Infections
Pilot study shows effectiveness of new, low-cost method for monitoring hand hygiene compliance
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Epidemiologists and computer scientists at the University of Iowa have collaborated to create a new low-cost, green technology for automatically tracking the use of hand hygiene dispensers before healthcare workers enter and after they exit patient rooms. This novel method of monitoring hand hygiene compliance, which is essential for infection control in hospitals, was released today at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA).
“We know that a range of pathogens are spread from healthcare workers to patients by direct touch and that the current rates of hand hygiene compliance are suboptimal,” said Philip Polgreen, MD, University of Iowa Health Care. “Our new low-cost method of monitoring could potentially reduce cost while increasing compliance rates.” The failure of healthcare workers to perform appropriate hand hygiene is one of the leading preventable causes of healthcare-associated infections.
This new technology marks a major shift from the current method of monitoring hand hygiene compliance that involves direct human observation, which is both costly and labor intensive. With human observation there is also the potential for a “Hawthorne Effect,” which means workers will only clean their hands when being actively observed. Older automated monitoring technology, called radio-frequency identification (RFID) infrastructure, is available, but can be prohibitively costly and consumes far more power than Polgreen’s method.
TB treatment delays in Taiwan
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Older people suffer delayed tuberculosis treatment. A Taiwanese study of 78,118 pulmonary tuberculosis (PTB) cases, reported in the open access journal BMC Public Health has found that older people had both diagnosis and treatment delays in tuberculosis and those with an aboriginal background had a longer treatment delay.
Pesus Chou from the National Yang-Ming University in Taipei, Taiwan, studied information from the Taiwan TB reporting system over the period 2002 to 2006. She said, “According to literature review, diagnosis and treatment delay of tuberculosis (TB) may result in more extensive disease and more complications, which in turn leads to a higher mortality. So, studies on delays are important. This is the first study to investigate delays using the Taiwan reporting system.”
A period of longer than nine days between medical examination and TB diagnosis was defined as a diagnosis delay and a period of longer than two days between diagnosis and initiation of therapy was defined as a treatment delay. According to Chou, “During the five-year study period, 78,118 new PTB patients were reported. Of these, 19,413 (24.9%) experienced a diagnosis delay and 14,270 (20.3%) experienced a treatment delay.”
A potential marker of increased histological activity in hepatitis C virus infection
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Early, vigorous and sustained lymphocyte proliferative responses specific to hepatitis C virus (HCV) have been regarded as pivotal for viral clearance. On the other hand, antibody responses’ contribution is still controversial. Research data have been accumulated regarding the significance of specific antibody classes during chronic infection. Particularly, the relation of IgA and alcohol-induced hepatic damage has been recognized, but its possible implication in HCV chronic infection has not been explored so far.
A research article to be published on November 28, 2008 in the World Journal of Gastroenterology addresses this question. This article investigated the HCV-specific immune responses in chronic treated and untreated patients, in paired samples taken 6 months apart. IgG, IgM and IgA levels, as well as IgG1-4 subclasses and peripheral blood lymphocyte proliferative responses against core, envelope and NS3 antigens were assayed by ELISA and CFSE staining, respectively.
Over 70% of the patients showed specific IgG and IgM against HCV capsid, E1 and NS3, while the hypervariable region-1 of E2 was recognized by half of patients. Anti-capsid IgM and IgG levels increased over time, while IgA levels did not; instead, an increase in IgA positive samples was observed.
Breastfeeding cuts baby girls’ pneumonia risk
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Breastfeeding appears to reduce the risk for severe lung infection and associated hospitalization among infant girls, but not among infant boys.
The finding comes from a study of babies in Buenos Aires, Argentina, by Dr. Fernando Polack, from Vanderbilt University in Nashville, Tennessee, and colleagues.
Boys may derive some protection from breastfeeding, noted Polack, but this study may have been too small to sufficiently identify this benefit.
Still, the results mirror previous research conducted in Argentina and the United States, Polack told Reuters Health, and when taken together indicate that “mothers of girls should pay close attention to the importance of breastfeeding to protect their infant’s lungs.”
More German children need measles jabs: WHO study
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More children in Germany must be vaccinated against measles to prevent another widespread outbreak, a World Health Organization (WHO) study published on Monday said.
