Infection Of Different Types Research Articles

Investigation of jaundice outbreak in a rural area of Odisha, India: Lessons learned and the way forward

Background and Objectives: Hepatitis, a condition with liver inflammation, mostly follows hepatitis virus infection of different types A, B, C, D, and E. Each year, numerous outbreaks of hepatitis virus are being reported from around the country, more so from the “Empowered Action Group (EAG) States.” The present outbreak investigation was performed in Odisha, India to study the epidemiology, explore the reasons behind it, and suggest preventive measures for the future. Materials and Methods: A team consisting of public health doctors from All India Institute of Medical Science (AIIMS), Bhubaneswar, Odisha, India investigated the hepatitis E outbreak as per standard guidelines in one of the villages of Tangi block in the state of Odisha, using a questionnaire between January 1, 2015 and January 15, 2015. The data were entered and analyzed in Microsoft Excel 2007. Time, place, and person analysis were performed for all case patients. Result: Hepatitis E outbreak occurred between November 16, 2014 and January 1, 2015, affecting 22 individuals. The attack rate was 44/1,000 in the population and young males were mostly infected. Spot map of the outbreak probably points toward point source epidemic. Most of the infected cases had visited allopathic doctors as well as traditional healers. Less than 50% people had some knowledge about the prevention and control of hepatitis virus infection. Open defecation was highly prevalent in the village. The well was the commonest source of drinking water and the condition of wells was non-sanitary. Less than 2% started hand-washing after the end of the outbreak in the community. Conclusion: Focus of outbreak investigation should not restrict only to immediate control but should rather lead to intervention by the health system in the area for construction of community toilets, improved drinking water facilities, and sustained information, education, and communication (IEC) activities to promote personal hygiene and water safety behavior in the community.

A joint model for repeated events of different types and multiple longitudinal outcomes with application to a follow-up study of patients after kidney transplant.

This paper presents an extension of the joint modeling strategy for the case of multiple longitudinal outcomes and repeated infections of different types over time, motivated by postkidney transplantation data. Our model comprises two parts linked by shared latent terms. On the one hand is a multivariate mixed linear model with random effects, where a low-rank thin-plate spline function is incorporated to collect the nonlinear behavior of the different profiles over time. On the other hand is an infection-specific Cox model, where the dependence between different types of infections and the related times of infection is through a random effect associated with each infection type to catch the within dependence and a shared frailty parameter to capture the dependence between infection types. We implemented the parameterization used in joint models which uses the fitted longitudinal measurements as time-dependent covariates in a relative risk model. Our proposed model was implemented in OpenBUGS using the MCMC approach.

A Longitudinal Study of Salmonella Infection in Different Types of Turkey Flocks in Great Britain

Salmonella is, after Campylobacter, the most reported zoonotic pathogen in the EU. Poultry are a common source of infection to humans, and turkey flocks are commonly colonized with the organism. We investigated the prevalence and risk factors of Salmonella infection in 179 houses in 60 holdings representative of turkey meat and breeder production in Great Britain. From each holding, up to four houses were chosen, and two consecutive flocks per house were sampled/tested for Salmonella to investigate the persistence, elimination and introduction of Salmonella in consecutive crops. At the first sampling, the overall flock-level Salmonella prevalence was 32.8% and 8.9% for meat and breeding flocks respectively. There was a higher prevalence of Salmonella in flocks in the rearing stage than in the fattening and breeding stages. At the first sampling, the flock-level prevalence of Salmonella was 26.8% (95% CI: 20.7-33.7%), while the prevalence level in the subsequent flock was 20.5% (95% CI: 13.6-29.7%). No houses were positive for any of the EU-regulated serovars. The most commonly encountered serovars were S. Kottbus and S. Kedougou. Carry-over of infection was observed in 44.8% of the positive houses, and introduction of new infection occurred in 8.4% of houses. Data from the questionnaires and auditing of all holdings and houses were combined and used to calculate adjusted farm- and house-adjusted risk factors. Significant risk factors were feed from a source other than a national compounder (OR = 2.4), feeder type other than pan feeders (OR = 2.4) and hygiene practices other than terminal cleaning and disinfection using power-washing with sanitizer and anteroom with boot change (OR = 2.8). The study discusses the main challenges currently faced by the industry to control Salmonella in turkey production.

