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1.
J Hosp Infect ; 147: 206-212, 2024 May.
Article in English | MEDLINE | ID: mdl-38521416

ABSTRACT

BACKGROUND: Elderly nursing home residents are vulnerable to infection from micro-organisms. Hand hygiene is considered one of the most important measures to prevent transmission. AIM: To determine the effect of increased accessibility to alcohol-based hand rub (ABHR) in nursing home wards by monitoring hand hygiene compliance (HHC) among healthcare workers (HCWs). METHODS: An 11-month intervention study was conducted in a Danish six-ward nursing home. Data were collected using an automatic hand hygiene monitoring system (AHHMS). After a baseline period, one extra ABHR dispenser was placed in each of the 150 apartments. Baseline HHC was compared with the HHC during an immediate intervention period and a long-term intervention period. FINDINGS: A total of 159 HCWs were included. The AHHMS registered 341,078 hand hygiene opportunities. Overall baseline HHC was 31% (95% confidence interval: 30-32). A significant +18% absolute immediate effect (first five months) (95% CI: 17-19; P < 0.0001) and +13 percentage points (95% CI: 11-14; P < 0.0001) long-term effect (another four months) were recorded. HCWs working day shifts and short-term employees had a higher baseline HHC than HCWs working evening/night shifts. However, HCWs working night shifts achieved the greatest long-term effect with a mean +27 percentage point difference (P < 0.0001). CONCLUSION: Placing an additional ABHR dispenser strategically within staff workflow significantly increased HHC among HCWs, demonstrating a noteworthy effect. The study is the first to report the effect on nursing home dispenser accessibility as a single intervention and to show a significant unmet potential.


Subject(s)
Alcohols , Guideline Adherence , Hand Hygiene , Health Personnel , Nursing Homes , Humans , Guideline Adherence/statistics & numerical data , Denmark , Health Personnel/statistics & numerical data , Hand Hygiene/methods , Hand Hygiene/statistics & numerical data , Hand Hygiene/standards , Alcohols/administration & dosage , Infection Control/methods , Infection Control/standards , Female , Male , Cross Infection/prevention & control , Hand Disinfection/methods , Hand Disinfection/standards , Hand Sanitizers/administration & dosage , Aged
2.
J Infect ; 42(4): 243-50, 2001 May.
Article in English | MEDLINE | ID: mdl-11545566

ABSTRACT

OBJECTIVES: To genetically characterize an unusual genotype of Cryptosporidium from the stools of humans with diarrhoea and to identify risk factors in the affected patients. METHODS: DNA was extracted from human faeces where Cryptosporidium oocysts were detected by light microscopy. Cryptosporidial gene fragments from six different loci were analysed by PCR alone, PCR/RFLP and by DNA sequencing. Oocysts were characterized by light and immunofluorescence microscopy and epidemiological data was collected from the affected patients. RESULTS: Analysis of the Cryptosporidium oocyst wall protein (COWP) gene amplified from > 2000 human faecal samples identified 19 patients all of which produced an unusual RFLP profile. Subsequent DNA sequence analysis of this and an additional four genetic loci (including 18S rRNA sequences) confirmed these as a homogeneous group which was genetically distinct from Cryptosporidium parvum. The isolates were identified as Cryptosporidium meleagridis since the gene sequences were identical to those from this species recovered from birds. Conventional microscopy showed oocysts indistinguishable from C. parvum and reacted strongly with two different commercially available anti-oocyst monoclonal antibodies. None of the patients showed risk factors unusual for cryptosporidiosis; however, ten of the cases occurred during the summer/autumn, six had a history of foreign travel, four were co-infected with Giardia, two were HIV positive, and six were without identifiable immunocompromising factors. CONCLUSIONS: This study further confirms that C. meleagridis, in addition to C. parvum, is involved in human disease. The study also highlights the lack of basic information on the host range of this genus of parasites, the complexity of the transmission routes involved in human cryptosporidiosis, and the value of molecular techniques in identify hitherto unrecognised differences in Cryptosporidium from human faeces.


Subject(s)
Cryptosporidiosis/diagnosis , Cryptosporidium/genetics , Feces/parasitology , Adolescent , Adult , Aged , Animals , Child , Child, Preschool , Cryptosporidiosis/parasitology , Cryptosporidium/pathogenicity , DNA Primers , Female , Genotype , Humans , Male , Microscopy, Fluorescence , Microscopy, Polarization , Middle Aged , Polymerase Chain Reaction/methods , Polymorphism, Restriction Fragment Length , Risk Factors , Sequence Analysis, DNA
3.
Lakartidningen ; 98(21): 2568-74, 2001 May 23.
Article in Swedish | MEDLINE | ID: mdl-11433992

ABSTRACT

UNLABELLED: By using a multimodal rehabilitation program professor Kehlet has shown accelerated recovery after colonic surgery with hospital stay of only two days, irrespective of open or laparoscopic technique. These results have not been confirmed in other studies. The aim of this study was to replace our traditional approach with Kehlet's multimodal regimen and try to reproduce his reported data. METHODS: 22 patients (median age 67 years) underwent right- or leftsided colectomies, 15 open (7 with midline incisions) and 7 laparoscopically. Continuous thoracic epidural, immediate mobilization and oral nutrition were used. Discharge was planned three days after surgery. On the first postoperative day all had oral intake and on the third day patients were mobilized for a median of 9.7 hours and all had resumed defecation. Pain and fatigue scores (VAS) were low. The median post-operative hospital stay was 3.5 (range 3-8) days. Two patients returned with complications. No cardiopulmonary or infectious complications were seen. The multimodal rehabilitation programme resulted in a quick recovery and a hospital stay of three days in most patients after colonic surgery.


