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Infection Rates (infection + rate)
Kinds of Infection Rates Selected AbstractsCOMPARISON OF INFECTION RATE USING DIFFERENT METHODS OF ASSESSMENT FOR SURVEILLANCE OF TOTAL HIP REPLACEMENT SURGICAL SITE INFECTIONSANZ JOURNAL OF SURGERY, Issue 7 2007Yoke-Fong Chiew Background: The surveillance of surgical site infections (SSI) has been undertaken in many centres worldwide to ascertain the extent of the problem and where possible, to improve the incidence rates, thereby decreasing the undesirable outcomes. The study investigates the processes and outcomes of total hip replacement SSI surveillance carried out in Dunedin Public Hospital in 2004. Methods: Two hundred and six patients were enlisted in the study and 189 primary replacements and 22 revision replacements were carried out. Four methods of diagnosis of SSI were applied: (i) clinician diagnosis; (ii) ASEPSIS score; (iii) presence of pus cells; and (iv) assessment by a clinical microbiologist. Infection rates were calculated according to the risk indexes. Results: The incidence of infections varies considerably among these four methods. The infection rates for risk index 0 were 4.35% (method 1), 2.61% (method 2), 0.87% (methods 3 and 4); and for risk indexes 1 and 2 were 4.17% (method 1), 2.08% (method 2), 1.04% (methods 3 and 4). Conclusion: There is a need for accurate infection data so that the appropriate follow-up responses, including infection control measures for total hip replacement SSI can be carried out. The preponderance of elderly patients in the study who are frequently on ,polypharmacy' regimens adds pressure to the need to obtain true infection rates. This is because when antimicrobials are prescribed to them, drug interactions, adverse effects of the antimicrobials and the selective pressure of antimicrobials causing resistances may occur. More resources and a multidisciplinary approach are required for future studies of similar nature. [source] Sterile Versus Nonsterile Gloves During Mohs Micrographic Surgery: Infection Rate is not AffectedDERMATOLOGIC SURGERY, Issue 2 2006BRANDON M. RHINEHART MC BACKGROUND: Mohs micrographic surgery (MMS) is an outpatient procedure, which has become the treatment of choice for certain cutaneous malignancies. Although the major steps in this procedure are relatively standardized, one difference involves the use of sterile or nonsterile, clean gloves during the tumor removal phase. OBJECTIVE: This retrospective, chart review study was performed to evaluate whether infection rates are affected by the use of sterile versus nonsterile gloves in the tumor extirpation phase of MMS. METHODS: This study evaluated the surgical records of 1,810 consecutive Mohs patients, of which 1,239 Mohs patients (1,400 Mohs procedures) met inclusion criteria. Age, sex, tumor diagnosis, anatomic location, number of Mohs stages, area of defect, closure type, cartilage exposure, and sterile versus nonsterile glove use were recorded and evaluated. RESULTS: Twenty-five infections were identified. Statistically significant infection rates were discovered for patients with cartilage fenestration with secondary healing and malignant melanoma diagnosis only. There was no statistical difference in infection rates with all other measured variables to include the use of sterile or clean, nonsterile gloves. CONCLUSION: Our study lends support that clean, nonsterile gloves are safe and effective for use in the tumor extirpation phase of MMS, at a significant cost savings. [source] Increased Interleukin-10 and Cortisol in Long-term Alcoholics after Cardiopulmonary Bypass: A Hint to the Increased Postoperative Infection Rate?ALCOHOLISM, Issue 9 2005Michael Sander Background: Previous studies have shown that 20% of all patients admitted to the hospital abuse alcohol and have increased morbidity after surgery. Long-term alcoholic patients are shown to suffer from immune alterations, which might be critical for adequate postoperative performance. Cardiac surgery with cardiopulmonary bypass (CPB) also leads to pronounced immune alteration, which might be linked with patients' ability to combat infections. Therefore, the aim of our study was to investigate the perioperative levels of TNF-alpha, interleukin-6, interleukin-10, and cortisol in long-term alcoholic and nonalcoholic patients undergoing cardiac surgery to elucidate a possible association with postoperative infections. Methods: Forty-four patients undergoing elective cardiac surgery were included in this prospective study. Long-term alcoholic patients (n= 10) were defined as having a daily ethanol consumption of at least 60 g and fulfilling the Diagnostic and Statistical Manual of Mental Disorders for alcohol abuse. The nonalcoholic patients (n= 34) were defined as drinking less than 20 g ethanol per day. Blood samples were obtained to analyze the immune status upon admission to hospital, the morning before surgery and on admission to the ICU, the morning of days one and three after surgery. Results: Basic characteristics of patients did not differ between groups. Long-term alcoholics had a fourfold increase in postsurgery infection rate and prolonged need for ICU treatment and mechanical ventilation. Postoperative levels of interleukin-10 and cortisol were significantly increased in long-term alcoholic patients compared with nonalcoholic patients. These observations were in line with postoperative interleukin-10 being predictive for postoperative infectious complications. Conclusions: The increased infection rate in long-term alcoholics strengthens the urgent need for interventional approaches providing modulation of the perioperative immune and HPA response in these high-risk patients to counteract their postoperative immune suppression. [source] Indole Glucosinolates and Camalexin do not Influence the Development of the Clubroot Disease in Arabidopsis thalianaJOURNAL OF PHYTOPATHOLOGY, Issue 6 2008J. Siemens Abstract Root galls of Brassicaceae caused by Plasmodiophora brassicae are dependent on increased auxin and cytokinin formation. In this study we investigated whether indole glucosinolates are involved in indole-3-acetic acid (IAA) biosynthesis in root galls, by using a genetic approach. The cytochrome P450 enzymes, CYP79B2 and CYP79B3, convert tryptophan to indole-3-acetaldoxime (IAOx), which is a precursor for indole glucosinolates and the phytoalexin camalexin in Arabidopsis thaliana. Root galls of the Arabidopsis ecotypes Wassilewskija (WS) and Columbia (Col) accumulated camalexin, WS at levels up to 320 ,g/g dry weight. By contrast, camalexin was absent in root galls of cyp79b2/b3 double mutants. Infection rate and disease