The Prevalence of Epstein-Barr Virus Infection in Different Types and Sites of Lymphomas

To analyze the association of several types of malignant lymphomas in different anatomical sites with the Epstein-Barr virus (EBV) infection status, 127 cases of formalin-fixed paraffin-embedded samples of malignant lymphomas were investigated with in situ hybridization detecting EBV-encoded small RNA (EBER) in tumor cells. Forty-six out of 108 non-Hodgkin lymphoma (NHL) cases were positive for EBER (42.6%). The EBER-positivity rate of NHL in the nasal cavity and nasopharynx (35/60 cases, 58.3%) was higher than that of NHL in stomach (9/30 cases, 30%) and in the superficial lymph nodes (2/18 cases, 11.1%) (P<0.05). The EBER-positivity rate of Hodgkin lymphoma in the superficial lymph nodes was 26.3% (5/19 cases). These findings suggest that the EBV-positivity rate in lymphomas is related to their histological types and locations.

Non‐parametric Tests for Recurrent Events under Competing Risks

Abstract. We consider a data set on nosocomial infections of patients hospitalized in a French intensive care facility. Patients may suffer from recurrent infections of different types and they also have a high risk of death. To deal with such situations, a model of recurrent events with competing risks and a terminal event is introduced. Our aim was to compare the occurrence rates of two types of events. For this purpose, we propose two tests: one to detect if the occurrence rate of a given type of event increases with time; a second to detect if the instantaneous probability of experiencing an event of a given type is always greater than the one of another type. The asymptotic properties of the test statistics are derived and Monte Carlo methods are used to study the power of the tests. Finally, the procedures developed are applied to the French nosocomial infections data set.

Incidence Rate and Variable Cost of Nosocomial Infections in Different Types of Intensive Care Units

Nosocomial infection (NI) is one of the most serious healthcare issues currently influencing healthcare costs. This study estimates the impact of NI on costs in intensive care units (ICUs). Prospective surveillance by a retrospective cohort study. A medical ICU, a surgical ICU, and a mixed medical and surgical ICU in a large tertiary referral medical center. Surveillance for NIs was conducted for all patients admitted to adult ICUs from 2003 through 2005. Retrospective chart review was conducted for each patient. The generalized linear modeling approach was used to assess the relationship of NIs to the increase in variable costs in individual ICUs and in all ICUs. A total of 401 NIs occurred in 320 of 2,757 screened patients. The incidence rate was 12.1% in the medical ICU, 14.7% in the surgical ICU, and 16.7% in the mixed medical and surgical ICU (P>.05). All of the mean variable costs were significantly higher for patients with NI than they were for patients without NI, after controlling for covariates. The medical ICU had the greatest increase in mean cost ($13,456, which was 3.52 times [95% confidence interval {CI}, 2.94-4.22 times] the mean cost for patients without NI), followed by the mixed medical and surgical ICU ($6,748, which was 2.74 times [95% CI, 2.33-3.22 times] the mean cost for patients without NI) and the surgical ICU ($5,433, which was 2.46 times [95% CI, 1.99-3.05 times] the mean cost for patients without NI). Mean cost increases according to the site of NI were $6,056 for bloodstream infection (2.36 times [95% CI, 1.97-2.84 times] the mean cost for patients without NI), $4,287 for respiratory tract infection (1.91 times [95% CI, 1.57-2.32 times] the mean cost for patients without NI), $1,955 for urinary tract infection (1.42 times [95% CI, 1.18-1.72 times] the mean cost for patients without NI), and $1,051 for surgical site infection (1.23 times [95% CI, 0.90-1.68 times] the mean cost for patients without NI). The medical ICU had the lowest rate of NI and the largest excess costs, the surgical ICU had the lowest excess costs, and the mixed medical and surgical ICU had the highest rate of NI. The cost is largely attributable to bloodstream infection and respiratory tract infection.

