GMS Hygiene and Infection Control最新文献

Background: Meningitis is highly prevalent in infant because their immune system is immature and they have less resistance to diseases. Among bacterial agents, Escherichia coli is recognized as one of the most important causes of meningitis in infants.

Case presentation: Herein, we report a case of late-onset meningitis, caused by E. coli (Patient:17-day-old female infant). The patient's body temperature was 39°C, and the initial diagnosis was sepsis. At the doctor's request, the patient underwent the basic tests and was hospitalized in the Neonatal Intensive Care Unit (NICU). In this case, blood culture and CSF culture were negative and positive, respectively. Echogenic particles were observed inside the bladder, indicating possible cystitis. The results of the antibiotic susceptibility tests showed that the meningitis-causing strain of E. coli was susceptible only to amikacin.

Conclusion: Conducting LP and CSF culture seems to be the most important strategy for diagnosing meningitis. It is also recommended to perform LP before taking antibiotics. For identifying the infection, some factors such as fever, CRP test results, CSF parameters (leukocyte count, glucose level, and CSF culture results) should be considered to prevent misdiagnosis.

Actinomycosis is an endogenous bacterial infection caused by Actinomyces israelii. This bacterium reside on the mucosa of oral cavity, tonsils, and genitourinary tract. Any insult such as trauma, surgery, or foreign body disrupts the mucosal barrier and gives entry to the underlying tissue to cause disease. We describe a rare presentation of Actinomycosis presenting as a nasal polypoidal mass in a young female, an uncommon presentation, thereby causing diagnostic challenge as it may mimic other lesions with similar clinical presentations like fungal polyps, allergic polyps or chronic sinusitis. A 22 year old female presented with history of recurrent upper respiratory tract infection to the ENT Outpatient Department, clinical evaluation showed deviated nasal septum and radiology showed a nasal polyp and patient underwent submucosal resection with middle meatal antrostomy and micro-debrider assisted polypectomy. Histopathology showed respiratory epithelium with underlying stroma showing dense basophilic filamentous organisms surrounded by peripheral eosinophilic clubs that were Gram-positive and Gomori Methanamine Silver stain positive. The disease was diagnosed as Actinomycosis. The disease is a mimicker of various diseases such as nocardiosis, botryomycosis or tuberculosis having a wide range of symptoms and affecting multiple organs. Prevalence of actinomycosis in nasal region is rare thereby increasing the risk of misdiagnosis. Thus, Actinomycosis should be kept as a differential diagnosis in any chronic infectious diseases of the nasal cavity and monitored closely to ensure precise diagnosis and timely management.

Background: The etiology of periodontitis is multifactorial, involving interactions between bacterial pathogens, host immune response, and environmental factors. Among the host immune factors, interleukin-1 alpha (IL-1α) has been implicated in the pathogenesis of periodontitis. Many studies have aimed to find the association between IL-1α and periodontitis in various populations worldwide. However, the evidence in the Indian population is limited. Therefore, this study aims to analyse data from the literature related to the genetic correlation between IL-1α polymorphisms and periodontitis among Indians.

Method: Only case-control and cross-sectional studies investigating the association between IL-1α polymorphisms (+4,845 and -889) and various forms of periodontitis in the Indian population were included. PubMed, Medline, Web of Science, Cochrane based reviews, Scopus, and Google Scholar were used for the search.

Results: The findings demonstrate a mixed pattern of associations between these polymorphisms and periodontitis across different regions of India.

Conclusion: The correlation of periodontitis with IL-1α polymorphism in Indians lacks evidence.

Objectives: The objectives of this retrospective cross-sectional study were to evaluate the demographic profile and aggravating factors in the prognosis of patients with COVID-19 in the years 2020 and 2022.

Methods: From the analysis of medical records, data were collected on age, sex, race, and municipality of residence, as well as dates of onset of symptoms, positive test result and length of hospitalization. Demographic data were analyzed qualitatively, while information on the presence of comorbidities and their influence on length of hospitalization, disease outcome and need for ICU admission were assessed using Pearson's correlation test. Student's t-test was used to compare the two analyzed moments, relating the age of patients and the progression of the disease from the onset of symptoms to the positive test result and finally clinical outcome.

Results: Among the most common comorbidities, hypertension had an influence on prognosis, as did the age and sex of the patients, with a higher prevalence of male patients over the age of 64. Vaccinated patients had a better prognosis when compared to those who were unvaccinated.

Conclusion: The findings highlight the continued need for public health strategies, including vaccination against COVID-19, risk monitoring and measures for vulnerable groups.

Objective: Hand washing is considered an important public health intervention to reduce the burden of communicable diseases such as gastrointestinal and respiratory tract infections. Washbasins in public restrooms are often only equipped with cold water and it can be observed that people only rinse their hands briefly after using the toilet instead of washing them properly with soap. As there are no recommendations on the optimal water temperature for efficacy, we measured the efficacy of simple hand rinsing with cold (4°C) and warm (40°C) water for 10 and 20 seconds compared to the European Norm EN 1499 reference hand wash.

Methods: A Latin square design was used with five treatment groups and three participants per group. Hands were contaminated by immersion in an Escherichia coli suspension. Before and after the respective treatment fingertips were sampled to obtain pre- and post-values. Pre- and post-values were averaged separately for each volunteer and the arithmetic means of all individual lg reductions were calculated and compared using Wilcoxon's matched-pairs signed rank tests (one-sided, P<0.05). Post hoc test of differences between treatmets was done by Tukey's honest significant difference tests, P<0.05 was considered significant.