index as a measure of club development in mutant and wild-type plants of the two ecotypes were investigated and no differences were found in gall formation. This demonstrates that camalexin is an ineffective inhibitor of P. brassicae and indole glucosinolates are not the source of elevated levels of IAA in galls, because free IAA levels in mutant galls were comparable with those in wild type. [source] Age- and sex-related differences in antibody responses against Schistosoma mansoni soluble egg antigen in a cohort of school children in Ethiopia,APMIS, Issue 12 2001F. ABEBE Acquired immunity is believed to be the main factor in the age-related differences in prevalence and intensity of Schistosoma infections. We studied antibody responses against S. mansoni soluble egg antigen (SEA) by ELISA in children before treatment, 5 weeks and one year after treatment. After screening for S. mansoni infection, positive children were treated with praziquantel (40 mg per kg body weight). Infection rate was significantly higher in boys younger than 12 years than in girls in the same age group. Levels of all antibody isotypes, except IgG1 (before treatment) or IgA (one year after treatment), were higher in children older or equal to 12 years than in those younger. The difference between age groups was significant for IgE, IgM, IgG3 and IgG4 (before treatment) and IgE (one year after treatment). Similarly, all antibody isotypes, except IgE, before treatment were higher in boys than in girls. At 5 weeks after treatment, IgG, IgE and IgG1 showed an increasing tendency, whereas IgM and IgG3 tended to decrease. One year after treatment, significant decreases were observed in IgG, IgG1 and IgG4 and a significant increase in IgG2 levels. The study presents further evidence for the difference in acquired immunity between younger and older children, and between boys and girls. The study also suggests that praziquantel differentially affects antibody responses against S. mansoni SEA. [source] Vector within-host feeding preference mediates transmission of a heterogeneously distributed pathogenECOLOGICAL ENTOMOLOGY, Issue 3 2010MATTHEW P. DAUGHERTY 1. Ecological theory predicts that vector preference for certain host species or discrimination between infected versus uninfected hosts impacts disease incidence. However, little information exists on the extent to which vector within-host feeding preference mediates transmission. This may be particularly important for plant pathogens, such as sharpshooter transmission of the bacterium Xylella fastidiosa, which are distributed irregularly throughout hosts. 2. We documented the within-host distribution of two vector species that differ in transmission efficiency, the leafhoppers Draeculacephala minerva and Graphocephala atropunctata, and which are free to move throughout entirely caged alfalfa plants. The more efficient vector D. minerva fed preferentially at the base of the plant near the soil surface, whereas the less efficient G. atropunctata preferred overwhelming the top of the plant. 3. Next we documented X. fastidiosa heterogeneity in mechanically inoculated plants. Infection rates were up to 50% higher and mean bacterial population densities were 100-fold higher near the plant base than at the top or in the taproot. 4. Finally, we estimated transmission efficiency of the two leafhoppers when they were confined at either the base or top of inoculated alfalfa plants. Both vectors were inefficient when confined at the top of infected plants and were 20,60% more efficient when confined at the plant base. 5. These results show that vector transmission efficiency is determined by the interaction between leafhopper within-plant feeding behaviour and pathogen within-plant distribution. Fine-scale vector and pathogen overlap is likely to be a requirement generally for efficient transmission of vector-borne pathogens. [source] Comparison of side hole versus non side hole high flow hemodialysis cathetersHEMODIALYSIS INTERNATIONAL, Issue 1 2006Michael G. TAL Abstract Current literature suggests that side holes may be detrimental to dialysis catheter performance. Today, these catheters are primarily available with side holes. The purpose of this study was to compare flow rates, infection rate, and survival of side hole vs. non side hole hemodialysis catheters. Over a 16-month period patients were arbitrarily assigned to either a 14.5 F MAHURKAR® MAXIDŌ cuffed dual lumen tunneled catheter with side holes or a 14.5 F MAHURKAR MAXID cuffed dual lumen tunneled catheter without side holes ("non side hole catheters"). We performed a retrospective analysis of catheter flow rates, patency, catheter survival, and catheter-related infections. Information was gathered for the life of the catheter or up to 28 weeks. A total of 54 patients were enrolled in the study. Thirty-seven of 54 (68%) patients received a catheter with side holes for a total of 3,930 catheter days and 17/54 (32%) received a similar catheter without side holes for a total of 2,188 catheter days. Catheter infection necessitating removal of the catheter occurred in 10/37 catheters with side holes and 1/17 without side holes. Infection rates per 1,000 catheter days were 2.545 with side holes and 0.254 without side holes (p<0.001). Slightly improved catheter survival (p<0.05) was recorded with the non side hole catheters. No insertion complication (e.g., air embolization, bleeding, or kinking) occurred with either catheter. One catheter without side holes had to be repositioned 5 days after insertion because of poor flows. No significant difference was recorded in mean blood flow rates between the catheters. Results indicate reduced catheter infection rate in hemodialysis patients with the use of non side hole dual lumen tunneled cuffed catheters. [source] Parthenogenetic flatworms have more symbionts than their coexisting, sexual conspecifics, but does this support the Red Queen?JOURNAL OF EVOLUTIONARY BIOLOGY, Issue 1 2001N. K. Michiels The Red Queen hypothesis predicts that sexuality is favoured when virulent parasites adapt quickly to host genotypes. We studied a population of the flatworm Schmidtea polychroa in which obligate sexual and parthenogenetic individuals coexist. Infection rates by an amoeboid protozoan were consistently higher in parthenogens than in sexuals. Allozyme analysis showed that infection was genotype specific, with the second most common clone most infected. A laboratory measurement of fitness components failed to reveal high infection costs as required for the Red Queen. Although fertility was lower in more infected parthenogens, this effect can also be explained by the accumulation of mutations. We discuss these and other characteristics of our model system that may explain how a parasite with low virulence can show this pattern. [source] Occurrence and effects of Nosema fumiferanae infections on adult spruce budworm caught above and within the forest canopyAGRICULTURAL AND FOREST ENTOMOLOGY, Issue 4 2007Eldon S. Eveleigh Abstract 1,Nosema fumiferanae infections in populations of both sexes of spruce budworm Choristoneura fumiferana moths, collected live above the forest canopy (canopy moths), within the tree crown (crown moths) and in drop trays (dead moths), were examined over a 5-year period in New Brunswick, Canada. 