Science topic

Infection Control - Science topic

Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms.
Questions related to Infection Control
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When malaria can is transmitted, why can't hepatitis B and C be transmitted?
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Hepatitis B yes theoretically possible because the blood necessary for transmission is very less(o.o3ml). and when a mosquito bites there is a chance of regugutation og blood from mosquito .HCV may not be transmitted
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Searching for Research articles on infection control in home health care (hand hygiene, protection eqipment, garbage disposal).
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Hello Else
I expected to find more than this and will be interested to see what other members suggest:
Bloomfield, S. F., Aiello, A. E., Cookson, B., O'Boyle, C., & Larson, E. L. (2007). The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers. American Journal of Infection Control, 35(10), S27-S64.
Felemban, O., St John, W., & Shaban, R. Z. (2015). Infection prevention and control in home nursing: case study of four organisations in Australia. British journal of community nursing, 20(9).
I have the full text if you are unable to access it.
This is a meta-analysis:
Aiello, A. E., Coulborn, R. M., Perez, V., & Larson, E. L. (2008). Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. American journal of public health, 98(8), 1372-1381.
. . . and this systematic review might be of interest:
Curtis, V., & Cairncross, S. (2003). Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. The Lancet infectious diseases, 3(5), 275-281.
Very best wishes
Mary
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Has anyone every seen a study or worked on a project where you analyzed how many people (Staff- physicians, pharmacist , nursing,......) enter a patients room on a daily basis ? This is related to an infection control issue.
Thanks
Brian
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Please find the following study about the frequency of patient contact with healthcare personnel and visitors: implications for infection prevention.
the second study also might be helpful
Hand-touch contact assessment of high-touch and mutual-touch surfaces among healthcare workers, patients, and visitors.
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In my ICU we´re currently working with a VAP bundle in which each measure is executed and registered by the nurse in charge of the patient.
However, the compliance of bundle is also evaluated by the same nurse. It´s there a bias in the procedure? Anyone knows evidence related?
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Estimado Dr. Padilla.
Lo siento, pero creo que efectivamente hay un sesgo importante: la persona que ejecuta la intervención (las tareas para evitar la neumonía relacionada con el respirador) es la misma que evalúa su cumplimiento. El problema surge cuando el equipo es demasiado pequeño como para que esta evaluación recaiga en otra persona. Yo no conozco estudios que comparen resultados de auto-evaluación con evaluación externa en este campo, pero creo que el problema es el problema general del enmascaramiento de los datos, del conflicto de intereses y, en fin, de la objetividad. En el terreno de los ensayos clínicos si hay mucha bibliografía sobre estos factores de sesgo.
Hace años usé una referencia (la adjunto) que trataba (más o menos) sobre este asunto. También adjunto el enlace a la guía del Institute for Healthcare Improvement sobre prevención de la VAP. Perdona si esta información es redundante.
Un saludo.
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thank you very mich
Mary C R Wilson 
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What is needed is a biocide or antiseptic that 1.) If applied to the scalp would not stain or damage hair. 2.) If applied to skin would not dye it. 3.) Safe and effective to use topically. 
Thank you! 
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Dear Ellie,
The best biocide/antiseptic available is Chlorhexidine, however, you can not use it because it stains the scalp and skin with yellow color.
Among the other biocides which are effective and do not stain the area of applications are:
Ethyl alcohol
Isopropyl alcohol (Personally I suggest to use this agent or ethyl alcohol)
Glutaraldehyde
o-Phthalaldehyde
For more on compounds used as biocides such as Anilides, Biguanides, Diamidines and etc., please use the following link:
Hoping this will be helpful,
Rafik
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We are a Brazilian group of research in infection control and prevention in children and newborns and it'll be great to start partnerships with colleagues around the world and share expetise. If you have interest , please contact me.
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Oi Pri. Na UNb haveria algum grupo na pediatria interessado? 
Hi Pri. The main idea is to study healthcare associated infections in children in ICU (PICU and NICU), mainly infections due to MDR bacteria (Gram negative and Gram positive) and interventions to reduce multirresistant bacteria in this setting.
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Human origin, polluted water,
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I would not say absolutely no, but since they are an indicator we used in water quality testing for sanitation, it would not be a very good indicator if they are multiplying in polluted water.  If you find higher concentrations as you go downstream with more flow, you have to address are their other sources, or is the sampling system biasing the data.  I have one brief report I coauthored concerning coliform from Stekoa Creek into the Chatttooga River about in 1994 I think.  In watching sediment entry also from Stekoa Creek, I learned that it may take several meander bends and turbulence for water entering from a tributary is mixed downstream.  If you sample from a stream's edge and near an area of fecal entry or concentration, you may find unusually high numbers locally within the stream or river that are not mixed completely yet in the discharge of that stream or river.  Streams or rivers with relative uniform flow pattern and velocity such as extended runs and wide and shallow such as Rosgen F type streams as the Chattooga River may take extended distances to mix.  For some sampling schemes, even though we prefer or it is convenient to sample from the margins or edge, obtaining sampling devices and taking a cross section with varying depths is probably the main way of insuring you get a quality sample.  Sometimes this might mean sampling from a boat and lowering the sampler into the water to its bottom and back up.  There are various hand and cable devices to accomplish this level of detail.  If you have a fluorometer, you might try some dye testing with fluorencent dye from point of entry to various downstream areas to find out where mixing occurs.  Otherwise, visually if there is sediment and a point of entry, go at least downstream far enough in sampling so you cannot visually see difference in sediment loading across the water, and then maybe go further if logical to do before the next tributary or pollution source.  Because animals can contribute fecal material, that is a concern.  I am attaching a file on drinking water in forests and grasslands, but it has some great info on fecal coliform and other contaminants.  It may give you some ideas.  In the back of my mind, I remember someone saying the idea that multiplication of fecal organism is a possibility, but don't remember reading about it or specifically that it is an issue.