Prevalence of high-risk human papillomavirus infection in different cervical lesion among organized health-examination women in Shanghai, China

Cervical cancer is the second most common cause of death from cancer among women worldwide. Human papillomavirus (HPV) plays a central role in the etiology of cervical cancer. It is important to describe the prevalence of HPV infection in different types of cervical lesions and to explore the relation between HPV viral load and the severity of cervical lesions. To describe the HPV infection prevalence and viral load in different age groups, we retrospectively investigated 6405 cases of women who were organized by their units to take health-examination. They were given Hybrid Capture II tests between January 2005 and December 2006. The correlation between HPV viral load and pathology was assessed. Overall HPV infection prevalence was 29.1% (1864/6405), while in women 18-20 years old it was 54.4% (31/57), the highest among all age groups. After declining rapidly, HPV prevalence stabilized at about 30.0% in women aged 30 and older. Of the 6405 women, 1483 women had a colposcopic biopsy and 33.2% (492/1483) were positive for HPV DNA. Twenty-one percent of women with a normal diagnosis (238/1095) had HPV infection, a statistically significantly lower prevalence than in women with cervical lesions, including those with cervical intraepithelial neoplasia (68.8% in CIN1, 66.7% in CIN2, and 76.5% in CIN3) or with cervical cancer (94.1%). The correlation coefficient between viral load and cervical lesion severity was 0.134, which was not statistically significant (P = 0.075). Viral load values in women with CINs and cervical cancer were calculated, and no significant differences were identified. The prevalence of high-risk HPV infection among women attending hospitals for health-examination in Shanghai is similar to the worldwide rate. HPV viral load can distinguish cervical lesions from normal individuals but cannot adequately predict the severity of cervical lesions.

Strategies of smoking cessation intervention before hernia surgery—effect on perioperative smoking behavior

Although it is now generally accepted that patients should be advised to quit smoking before surgery, the effect of low-intensive smoking cessation intervention, both on preoperative smoking behavior and on risk reduction, remains unclear. Our objective was to study the effect on perioperative smoking behavior and on postoperative wound infection of different types of low-intensive intervention before herniotomy. Between October 1998 and October 2000, 180 consecutive smokers scheduled for elective herniotomy were advised to quit smoking perioperatively and subsequently allocated randomly to three low-intensive smoking cessation groups: a standard (control) group, a telephone group, which was reminded by telephone, and an out-patient group, which was reminded by means of an out-patient talk and demonstration of nicotine replacement drugs. Spontaneous perioperative smoking behavior was recorded for 64 consecutive non-advised smokers. Postoperative wound infection was evaluated by independent assessors. Of the advised patients, 19% (29/149) stopped smoking before surgery compared with 2% (1/64) in the non-advised cohort (P < 0.01). In the standard group 13% (6/48) quit smoking compared with 23% (23/101) in the pooled telephone and outpatient group (NS). In the last group 64% (65/101) reduced or stopped smoking compared with 42% (20/48) in the standard group (P < 0.05). Predictors of failed perioperative cessation of smoking were a CO breath-test at inclusion above 20 ppm (OR: 0.11; 0.02-0-57) and low motivation to quit smoking (OR: 0.25; 0.09-0.70). Wound infection occurred in 6% (13/213) and there was no difference between the groups. Low-intensive smoking cessation intervention helps approximately one fifth of patients to stop smoking perioperatively. Patients who are reminded in addition to preoperative advice are more likely to stop or reduce smoking. Failure to stop smoking is greater if the patients are not motivated and if the CO breath test is high at the time of the preoperative advice.

