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Soraya P A Verstraeten, Hans A M van Oers, Johan P Mackenbach
Decolonization has brought political independence to half the Caribbean states in the last half of the 20th century, while the other states remain affiliated. Previous studies suggested a beneficial impact of affiliated status on population health, which may be mediated by more favorable economic development. We assessed how disparities in life expectancy between currently sovereign and affiliated states developed over time, whether decolonization coincided with changes in life expectancy, and whether decolonization coincided with similar changes in GDP per capita...
September 28, 2016: Social Science & Medicine
R Fussen, S Lemmen
Multidrug resistant (MDR) bacteria present an increasing threat for intensive care patients. Whereas colonization of intensive care patients with methicillin-resistant staphylococcus aureus (MRSA) in German ICUs has remained at a constant level in recent years and therapeutic options have improved, colonization and infections with MDR gram-negative bacteria and vancomycin-resistant enterococci are increasing year by year. Only a few or even no therapeutic options remain for the treatment of these bacteria...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Reuben Olaniyi, Clarissa Pozzi, Luca Grimaldi, Fabio Bagnoli
Skin and soft tissue infections (SSTIs) are among the most common infections worldwide. They range in severity from minor, self-limiting, superficial infections to life-threatening diseases requiring all the resources of modern medicine. Community (CA) and healthcare (HA) acquired SSTIs are most commonly caused by Staphylococcus aureus . They have variable presentations ranging from impetigo and folliculitis to surgical site infections (SSIs). Superficial SSTIs may lead to even more invasive infections such as bacteraemia and osteomyelitis...
October 16, 2016: Current Topics in Microbiology and Immunology
Elizabeth Fee, Marcu Cueto, Theodore M Brown
The World Health Organization's (WHO's) leadership challenges can be traced to its first decades of existence. Central to its governance and practice is regionalization: the division of its member countries into regions, each representing 1 geographical or cultural area. The particular composition of each region has varied over time-reflecting political divisions and especially decolonization. Currently, the 194 member countries belong to 6 regions: the Americas (35 countries), Europe (53 countries), the Eastern Mediterranean (21 countries), South-East Asia (11 countries), the Western Pacific (27 countries), and Africa (47 countries)...
November 2016: American Journal of Public Health
James R Johnson, Gregg Davis, Connie Clabots, Brian D Johnston, Stephen Porter, Chitrita DebRoy, William Pomputius, Peter T Ender, Michael Cooperstock, Billie Savvas Slater, Ritu Banerjee, Sybille Miller, Dagmara Kisiela, Evgeni V Sokurenko, Maliha Aziz, Lance B Price
Background.  Within-household sharing of strains from the resistance-associated H30R1 and H30Rx subclones of Escherichia coli sequence type 131 (ST131) has been inferred based on conventional typing data, but it has been assessed minimally using whole genome sequence (WGS) analysis. Methods.  Thirty-three clinical and fecal isolates of ST131-H30R1 and ST131-H30Rx, from 20 humans and pets in 6 households, underwent WGS analysis for comparison with 52 published ST131 genomes. Phylogenetic relationships were inferred using a bootstrapped maximum likelihood tree based on core genome sequence polymorphisms...
September 2016: Open Forum Infectious Diseases
Nataliya G Batina, Christopher J Crnich, David F Anderson, Dörte Döpfer
BACKGROUND: Residents of nursing homes are commonly colonized with methicillin-resistant Staphylococcus aureus (MRSA) but there is a limited understanding of the dynamics and determinants of spread in this setting. To address this gap, we sought to use mathematical modeling to assess the epidemic potential of MRSA in nursing homes and to determine conditions under which non-USA300 and USA300 MRSA could be eliminated or reduced in the facilities. METHODS: Model parameters were estimated from data generated during a longitudinal study of MRSA in 6 Wisconsin nursing homes...
2016: Antimicrobial Resistance and Infection Control
C A Burnham, Patrick G Hogan, Meghan A Wallace, Elena Deych, William Shannon, David K Warren, Stephanie A Fritz
Topical antimicrobials are often employed for decolonization and infection prevention and may alter the endogenous microbiota of the skin. The objective of this study was to compare the microbial community, richness, and diversity in community-dwelling subjects and intensive care unit (ICU) patients before and after the use of topical decolonization protocols. We enrolled 15 adults at risk for Staphylococcus aureus infection. Community subjects (n=8) underwent a 5-day decolonization protocol (twice daily intranasal mupirocin and daily dilute bleach water baths) and ICU patients (n=7) received daily chlorhexidine baths...