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I would like to know about the infection control risks of readmitting infants to the newborn nursery following discharge.
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Hello Deeann, I believe that very often the decision has to be made depending on weighing up the risks to those who have been discharged, as well as the risks of all the occupants in the nursery.  In some places, there may be alternative areas assigned to babies that still have the infection, and those that are on the road to recovery. (In some places, the availability of nurses to care for them is also another need to be considered.)
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I have found different conditions, with no racional sense or scientific reference.
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It will depend on more than one variable.
  • What are you sterilizing?
  • Which is the geometry? Plan?
  • static or forced air?
I suggest going into some good references:
After that, if you are in doubt, be conservative and pick for the same temperature, the longest time and check the sterility at the end.
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the availability of HCV direct-acting antivirals (DAAs)
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Dear Sir/Madam,
See these links may be useful for you.
1) HBV/HIV Co-Infection Management and Treatment www.hepb.org/.../hbv_hiv_co-infection_treatment_g...Traduire cette pageHBV/HIV Co-infection. Management and Treatment. There are two main reasons for considering HBV therapy as a priority in HBV/HIV co-infected patients:.
2) Treatment of hepatitis C virus infection in the HIV-infected ...www.uptodate.com/.../treatment-of-hepatitis-c-virus-i...Traduire cette page13 janv. 2016 - This topic will address the management of the HIV/HCV-coinfected ... Top. McGovern BH. Hepatitis C in the HIV-infected patient. J Acquir ...
3) Best Practices in the Management of HCV/HIV Coinfection www.clinicaloptions.com › ... › CCO Slideset
 Traduire cette page6 janv. 2014 - Jürgen K. Rockstroh, MD, provides a concise update on screening strategies and emerging treatment options for patients with HIV/HCV ...
4) Managing HIV/hepatitis C co-infection in the era of direct ...bmcmedicine.biomedcentral.com/.../1741-7015-11-2...
 Traduire cette page de JK Rockstroh - ‎2013 - ‎Cité 32 fois - ‎Autres articles
Managing HIV/hepatitis C co-infection in the era of direct acting antivirals ..... Response rates at Week 16 were best for previous relapsers (with 90% <15 IU/ml) ...
0 / 0 · Just now
How long might a dead M. tuberculosis cell remain intact in medium containing only Mtb cells? - ResearchGate. Available from: https://www.researchgate.net/post/How_long_might_a_dead_M_tuberculosis_cell_remain_intact_in_medium_containing_only_Mtb_cells#56a3c6b35dbbbdd1b68b4567 [accessed Jan 23, 2016].
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We're implementing a CVC insertion bundle that includes maximal sterile barriers for patients but the actual suppliers don´t give enough security for operators because it needs 3 cloths to fully cover the patient.
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Dear Cristobal
you may try these links:
Mayo Standard cover
Surgical Chest Pack with Standard Surgical Gown
Best regards Michaela
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Is clindamycin the best choice to prevent odontogenic osteomyelitis, are there no other antibiotics, and what kind of release profile is preferred for such scenario any evidence in literature?
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I suggest that in these cases a prolonged course of therapy has to be planned, but this practice may be difficult to apply without an ID consultation. Probably, Clindamycin has the problem of a low genetic barrier to the resistance and an associative regimen with Ampicillin (or similar) may be efficacious.
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Is it safe and advisable for selected group of patients? If so, then which are the most suitable candidates for it.
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There are a lot of people who prefer to perform this type of treatment to their patients. This was produced by the observation that some patients who were planned to have a two stage revision after the insertion of the spacers (either cement or new prosthetics which were inserted "loosely") at the first stage were not coming for the 2nd stage as they were happy with the outcome and there were a great deal of discussions with them to persuade them to come back for the definitive implantation. So it was found that an one stage could be applied. Usually these patients are worked nicely prior to their surgery and all bacteria are known. The debridement is thorough (as in the two stage) and the prosthesis well fixed. Post-op some surgeons place a slab to prevent immediate movement and continue the antibiotic treatment according to the pre-op plan and add more according to the intra-op taken specimens for 6-12 weeks following the CRP graph to monitor the improvement. Candidates could be either patients who may be at risk from series of operations or these of an early stage of the infection and good bone quality.
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A relative recent meta - analysis by Safdar et al. (2014) shows statistical benefits in the reduction of CRBSI. However, there´re several questions related to the clinical heterogeneity, bias and baseline infection rates of RCT included.
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As far as i know it is recommended by the CDC guidelines but clinically there is still issues around side effects such as skin irritation u know plus issues around resistance that might occur.  
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Many peoples in our district East Godavari and in Agency area having no awareness on Aids and HIV. So that we are planning to aware the children and people from their School level. Itself so we are selecting some Z.P School and A.P.S.W. R Schools and we go for awareness programs and camps to educate the children. And we are also planning to make an HIV Anti- group. We select some children and conduct some competitions, seminars and workshops and aware them against HIV and Aids.
We are requesting you for the fund needed for our plan and requesting for the addresses of any other organizations who are supporting us.
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Bill & Melinda Gates Foundation
Commonwealth Foundation
Elton John AIDS Foundation
European Union
Global Fund to Fight AIDS, Tuberculosis and Malaria
Hewlett Foundation
International HIV/AIDS Alliance
Government of the Netherlands
The Abbott Fund
US President’s Emergency Plan for AIDS Relief (PEPFAR)
UK Department for International Development (DFID)
UNAIDS
United States Agency for International Development (USAID)
United Nations Development Programme
World Health Organization
NACO, 9th Floor, Chanderlok Bldg., 36 Janpath,
New Delhi-110001 Tel: 23325337
Rajiv Gandhi Foundation
Rajendra Prasad Road
New Delhi - 110 001, India
Tel.: +91 11 2375 5117
Fax: +91 11 2375 5119
The Foundation supports HIV training programs for health professionals working with NGOs to treat the underprivileged throughout India. It also supports education, prevention and direct services programs for PLWHA as well as capacity-building grants for CBOs working in this area.
