Assuntos
Actinomycetaceae/isolamento & purificação , Bacteriemia/diagnóstico , Endoftalmite/microbiologia , Infecções por Bactérias Gram-Positivas/diagnóstico , Actinomycetaceae/efeitos dos fármacos , Idoso , Antibacterianos , Bacteriemia/tratamento farmacológico , Sequência de Bases , Cegueira , Quimioterapia Combinada/administração & dosagem , Endoftalmite/diagnóstico , Endoftalmite/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Imunocompetência , Masculino , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , RNA Bacteriano/análise , Medição de Risco , Resultado do TratamentoRESUMO
A retrospective study was performed to determine the frequency of and risk factors for long-term carriage of methicillin-resistant Staphylococcus aureus amongst 79 patients who initially acquired MRSA during hospital admission and were re-admitted at least once during the study period (28 months in total). Of the 52 patients who were re-screened during their re-admissions, 33 (63%) had positive MRSA screens on at least one re-screening and 19 (37%) had all negative screens. Patients whose case notes had been tagged were more likely to have screens performed. Of the potential risk factors assessed, only the presence of skin lesions significantly increased the risk of prolonged MRSA carriage (P = 0.032). Evaluation of the effect of anti-MRSA eradication treatment showed that patients who were subsequently MRSA negative on all re-admissions were more likely to have received some form of anti-MRSA treatment than those who remained positive on at least one re-admission (P = 0.048). The results show that the strain of MRSA at our hospitals (predominantly EMRSA 15) is associated with prolonged carriage in certain patients and that attempts at eradication often do not affect the duration of carriage. This has infection control implications for the management of known MRSA positive patients re-admitted to hospital.
Assuntos
Portador Sadio/epidemiologia , Infecção Hospitalar/epidemiologia , Resistência a Meticilina , Infecções Estafilocócicas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Portador Sadio/prevenção & controle , Infecção Hospitalar/prevenção & controle , Inglaterra/epidemiologia , Feminino , Humanos , Controle de Infecções/métodos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/prevenção & controle , Fatores de TempoRESUMO
A study of the peak-shift phenomenon was conducted from the standpoint of adaptation level (AL) and anchor theory. 60 human Ss were divided into 6 groups - 3 control and 3 experimental. During a training period each S lifted 2 weights of 50 and 250, 100 and 300, or 150 and 350 gm. and was told to respond "same" or "different" by pressing the appropriate telegraph key during a forthcoming testing period, according to whether the weight he would lift was or was not one of the original two. Experimental Ss received discrimination training, in addition, with weights of 150, 200, and 250 gm. Following training, Ss were tested on 10 weights ranging from 50 to 500 gm. at 50-gm. intervals. The mean peaks for 4 of the 6 groups, 3 experimental and 1 control, were consistent with an AL-anchor interpretation.