2,The incidence of infection and of moderate,heavy infections in canopy and crown moths of both sexes increased concomitantly with moth eclosion, indicating that N. fumiferanae retards larval/pupal development, with infected moths, particularly those having higher disease loads, emerging later in the season. 3,Infection rates differed among canopy, crown, and dead female, but not male, moths. Canopy (i.e. emigrating) females had a lower incidence of infection, lower incidence of moderate,heavy infections, and had longer forewings and higher dry weights, than crown females. These results suggest that N. fumiferanae infections negatively affect aspects of female, but not male, flight performance. Regardless of infection, forewing length and dry weight of both canopy and crown females declined over the moth flight period, but infected females in both moth types were smaller than their uninfected counterparts. Forewing lengths and dry weights of moderately,heavily infected females were most severely affected. 4,Despite high annual infection rates in parents, only a small percentage of offspring (second-instar larvae) that established feeding sites each spring were infected, indicating that high rates of horizontal transmission occurred annually throughout the larval period. 5,The present study indicates that whether N. fumiferanae infections are a debilitating sublethal factor in spruce budworm populations depends more on the disease load than on the overall incidence of infection. The potential importance of N. fumiferanae infections on various fitness parameters related to host dispersal is discussed. [source] Rhesus monkey model for Leishmania major transmitted by Phlebotomus papatasi sandfly bitesMEDICAL AND VETERINARY ENTOMOLOGY, Issue 1 2001R. J. Probst Summary Leishmaniasis research needs a near-human model for investigations of natural infection processes, immunological responses and evaluation of treatments. Therefore, we developed a reproducible system using Leishmania major Yakimoff & Schokhor (Trypanosomatidae: Kinetoplastida), the cause of Old World zoonotic cutaneous leishmaniasis (ZCL), transmitted to rhesus monkeys Macaca mulatta (Zimmerman) (Primates: Cercopithecidae) by sandfly bites of experimentally infected Phlebotomus papatasi (Scopoli) (Diptera: Psychodidae). Eight monkeys of presumed Indian origin (Leishmania naļve) were exposed to bites of female sandflies that had been infected with L. major by membrane-feeding on human blood seeded with amastigotes isolated from hamster footpad lesions. Infection rates of membrane-fed sandflies averaged >,85% seven days after the infective feed, with uniformly high numbers of promastigotes in the stomodaeal valve region of the sandfly gut. Nodules and ulcerating dermal lesions developed on 7/8 monkeys 2,4 weeks post-bite and persisted for 3,7 months. Monkeys also developed satellite lesions beyond the area of sandfly bites on the head, but not on the chest. Three re-challenged monkeys developed lesions that healed faster than lesions from their primary challenges. After infection, monkeys developed delayed type hypersensitivity (DTH) responses to a panel of Leishmania skin test antigens (LSTA) and, when tested by ELISA and IFA, showed significant post-infection antibody titres which typically rose for ,170 days and then gradually receded during the next 100 days following the first challenge. After the second challenge, antibody titres spiked higher within ,50 days and receded more rapidly. In contrast, four rhesus macaques of Chinese origin developed no lesions following infected sandfly bites, although they raised antibodies and LSTA reactions, indicating subclinical infection. [source] COMPARISON OF INFECTION RATE USING DIFFERENT METHODS OF ASSESSMENT FOR SURVEILLANCE OF TOTAL HIP REPLACEMENT SURGICAL SITE INFECTIONSANZ JOURNAL OF SURGERY, Issue 7 2007Yoke-Fong Chiew Background: The surveillance of surgical site infections (SSI) has been undertaken in many centres worldwide to ascertain the extent of the problem and where possible, to improve the incidence rates, thereby decreasing the undesirable outcomes. The study investigates the processes and outcomes of total hip replacement SSI surveillance carried out in Dunedin Public Hospital in 2004. Methods: Two hundred and six patients were enlisted in the study and 189 primary replacements and 22 revision replacements were carried out. Four methods of diagnosis of SSI were applied: (i) clinician diagnosis; (ii) ASEPSIS score; (iii) presence of pus cells; and (iv) assessment by a clinical microbiologist. Infection rates were calculated according to the risk indexes. Results: The incidence of infections varies considerably among these four methods. The infection rates for risk index 0 were 4.35% (method 1), 2.61% (method 2), 0.87% (methods 3 and 4); and for risk indexes 1 and 2 were 4.17% (method 1), 2.08% (method 2), 1.04% (methods 3 and 4). Conclusion: There is a need for accurate infection data so that the appropriate follow-up responses, including infection control measures for total hip replacement SSI can be carried out. The preponderance of elderly patients in the study who are frequently on ,polypharmacy' regimens adds pressure to the need to obtain true infection rates. This is because when antimicrobials are prescribed to them, drug interactions, adverse effects of the antimicrobials and the selective pressure of antimicrobials causing resistances may occur. More resources and a multidisciplinary approach are required for future studies of similar nature. [source] Randomized trial comparing natural and synthetic surfactant: increased infection rate after natural surfactant?ACTA PAEDIATRICA, Issue 5 2000AK Kukkonen The efficacy of a natural porcine surfactant and a synthetic surfactant were compared in a randomized trial. In three neonatal intensive care units, 228 neonates with respiratory distress and a ratio of arterial to alveolar partial pressure of oxygen <0.22 were randomly assigned to receive either Curosurf 100mgkg,1 or Exosurf Neonatal 5 ml kg,1. After Curosurf, the