Vasavya Mahila Mandali
Benz Circle, Vijayawada - 520 010
Andhra Pradesh, India
Tel.: +91 86 6247 0966
Fax: +91 86 6247 3056
Vasavya is an intermediary for international and national
funders and governments. It supports home and community-based HIV/AIDS care and prevention programs.
MAMTA MAMTA
Health
Institute for Mother and Child
B-5, Greater Kailash Enclave-II
New Delhi, India 110048
Tel.: +91 11 2922 0210
Fax: +91 11 2922 0575
MAMTA is an intermediary for international and national funders and governments. It supports HIV/AIDS programs focusing on direct care, advocacy, and training throughout the country.
Palmyrah Workers Development Society (PWDS PWDS PWDS )
Crystal Street, Marthandam – 629165
Kanyakumari District
Tamil Nadu, India
Tel.: +91 46 5127 0241
Fax: +91 46 5127 0138
PWDS is an intermediary for international and national funders and governments. It supports CBOs and NGOs working with AIDS orphans as well as organizations providing community-based care and support programs for PLWHA.
LEPRA
Society
Post Box No. 1518
West Marredpally, Secunderabad
Andhra Pradesh, India
Tel.: +91 040 2780 2139
Fax: +91 040 2780 1391
LEPRA is an intermediary for international and national funders and governments. It supports a wide range of HIV/AIDS projects from direct care to advocacy to education and vocational programs throughout the country.
TEST Foundation
4, Sathalvar Street
Mugappair West
Chennai, India 600037
Tel.: +91 044 2624 4100
Fax: +91 044-2625 0315
TEST is both an operating foundation, running its own programs including home-based care and a hospice for AIDS patients, and a grantmaking
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Ethical considerations with regard to entry screening of migrants are often mentioned in (bio)medical articles, but rarely further explained. I addressed this question in my philosophy thesis, and I am curious how others think about this question and/or related articles on this topic.
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"These people should give consent for samples to be collected."
And what if they don't?
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Looking to quantify germ kill within a soap bar ie 90 - 99%
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Thank you both, I will review both recommendations
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We can differentiate HA-MRSA from CA-MRSA; is there any way to to differentiate HA-mrsa and CA-MRSA from LA-MRSA?
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More info.:
LA-MRSA: mecC+,  mostly type XI SCCmec
CA-MRSA: mecA+, mostly type VI or V SCCmec, mostly PVL+
HA-MRSA:  mecA+, mostly type I to III SCCmec, mostly PVL-
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Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens from both recognized and unrecognized sources. (WHO) It is also recommended to assume that every person is potentially infected or colonized with an organism that could be transmitted in the health-care setting and apply the following infection control practices during the delivery of health care. (Guideline recommendation). Personal Protective equipment are to be used as one such measure. But I am unable to find whether the OT table and floor should also be covered with plastic? Please give your opinion with logic (reasoning) and evidences.
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The built environment should be appropriate to allow cleaning and disinfection e.g. Impervious and intact surfaces for floors , walls , coverings on the mattresses, that allow ease of cleaning and prevent ingress. The principles of environmental decontamention after any patient is based on cleaning then disinfection if needed Including after spillage of blood or body fluids or patient known to be infected e.g. MRSA! CPE etc . All medical devices which includes the theatre table and any device used for treatment and therapy must be provided with manufacturer instructions for decontamination which must include method, product for risk levels of contamination low, medium, high risk!. In the UK, decontamination is guided by medical devices directives and Health technical memorandum's on decon. There are also national standards for environmental cleanliness and infection control in the built environment guidance to refer to. Therefore plastic covering for floor and table is not needed as the environment should be appropriate to prevent infection and allow decontaminationalongside management and decontamination of equipment and medical devices.
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I did orthopedic surgery on my mouse yesterday and for surgical prophylaxis, I had 10 mg of intraperitoneal cefazolin injection 30min before surgery, then once every day for 5 days 10mg of cefazolin will be injected intraperitoneally, today when I checked my mouse, I saw sth around the patella that swelled outward, I want to know if it's ok and it's sth normal like inflammation or its sth serious like infection or abscess, and what should I do with that, if it's the inflammation should I use NSAIDs or if it's infection, should I change or add another antibiotics?
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I always give analgesia like buprenorphine just before surgery and than morning/evening for three days post-surgery. That has worked very well in Nude rats. But normal mice even need less analgesia. You are giving antibiotics before and post-surgery. May be you should include some analgesia also. Swelling first day, I will be of some concerned but can not do much and will wait for 2/3 days, hope that will be go down. If any internal suture has not broken, sometime it can happen also. If veterinarian around, you should address this question to him/her. And watch your mouse morning /evening for few days regularly. Mice in general heal faster than other animals like rabbit.
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Many Infection Control & Prevention protocols are based on the use of aggressive chemistry-only cleaners and disinfectants which are operate on the basis of "all bacteria are bad" and so seek to kill all bacteria. This leaves an un-natural, un-sustainable indoor surface microbiome that is rapidly re-populated by free floating bacteria, especially pathogens.
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Dear Graeme,
thank you for your question. Environmental cleaning and the influence of the environment on transmission of pathogens is part of our curriculum subsumized under the aspects of the so called technical hygiene issues and of course microbiological aspects such as the indoor microbiome.
Kind regards
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Any suggestions or experiences about this question
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I would say proper hand washing method is best for infection control. If your hand is not greasy or soiled then sanitizer is an ok option.but it can't replace hand washing.
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Hi Guys
For the last couple of months my lab has been riddled with infections. All cell lines. It is odd though in that the infection is only visible the day after transfection with either CaP or Lipofectamine 2000. These are not typical bacteria – they are absolutely tiny and don’t swim, but appear to wriggle. It is not Brownian motion and is definitely infection of some sort as confirmed by my confocal microscopy staining.