Results: Rinsing hands for 10 seconds with cold (1.93 lg) or warm water (2.01 lg), and for 20 seconds with cold (2.23 lg) or warm water (2.39 lg) was significantly inferior to the 1 minute reference hand wash with sapo kalinus (2.68 lg), but there were no significant differences between the use of cold or warm water in the pairwise comparison for both times. However, the duration seems to have an effect on the bacterial reduction as the differences between the hand rinsing times were significant for both temperatures.

Conclusion: Rinsing hands with cold water was as effective as warm water. Its implementation in the community could save energy and resources without losing any efficacy.

Background: Surgical site infections (SSIs) have been shown to increase patient morbidity and mortality, impact on quality of life and place a significant economic burden on healthcare systems worldwide. Irrigation using wound cleansing and antiseptic effective solutions during surgical procedures is a key part of SSI prevention. The optimal solution would have minimal cytotoxicity to the patient while maintaining a minimum concentration required for antimicrobial activity necessary to prevent opportunistic pathogens and biofilm formation.

Method: A variety of common wound irrigation products, including polyhexanide in various concentrations and compositions, iodine and hypochlorous acid-based solutions, were tested and compared for their activity against pathogens according to the ESKAPE group of nosocomial relevant microbes. The antimicrobial efficacy of the solutions was tested against planktonic cells using a time-kill assay. Its minimal bactericidal concentration (MBC) and its cytotoxicity against mouse fibroblast cells were determined. Finally, the Therapeutic Index (TI) was compared and the biofilm activity of a selected solution containing 0.1% polyhexanide (PHMB) was tested.

Results: Irrigation solutions containing 0.1% PHMB demonstrated rapid inactivation against planktonic cultures, achieving >4 lg reduction within 60 seconds. When comparing the TI of all irrigation solutions tested, the combination of 0.1% PHMB and poloxamer as an additive showed the best results in killing nosocomial pathogens and also to be less cytotoxic to mammalian fibroblasts, as demonstrated for PREVENTIA^® Surgical Irrigation. When exposed to five single-species biofilms, PREVENTIA^® Surgical Irrigation showed a 3 lg reduction (average) after 60 minutes; this was supported by microscopy showing significant biofilm disruption and an abundance of non-viable microcolony formations.

Conclusion: This study highlights the impact of irrigation solutions containing PHMB. It also demonstrated the effect of using different concentrations of PHMB in combination with surfactants as additives. The combination of 0.1% PHMB and poloxamer as a surfactant demonstrated effective benefits in eradicating established biofilm combined with a relatively high Therapeutic Index (TI), indicating low cytotoxicity and high bactericidal activity.

Because oral lesions can develop from various etiological factors, it is of utmost importance to obtain a comprehensive history and oral examination. Fellatio is a commonly practiced sexual act, which may result in submucosal hemorrhage of the palate. The lesions are asymptomatic and typically appear on the soft palate. We report a case of a 57-year-old woman who presented with an incidental erythematous lesion about 3 cm with a clear center on her soft palate during her dental visit. As the patients may be unaware of the etiology of the lesions and when they hesitate to provide the details of the sexual history, it is important that the clinician, based on the patient's clinical presentation, consider fellatio as a possible cause.

Lesions of monkeypox affect the oral mucosa in approximately 70% of infected patients and reported as the first clinical sign of the disease, manifesting as macules, papules, vesicles, or blisters, which are highly contagious and are followed by the appearance of lesions on the face and extremities of the body. These lesions have clinical aspects like recurrent herpes simplex, herpes zoster, and secondary syphilis and should be part of differential diagnoses. The clinical course after initial oral manifestation is shown to support the clinical diagnosis.

Introduction: The success of flu vaccination depends primarily on the willingness of health care workers (HCWs) to be vaccinated. To identify barriers and drivers to vaccination, an online survey among employees and students of a university hospital was performed to develop a local strategy to increase the vaccination willingness in line with the WHO recommendation.

Method: A cross-sectional, anonymous, self-administered online survey was performed among HCWs, other staff, trainees and students of the Greifswald University Hospital between 17.02.2022 and 17.03.2022.

Results: Of 4,709 online questionnaires, 1,515 were answered (response rate 32.2%). 45.3% stated that they were vaccinated annually, 33.4% irregularly and 7.7% had been vaccinated once. 13.6% had never been vaccinated. The proportion of non-vaccinated was highest among trainees and students (25.4%). 5.7% of those vaccinated said the willingness to be vaccinated has decreased because of the pandemic, and 12.1% felt encouraged. 5.8% of those vaccinated at least once did not want to be vaccinated in the future; 14.8% were undecided. The reasons for non-vaccination were dominated by perception of low assumed risk of infection (62.1%), followed by doubts about vaccine efficacy (22.8%) and fear of side effects (13.8%).

Conclusions: Because a timely reminder of vaccination was essential for 16.7% of staff, the occupational medical service will intensify the annual vaccination campaign within the hospital. Additionally, staff will be provided with a brief sheet on the importance of flu vaccination every year before the flu season with the option of personal advice from the occupational medical service. In a lecture, medical students are informed about the benefits of the flu vaccination.