fraction of inspired oxygen was lower from 15min (0.45 ± 0.22 vs 0.70 ± 0.22, p = 0.0001) to 6 h (0.48 ± 0.26 vs 0.64 ± 0.23,p= 0.0001) and the mean airway pressure was lower at 1 h (8.3 3.2 mmH2O vs 9.4 ± 3.1 mmH2O ,= 0.01). Thereafter the respiratory parameters were similar. The duration of mechanical ventilation (median 6 vs 5 d) and the duration of oxygen supplementation (median 5 vs 4 d) were similar for Curosurf and Exosurf After Curosurf, C-reactive protein value over 40 mg r1 occurred in 45% (vs 12%; RR 3.62, 95%CI 2.12-6.17, p = 0.001), leukopenia in 52% (vs 28%; RR 1.85, 95%CI 1.31-2.61, ,= 0.001) and bacteraemia in 11% (vs 4%; RR3.17, 95%CI 1.05-9.52, p < 0.05). We conclude that when given as rescue therapy Curosurf had no advantage compared with Exosurf in addition to the more effective initial response. Curosurf may increase the risk of infection. [source] Liver transplantation for alcoholic liver diseaseADDICTION BIOLOGY, Issue 4 2001Georges-Philippe Pageaux Although increasing numbers of alcoholic patients are being referred to liver transplant centres, liver transplantation for alcoholic liver disease still remains controversial, essentially because we are in an era of organ shortage. In fact, the main issue is the likelihood of relapse and its influence on outcome, because it is the possibility of returning to alcohol use that separates patients with alcoholic liver disease from those with other forms of chronic liver disease. In all proposed clinical guidelines of indications for referral and assessment for liver transplantation for alcoholic liver disease, the authors emphasize the risk of alcoholism recurrence and, thus, a multidisciplinary approach is required to select patients who are likely to comply with follow-up and not return to a damaging pattern of alcohol consumption after transplantation. It emerges from all clinical studies that when we take into account the usual criteria of success for liver transplantation, i.e. patient and graft survival, rejection rate and infection rate, alcoholic liver disease is a good indication for liver transplantation. Predictive factors for alcoholic relapse after liver transplantation have been assessed in numerous studies, often with contradictory results making these difficult to analyse and compare. Several predictive factors for alcoholic relapse have been studied: length of abstinence before transplantation, associated psychiatric problems, social conditions, associated drug addiction, age. Abstinence after transplantation is the goal, but the necessary treatment for alcoholic disease can result in considerable improvement, even when complete abstinence is not achieved. Finally, the good results obtained with liver transplantation for alcoholic liver disease should help us to educate the general population about alcoholic disease. [source] Contrasting infection frequencies of Neotyphodium endophyte in naturalized Italian ryegrass populations in Japanese farmlandsGRASSLAND SCIENCE, Issue 2 2010Masayuki Yamashita Abstract Neotyphodium endophytes often confer benefits to their host grasses and may enhance invasiveness of some grasses. The knowledge of infection frequencies of endophytes among invading weed populations is necessary to understand the relationships between endophyte infection and invasiveness. Here we present data on infection frequencies of Italian ryegrass (Lolium multiflorum Lam.), an important weed in some farmlands in Japan, persisting in contrasting farmlands: a terraced paddy field and a wheat-soybean double-cropped field in the western region of Shizuoka prefecture, Japan. The terraced paddy site is a mosaic of several landscape elements such as paddy fields, levees, fallow and abandoned fields, with a high percentage of non-crop area. Rice (Oryza sativa L.) has been cultivated for more than a decade with no application of chemical fertilizers, pesticides and fungicides. The wheat-soybean field is characterized by the aggregation of large-scaled fields that were originally reconstructed paddy fields, showing a low percentage of non-crop area. Wheat and soybean have been grown as winter and summer crops, respectively, using chemical fertilizers and herbicides. We examined the presence or absence of endophytes in a total of 1200 seeds sampled from the two Italian ryegrass populations. The terraced paddy population exhibited a markedly high infection frequency (91.0%), due possibly to selective feeding of non-infected seeds by insects. In contrast, the wheat-soybean farmland population showed almost no infection (1.1%), whereas the putative source of the invasion in the proximity exhibited a relatively high infection rate (64.4%). Such a micro-scale variation in infection frequencies may be attributable to a loss in endophyte viability within the wheat-soybean field. The findings suggest that endophyte infection frequency may markedly differ among the Italian ryegrass populations even within the same region, presumably depending on the abundance of the seed-eating insects, farmland management regimes and/or environmental conditions such as soil humidity. [source] Central venous access devices for paediatric patients with haemophilia: a single-institution experienceHAEMOPHILIA, Issue 1 2009R. TITAPIWATANAKUN Summary., Use of a central venous access device (CVAD) can facilitate early introduction of home-based infusion of factor concentrate for long-term prophylaxis or immune tolerance therapy in children with bleeding disorders. The aim was to review outcomes associated with use of CVAD. Retrospective review of paediatric patients with bleeding disorders was observed at the Mayo Clinic Comprehensive Hemophilia Center. Thirty-seven CVAD were placed in 18 patients (haemophilia A [n = 15], type 3 von Willebrand disease [n = 2] and haemophilia B [n = 1]). Follow-up was for 45 952 CVAD days, and median time that CVAD remained in place was 1361 days per device. Factor VIII (FVIII) inhibitors were present in 4 of the 15 patients. Ten CVAD-related infections occurred (median, 672 days; range, 72,1941 days), of which six were in one patient with FVIII inhibitors. Overall infection rate was 0.22 (95% confidence interval [CI], 0.10,0.40) per 1000 CVAD days, with 0.11 infections in patients without FVIII inhibitors compared with a pooled incidence of 0.66 (95% CI, 0.44,0.97) reported in the literature. Indications for removal of 27 CVAD were blockage, change to peripheral venous access, catheter displacement, infection, leak in the port septum, short catheter and skin erosion. No clinically apparent thrombosis or sequelae of thrombosis were observed. Infection is the most common complication associated with CVAD use and is increased