Colum Dunne

University of Limerick | UL · School of Medicine

With the escalation of hospital-acquired infections by multidrug resistant bacteria, understanding antibiotic resistance is of paramount importance. This study focuses on the β-lactamase gene, blaOXA-58, an important resistance determinant identified in a patient-facing hospital wastewater system. This study aimed to characterize the behaviour of t...

Neonatal sepsis is a catastrophic condition of global concern, with reported mortality rates exceeding 10%. Bloodstream infections are an important cause of sepsis, and epidemiological studies of these infections are crucial for predicting the most common aetiological agents and antimicrobial susceptibility patterns and for developing antimicrobial...

Introduction: Human milk is the preferred source of enteral nutrition for very low birthweight (VLBW) infants, and it possibly decreases dependence on parenteral nutrition (PN) and reduces incidence of late-onset sepsis (LOS). No systematic review to date has specifically addressed the value of early versus late introduction of human milk diet (HMD...

Introduction Three Yersinia species were identified from samples of drinking water from diverse geographic regions of Ireland. Conventional commercial biochemical identification systems classified them as Yersinia enterocolitica . Since this organism is the most common cause of bacterial gastroenteritis in some countries, further investigation was...

Introduction Greater than half of in-hospital maternal deaths are caused by sepsis, a condition that occurs when infection exceeds local tissue containment and results in organ dysfunction. Determining the source of infection can be challenging. Microbiological cultures of the uterine cavity are often difficult to obtain, so antimicrobial susceptib...

Introduction. Chryseobacterium shandongense is a Gram-negative Flavobacterium bacillus with intrinsic multidrug-resistant properties. Case Presentation. Herein, we present the first case report of human C. shandongense infection, relating to an implantable portal and catheter (port-a-cath) central line in a 5-year-old female with cystic fibrosis. T...

Introduction Chryseobacterium shandogenes is a Gram-negative Flavobacterium bacillus with intrinsic multi-drug resistant properties Case Presentation : Herein, we present the first case report of human C. shandogenes infection, relating to an implantable portal and catheter (port-a-cath) central line in a five-year-old female with Cystic Fibrosis (...

Introduction Chryseobacterium shandogenes is a Gram-negative Flavobacterium bacillus with intrinsic multi-drug resistant properties Case Presentation : Herein, we present the first case report of human C. shandogenes infection, relating to an implantable portal and catheter (port-a-cath) central line in a five-year-old female with Cystic Fibrosis (...

Hospital-acquired infection (HAI) and infectious agents exhibiting antimicrobial resistance (AMR) are challenges globally. Environmental patient-facing wastewater apparatus including handwashing sinks, showers and toilets are increasingly identified as sources of infectious agents and AMR genes. We performed large-scale metagenomic analysis of the...

Objectives: To compare the etiology, phenomenology and motor subtype of delirium in patients with and without an underlying dementia. Methods: A combined dataset (n = 992) was collated from two databases of older adults (>65 years) from liaison psychiatry and palliative care populations in Ireland and India. Phenomenology and severity of deliriu...

Background: Whole-genome sequencing (WGS) has been used widely to elucidate transmission of SARS-CoV-2 in acute healthcare settings, and to guide Infection, Prevention and Control (IPC) responses. Aims: To systematically appraise available literature, published between January 1st 2020 and June 30th 2022, describing the implementation of WGS in...

Background The objective of this review is to describe individual-level factors that influence and contribute to sick leave in healthcare, and especially hospital, settings. In doing so, to utilize relevant publications from the period 2004 – 2022 in order to provide a comprehensive and evidence-based resource for readers interested in effective hu...

High levels of bacterial antimicrobial resistance (AMR) have been reported in many environmental studies conducted in Ireland and elsewhere. The inappropriate use of antibiotics in both human and animal healthcare as well as concentrations of residual antibiotics being released into the environment from wastewaters are thought to be contributing fa...

Background Human milk (HM) fortification has been recommended for the nutritional optimization of very low–birthweight infants. This study analyzed the bioactive components of HM and evaluated fortification choices that could accentuate or attenuate the concentration of such components, with special reference to human milk-derived fortifier (HMDF)...

