ABSTRACT
Between February 2011 and April 2012, an outbreak caused 55 episodes of Tinea corporis in a Berlin kindergarten. According to the case definition Tinea corporis was confirmed in 2 cases, 16 cases were dermatologically probable, 24 cases were suspicious, whereas 13 cases were viewed as improbable. 48% (n=32/67) of all children had at least one episode of disease. Of those aged 4-6 years 76% (n=29/38) were affected, compared with 10% (n=3/29) of those younger than 4 years. Despite comprehensive hygienic measures being taken, the outbreak could not be quickly controlled. To stop the outbreak the immediate cooperation of public health service and medical staff, kindergarten employees, parents and children was necessary. The timely involvement of dermatologists along with a uniform treatment approach turned out to be of major importance. The recommended long treatment duration over several weeks affected adherence to treatment. Overall, the extended treatment in the kindergarten of affected skin areas of children proved to be the most effective measure for the control of the outbreak.
Subject(s)
Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Hygiene , Population Surveillance/methods , Schools, Nursery/statistics & numerical data , Tinea/epidemiology , Tinea/prevention & control , Child , Child, Preschool , Female , Germany/epidemiology , Health Communication/methods , Humans , Infant , Male , Prevalence , Risk Factors , Tinea/diagnosis , Treatment OutcomeABSTRACT
Bacterial transmission remains the major component of morbidity and mortality associated with transfusion-transmitted infections. Platelet concentrates are the most common cause of bacterial transmission. The BacT/ALERT 3D automated blood culture system has the potential to screen platelet concentrates for the presence of bacteria. Evaluation of this system was performed by spiking day 2 apheresis platelet units with individual bacterial isolates at final concentrations of 10 and 100 colony-forming units (cfu) mL-1. Fifteen organisms were used which had been cited in platelet transmission and monitoring studies. BacT/ALERT times to detection were compared with thioglycollate broth cultures, and the performance of five types of BacT/ALERT culture bottles was evaluated. Sampling was performed immediately after the inoculation of the units, and 10 replicates were performed per organism concentration for each of the five types of BacT/ALERT bottles. The mean times for the detection of these 15 organisms by BacT/ALERT, with the exception of Propionibacterium acnes, ranged from 9.1 to 48.1 h (all 10 replicates were positive). In comparison, the time range found using thioglycollate was 12.0-32.3 h (all 10 replicates were positive). P. acnes' BacT/ALERT mean detection times ranged from 89.0 to 177.6 h compared with 75.6-86.4 h for the thioglycollate broth. BacT/ALERT, with the exception of P. acnes, which has dubious clinical significance, gave equivalent or shorter detection times when compared with the thioglycollate broth system. The BacT/ALERT system detected a range of organisms at levels of 10 and 100 cfu mL-1. This study validates the BacT/ALERT microbial detection system for screening platelets. Currently, the system is the only practically viable option available for routinely screening platelet concentrates to prevent bacterial transmission.