in patients who have inhibitors. The low rate of clinically apparent thrombosis reflects our practice of not screening for thrombosis. The low infection rate reflects our practice of using and reinforcing the aseptic technique. [source] Experience of prophylaxis treatment in children with severe haemophiliaHAEMOPHILIA, Issue 2 2002T. T. YEE The practice of prophylactic treatment of boys with severe haemophilia has been evaluated in our centre. Prophylaxis was started at the median age of 3.7 years (range 0.4,12.7 years) in 38/41 children (93%) under 17 years of age. Median follow-up was 4.1 years (range 0.4,12.7 years). The criteria of primary prophylaxis according to the definition by the European Paediatric Network of Haemophilia Management was fulfilled by 9/38 (24%). Although a majority [76%, 29/38] of the children started prophylaxis after a median number of joint bleeds of 3.5, 70% of the children in this group had clinical joint scores of 0. Intravenous catheter insertion was required at a median age of 15.5 months (range 5,36 months) in 21% of the children, resulting in a catheter infection rate of 1.74 per 1000 catheter days. None developed an inhibitor on prophylaxis and three patients who had low-titre inhibitors (< 5 Bethesda units) prior to prophylaxis had undetectable inhibitors after prophylaxis. The home-treatment training programme required considerable time and cost. As a result, 87% of the children used peripheral venous access and hospital visits declined as prophylaxis became established. Parents' incentives for prophylaxis were that the children undertook many physical activities and sports previously not recommended, there was less parental anxiety and an overall improvement in the quality of life for the whole family. [source] Helicobacter pylori Infection may be Implicated in the Topography and Geographic Variation of Upper Gastrointestinal Cancers in the Taihang Mountain High-Risk Region in Northern ChinaHELICOBACTER, Issue 5 2010Denggui Wen Abstract Backgrounds:,Helicobacter pylori infection is prevalent in China. Chronic infection of the bacterial not only causes distal stomach cancer, but also confers risk to gastric cardia adenocarcinoma. Because H. pylori infection is inversely associated with esophageal adenocarcinoma, globally the infection rate is significantly correlated with the ratio of squamous carcinoma to adenocarcinoma of the esophagus. These agree with the topography of upper gastrointestinal cancer observed in the Taihang Mountain high-risk region where both gastric cardia and non-cardia adenocarcinoma coincide with esophageal squamous cancer, but with almost no distal esophageal adenocarcinoma. Moreover, as altitude increases from plain to mountains, we observed progressively increasing incidence rates of gastric adenocarcinomas in recent years in the region. Because H. pylori infection is a definite carcinogen to gastric adenocarcinoma and is more prevalent in the mountain than in plain areas due to undeveloped living conditions, the observation gives the impression as though H. pylori infection is implicated. Aims:, This article aims to note the role of H. pylori infection in upper gastrointestinal cancer in the Taihang Mountain high-risk region in northern China. Materials and Methods:, First the unique topography and geographic variation of upper gastrointestinal cancer in the region is described to indicate a possible role of H. pylori infection, then we review studies on prevalence of H. pylori infection in the high-risk region and describe difference in socioeconomic development and water hygiene between the plains and the mountains as related to the prevalence of H. pylori infection. Results:, Coincidence of gastric cancer in the region and a progressively increasing rate of the cancer from the plain towards the mountains indicate H. pylori infection may be implicated in upper gastrointestinal cancer. Conclusion:, International collaboration is needed to study H. pylori and upper gastrointestinal cancer in the region when rapid industrialization is just beginning. [source] Distinctiveness of the cagA Genotype in Children and Adults with Peptic Symptoms in South ChinaHELICOBACTER, Issue 4 2009Juan Li Abstract Background:,Helicobacter pylori infection is different between children and adults, not only in infection rate but also in virulence genotypes. However, the 3, region of CagA, important in stomach carcinogenesis, still remains unclear in children. The present study aims to compare the frequency of cagA and the distribution of its subtypes between children and adults in South China. Materials and Methods:, One hundred and twenty-eight children and 99 adults with peptic symptoms were enrolled in our research. Histology, rapid urease test, and real-time polymerase chain reaction (PCR) assay were used to diagnose H. pylori infection. vacA s1 was detected by real-time PCR, and EPIYA motifs in the 3, region of CagA by conventional PCR and DNA sequencing. Results:,H. pylori infection was diagnosed in 53 children and 62 adults. vacA s1 was identified in 90.6% and 91.9% of infected children and adults, respectively. Furthermore, cagA was identified in 73.6% and 82.3% of infected children and adults, respectively. No patient with multiple cagA subtypes was observed. A higher prevalence of more virulent cagA genotype was found in children compared to adults (p < .05). Thirty-eight of 39 (97.4%) cagA -positive children were found to have EPIYA-ABD and only one (2.6%) with EPIYA-ABC. In adults, four types of EPIYA motifs , ABC (29.4%), ABD (64.7%), ABAB (2%), and AAD (3.9%) , were identified, and the ABD type was found more commonly in severe diseases, such as atrophic gastritis (53.3%) and gastric cancer (71.4%). Conclusion:,cagA genotypes in children and in adults are different, and EPIYA-ABD may have potential clinical implication in the development of gastric cancer in South China. [source] Factors Related to Helicobacter pylori Prevalence in an Adult Population in BrazilHELICOBACTER, Issue 1 2007Schlioma Zaterka Abstract Background:, The prevalence of Helicobacter pylori is higher in developing countries. Sanitary facilities, crowding and ethnic group are some of the factors related to H. pylori infection. The aim of this study was to investigate in blood donors, free of dyspeptic symptoms, the prevalence and factors influencing H. pylori infection. Materials and Methods:, This study was conducted in Sćo Paulo, a city known to have a mixed population coming from all over the country. A total of 1008 blood donors were initially included in the study. After a final revision of all the questionnaires, 993 were included in the final analysis (746 males). H. pylori