Subject(s)
Colectomy/rehabilitation , Colonic Diseases/surgery , Postoperative Care/methods , Recovery of Function , Adult , Aged , Analgesia/methods , Female , Humans , Length of Stay , Male , Middle Aged , Pain Measurement , Pain, Postoperative/diagnosis , Pain, Postoperative/prevention & control , Patient Education as Topic , Postoperative Care/economics , Prospective Studies , Regional Medical Programs , Sweden
4.
J Med Microbiol ; 50(3): 293-296, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11232777

ABSTRACT

DNA was extracted from faecal samples collected from 1680 patients in which Cryptosporidium oocysts were recognised by light microscopy. DNA from faeces from five of these patients failed to amplify by PCR three gene fragments--the Cryptosporidium oocyst wall protein (COWP) gene, the thrombospondin-related adhesive protein of Cryptosporidium-1 (TRAP-C1) gene and the thrombospondin-related adhesive protein of Cryptosporidium-2 (TRAP-C2) gene--with primers designed from C. parvum sequences. However, DNA from these five patients did amplify cryptosporidial 18S rDNA gene fragments and a heat-shock protein (HSP70) gene fragment was also amplified from four of them. The purpose of this study was to characterise further the Cryptosporidium associated with infection in these patients. DNA sequence analysis of 18S rDNA genes showed that four of these patients were infected by C. felis, and the remaining one by an as yet un-named Cryptosporidium species designated the 'dog type' (C. dt). Infection by C. felis was further confirmed in all four patients by DNA sequence analysis of the HSP70 gene. Oocysts present in all five samples reacted strongly with two anti-cryptosporidial oocyst monoclonal antibodies, except for the C. dt, which was tested with only one of the antibodies. Two of the patients infected by C. felis had underlying illness; one 8-year-old male had an undefined severe inherited underlying condition, and the second patient, a 32-year-old male, was HIV positive. Two of the remaining three patients (two females aged 1 and 2 years, respectively) were apparently immunocompetent (one infected with C. felis and one with the C. dt). No information was obtained for the fifth patient. The patient infected by C. dt had a recent history of travel to Africa. This is the first report of infection with these two Cryptosporidium species in immunocompetent patients, and in any patient in the UK.


Subject(s)
Cryptosporidium/isolation & purification , Feces/parasitology , Adult , Animals , Child , Child, Preschool , Dogs , England , Female , HSP70 Heat-Shock Proteins/genetics , Humans , Male , RNA, Ribosomal, 18S/genetics
5.
Lipids ; 36 Suppl: S79-82, 2001.
Article in English | MEDLINE | ID: mdl-11837997

ABSTRACT

Studies of Greenland Eskimos showed that a very high intake of marine n-3 fatty acids markedly inhibited platelet reactivity and suggested that intake of these fatty acids might prevent coronary thrombosis. Later studies with lower, more practical doses of n-3 fatty acids also have shown a platelet inhibitory effect of n-3 fatty acids, albeit fairly marginal. Furthermore, n-3 fatty acids have little effect on measures of blood coagulability and may slightly decrease fibrinolysis. In animal models, n-3 fatty acids often have been shown to inhibit thrombosis, but again the doses have tended to be very high. Finally, there has been little effect of (low-dose) n-3 fatty acids in clinical trials in humans on the incidence of myocardial infarction. Overall, there is little evidence for a major antithrombotic effect of practical doses of n-3 fatty acids on coronary thrombosis. This does not exclude a beneficial effect of n-3 fatty acids on coronary heart disease as suggested from clinical trials, but the major effect may be antiarrhythmic rather than antithrombotic.


Subject(s)
Coronary Thrombosis/prevention & control , Fatty Acids, Omega-3/administration & dosage , Animals , Blood Coagulation/drug effects , Blood Platelets/drug effects , Blood Platelets/physiology , Coronary Thrombosis/epidemiology , Fibrinolysis/drug effects , Greenland/epidemiology , Humans , Inuit , Myocardial Infarction/epidemiology , Myocardial Infarction/prevention & control
6.
Commun Dis Rep CDR Rev ; 5(7): R106-8, 1995 Jun 23.
Article in English | MEDLINE | ID: mdl-7613586

ABSTRACT

In an outbreak of pharyngitis caused by group A beta-haemolytic Streptococcus pyogenes in a boarding school of 261 pupils and 45 staff, 14 cases and 16 asymptomatic carriers were identified in pupils and one case was a member of staff. One symptomatic pupil had negative swabs. Two pupils had recurrent S. pyogenes pharyngitis before the outbreak. The attack rate was significantly greater in two dormitories than in the other seven. Swabs were taken from all staff and pupils, and the outbreak was controlled by treating all carriers and cases. Environmental factors enhancing airborne transmission were considered. The two dormitories with the most cases were poorly ventilated.


Subject(s)
Disease Outbreaks , Pharyngitis/epidemiology , Pharyngitis/microbiology , Streptococcal Infections/epidemiology , Streptococcus pyogenes/isolation & purification , Adolescent , Child , England/epidemiology , Female , Humans , Male , Pharynx/microbiology , Schools , Seroepidemiologic Studies
7.
Lancet ; 2(8558): 556-8, 1987 Sep 05.
Article in English | MEDLINE | ID: mdl-2887841

ABSTRACT

In two outbreaks of diarrhoea and vomiting that were caused by a small round structured virus (SRSV) that affected over 275 people, epidemiological and laboratory evidence showed that certain foods were the vehicles of infection and suggest that one of the chefs who prepared them may have been excreting this virus for a long time.


Subject(s)
Carrier State/microbiology , Disease Outbreaks , Food Handling , Food Microbiology , Gastroenteritis/epidemiology , Virus Diseases/epidemiology , Fruit/microbiology , Humans , London , Norwalk virus/isolation & purification
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