Background: There is increasing evidence that uncomplicated appendicitis (UA) may be treated nonoperatively in cases of UA. This study aimed to evaluate and compare the diagnostic accuracy of circulating fibrocyte percentage (CFP), white blood cell count, C-reactive protein, and neutrophil-lymphocyte ratio (NLR) in diagnosing uncomplicated and com...

Background Organizational level factors may influence and contribute to sick leave in healthcare, and particularly hospital, settings. We utilize relevant publications from recent literature to provide a useful, comprehensive and evidence-based resource for readers interested in effective human resource management and healthcare or hospital workfor...

**Background:** Organizational level factors may influence and contribute to sick leave in healthcare, and particularly hospital, settings. We utilize relevant publications from recent literature to provide a useful, comprehensive and evidence-based resource for readers interested in effective human resource management and healthcare or hospital wo...

Background Respiratory syncytial virus (RSV) is the principal cause of acute lower respiratory infections (ALRI) among infants worldwide, and an important cause of morbidity, hospitalisation and mortality. While infants are universally exposed to RSV, most mortality occurs among normal term infants from low-income and middle-income countries. Breas...

Presented are four cases involving urgent interventions to repair PEG tube failures in PEG dependent patients. We report on the practical utility of 3D printed devices designed for contingency repair of pediatric PEG tubes when other options, including surgical approaches or manufacturer supplied repairs, were not possible. The patients were depend...

It is incontrovertible that relationships exist between the intestinal microbiome and intestinal structure, function, health and disease. Understanding these relationships has been enabled through the evolution of microbiology techniques; from growth and enumeration using media selective for specific species to current exploitation of technologies...

Background: Conventional testing methods for dermatophytes are time-consuming, and resource limitations in our institution have prompted curtailed access to these diagnostics. Objectives: Evaluation of our hospital's dermatological mycology diagnostic services and similar services nationally. Methods: This was a retrospective observational stu...

Background Oscillating positive expiratory pressure (OPEP) devices play a key role in airway clearance, particularly in patients with cystic fibrosis. These devices, however, have the potential to become reservoirs for pathogenic organisms and require daily, or even more frequent, cleaning. This places a large burden on patients and their carers.Ai...

Background E-learning is recognised as a useful educational tool and is becoming more common in undergraduate medical education. This review aims to examine the scope and impact of e-learning interventions on medical student learning in clinical medicine, in order to aid medical educators when implementing e-learning strategies in programme curricu...

Despite a number of public health and policy-based initiatives, Ireland's national breastfeeding rates are among the lowest globally. Regionally, the Mid-West of Ireland has historically had low breastfeeding initiation rates, and parts of its major urban area such as Limerick City suffer the highest levels of economic deprivation in the country. I...

Background Delirium is extremely prevalent, yet underdiagnosed, in older patients and is associated with prolonged length of hospital stay and higher mortality rates. Impaired attention is the cardinal deficit in delirium and is a required feature in diagnostic criteria. The verbal months backwards test (MBT) is the most sensitive bedside test of a...

Background Carbapenemase producing Enterobacterales (CPE) are major public health threats. Aim To review microbial epidemiology of CPE, as well as clinical risk factors and infections, amongst CPE positive patients over 12 years in an Irish tertiary hospital. Methods Retrospective observational study of data extracted from a laboratory CPE databa...

Abstract Background People with intellectual disabilities are over-represented in the criminal justice system. The United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD) enshrines a right to equal access to justice for persons with disabilities (Article 13, UNCRPD). Accessible information is a key aspect of exercising this...

Breast cancer is the most prevalent form of cancer worldwide, with surgery remaining a standard treatment. Although a treatable disease, with the survival rate improving due to enhancements in screening and treatment, cancer recurrence remains a dominant contributor to breast cancer related deaths. It has been suggested that systemic factors during...