A proteomic-based approach for the identification ofCandida albicans protein components present in a subunit vaccine that protects against disseminated candidiasis

Candidiasis has become a prevalent infection in different types of immunocompromised patients. The cell wall of Candida albicans plays important functions during the host-fungus interactions. Cell wall (surface) proteins of C. albicans are major elicitors of host immune responses during candidiasis, and represent candidates for vaccine development. Groups of mice were vaccinated subcutaneously with a beta-mercaptoethanol (beta-ME) extract from C. albicans containing cell wall proteins. Vaccinated mice were then infected with a lethal dose of C. albicans. Increased survival and decreased fungal burden were observed in vaccinated mice as compared to a control group, and 75% of vaccinated mice with the beta-ME extract survived this otherwise lethal infection. We used a proteomic approach (2-DE followed by immunoblotting) to demonstrate a complex polypeptidic pattern associated with the beta-ME extract used in the vaccine formulation and to detect immunogenic components recognized by antibodies in immune sera from vaccinated animals. Reactive protein spots were identified by MALDI-TOF-MS and searches in genomic databases. As a conclusion, vaccination strategies using C. albicans cell wall proteins induce protective responses. These antigens can be identified by proteomic approaches and may be used as components of subcellular vaccines against candidiasis.

The integration of key players in the control of healthcare associated infections in different types of domestic services

PurposeThe main purpose of this paper is to present some of the findings of a PhD research project. The findings are related to issues of integration of the key players in the control of healthcare associated infections (HAI) in FM services. Out of the FM services, the focus of the study was limited only to domestic services.Design/methodology/approachMost of what is put forward in this paper is based on a PhD research project which is at its final stages. The findings are grounded on a case study approach and a questionnaire survey approach, carried out as part of the research. Informal interviews with infection control experts in the national health service (NHS) in Scotland and a thorough review of literature also provided useful insights to make conclusions of this paper.FindingsIt is evident from a thorough review of literature that the integration between the clinical teams and domestic teams is vital in order to ensure well maintained standards in the control of HAI in domestic services. However, the findings of the case studies and questionnaire survey suggest that, at present, there is less integration between domestic teams and clinical teams (mainly infection control team members). This is mostly due to the fact that the clinical teams and domestic teams consider themselves as two separate entities. This is obvious especially when the domestic service is managed by an external party (e.g. PFI contractor). However, many UK government studies have shown that there is no correlation between contracting‐out and HAI. Therefore, the solution (to control HAI) is not to rush and bring cleaning contracts back in‐house, but to take steps to create and improve communication and coordination between the domestic teams and clinical teams. More empirical research is, therefore, needed to resolve the issue of “integration” in order to create a “friendly” and a “coordinative” environment in hospitals.Research limitations/implicationsTargeted guidelines on the role of domestic services in the control of HAI as well as the paucity of relevant literature on related areas could be considered as limitations.Practical implicationsThe cultural issues between the clinical teams and non‐clinical teams (particularly domestic teams in this study point of view) are major implications to adopt a team‐based approach in the control of HAI.Originality/valueThe paper focuses on one of the major issues in healthcare, i.e. HAI. Few have taken an FM perspective on this issue. It is worthwhile to note that, at the time of this research, there was only a handful of literature on the aforementioned issue. Besides, none of the literature has discussed the issue of involvement and integration particularly with regard to control of HAI in domestic services. Many of the case study participants and survey respondents also commended the in‐depth interest taken on the aforementioned issue. This paper, therefore, adds a significant value to healthcare research and research on FM.

Acute infection as a risk factor for ischemic stroke.

Prior studies have demonstrated that infections might precipitate ischemic strokes (IS), but the role of infection as a risk factor remains unclear. We conducted a case-control study to investigate this issue. Consecutive patients (n = 182) with acute IS were examined within 48 hours after admission to our center. A history of acute infections within 2 months before the IS was assessed by means of a specially designed questionnaire that was also given to a control group consisting of 194 consecutive patients who were seen in our outpatient clinic and had suffered IS at least 6 months previously. The prevalence of acute infection in the study group was significantly higher (44/182 = 24.2%) than in the control group (19/194 = 9.7%; odds ratio, 2.93; 95% confidence interval, 1.64 to 5.26; P = .0002) and infection occurred mostly within 1 week before the IS (41/44). Neither the severity of the IS nor the type of the infection was significantly different in patients and control subjects. Acute infections of different types constitute a risk factor for IS, particularly within 1 week of the event. However, the severity of the stroke is not related to this factor.

