective on ethics.
No full textThe decisions made by infection control personnel affect both individuals and those in the broader patient population in a health care facility. In making the decisions required to provide an environment free of infectious risks, while maintaining the rights of individuals to attain optimal health outcomes, infection control practitioners are often confronted with ethical dilemmas. This article describes an ethical dilemma commonly faced in infection control practice, where the needs of one patient must be weighed against the needs of the patient population. A case study describing the decision to isolate an infectious patient is presented, highlighting the role that ethics plays in decisions made to control infection. A decision making framework is applied to ensure that the needs of both individuals and groups are considered. Resource considerations and the need to conform to basic microbiological and epidemiological principles are also considered. The various issues in conflict are described, analysed, resolved and rationalised. The use of a decision making framework can help to ensure that competing interests are carefully considered to produce an ethical, and optimal, decision.Griffith Health FacultyNo Full Tex
Mixed Infection with Beijing and Non-Beijing Strains in Pulmonary Tuberculosis in Taiwan: Prevalence, Risk Factors and Dominant Strain
No full textClin Microbiol Infect ABSTRACT: Patients with pulmonary tuberculosis (TB) can be simultaneously infected with different strains of Mycobacterium tuberculosis (mixed infection). We investigated the prevalence and risk factors of mixed infection by Beijing and non-Beijing strains in pulmonary TB patients in Taiwan. We developed a quantitative PCR method to simultaneously detect the presence of Beijing and non-Beijing strains. A total of 868 pretreatment samples (from 868 patients), including 563 sputum samples smear-positive for acid-fast bacilli and 305 liquid medium samples culture-positive for mycobacteria, were tested. Medical records of patients with culture-confirmed pulmonary TB were reviewed. The detection limit of our quantitative PCR method was five copies of target sequences. With mycobacterial culture result as the reference standard, the sensitivity and specificity of our quantitative PCR method were 95% and 98 %, respectively. M. tuberculosis strains were isolated in 466 samples, of which 231 (49.6%) were infected with a Beijing strain. Another 14 patients (3.0%) had mixed infection, with the Beijing strain being the dominant strain in 13 (93%). Age <25 years with pulmonary cavities was associated with mixed infection. In patients infected with non-Beijing strains, the bacterial load of non-Beijing strains was lower among those with mixed infection than among those without. Our quantitative PCR method was accurate in detecting Beijing and non-Beijing strains in smear-positive sputum and culture-positive liquid medium samples. Mixed infection was present in pulmonary TB patients (3.0%), especially in those aged <25 years with pulmonary cavities. Beijing strains seem to be more dominant than non-Beijing strains in patients with mixed infection
Subcutaneous Infection Caused by Corynespora Cassiicola, a Plant Pathogen
No full textWe describe a 69-year-old female farmer with diabetes mellitus who developed subcutaneous infection due to a plant pathogen, Corynespora cassiicola. The organism was identified based on characteristic morphotypes and confirmed by sequence analysis of the internal transcribed spacer ( ITS) regions. The patient was treated successfully with amphotericin B therapy
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