My working theory is that the bacteria (I feel it is mycoplasma…) are INSIDE the cells until we “stress” the cells by transfecting them, whereby the cells burst open and release the bacteria into the media. I have not seen this online so I am not sure. Has anyone seen this before?
I am aware you cannot really see mycoplasma under the light microscope but the “wriggling” things could be colonies, and my confocal appears to indicate mycoplasma infection.
We have absolutely no idea what else it could be at this stage as we have cleaned everything four times, filtered all reagents…. Everything!
Does anybody have any suggestions as to how to solve this issue? We are currently treating some cell lines with Plasmocin and any cells we “hope” are not infected are being cultured with a low dose to prevent mycoplasma infection.
It is absolutely insane how this infection won’t pass! I think it must be mycoplasma as I have started using both Gentamycin, Amp B AND Pen/Strep in my media to ensure/kill bacteria. And yet… we are always getting infections BUT only apparent following transfection. It is not the transfection reagent as I have used different brands, batches and even tested all individual reagents on cells (ie. Added a few microliters of DNA, Calcium Chloride, HBS, PBS, FBS etc…) and no infection is seen. It seems stress induces the exit of the bacteria from cells.
Has anyone seen this before?
Please help if you can!
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Thanks @can
Which biochemical test do you recommend?
Do the IPAC (infection prevention and control canada) programs apply in Quebec health care institutions ?
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Hello, Do the IPAC (infection prevention and control canada) programs apply in Quebec health care institutions ? or there are only applicable in English-speaking territories / regions of canada? In French : Est ce que les programmes de l' IPAC (infection prevention and control canada) concernant la prevention et le controle d'infection s'appliquent dans les etablissemnt de santé quebecois ? ou ne s'applique que dans les territoire/regiosn anglophones du canada ? IPAC Website : https://ipac-canada.org/
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I'm interesting.
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Are there any real hypotheses for developing new and more active antibiotics?
Do we really know the extent of the phenomenon? How widespread and in which areas in the world?
Is it possible to control the patient-to-patient transmission of these pathogens, through what is called 'infection control', at the level of health facilities?
Is there still room for a prudent and rational use of antibiotics, to counter infections and to minimize the selective pressure that selects resistant bacteria, ie for the strategy known as antimicrobial stewardship?
Is it possible, finally, to improve and make microbiological diagnostics faster and more efficient?
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Dear Teresa...
I asked a question in the same field; Which one evolves faster, the microbe or antimicrobial?, and I highly recommend Dr. Alan Coulson answer which was:
"I would think that the microbes evolve faster than anti-microbials, otherwise there wold be no microbes left.
The impact of this line of thinking is that eventually only microbes will be left to inherit this planet. In the millions of years ahead living conditions have been predicted to involve extremes of heat and cold and radiation; thus complex organisms would not be able to survive."
Regards.
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we need proven cases to justify infection control guidelines
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Hi Susan,
You mean: the ultrasound operator is infected?
I mean, I can see that there might be a risk for cross infecting the next patient or so if cleaning has not been very good, but for t he operator?
Are you aware of t he follwoing papers that might have additional references:
Bell et al 2011, doi: doi: 10.1016/j.jcrs.2011.09.018
Karadenz et al. Evaluation of the role of ultrasound machines as a source of nosocomial and cross-infection.Invest Radiol 2001;554-8,
Chaloui G et al 2008.Hygiene en échographie endocavitaire gynécologique … http://www.em-consulte.com/en/article/199641
Sahu B & Raine-Fenning Utrasound and the risk of nosocomial cross infection. doi: 10.1002/uog.7729
I know these don’t really help you, but it moght be a good idea to contact one of these authors,… may be they know. I actually can’t really imagine how a study to investigate your question should look like (and who would give the money…?). Probably, one of he authors also knows of some case reports, where your scenario happened….
Good luck with your endeavour!
SR
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I have done screening of hepatitis B for all Health care workers in a Dental ce centre and findings were showing 12% of staff are infected! what study design i can use this data in to form a research?
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Thanx all for your advice.. I have a sample of 1000 HCWs from a tertiary care hospital and a Dental medical center with more than 18 specialised dental clinics. about 120 Hcws are working in the Dental center clinics. General data (demographic, age etc ) taken. History of immunization and the infection status (acute/Chronic) is recorded too. The titer level is documented along with the last vaccine or booster taken. 
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How much of number of shigella will be there in a given population of Fecal coliform.
How much of shigella dose is risky to cause harmful affect in human being?
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Certainly, most opinions are in the sense that a few number of Shigella are just necessary to be an infective dose, but proportion of this bacteria in total population of fecal coliforms I think should be quite variable from place to place. 
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" Implementation of Electronic Nose in the hospital to detect dangerous and harmful bacteria". This could help to detect and therefore prevent contamination of other patient or equipment by many highly contagious pathogens.
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Thanks sir, I appreciate
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Draining down the sink is always an easy option but not always the right way of disposal. Antibiotics like vancomycin are toxin and are not allowed at any level in animal products for human consumption at any level. Antibiotic resistance is a major challenge of the time so there is no logic in getting rid of antibiotics down the sink. I have various solutions of antibiotics which I want to dispose of safely. Is sending them to disposal company the only option?
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i agree with Khetam Qaid Mayee
good luck 
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Bed bugs like Cimex lectularius feed on the blood of mammals. They are common pests in urban areas. There are only few journal articles or studies that tackled the bed bug. They are blood feeding bugs yet unlike other blood feeding insects, they do not transmit diseases or serious illnesses. Other bug studies would always label bed bugs as bugs that are not a threat to humans since they show a negative result when tested whether they cause serious illnesses.
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Take a look at this article:
As we mentioned here, there are no definitive reports of pathogens transmitted by Cimicidae to humans so far. However, there are several studies that show the possibility of their future role in the field of vector-borne diseases.