Analysis Of Circulating Phagocyte Activity Measured By Whole Blood Luminescence: Correlations With Clinical Status

The present study was undertaken to determine if measurement and analysis of phagocyte function are useful for diagnosis and staging of infection. Circulating phagocyte activity was measured in healthy volunteers and sequentially in patients with acute infections of different types and severity, including those with diabetes mellitus or human immunodeficiency virus (HIV) infection. Using an automated luminescence system, these phagocyte functions were measured in whole blood: basal and phorbol 12-myristate 13-acetate (PMA)-stimulated oxidase activity, basal and PMA-stimulated simple dioxygenation (e.g., oxidase-driven haloperoxidase activity), and circulating and primed opsonin receptor-dependent dioxygenation. Multiple discriminant analysis of these data showed significant differences between healthy controls, diabetic patients, HIV-positive subjects, and patients with pneumonia or sepsis syndromes. Longitudinally, circulating phagocyte function correlated with clinical condition, severity of infection, and outcome. This methodology provides rapid, objective, and sensitive diagnostic and monitoring information for patients with infections.

Nosocomial infections in surgical patients in the United States, January 1986-June 1992. National Nosocomial Infections Surveillance (NNIS) System.

To describe the distribution of nosocomial infections among surgical patients by site of infection for different types of operations, and to show how the risk of certain adverse outcomes associated with nosocomial infection varied by site, type of operation, and exposure to specific medical devices. Surveillance of surgical patients during January 1986-June 1992 using standard definitions and protocols for both comprehensive (all sites, all operations) and targeted (all sites, selected operations) infection detection. Acute care US hospitals participating in the National Nosocomial Infection Surveillance (NNIS) System: 42,509 patients with 52,388 infections from 95 hospitals using comprehensive surveillance protocols and an additional 5,659 patients with 6,963 infections from 11 more hospitals using a targeted protocol. Surgical site infection was the most common nosocomial infection site (37%) when data were reported by hospitals using the comprehensive protocols. When infections reported from both types of protocols were stratified by type of operation, other sites were most frequent following certain operations (e.g., urinary tract infection after joint prosthesis surgery [52%]). Among the infected surgical patients who died, the probability that an infection was related to the patient's death varied significantly with the site of infection, from 22% for urinary tract infection to 89% for organ/space surgical site infection, but was independent of the type of operation performed. The probability of developing a secondary bloodstream infection also varied significantly with the primary site of infection, from 3.1% for incisional surgical site infection to 9.5% for organ/space surgical site infection (p < .001). For all infections except pneumonia, the risk of developing a secondary bloodstream infection also varied significantly with the type of operation performed (p < .001) and was generally highest for cardiac surgery and lowest for abdominal hysterectomy. Surgical patients who developed ventilator-associated pneumonia were more than twice as likely to develop a secondary bloodstream infection as nonventilated pneumonia patients (8.1% versus 3.3%, p < .001). For surgical patients with nosocomial infection, the distribution of nosocomial infections by site varies by type of operation, the frequency with which nosocomial infections contribute to patient mortality varies by site of infection but not by type of operation, and the risk of developing a secondary bloodstream infection varies by type of primary infection and, except for pneumonia, by type of operation.

Binding of type 3 reovirus by a domain of the sigma 1 protein important for hemagglutination leads to infection of murine erythroleukemia cells.