status was checked by an ELISA test. The following associations to infection were analyzed: sex, age, ethnic group, previous upper gastrointestinal (GI) endoscopy, smoking, alcoholism, drug addiction, type of drinking water, crowding, sanitary facilities, and family income. Results:, Infection was observed in 496 of 746 male (66.5%) and in 156 of 247 female (63.2%) blood donors. Infection prevalence increased according to age group, regardless of sex. Prevalence was lower in White population than in non-White. No relationship was observed between infection and smoking, drug addiction, and alcohol. A positive relation was observed between infection and previous upper GI endoscopy, and type of drinking water, regardless if currently or during childhood. Crowding and lack of toilet in the house during childhood resulted in a higher infection rate. Lower familial income and educational level showed a positive association to infection. Conclusions:, Prevalence of H. pylori is higher in non-White population, independent of gender. A positive association was observed in aging, previous upper GI endoscopy, crowding, type of drinking water, lack of toilet during childhood, lower family income, and lower educational level. [source] Comparison of side hole versus non side hole high flow hemodialysis cathetersHEMODIALYSIS INTERNATIONAL, Issue 1 2006Michael G. TAL Abstract Current literature suggests that side holes may be detrimental to dialysis catheter performance. Today, these catheters are primarily available with side holes. The purpose of this study was to compare flow rates, infection rate, and survival of side hole vs. non side hole hemodialysis catheters. Over a 16-month period patients were arbitrarily assigned to either a 14.5 F MAHURKAR® MAXIDŌ cuffed dual lumen tunneled catheter with side holes or a 14.5 F MAHURKAR MAXID cuffed dual lumen tunneled catheter without side holes ("non side hole catheters"). We performed a retrospective analysis of catheter flow rates, patency, catheter survival, and catheter-related infections. Information was gathered for the life of the catheter or up to 28 weeks. A total of 54 patients were enrolled in the study. Thirty-seven of 54 (68%) patients received a catheter with side holes for a total of 3,930 catheter days and 17/54 (32%) received a similar catheter without side holes for a total of 2,188 catheter days. Catheter infection necessitating removal of the catheter occurred in 10/37 catheters with side holes and 1/17 without side holes. Infection rates per 1,000 catheter days were 2.545 with side holes and 0.254 without side holes (p<0.001). Slightly improved catheter survival (p<0.05) was recorded with the non side hole catheters. No insertion complication (e.g., air embolization, bleeding, or kinking) occurred with either catheter. One catheter without side holes had to be repositioned 5 days after insertion because of poor flows. No significant difference was recorded in mean blood flow rates between the catheters. Results indicate reduced catheter infection rate in hemodialysis patients with the use of non side hole dual lumen tunneled cuffed catheters. [source] Risk factors for infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C,HEPATOLOGY, Issue 4 2010Robert Roomer Neutropenia during treatment with peginterferon alfa and ribavirin for chronic hepatitis C virus (HCV) infection is a common cause of dose reductions of peginterferon alfa. These reductions are performed to prevent bacterial and fungal infections, which are common during HCV treatment and can be attributed to neutropenia. The aims of this study were to investigate the occurrence of infections and their relation to neutropenia and to identify potential risk factors for infections during HCV treatment. In this single-center cohort study, 2,876 visits of 321 patients treated with peginterferon alfa and ribavirin were evaluated for neutropenia, infections, dose reductions, and potential risk factors for infection during HCV treatment. The baseline mean absolute neutrophil count (ANC) was 3,420 cells/,L, and 16 patients had a baseline ANC of <1,500 cells/,L. During treatment, neutropenia, which was defined as ANC <750 cells/,L, was observed in 95 patients (29.7%) and ANC <375/,L was observed in 16 patients (5%). Ninety-six infections were observed in 70 patients (21.8%). Thirteen infections (13.5%) were defined as severe. Infections were not correlated with neutropenia during treatment. Dose reductions did not lead to a decrease in infection rate. Multivariate logistic regression analysis revealed that age >55 years (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.19-3.56, P = 0.01) and baseline hyperglycemia (OR 2.17, 95% CI 1.15-4.10, P = 0.016) were associated with an increased risk of infection during HCV treatment. Cirrhosis and chronic obstructive pulmonary disease were not risk factors for infection. Conclusion: Bacterial infections during treatment with peginterferon alfa and ribavirin are not associated with neutropenia. Older patients and patients with poorly controlled diabetes mellitus have a greater risk of developing infections during HCV treatment. (HEPATOLOGY 2010) [source] Epstein-Barr virus infection in immortalized nasopharyngeal epithelial cells: Regulation of infection and phenotypic characterizationINTERNATIONAL JOURNAL OF CANCER, Issue 7 2010Chi Man Tsang Abstract Epstein-Barr virus (EBV) infection has been postulated to be an early event involved in the pathogenesis of nasopharyngeal carcinomas (NPC). The lack of representative premalignant nasopharyngeal epithelial cell system for EBV infection has hampered research investigation into the regulation and involvement of EBV infection in NPC pathogenesis. We have compared the efficiency of EBV infection in nasopharyngeal epithelial cells with different biological properties including immortalized, primary and cancerous nasopharyngeal epithelial cells. EBV infection could be achieved in all the nasopharyngeal epithelial cells examined with variable infection rate. TGF-, effectively enhanced EBV infection into nasopharyngeal epithelial cells both in the immortalized and primary nasopharyngeal epithelial cells. Stable infection of EBV was achieved in a telomerase-immortalized nasopharyngeal epithelial cell line, NP460hTert. The expression pattern of EBV-encoded genes and biological properties of this EBV infected cell line on long-term propagation were monitored. The EBV-infected nasopharyngeal epithelial cells acquired anchorage-independent growth and exhibited invasive growth properties on prolonged propagation. A distinguished feature of this EBV-infected nasopharyngeal epithelial cell model was its enhanced ability