September 26, 2016: Antimicrobial Agents and Chemotherapy
John Hallett, Suzanne Held, Alma Knows His Gun McCormick, Vanessa Simonds, Sloane Real Bird, Christine Martin, Colleen Simpson, Mark Schure, Nicole Turnsplenty, Coleen Trottier
Community-based participatory research and decolonizing research share some recommendations for best practices for conducting research. One commonality is partnering on all stages of research; co-developing methods of data analysis is one stage with a deficit of partnering examples. We present a novel community-based and developed method for analyzing qualitative data within an Indigenous health study and explain incompatibilities of existing methods for our purposes and community needs. We describe how we explored available literature, received counsel from community Elders and experts in the field, and collaboratively developed a data analysis method consonant with community values...
September 21, 2016: Qualitative Health Research
Joseph M Swanson
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
Manon R Haverkate, Tamara N Platteel, Ad C Fluit, James W Cohen Stuart, Maurine A Leverstein-van Hall, Steven F T Thijsen, Jelle Scharringa, Fieke R C Kloosterman, Marc J M Bonten, Martin C J Bootsma
OBJECTIVES: Patients can acquire extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae during hospitalisation and colonised patients may transmit these bacteria after discharge, most likely to household contacts. In this study, ESBL transmission was quantified in households. METHODS: Fecal samples were longitudinally collected from hospitalised patients colonised with ESBL-producing bacteria and from their household members during hospitalisation of the index patient and at 3, 6, 12, and 18 months...
September 2, 2016: Clinical Microbiology and Infection
Heather Isenman, Dale Fisher
PURPOSE OF REVIEW: This article reviews data, particularly from the last 2 years, addressing the prevention and treatment of vancomycin-resistant Enterococcus (VRE). We focus on infection control, particularly active screening, use of contact precautions as well as pharmacologic options for therapy. This is timely given the evolving priorities in efforts towards the prevention and treatment of multidrug-resistant organisms globally. RECENT FINDINGS: Key findings include new data regarding the impact of contact precautions on the incidence of VRE colonization and bloodstream infection, new laboratory screening methods, and novel decolonization strategies and treatments...
August 31, 2016: Current Opinion in Infectious Diseases
Mary K Hayden, Karen Lolans, Katherine Haffenreffer, Taliser R Avery, Ken Kleinman, Haiying Li, Rebecca E Kaganov, Julie Lankiewicz, Julia Moody, Edward Septimus, Robert A Weinstein, Jason Hickok, John Jernigan, Jonathan B Perlin, Richard Platt, Susan S Huang
Whether targeted or universal decolonization strategies for control of methicillin-resistant Staphylococcus aureus (MRSA) select for resistance to decolonizing agents is unresolved. The REDUCE MRSA trial provided an opportunity to investigate this question. REDUCE-MRSA was a 3-arm, cluster-randomized trial of screening and isolation without decolonization, targeted decolonization with chlorhexidine and mupirocin, or universal decolonization without screening to prevent MRSA infection in intensive care unit patients...
August 24, 2016: Journal of Clinical Microbiology
Tennison L Malcolm, Le Don Robinson, Alison K Klika, Deepak Ramanathan, Carlos A Higuera, Trevor G Murray
Protocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexidine reduces the risk of revision compared with no screening protocol (i.e., chlorhexidine alone) and (2) whether clinical criteria could reliably predict colonization with MSSA and/or MRSA. Electronic medical records of primary patients undergoing TJA that were screened (n = 3,927) and were not screened (n = 1,751) for Staphylococcus aureus at least 4 days prior to surgery, respectively, were retrospectively reviewed...
2016: Interdisciplinary Perspectives on Infectious Diseases
Cibele Grothe, Mônica Taminato, Angélica Belasco, Ricardo Sesso, Dulce Barbosa
BACKGROUND: This study was performed to evaluate the clinical effectiveness of alternative strategies for the prevention and treatment of patients with chronic kidney disease undergoing peritoneal dialysis and colonized by Staphylococcus aureus. METHODS: A systematic review and meta-analysis were performed. The literature search involved the following databases: the Cochrane Controlled Trials Register, Embase, LILACS, CINAHL, SciELO, and PubMed/Medline. The descriptors were "Staphylococcus aureus," "MRSA," "MSSA," "treatment," "decolonization," "nasal carrier," "colonization," "chronic kidney disease," "dialysis," and "peritoneal dialysis...