The recognition of cellular receptors by the mammalian reoviruses is an important determinant of cell and tissue tropism exhibited by reovirus strains of different serotypes. To extend our knowledge of the role of reovirus-receptor interactions in reovirus tropism, we determined whether type 1 and type 3 reovirus strains can infect cells derived from erythrocyte precursors. We found that reovirus type 3 Dearing (T3D), but not type 1 Lang, can grow in murine erythroleukemia (MEL) cells. This difference in growth was investigated by using reassortant viruses and we found that the capacity of T3D to infect MEL cells is determined by the viral cell-attachment protein, sigma 1. In experiments using murine monoclonal antibodies (mAbs) that bind to different sigma 1 regions, we show that T3D binding to MEL cells is inhibited by a mAb that identifies a domain important for hemagglutination (HA). We also determined that type 3 strains that can infect murine L cells but do not produce HA do not infect MEL cells. These results suggest that type 3 reovirus binds to and infects erythrocyte precursor cells via a sigma 1 domain important for HA. Moreover, this study suggests that different domains of some viral cell-attachment proteins are used to initiate productive infections of different types of cells.

Studies on the Schistosomes of domestic animals in Iran. I. Observations on Ornithobilharzia turkestanicum (Skrjabin, 1913) in Khuzestan.

O. turkestanicum infection was found to be uniformly distributed in the northern and central parts of Khuzestan (cattle, 30%, sheep, 15%; goats, 7% and buffaloes, 2%). In the southern part of Khuzestan the infection rate was very low. A new technique was devised for exposing large animals by leg immersion in a cercarial suspension in a polythene bag and good infections were obtained by this method. The prepatent period of O. turkestanicum infection in different types of animals varied from 43–46 days. The recovery rates of adult worms were 37.6% in calves, 33.9% in sheep, 22.5% in goats and 9.6% in a buffalo. O. turkestanicum produced a milder pathological response in ruminants than did S. bovis, but is nevertheless of considerable economic importance in Khuzestan.

Gastrointestinal Helminths Infection in Different Types of Poultry

The prevalence of gastrointestinal helminth parasites and the gross pathological lesions produced by them in different types of poultry were studied from March 2005 to March 2006, in the Department of Parasitology, Bangladesh Agricultural University, Mymensingh. In this study, 240 viscera of three types of poultry such as broiler, layer and backyard indigenous chickens were collected from local markets of Mymensingh district. During routine examination, total six species of helminth parasites were recorded, of which three species were nematodes such as Ascaridia galli, Heterakis gallinarum and Capillaria annulata; two species were cestodes such as Raillietina tetragona and Amoebotaenia sphenoides and only one species was belonged to trematode such as Catatropis verrucosa. Prevalence of different species of gastrointestinal helminths was highest in backyard poultry (100%) followed by layer (48.75%) and broiler (3.75%) which was statistically significant (p &lt; 0.01). Backyard poultry was significantly (p &lt; 0.05) 168.21 and 4106.67 times more susceptible to helminth infection than layer and broiler respectively. But layer was 24.41 times more susceptible to helminth infection than broiler. In backyard poultry, all six species of helminth parasites were found. A statistically significant (p &lt; 0.05) variation in the prevalence of the recovered parasites from backyard poultry were observed such as the prevalence of R. tetragona (100%) was the highest followed by that of A. galli (87.50%) and H. gallinarum (80%). From the odds ratio of the recovered parasites, it was observed that chance of developing R. tetragona (odds ratio 189.73) in backyard poultry was the highest followed by A. galli (odds ratio 7.51) and H. gallinarum (odds ratio 4.04). In case of layer, only A. galli and R. tetragona were recorded, of which, prevalence of A. galli was the highest (43.75%). In broiler, only A. galli (3.75%) was found. Gross pathological lesions were found only in backyard poultry. Pathological changes were detected in case of A. sphenoides and H. gallinarum infection. In A. sphenoides infection petechial hemorrhages were observed in the mucosa of the duodenum. On the other hand, tiny, white, circumscribed nodules of about 2-3 mm of diameter were found in the caecal mucosa in case of H. gallinarum infection. Results of the present study suggest that the backyard poultry is at the high risk of helminth infection. However, layers are also vulnerable to parasitic infection. So regular deworming is essential both in backyard poultry and layer birds to obtain better production from them. Key words: Gastrointestinal helminths, prevalence, pathology, broiler, layer, backyard poultry doi:10.3329/bjvm.v4i1.1519 Bangl. J. Vet. Med. (2006). 4 (1): 13-18