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if u isolate pathogens from outpatients admitted to certain hospitals , how u can determine source of infections nosocomial or community-acquired infection?
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If an infection becomes manifest 48 hrs or later after admission, a nosocomial infection is likely. A nosocomial infection. however, does not necessarily mean that the pathogen has been transmitted during hospital stay. A hospital acquired infection may be caused by endogenous flora or by exogenous flora (i.e. transmitted to the patient in whatsoever way).
Pointing towards the pathogens itself it means, if you isolate a pathogen within the first 48 hrs after admission, and the patient has had no previous hospitalization or health care stay (nursing home, ...) than it is pretty much likely a community and not a hospital acquired pathogen. A pathogen, isolated later during hospital stay can be reliably categorized as hospital acquired (i.e. nosocomial acquired) only, if you can rule out that the patient was not colonized upon admission. (Make sure to discriminate between colonization and infection; a patient may acquire MRSA in a hospital without getting sick – i.e. he becomes colonized. A patient without MRSA colonization upon admission may get a wound infection with MRSA after surgery – he acquires a nosocomial infection.)
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Just after receiving the post-op patients in the ward, conventionally, we do not allow his/her relatives to visit their patient in the name of infection control. But, what did I see, if they are allowed to do so, patients' comfort, recovery & outcomes got improved. Even the requirement of medications got reduced. 
But, can we compromise with the increased possibility of infection in a big (75 bed) sophisticated post-op ward?
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Rabaul,
In the US, there is much more liberal visitation policies than you present. As a family member of a recent surgical patient, I could not imagine being separated from my loved one during the hospital stay. Continued family presence improves monitoring of the patient. When there is an adverse outcome, the family is well aware of the care rendered and removes the mythical scenarios. 
Concerns of infection are real when family is visibly dirty or sick. In these cases, separation is indicated.
Regards,
Christopher
Davidson, J. E., Powers, K., Hedayat, K. M., Tieszen, M., Kon, A. A., Shepard, E., ... & Ghandi, R. (2007). Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Critical care medicine, 35(2), 605-622.
Azoulay, E., Pochard, F., Kentish-Barnes, N., Chevret, S., Aboab, J., Adrie, C., ... & Fassier, T. (2005). Risk of post-traumatic stress symptoms in family members of intensive care unit patients. American journal of respiratory and critical care medicine, 171(9), 987-994.
Sidani, S. (2008). Effects of patient-centered care on patient outcomes: An evaluation. Research and Theory for Nursing Practice, 22(1), 24-37.
How can I silence a mosquito transcript that increases after blood-feeding using RNAi?
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Hi all. It seems that the mosquito transcript I am trying to silence increases after blood-feeding. I am particularly interested to downregulate it 24hrs after feeding with infected blood to elucidate its potential role after infection. It is important to hit the 24hrs timepoint because the response it triggers is active only in a very tight time window around 24 hrs after infected blood feeding. I am using the RNAi to downregulate it and that's the only available method I have. Any ideas?
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60 micrograms of 460 nt dsRNA per reaction does not sound high yield to me. I would put more template and increase the reaction time (overnight is desirable). See "Optimizing yield of short transcripts" section of the manual and Supplemental material for the paper I referred. The authors of the referred paper used 2 micrograms per reaction (I assume in 20 microliter). Quantification of PCR product directly is not really reliable, because unincorporated primers and dNTPs absorb 260 nm pretty strongly. If the PCR product shows multiple bands on the gel, you would have to gel-purify. If it is single band on the gel, you can just use PCR purification kit (like that from QIAGEN). I personally contacted the author of the article referred. He told importance of quality of dsRNA on knockdown efficiency. I used MEGAclear which is a part of MEGAscript T7 RNAi kit. I do not get why you use the antibody that does not work for Western for immunofluorescence. The antibody likely reacts with non-target proteins.
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Hi everyone, I want to isolate daphnia protein from bacterial infected organisms for 2 dimensional gel electrophoresis operation. The problem is the total protein includes bacterial protein after extraction. Therefore, it is impossible to compare the protein expression of daphnia between the infected and the control organisms.
I really need some suggestions from all of whom may concerned.
Thanks a lot!
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Thanks for your answers.
Actually I want to get purified daphnia proteins, not bacterial proteins. 
I treat bacteria on daphnia but daphnia also eat bacteria, therefore bacteria go through daphnia's gut and cause some effects there. 
After exposure time, I want to check the response of daphnia via total protein expression. So I isolated proteins from treated and control organisms (non-treated) and compared. But the total protein samples from treated organisms also include bacterial proteins which I don't want to have in my final samples. That makes me confused.
I would be thankful if someone can help.
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I have a patient with chronic lung disease and allergic reaction to aspergillus. I want to be sure that the items brought to that patients apt by a family member moving from apt contaminated with unknown species of black mold will not expose the patient to aspergillus. What can be used safely on paintings or furniture?
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Thank you, i will do so and let any info i find back on this site.
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One finding says that the infection of H37Ra strain is not distinguishable from infection of H37Rv strain. Is that true?
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Visually on culture, both H37Ra and H37Rv are indistinguishable from each other. However 'cord factor"( 3, 3' dimycoloyl trehalose) or mycolic acid content could be used as a reliable parameter. H37Ra has a lower content of cord factor and mycolic acid as compared to H37Rv.
Nalini Vemuri
Lifecare Innovations Pvt Ltd
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Or information on the progress in the development of its vaccine? The vector is the Aedes mosquito; and the DENV (dengue fever virus) is an RNA virus.