to survive under growth factor and nutrient starvation. This was evidenced by the suppressed activation of apoptotic markers and sustained activation of pAkt of EBV-infected cells compared to control cells under nutrient starvation. Examination of cytokine profiles of EBV-infected NP460hTert cells to nutrient and growth factor deprivation revealed upregulation of expression of MCP-1 and GRO-,. The establishment of a stable EBV infection model of premalignant nasopharyngeal epithelial cells will facilitate research investigation into the pathogenic role of EBV in NPC development. [source] Surgical site infection rate and associated risk factors in elective general surgery at a public sector medical university in PakistanINTERNATIONAL WOUND JOURNAL, Issue 1 2008Ahmed Khan Sangrasi Abstract This prospective study aimed to determine the surgical site infection (SSI) rate and associated risk factors was carried in a general surgical ward at Liaquat University Hospital Jamshoro. A total of 460 patients requiring elective general surgery from July 2005 to June 2006 were included in this study. All four surgical wound categories were included. Primary closure was employed in all cases. Patients were followed up to 30th day postoperatively. All cases were evaluated for postoperative fever, redness, swelling of wound margins and collection of pus. Cultures were taken from all the cases with any of the above finding. Mean ± SD age of the patients was 38·8 ± 17·4 years with male to female ratio of 1·5:1. The overall rate of surgical site infection was 13·0%. The rate of wound infection was 5·3% in clean operations, 12·4% in clean-contaminated, 36·3% in contaminated and 40% in dirt-infected cases. Age, use of surgical drain, duration of operation and wound class were significant risk factors for increased surgical site infection (P < 0·05). Postoperative hospital stay was double in cases who had surgical site infection. Sex, haemoglobin level and diabetes were not statistically significant risk factors (P > 0·05). In conclusion, surgical site infection causes considerable morbidity and economic burden. The routine reporting of SSI rates stratified by potential risk factors associated with increased risk of infection is highly recommended. [source] Evaluation of Ssp I polymerase chain reaction assay in the detection of Wuchereria bancrofti infection in field-collected Culex quinquefasciatus and its application in the transmission studies of lymphatic filariasisJOURNAL OF APPLIED ENTOMOLOGY, Issue 7-8 2002S. L. Hoti The evaluation of the assay was carried out using pools of vector mosquitoes collected from areas under filariasis survey and control trial projects, in comparison with the standard dissection and microscopy technique. In the filariasis survey area the infection rate as determined by the dissection and microscopy technique was 0.89% whereas it was 1.7% by PCR assay. In the Bacillus sphaericus trial area the infection rates as assessed by the conventional technique were 6.6 and 4.5% in the treated and check areas, respectively, whereas those obtained by the PCR assay were 4.7 to 2.2%. Although the infection rates determined by the PCR assay are slightly higher or lower than the rates obtained by the conventional technique, the difference was not statistically significant (P=0.451 for filariasis survey area, and P=0.203 and 0.161 for B. sphaericus trial area). When the pool size of Cx. quinquefasciatus was increased to 50 the sensitivity of the PCR was affected. The changes in infection rates as influenced by the antifilarial chemotherapy were similar when determined by PCR assay and the standard method. The major advantage of the PCR assay over the conventional technique is that thousands of mosquitoes can be processed within a short duration and this attribute has potential application in rapid assessment of disease prevalence and monitoring of the transmission dynamics. [source] Studies on the significance of pathogenic fungi in the population dynamics of the Lesser Spruce Sawfly, Pristiphora abietina Christ. (Hym., Tenthredinidae)JOURNAL OF APPLIED ENTOMOLOGY, Issue 5 2001Führer The population dynamics of Pristiphora abietina, an important pest in Norway spruce in central Europe, is significantly influenced by factors causing nymph mortality during the cocoon stage. In contrast to other findings reported in the literature, pathogenic fungi of the genera Beauveria, Paecilomyces and Metarhizium were found to be important natural enemies. Their epizootics occur soon after cocoon formation by the larvae in the ground litter, i.e. in June/July, and progress only slightly in autumn and winter. ,Obscure' mortality, which is ascribed mainly to abiotic factors, is observed more in winter. Field and laboratory experiments as well as histological analyses suggest that the fungal disease in nymphs is due to spore contamination occurring before cocoon formation, and that penetration of fungi from outside through the intact cocoon wall appears very unlikely. Thus, the infection rate of cocoons depends on the spore density in the ground litter of spruce stands during the cocoon spinning period of May/June. Perspectives for biocontrol arising from these findings are discussed. [source] Diagnosis of Chlamydia trachomatis infectionJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 1 2006Jayanti Mania-Pramanik Abstract Important progress in the diagnosis of Chlamydia trachomatis (C. trachomatis) includes the development of nucleic acid amplification techniques such as polymerase chain reaction (PCR) and ligase chain reaction (LCR). Commercial kits are available, but they are costly, sporadic in availability, must be imported, and are economically beyond the reach of common people. To overcome this limitation, most research laboratories have standardized their in-house-developed PCR methods for diagnosing this infection. However, each laboratory has to spend a great deal of time and money to accomplish this. Published reports do not always elaborate the steps involved in standardizing a test so that it can immediately be reproduced in another setting. In the present study we attempted to elaborate the steps involved in standardizing a sensitive and specific PCR technique followed by hybridization with specific C. trachomatis probe to diagnose this infection in cervical, introital, and urine specimens, and used it to determine the infection rate in a clinical population. J. Clin. Lab. Anal. 20:8,14, 2006. © 2006 Wiley-Liss, Inc. [source] Maximized virulence in a sterilizing pathogen: the anther-smut fungus and its co-evolved hostsJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 6 2008D. B. SLOAN Abstract Host