More than 12,000 people were infected with measles three years ago in Germany, Romania, Britain, Switzerland and Italy in an unusual epidemic caused by relatively low immunization rates against the contagious viral disease.
“The 2006 measles outbreak ... must be regarded as a wake-up call,” experts from Berlin’s Robert Koch Institute and two German public health centers said in the latest WHO Bulletin, in a study that focused only on Germany.
Cholera under-reported, infects millions a year
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Cholera infects millions of people each year, 10 times the number of cases reported by countries who fear losing tourist or trade income by acknowledging the real scale of an outbreak, experts at the World Health Organization said Monday.
Claire-Lise Chaignat, cholera coordinator at the WHO, said the diarrheal disease that is spreading fast in Zimbabwe is also under-reported because the stigma attached to it means people often fail to seek treatment.
“People see it as a dirty disease,” she said in the latest WHO Bulletin. “People don’t want to talk about it. They think it’s normal to have diarrhea. Quite often, nobody is interested in providing the minimal support needed for prevention.”
Predicting the Future Spread of Infectious-Disease Vectors
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As global warming raises concerns about potential spread of infectious diseases, a team of researchers has demonstrated a way to predict the expanding range of human disease vectors in a changing world.
Researchers from Australia and the University of Wisconsin-Madison have identified the key biological and environmental factors constraining a population of the dengue fever vector, the mosquito Aedes aegypti. In a study publishing online Jan. 28 in the British Ecological Society’s journal Functional Ecology, they report that climate changes in Australia during the next 40 years and the insect’s ability to adapt to new conditions may allow the mosquitoes to expand into several populated regions of the continent, increasing the risk of disease transmission.
While the current study focuses on the Australian population of the dengue mosquito, these mosquitoes live around the world and present a global threat similar in scope to malaria, according to the Centers for Disease Control and Prevention. Study author and UW-Madison zoologist Warren Porter says that the Australian findings are likely to apply to other worldwide mosquito populations as well.
South African dies of suspected deadly virus in Rio
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Brazilian health officials were monitoring people in Rio de Janeiro for possible infections on Wednesday, after a South African man on a business trip died of a suspected hemorrhagic virus.
The body of the 53-year-old man, who arrived in Brazil on Nov. 23 and began showing symptoms two days later, was being repatriated to South Africa in a zinc-sealed coffin, the Ministry of Health said in a statement.
Brazilian media reported officials as saying he may have been infected when he was a patient at a hospital in South Africa where four people died from a new strain of arenavirus, which also includes the germ that causes Lassa fever.
Asthma may boost pneumococcal infection risk
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People with asthma are at increased risk of serious infection with pneumococcal bacteria, according to a new analysis of medical records.
The findings, along with the high fatality rate from such infections, suggest that adults with asthma would benefit from the pneumococcal vaccine, Dr. Young J. Juhn of the Mayo Clinic in Rochester, Minnesota and colleagues say. However, the ability of asthmatics to react normally to the vaccine must be determined before such recommendations can be made, they add.
A previous study found that Medicaid patients with asthma were more than twice as likely to contract invasive pneumococcal disease, in which pneumococcal pneumonia develops and the bacteria invades the bloodstream or the membranes surrounding the brain, Juhn and colleagues note.
Hardest-to-treat form of TB rare in U.S. -study
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The hardest-to-treat form of drug-resistant tuberculosis is a growing threat in many parts of the world, but remains quite rare in the United States, U.S. government health researchers said on Tuesday.
From 1993 through 2007, there were 83 cases of extensively drug-resistant TB, or XDR-TB, reported in the United States, U.S. Centers for Disease Control and Prevention researchers wrote in the Journal of the American Medical Association.
XDR-TB defies nearly all drugs used to treat tuberculosis, the top cause of infectious disease death among adults worldwide. It is more difficult to treat than the more common multidrug resistant TB, or MDR-TB, which does not respond to the treatment by two or more of the primary drugs used for TB.
Rutgers researchers identify new antibiotic target and new antibiotic mechanism
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A team of Rutgers University scientists led by Richard H. Ebright and Eddy Arnold has identified a new antibiotic target and a new antibiotic mechanism that may enable the development of broad-spectrum antibacterial agents effective against bacterial pathogens resistant to current antibiotics. In particular, the results could lead the way to new treatments for tuberculosis (TB) that involve shorter courses of therapy and are effective against drug-resistant TB.