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Biological control of Dengue: 1) Fish- Poecilia reticulata (viviparous species)
2) Predatory copepods- cyclopoidea- small fresh water crustaceans
Dengue vaccine: No licensed dengue vaccine available. several vaccine candidates are currently being evaluated in clinical studies. The candidate currently at the most advanced clinical developmental stage is a Live-attenuated tetravalent vaccine based on chimeric yellow fever-dengue virus (CYD-TDV). It has progressed to phase III trial. Several other live-attenuated vaccines, as well as subunit, DNA and purified inactivated vaccine candidates are at earlier stages of clinical development. Virus-vectored and VLP-based vaccines are under evaluation in pre-clinical studies.
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How controlled is the laundry, handling, transport and storage process in Healthcare Institutions? Is there evidence of good practice?
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Werner, so do hospitals in Germany change linen like curtains on a routine basis?
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We want to investigate risk factors of increased resistant bacteria isolates. Screening isolates of all patients in a hospital are available. And this is my plan: I will choose one department (dialysis) and find a control group (dialysis patient without resistant isolates) and I will collect data such as: age, sex, antibiotic use, duration of antibiotic use, duration, medical history, race, living condition, duration and type of dialysis.
I want to brainstorm with you about these areas:
- Do you want to choose other cases? For example from IC? I chose dialysis because of possible consequences.
- What are other control groups would you use?
Thanks a lot.
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Cases could be chosen from the group/ department that are most likely to have patients with bacterial isolates, if that is the dialysis unit then it is fine. If for some reason you are not able to make up the sample size as well, you could think of adding in patients from other departments/ units as well. Baseline differences may be a lot that way, and would have to be taken in to account. Choosing other control groups as Lalitha has said above is for additional comparative power/ further hypothesis generation.
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...
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am not sure about which tools are most promoted, however, IPS Quality Improvement Tool (QIT) can be used in dental setting also.
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In a surgical daycare open ward, a chemotherapy open ward or an isolation room?
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Good question, as people in CT rooms are expected having some immune-suppression, and contagion with a BCG strain could be dangerous to them.
Perhaps you may obtain an opinion from what surgeons do when operating in 'dirty' fields, such as an abscess, but BCG rods last longer than common bacteria in the environment. Usually, urologists put the BCG into the bladder, also producers of BCG strains may have indications, as this procedures should follow the HRA approved ways of use., 
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Surviellance for Nosocomial infections is restricted to intensive care units in most of USA hospitals, although 40-60% of infections related to urinary catheters or central lines acquired outside intensive care units i.e. in general wards. Do we have to continue surviellance in intensive care units only or we have to consider it hospital wide?
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I would suggest you to continue surveillance in ICU, and additionally as a measure of HAI prevention you can implement protocols for the maintenance and use of central lines and urinary catheters. Hospital wide surveillance requires IC staff and lots of time. You can also gain a lot, seeking surveillance support from Microbiology lab, as they can follow and trace hospital strains of microbes within your facility.
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This is my research results, does any scientist have other experiences?
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It is possibile to get a more detailed outline? You know: in all Europe Rubella Vaccine is mandatory and we're experiencing a significant resurgence of malaria in Mediterranean regions (at the moment, Albania and Peloponnesian Greece)...
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Healthcare-acquired infections (HAIs) affect the well-being of the patients. To prevent, monitor, and control the HAIs in a time-saving manner, Infection Preventionists need advanced and integrated software for surveillance.
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I think bioMerieux has a product or couple of products which could help you in Infection Control (Observa & Vigiguard), i am not sure if they are still being marketed though.
D&V in A&E, ways to reduce admissions, reduce infection control risks and manage the condition in the unit?
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A&Es have a high admission rate with patients presenting with D&V, we are looking at ways to reduce admissions, reduce infection transmission rates and effective methods to deal with infective admissions.
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I may suggest the followings: - Increase community awarness about the disease, mothod of transmission, prevention and homecare - Encourage visiting to Primary healthcare if it is needed - Accept patients with moderat to severe dehydation to short stay in emergency department in hospital - Increase awarness and comliance of emergency room about related iunfection control measure. i e. contact precautions. - Discharge patients as early as possible, with OPD follow up if needed
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I am looking for a good epidemiology web-based program that my undergraduate students could use to track the distribution of an infectious disease.
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I would also suggest CDC as a very usable tool. It´s ease of use would make it ideal for students.
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There is an urgent need to take initiatives to formulate an effective national policy to control the rising trend of antimicrobial resistance in India, including a ban on over-the-counter sale of antibiotics, and changes in the medical education curriculum to include training on antibiotic usage and infection control. I would be very much interested to know how the developed countries are handling such a situation and make proactive measures in preventing antimicrobial resistance. Your opinions and suggestions are highly appreciated.
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I believe that the need to control this should come from within and not from without. We definitely need to educate youngsters and show them proof that this is a menace and we need to address now.
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I want to quantify the usage of correct practices in the tb wards and how it measures up to the standards set by WHO.
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A very good subject to work . wish you all the best
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For application in dentistry
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Hi Dennis
Thanks for the reply. The tool needs to applied in dental facilities by dental professionals only. In dental practices we do not test the average patient for any infection in particular. Only after exposure incidents, for example with a used needle or dental instrument tests for the injured person and source patient will be requested. To frame my question a bit better....
The application needs to be developed to do an audit for application of standard precautions and other safety measures, with specific reference to transmission of infectious diseases. In other words, application of CDC Guidelines for infection control in dental health-care settings - 2003. [Recommendations and reports]. Morbidity and Mortality Weekly Report, 52(Number RR-17), 1-68.
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Samples were taken from environment, equipment, personnel hands and uniforms.
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Thank Mr. Ghazal. Of course it is normal to have bacteria, for what I wanted to discuss was about rates up when you can say it is normal, taking into account the type of bacteria and the number of colonies.
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Literature shows low figures of hand hygiene compliance (40-60%). Is it an "epidemic" of poor compliance with hand hygiene in hospitals, or the monitoring of hand hygiene is not done properly?