sterilization is a common feature of sexually transmitted diseases (STDs). Because host reproductive failure may free up resources for pathogen reproduction and transmission, theory predicts that selection on sterilizing pathogens will favour maximum virulence (i.e. complete sterilization). We examined patterns of infection in sexually transmitted anther-smut fungi (Microbotryum) on four of their host species in the Caryophyllaceae. Using controlled fungal matings and experimental inoculations, we compared disease expression in inoculations ranging from host-specific pathogens to hybrids and cross-species treatments. Our data support the existence of host-specific sibling species within the genus Microbotryum based on a low infection rate from cross-inoculations and reduced fitness for hybrid pathogens. These patterns of host specificity and reproductive isolation, however, were not absolute. We did observe some successful cross-species and hybrid infections, but the expression of disease was frequently incomplete, including only partial host sterilization and the failed dehiscence of pathogen spores. The prevalence of these maladapted disease phenotypes may greatly inhibit the emergence of novel host pathogen combinations. Infections by hybrid pathogen genotypes were intermediate, in terms of both infection rate and the normality of disease symptoms, between host-specific and cross-inoculated pathogens. In addition, the frequency with which hybrid and cross-inoculated anther-smut pathogens were able to infect but not sterilize new hosts supports the prediction that sterilizing STDs are under selection to maximize virulence in natural populations. [source] Investigation of wild caught whitefish, Coregonus lavaretus (L.), for infection with viral haemorrhagic septicaemia virus (VHSV) and experimental challenge of whitefish with VHSVJOURNAL OF FISH DISEASES, Issue 7 2004H F Skall Abstract One hundred and forty-eight wild whitefish, Coregonus lavaretus (L.), were caught by electrofishing and sampled for virological examination in December 1999 and 2000, during migration from the brackish water feeding grounds to the freshwater spawning grounds, where the whitefish may come into contact with farmed rainbow trout. All samples were examined on cell cultures. No viruses were isolated. Three viral haemorrhagic septicaemia virus (VHSV) isolates of different origin were tested in infection trials by immersion and intraperitoneal (IP) injection, using 1.5 g farmed whitefish: an isolate from wild caught marine fish, a farmed rainbow trout isolate with a suspected marine origin and a classical freshwater isolate. The isolates were highly pathogenic by IP injection where 99,100% of the whitefish died. Using an immersion challenge the rainbow trout isolates were moderately pathogenic with approximately 20% mortality, whereas the marine isolate was virtually non-pathogenic. At the end of the experiment it was possible to isolate VHSV from survivors infected with the marine and suspected marine isolates. Because of the low infection rate in wild whitefish in Denmark, the role of whitefish in the spread of VHSV in Denmark is probably not significant. The experimental studies, however, showed that whitefish are potential carriers of VHSV as they suffer only low mortality after infection but continue to carry virus. [source] Biopsy site for detecting Helicobacter pylori infection in patients with gastric cancerJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2009Chan Gyoo Kim Abstract Background:,Helicobacter pylori eradication is recommended in post-gastric cancer resection, but premalignant changes may prevent the detection of H. pylori. The aim of this study was to determine appropriate biopsy site for detecting H. pylori in gastric cancer patients. Materials and Methods:, Consecutive patients (194) with gastric adenocarcinoma were prospectively enrolled. Helicobacter pylori was evaluated by serology, histology and rapid urease test. Biopsy sites included antrum lesser curvature, upper body lesser curvature (UBLC) and upper body greater curvature (UBGC). Two biopsy specimens were obtained from each site for histological examination. One additional specimen was obtained from UBGC for the rapid urease test. Results:, The overall infection rate of H. pylori was 84.0% (95% CI 78.9,89.2). The sensitivity of histology for detecting H. pylori at various sites was: antrum (54.9%; 95% CI 45.7,63.9), UBLC (80.3%; 95% CI 72.2,87.0) and UBGC (95.1%; 95% CI 89.6,98.2). Specificities of all three biopsy sites were more than 95%. Sensitivity and specificity of the rapid urease test performed at UBGC were 96% and 100%, respectively. Sensitivities of histology decreased in correlation with increasing severity of atrophy and intestinal metaplasia (both P < 0.001 using the chi-square test for trend). The proportions of moderate to marked atrophy/intestinal metaplasia at UBGC (12.8%/14.7%) were significantly lower than those at antrum (50.0%/57.8%, P < 0.001 respectively) or UBLC (40.0%/48.9%, P < 0.001 respectively). Conclusions:, The UBGC side is the most sensitive and specific biopsy site to detect H. pylori in gastric cancer patients due to less frequent atrophy and intestinal metaplasia than at the antrum or UBLC side. [source] Reflux esophagitis facilitates low Helicobacter pylori infection rate and gastric inflammationJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2002Tae Jung Jang Abstract Background:Helicobacter pylori is regarded as an important pathogen in upper gastrointestinal diseases. However, little is known about the relationship between H. pylori infection and reflux esophagitis. Therefore, an investigation was undertaken in Korean subjects regarding the incidence of H. pylori infection, and a histopathological study of reflux esophagitis was also carried out. Methods: Analysis of gastric biopsy specimens was conducted for 73 patients with reflux esophagitis and 132 control subjects without reflux esophagitis. The H. pylori infection was assessed by using rapid urease test and the immunohistochemical method, and gastric mucosal morphologic change was analyzed according to the updated Sydney system. Results: The prevalence of H. pylori infection was significantly lower in patients with reflux esophagitis than in the non-reflux group. Grade of inflammation and glandular atrophy in the antrum and body were higher in patients in the non-reflux group compared with those in the reflux esophagitis group. Conclusions: It is suggested that H. pylori infection decreases the risk of reflux esophagitis by inducing atrophic gastritis. © 2002 Blackwell Publishing Asia Pty Ltd [source] | ||||||||||||||||||||||||||||||||||||||||