2016: BMC Nephrology
Jae-Seok Kim, Yun Kyung Chung, Seung Soon Lee, Jeong-A Lee, Han-Sung Kim, Eun Young Park, Kyong-Sok Shin, Bog Soun Kang, Hee Jung Lee, Hyun Joo Kang
BACKGROUND: Universal decolonization is recommended in intensive care units (ICUs) that have unacceptably high rates of methicillin-resistant Staphylococcus aureus (MRSA) despite implementation of basic prevention strategies. METHODS: An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of MRSA in a medical ICU with MRSA endemicity. There was a 14-month control period and a 16-month chlorhexidine bathing period...
August 9, 2016: American Journal of Infection Control
Isabel Machuca, Belén Gutiérrez-Gutiérrez, Salvador Pérez Cortés, Irene Gracia-Ahufinger, Josefina Serrano, María Dolores Madrigal, José Barcala, Fernando Rodríguez-López, Jesús Rodríguez-Baño, Julián Torre-Cisneros
OBJECTIVES: Invasive infections caused by KPC-producing Klebsiella pneumoniae (KPCKP) are associated with very high mortality. Because infection is usually preceded by rectal colonization, we investigated if decolonization therapy (DT) with aminoglycosides had a protective effect in selected patients. METHODS: Patients with rectal colonization by colistin-resistant KPCKP who were at high risk of developing infection (because of neutropenia, surgery, previous recurrent KPCKP infections or multiple comorbidities) were followed for 180 days...
July 26, 2016: Journal of Antimicrobial Chemotherapy
Lance R Peterson, Susan Boehm, Jennifer L Beaumont, Parul A Patel, Donna M Schora, Kari E Peterson, Deborah Burdsall, Carolyn Hines, Maureen Fausone, Ari Robicsek, Becky A Smith
BACKGROUND: Antibiotic resistance is a challenge in long-term care facilities (LTCFs). The objective of this study was to demonstrate that a novel, minimally invasive program not interfering with activities of daily living or socialization could lower methicillin-resistant Staphylococcus aureus (MRSA) disease. METHODS: This was a prospective, cluster-randomized, nonblinded trial initiated at 3 LTCFs. During year 1, units were stratified by type of care and randomized to intervention or control...
August 1, 2016: American Journal of Infection Control
Lori E A Bradford, Udoka Okpalauwaekwe, Cheryl L Waldner, Lalita A Bharadwaj
BACKGROUND: Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. OBJECTIVE: The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. DESIGN: A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada...
2016: International Journal of Circumpolar Health
Cedric Hunter, Lorne Rosenfield, Elena Silverstein, Panayiota Petrou-Zeniou
BACKGROUND: Up to 20 percent of the general population is persistently colonized with Staphylococcus aureus, and 1 to 3 percent of the population is colonized with community-acquired methicillin-resistant S. aureus. Currently, the knowledge of methicillin-resistant Staphylococcus aureus carriage sites other than the nose, and their effect on surgical site infections in cosmetic surgery, is lacking. METHODS: A comprehensive literature review using the PubMed database to analyze prevalence, anatomical carrier sites, current screening and decontamination protocols and guidelines, and methicillin-resistant S...
August 2016: Plastic and Reconstructive Surgery
Valerie C Cluzet, Jeffrey S Gerber, Joshua P Metlay, Irving Nachamkin, Theoklis E Zaoutis, Meghan F Davis, Kathleen G Julian, Darren R Linkin, Susan E Coffin, David J Margolis, Judd E Hollander, Warren B Bilker, Xiaoyan Han, Rakesh D Mistry, Laurence J Gavin, Pam Tolomeo, Jacqueleen A Wise, Mary K Wheeler, Baofeng Hu, Neil O Fishman, David Royer, Ebbing Lautenbach
OBJECTIVE To determine the impact of total household decolonization with intranasal mupirocin and chlorhexidine gluconate body wash on recurrent methicillin-resistant Staphylococcus aureus (MRSA) infection among subjects with MRSA skin and soft-tissue infection. DESIGN Three-arm nonmasked randomized controlled trial. SETTING Five academic medical centers in Southeastern Pennsylvania. PARTICIPANTS Adults and children presenting to ambulatory care settings with community-onset MRSA skin and soft-tissue infection (ie, index cases) and their household members...
October 2016: Infection Control and Hospital Epidemiology
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