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The most reliable way to monitor compliance with hand hygiene practices remains direct monitoring by expert, validated, infection control professionals
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Of course when we confirm that the infection is due to gram positive bacteria or a polymirobial infection that is persistent and may lead to amputation??
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Like phage therapy, bacteriocin therapy is 'likely' to select for resistant mutants.
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Nanobacterium sanguineum occurred in my 293T dish.how to handle it? can i go on my experiments
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Its better to free your culture from the bacterium by plugging all the avenues from where it comes along.
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It is known A. baumannii complex is implicated in HAI especially among intensive care patients.  Typing the bacteria do help in proper infection control implementation.
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See the following PFGE vs Trilocus PCR vs MLST
Warner WA, Kuang SN, Hernandez R, Chong MC, Ewing PJ, Fleischer J, Meng J, Chu S, Terashita D, English L, Chen W, Xu HH.  Molecular characterization and antimicrobial susceptibility of Acinetobacter baumannii isolates obtained from two hospital outbreaks in Los Angeles County, California, USA.  BMC Infect Dis. 2016 May 4;16(1):194.
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Many papers talk about how iron oxide is used as antiseptic in some tribes, and also has the property of preserving collagen on dead bodies. What I need to know is the chemical reason why this happens, particularely if it has anything to do with the amount of oxigen that the different kinds of iron oxides present. I'd appreciate some bibliography about it. Thank you very much for your attention in advance,
Alfredo Cortell
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Alfredo... if there are no clear examples from the past that have been studied, how do we know of its existence? Mentioning the fact should not count as evidence. Where is the "fossil" evidence of this presumed effect? Such evidence can then be studied.
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As described in literature, CGD usually complicates with frequent gram pos. (but not gram neg.) infections. Does anyone know about the severity (i.e. severe sepsis, septic shock, need of ICU administration) of these infections? And about treatment? How well reacts these patient to antibiotic treatment?
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Hi Csaba
Please see attached literature, might be useful.
Best regards
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is there a known standard or  guideline regarding the adequate ratio between hand hygiene devices and number of patients' beds in ward ..i found many articles and researches but i did not find a standard for the proper sink to bed ratio for infection control purposes 
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The WHO or the IRC International Red Cross may have these guidelines for you, else search on Google Scholar for studies involving hand washing, etc.
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diagnostic value,
significant value in ER
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Take a look at some of our work on the subject
1.      Teperman J, Torres JA, Dubrovskaya Y, Tobias H, Press R, Teperman L & Safdar A. Feasibility of Procalcitonin in Recipients of Liver, Kidney and Hematopoietic Stem Cell Transplantation: A Novel Tool in Diagnosis for Bacterial Sepsis and Respiratory Tract Infection. 2nd World Transplant Congress (WTC), a joint meeting of the American Society of Transplant Surgeons (ASTS), The Transplantation Society (TTS) and the American Society of Transplantation (AST). San Francisco, CA July 26–31, 2014
2.      Torres JA, Teperman J, Dubrovskaya Y, Press R & Safdar A.  Procalcitonin (PCT) Trends as Predictor for Hospital Mortality and Improved Infection Diagnosis Compared with C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) in Cancer and Transplant Population and Patients in Critical Care Units. (Abstract # D-182) 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).  American Society for Microbiology (ASM). Washington, DC, September 5–9, 2014
3.      Torres JA, Dubrovskaya Y, Teperman J, Press R & Safdar A. Serial Procalcitonin in Critically Ill Patients including Solid-Organ Transplantation (SOT) Recipients with Infection or Infection-Like Syndrome may Predict Outcomes. IDWeek 2014TM, Philadelphia, PA. October 8-12, 2014
4.      Torres Isasiga J, Teperman J, Dubrovskaya Y, Press R, & Safdar A. Procalcitonin in Patients with Cancer: Role of Biomarker-Assisted Diagnosis for Bacterial Infections, SIRS and Sepsis Syndrome.  (eP310) The 24th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). Barcelona, Spain  May 10-13, 2014
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As you are probably aware hidradenitis suppurativa is a chronic pyogenic and scarring condition involving apocrine glands in the axillary, perineal and genital areas of the body.  The aetiology is shrouded in mystery.  However the pathophysiology involves an unexplained keratinous plugging of the ducts of the apocrine glands.  This leads to dilatation and rupture of the glands with intense inflammation in the surrounding tissues. 
The lesions may subsequently become infected with a variety of Gram positive and Gram negative microorganisms including Staphylococcus aureus, non-haemolytic streptococci, E. coli, Proteus species, Pseudomonas aeruginosa, and Bacteroides fragilis. 
Chronic extensive disease could be extremely distressing to the patient.  In advanced disease there is often poor response to antibiotic therapy (including tetracycline, ciprofloxacin and clindamycin) and surgical intervention may become necessary followed by skin grafting. 
I would welcome your thoughts on the management of a patient with chronic and extensive ciccatricial disease.   Many thanks in anticipation for your suggestions.
Best regards
Sayed S Bukhari MD FRCPath
Consultant in Infection
Midlands, UK
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Dear All,
I see such patients regularly, and indeed, some suffer extensive disease.I diagree with Dr Broxmeyer that antibiotics are first line treatment, as the infectious part is just due due surinfection and not the primary cause. Extensive android development of the sebaceous glands is certainly involved, as you never see the diesese in women without android hallmarks. I Always change their hormonal milieu to a cyproterone dominated milieu. Also ygienic measures, reduction of sugars and animal fat (reducing obesity, often related) is a collateral measure. If a lesion Always re-appears on the same site, it means the glands are destroyed and hide bacteria. This I treat with proper and deep surgical removal. But again, only on the condition it is repeatedly recurent on the same spot.
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some publications say that 3% gluteraldhyde may be used , others say that it is not sufficient !!! others say that bleach is the most suitable agent for this purpose ........ can anyone give me a clear answer ?