This paper outlines international obligations and domestic safeguards that shape the treatment of suspects with intellectual disabilities in Ireland. In recognising that the meaningful operationalisation of these safeguards, and, by extension, the realisation of Ireland's international human rights obligations, is often contingent upon securing a c...

Against a backdrop of Article 13 of the UNCRPD and recommendations from the Council of Europe CPT, this paper describes the design, delivery and evaluation of an intellectual disabilities and mental health awareness programme for general practitioners attending Garda (Police) stations in Ireland.

Aim: To provide a detailed genomic-epidemiological description of a complex multi-ward SARS-CoV-2 outbreak, which originated in the crowded emergency department (ED) in our hospital during the third wave of the COVID-19 pandemic, and was elucidated promptly by local whole genome sequencing (WGS). Methods: SARS-CoV-2 was detected by reverse trans...

Background: Fungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification m...

Background: Tocilizumab is an IL-6 inhibitor that reduces mortality and need for invasive mechanical ventilation, while increasing possibility of successful hospital discharge for hyper-inflammatory patients with severe COVID-19. No increase in adverse events or serious infections have been reported previously. Aim: To describe characteristics a...

Background In most high-income countries, emergency departments (ED) represent the principal point of access forcer by critically ill or injured patients. Unlike inpatient units, ED healthcare workers (ED HCWs) have demonstrated relative lack of adherence to hand hygiene (HH) guidelines, commonly citing frequency of intervention and high rates of a...

Purpose This paper aims to critically evaluate contemporary Irish police practice, with an emphasis on emergent procedural innovations, in light of the needs of suspects with intellectual disabilities. Design/methodology/approach A review of published prevalence data in respect of people with intellectual disabilities in the Irish criminal justice...

Background Acute meningoencephalitis is encountered commonly in the acute hospital setting and is associated with significant morbidity and mortality, in addition to significant healthcare costs. Multiplex PCR panels now allow syndromic testing for central nervous system infection. The BioFire® FilmArray® Meningoencephalitis (ME) allows testing of...

Coercive measures to protect public health are controversial, eliciting questions regarding state-patient relationships and conflicts between individual autonomy and public good. This is challenging in a time when respect for patient autonomy has become elevated yet society faces an increasing number of public health challenges, the most recent bei...

The United Nations’ (UN) Convention on the Rights of Persons with Disabilities (CRPD), which was adopted in 2006 states that, “in order to help to ensure effective access to justice for persons with disabilities”, governments “shall promote appropriate training for those working in the field of administration of justice, including police and prison...

Objectives Disability awareness training is mandated by the United Nations Convention on People with Disabilities (UNCRPD), but there is a paucity of evidence regarding the systematic evaluation of the effectiveness of such training. This study describes the evaluation of a pilot intellectual disability awareness programme for law enforcement offic...

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Background Handheld oscillating positive expiratory pressure (OPEP) devices have been a mainstay of treatment for patients with hypersecretory conditions such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) since the 1970s. Current devices are reusable and require regular cleaning and disinfection to prevent harbouring pote...

Background Although culture-based methods remain a staple element of microbiology analysis, advanced molecular methods increasingly supplement the testing repertoire. Since the advent of 16s and 18s ribosomal RNA PCR in the 2000s, there has been interest in its utility for pathogen detection. Nonetheless, studies assessing the impact on antimicrobi...

Crohn’s disease (CD) is a debilitating inflammatory bowel condition of unknown aetiology that is growing in prevalence globally. Large-scale studies have determined associations between female obesity or low body mass index (BMI) with risk of CD at all ages or 8– < 40 years, respectively. For males, low BMI entering adult life is associated with in...

Background Linezolid is an oxazolidinone antimicrobial regarded as a “last resort” antimicrobial, used typically for treatment of Gram-positive bacterial infections. It is acknowledged that prevalence of resistance to linezolid is increasing in Europe. In Ireland, a number of outbreaks of linezolid-resistant isolates have been reported, including a...

Impact of the intestinal microbiome on human health has become increasingly apparent. A plethora of studies have focused on dietary influence, in addition to antimicrobial use and other therapeutic interventions, on microbial diversity. Despite this increased emphasis on elucidating microbiota of the healthy or diseased gut, very few data are avail...