The researchers showed how three antibiotics – myxopyronin, corallopyronin and ripostatin – block the action of bacterial RNA polymerase (RNAP). RNAP is the enzyme that transcribes genetic information from DNA into RNA, which, in turn, directs the assembly of proteins, the building blocks of all biological systems. Blocking bacterial RNAP kills bacterial cells.
The research findings are reported in the journal Cell, published online Oct. 16 and in the Oct. 17 print issue of the journal.
Biomarkers for identifying infant infections
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Infection is the leading cause of infant deaths worldwide, and particularly a common killer of weaker, pre-term infants. Current diagnostic tests can be slow and non-specific, but researchers have now identified potential biomarkers in the blood that can rapidly identify both the onset of infection and type of microbe.
The circulatory system is a major hotbed of immune system activity, so Stephen Kingsmore and colleagues analyzed plasma samples from 107 infected and non-infected premature infants to try and identify proteins that could reliably identify an infected state.
Their analysis revealed eight proteins, associated with immune responses like inflammation and blood coagulation, which were consistently over-expressed in infected neonates. In addition, the relative levels of these serum proteins could provide insight into the type of infection (for example, the inflammatory proteins IL-6 and IL-8 were 1000-fold higher in streptococcus infections compared to other types).
Study finds association between hepatitis B and pancreatic cancer
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A new study has shown that evidence of past hepatitis B infection was twice as common in people with pancreatic cancer than in healthy controls. This study is the first to report an association between past exposure to the hepatitis B virus and pancreatic cancer, but researchers cautioned that more studies are necessary to evaluate the nature of the link.
“While our findings indicate that past exposure to hepatitis B is associated with the development of pancreatic cancer, more research is needed to determine whether this relationship is one of cause and effect,” said lead author Manal M. Hassan, MD, PhD, assistant professor at The University of Texas M. D. Anderson Cancer Center. “If these findings can be confirmed by other studies, hepatitis B could be another risk factor for pancreatic cancer that is readily modifiable with treatment, and even preventable with a vaccine.”
In this study, Dr. Hassan and her colleagues compared evidence of hepatitis B and C infection (as determined by blood tests assessing antibodies to these viruses) between 476 patients with pancreatic cancer and 879 matched healthy individuals. Evidence of past exposure to hepatitis B was found in 7.6 percent of patients with pancreatic cancer versus 3.2 percent of controls. The association between hepatitis B exposure and pancreatic cancer remained statistically significant even after controlling for other risk factors, such as smoking. People with both diabetes (an established risk factor for pancreatic cancer) and hepatitis B exposure had a 7-fold increase in pancreatic cancer risk, compared to controls. No association was observed between hepatitis C exposure and pancreatic cancer.
Chronic infection most common cause of adult tonsillectomy
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Efforts to fill in holes in data regarding the primary causes of tonsillectomy in adults have determined that chronic infection is the most common reason for the procedure, according to new research presented at the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in Chicago, IL.
The study, conducted by researchers at Emory University and Johns Hopkins University, reviewed the medical records of 361 adult patients who had tonsillectomies between 2001 and 2007. Among this group, over 50 percent (207 patients) had the surgery to treat chronic infection to the tonsils and throat, while a quarter (98 patients) had procedures done to correct upper airway obstructions. No trends in complications emerged as significantly different from those of the pediatric population.
Tonsillectomy in adults, while significantly less common than that in the pediatric population, still accounts for a third of all tonsillectomies.
Hepatitis C patients may have abnormal blood sugar
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Nearly two thirds of patients with chronic hepatitis C infection may have abnormal blood sugar levels, according to a report in the American Journal of Gastroenterology.
Blood sugar, or “glucose,” abnormalities “are common and easily underestimated among patients with chronic hepatitis C infection,” Dr. Ming-Lung Yu from Kaohsiung Medical University, Taiwan told Reuters Health. Careful evaluation for undetected glucose abnormalities is “essential” in caring for chronic hepatitis C patients.
Yu and colleagues compared the prevalence and characteristics of glucose abnormalities among 522 chronic hepatitis C patients and a comparison group of 447 without hepatitis C infection (“controls”), based on the results of an oral glucose tolerance test.