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Glutaraldehyde is used for high level disinfection of  instruments which cannot be sterilised by steam/heat.  It is used in a closed system. Exposure time is critical to be effective.  This is in the CDC guidelines already posted.  Glutaraldehyde is quite toxic and when handling in an open environment the operator needs to wear a respirator. Long and short term exposure can health and so is an OH&S risk. I do not believe it is a solution for environmental surface cleaning.
For environmental surface cleaning, where C.difficile is present,  sodium hypochlorite (bleach) at a strength of 1000 ppm is recommended. This is relatively inexpensive and can be used for daily cleaning while patients are still in the room.
Another system that is effective include Nocospray (brand name) which uses disperses an aerosolised form of hydrogen peroxide and silver nitrate.  However this must be used in a closed room without a patient and is only suitable for a discharge clean.  It also requires a capital outlay for the machine and then ongoing purchase for the solution.
Ultra violet light is also effective but requires a large capital outlay and replacement of the light tubes is costly. 
It should be noted that all systems have OH&S risks.
The CDC guideline is a key document. A number of clinicians have done some major research on cleaning and validation of cleaning particularly where there are spore forming or resistant organisms.  These include William Rutala, Philip Carling and Stephanie Dancer (all medicos).  For your interest I have attached an article on the use of nocospray.
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Some cases of acute Haemobartonellosis reffered cases in our clinic occured 14-30 days after a surgical intervention (castration etc). Since Haemobartonellosis is a vectorial infection, surgical stress could  be involved in accutization of an occulte infection, or surgery instruments may be involved?
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Gheorghe,
The organism is unlikely to survive washing in water. It is a mycoplasma and has no cell-wall. If the instruments have been cleaned with detergents prior to any heat treatment then the probability of infection from the instruments is extremely low. If this is then taken into consideration as an infectious dose then the probability of an infection by this route is negligible. 
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I mean patients that received Broad-spectrum antibiotics. If the answer is yes, please explain which one is better?
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Surveillance studies on antibiotic use, indications for prescription, incidence of infection and distinguishing between bacteriologically proven and non bacteriologically proven infections may help to develop local strategies to reduce antibiotic use. prevention of respiratory tract infections has the greatest potential to
reduce overall antibiotic use and costs. In addition, studies evaluating the optimal duration of antibiotic therapy may help to reduce unnecessary antibiotic use.
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Infection is a huge problem in hospitals, especially as they get larger and infections become resistant to antibiotics and disinfectants. 
Does anyone know of new IC models or IC risks? 
One of the methods we use for IC is disposable gowns and gloves - but when does the disposal of these become a risks in themselves? When does swabbing floors and surfaces spread infection, rather than prevent it? 
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Interesting question
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The cost of health care seems to be increasing all this while.  The reasons include 'higher prices for medical services, paying for volume over value, defensive medicine, use of new technologies and treatments without considering effectiveness, and a lack of transparency of information on prices and quality'.  See this link: http://www.ahip.org/Issues/Rising-Health-Care-Costs.aspx
In my country, more govt clinics have been set up that charge a minimum cost, and operate from 10 am to 10 pm, but the services provided are mainly for cough, cold, flu, wounds, and removal of stitches.  (Sometimes, I wish we have the British NHS system.)
What is being done in your country to make health care affordable, who has been researching this area?
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Dear @Miranda, it is a sad, very sad story about Serbia! "Serbian healthcare system got 451 of possible 1,000, and the Netherlands received the most of them – 870. Serbia shares the bottom of the list with Romania, Latvia, Poland and Bulgaria.
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What are the possible negative effects of the low-dosage drug on the people who drink the water? Have there any been studies that look at its effectiveness?
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It also may be considered bodily injury.
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I believe that keeping children out of daycare or school to reduce risk of infection may actually leave them more vulnerable if they are exposed. However, I can't back up this idea with research or prove that it is true. Is it true? Is there research to support this idea? Many children with disabilities have some degree of immune compromise or increased susceptibility. Might this also be true for children with weak immune systems?
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Essential book for you to read is An Epidemic Of Absence by Moishe Velasques-Manoff. It will open your eyes
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Many metals have some kind of bactericidal effect, such as copper, zinc and silver. Do you have some experience in this field?
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These metals have strongest antimicrobial effect in composition with ionic and some less with non-ionic polymers on any surface. http://link.springer.com/article/10.1023%2FA%3A1008811501734#page-1
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see above
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Devices are coated with antibiotics or Quorum sensing inhibitors, which are either covalently bound to the device, or are locally eluted from it. Device coatings are of two types – active and passive. Passive coating such as ethylene glycol, poly ethylene oxide and hydrophilic poly urethane can be used. The effectiveness of passive coating is limited. In active coating, the release of antimicrobial agents in high fluxes occur to inhibit the initial adhesion of bacteria (Prasanna and Doble, 2008; Simon and Robertson, 2008)
I wish this be useful
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This article sounds really interesting; I would be really curious to know if you studied the effect of Cu on the skin and the consequences for people.
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Copper has been used for millenniums as copper alone or in alloys, never the less, there is not significative evidence that copper is toxic for humans. You could find interesting this article: Borkow G, Gabbay J, Dardik R,et al. Molecular mechanisms of enhanced wound healing by copper oxide-impregnated dressings. Wound Repair Regen2010;18:266e275
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A study in 2005 tested in an experimental setup the efficiency of chloroquine to stop the coranavirus S spike from developing and to ace 2 enzyme thereby stopping transmission and cutting the infection time. However this was done in SARS-CoV infecting primate kidney cell lines. Does anyone have any literature or source if chloroquine is effective in preventing transmission and infections in humans against the 2019-nCoV and if so what would be best effective drug concentration to do so?
Also has anyone tested the efficiency of using ace 2 inhibitors to stop the transmission
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This is a very interesting point, as chloroquine has also been shwon to inhibit replication of the MERS CoV in cell cultures. As far as I am aware there is so far no literature available on CQ and 2019-nCoV.