The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of abdominal anatomy, there are multiple mesenteries. Recent findings point to an alternative model in which digestive organs are connected to a single mesentery. Given that direct evi...

Introduction The bi-directional relationship between mental and physical illness is well established. Therefore, in order to lower the already high mortality rates associated with psychiatric disorders, physical health issues must be closely monitored in this population [1,2]. A recent Lancet commission highlights emerging strategies and recommenda...

The use of congregated settings to accommodate people with disabilities in Ireland may be in breach of the UN Convention on the Rights of Persons with Disabilities (CRPD). The report of the Health Service Executive (Ireland's public health provider) working group on congregated settings in 2011 called for immediate action to provide community suppo...

Until recently, three-dimensional (3D) printing/additive manufacturing has not been used extensively to create medical devices intended for actual clinical use, primarily on patient safety and regulatory grounds. However, in recent years there have been advances in materials, printers, and experience, leading to increased clinical use. The aim of t...

Purpose: This study aims to review international literature systematically to estimate the prevalence of homelessness among incarcerated persons at the time of imprisonment and the time of discharge. Design/methodology/approach: A systematic review methodology was used to identify quantitative observational studies that looked at the prevalence...

Background Delirium is a common neuropsychiatric disorder associated with prolonged hospital stays, and increased morbidity and mortality. Diagnosis is frequently missed due to varying disease presentation and lack of standardized testing. We examined biomarkers as diagnostic or prognostic indicators of delirium, and provide a rational basis for fu...

Positive expiratory pressure (PEP) devices are an important element of the management of cystic fibrosis, and other respiratory diseases. While there have been reports in the literature of contamination of airway clearance devices and their surfaces by microbial pathogens, there is little evidence available regarding such contamination and its cont...

Background: SARS-CoV-2 antibody testing in community settings may help us better understand the immune response to this virus and therefore help guide public health efforts. Aim: Conduct a seroprevalence study of IgG antibodies in Irish GP clinics. Design and setting: Participants were 172 staff and 799 patients of 15 general practices in the...

Background Oscillating Positive Expiratory Pressure (OPEP) devices are important adjuncts to airway clearance therapy in patients with cystic fibrosis (CF). Current devices are typically reusable and require daily, or often more frequent, cleaning to prevent risk of infection by acting as reservoirs of potentially pathogenic organisms. In response,...

This study set out to assess the confidence levels of practising psychiatrists in physical healthcare competencies through a cross-sectional survey in one Irish region, and to explore availability of learning opportunities.

People with severe mental illness and intellectual disabilities are overrepresented in the criminal justice system worldwide and this is also the case in Ireland. Following Ireland's ratification of the United Nations' Convention on the Rights of People with Disabilities in 2018, there has been an increasing emphasis on ensuring access to justice f...

Objectives To investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology. Design Cross-sectional study. Setting International study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings. Participants 1757 patients dia...

Objectives To investigate the frequency, characteristics and impact of death threats by patients towards psychiatrists. Methods A cross-sectional survey of psychiatrists ( n = 60) was undertaken to investigate the frequency, characteristics and impact of death threats by patients in one Irish healthcare region serving a mixed urban–rural populatio...

Background: People with intellectual disabilities (PWID) are over-represented in criminal justice systems globally. This over-representation reveals itself at once in the demographic make-up of prison populations, as well as those detained in police settings as suspects of crime. While it is well-established in international literature that individ...

Background There is general consensus that hand hygiene is the most effective way to prevent healthcare associated infections. However, low rates of compliance amongst healthcare workers have been reported globally. The COVID-19 pandemic has further emphasized the need for global improvement in healthcare worker hand hygiene compliance. Aim This c...

Background: This cross-sectional study sought to establish the prevalence of homelessness amongst inpatients in two psychiatric units in Ireland and explore the perceived relationship between psychiatric illness and homelessness. Methods: The study employed a semi-structured interview format utilising a specifically designed questionnaire which...